• Dr Emma Derbyshire

Nutrition – Getting it right BEFORE pregnancy


This life-stage is often overlooked but eating well and obtaining the right balance of nutrients before pregnancy is highly important. Not only is this of value from a fertility stance but it is also important to build adequate nutrition stores in ‘anticipation’ of pregnancy. One example of this is in the case of iron.

Presently, around half of girls aged 11 to 18 years and a quarter of women aged 19 to 64 years have low iron intakes i.e. below the Lower Reference Nutrient Intakes (LRNI; the level below which deficiency may occur). Bearing this in mind it is not surprising that iron deficiency is so highly prevalent in pregnancy.


The Nutritional Picture

In the UK women of childbearing age are not necessarily getting the array or amounts of nutrients needed for their own wellbeing, even before conception is layered on top.


An in-depth analysis of UK data showed that intakes of nine micronutrients – riboflavin, vitamin B6, B12, folic acid, calcium, iron, magnesium, potassium, and iodine were lower amongst UK females aged 20 to 59 years compared with males of this age.


For magnesium 19% of young people in their twenties had intakes below the LRNI.  Young adults in their twenties also had significantly lower intakes of vitamin A, riboflavin, folic acid, calcium, magnesium, potassium and iodine compared with those in their 30s, 40s and 50s.


There were sizable gaps in dietary selenium intakes with 50.3% females having total intakes beneath the LRNI. A quarter of women also had iron (25.3%) and potassium (24.3%) intakes below the LRNI.


What can be done

  1.  In an ideal world good nutrition before and in the early stages of pregnancy should coincide with smoking cessation.

  2. Women should aim for a healthy body weight (body mass index between 18.5 and 24.9) and avoid restrictive diets that could impact on diet quality.

  3. Women should consider topping up their dietary intakes with a supplement containing folic acid and ideally iron and B12 if vegetarian or vegan.

  4. Iodine can be found in a found in a range of foods, especially fish and dairy products but if these are avoided look to include foods that are fortified or pre-conception supplements that also include this.

  5. Amongst males research has shown that certain nutrients including: selenium, zinc and omega-3 fatty acids can improve sperm quality too.

  6. Amongst men research has shown that alcohol has a ‘U-shaped’ effect on sperm quality so moderation appears to be key.

  7. For women the safest approach is not to drink alcohol at all if conception could occur and to avoid drinking it throughout pregnancy.

Conclusions

Good nutrition is highly important when there is a chance that we could conceive. Building up our bodies’ reserves of key nutrients and being ‘body ready’ can help to tackle to the physiological demands that coincide with pregnancy, including nausea and fatigue. It can also help from a fertility stance and both partners should equally reflect on their dietary and lifestyle habits.


References

Bates et al. (2018) NDNS: results from years 7 and 8 (combined) Results of the National Diet and Nutrition Survey (NDNS) rolling programme for 2014 to 2015 and 2015 to 2016. PHE/FSA: London.

Derbyshire E (2018) Micronutrient Intakes of British Adults Across Mid-Life: A Secondary Analysis of the UK National Diet and Nutrition Survey. Front Nutr 5:55.

Derbyshire EJ (2011) Nutrition in the Childbearing Years. Wiley Blackwell: Oxford.

Ricci E et al. (2018) Alcohol intake and semen variables: cross-sectional analysis of a prospective cohort study of men referring to an Italian Fertility Clinic. Andrology 6(5):690-696.

Salas-Huetos A et al. (2018) The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Adv Nutr 9(6):833-848.

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