Nourished Magazine :: Wisdom to thrive by

The term ‘preconception care’ can be defined as optimising health prior to attempting conception in the hope that a couple will conceive easily and attain a healthy pregnancy and birth. This idea has been part of a holistic approach to reproductive health for many years but has been gaining popularity in mainstream medical circles of late. The Fertility Society of Australia have been leading the push to have a national fertility policy in Australia following in the footsteps of the United States. A massive campaign to address fertility and reproductive health in America was launched in 2006 with a large focus on preconception care.

There is perhaps a greater need for preconception care today, given such things as inadequate diets, a polluted environment and our often stressful lifestyles. Moreover, as many as 50% of couples who conceive report an unplanned pregnancy. Thus the preconception period is crucial to reducing many of the risks of birth defects and premature birth. Nearly 85 percent of women are reported to receive early prenatal care, which can improve maternal and infant health. Many women only first see their doctor or obstetrician at around 9-10 weeks pregnant which fails to target the women in the very early stage of pregnancy and embryo development. Moreover, even with early prenatal care it may still be too late to make a difference in some cases. Some interventions work best - and others only work - if they begin before pregnancy. Thus to continue to prevent premature birth and low birth weight babies as well as positively influence the child’s health into adulthood, the focus must shift to the preconception period.

Lifestyle issues that help couples conceive also help them have a healthy baby in the long term. Smoking, drugs and alcohol are detrimental across the board - to fertility, pregnancy outcomes and infant health. While much of the focus on preconception care has been aimed at women, researchers are also becoming increasingly aware that a man’s health at the time of conception has an impact on the baby’s health. A child born to a male smoker is four times more likely to have cancer in childhood. Moderate alcohol intake of 1-5 drinks per week increases the risk of fertility problems and miscarriage in women and fertility problems and sperm DNA damage in men.

As many as 40-50% of the adult population are considered overweight or obese. Overweight women have a 2-5 fold increase in fertility issues and higher miscarriage rates. Weight reduction by as little as 5-10% can improve pregnancy rates and outcomes. Overweight men also suffer lower fertility and erectile dysfunction. Insulin resistance is often the cause of weight issues and it plays havoc with a range of body functions and can affect hormones and fertility.

Of all the issues relating to preconception health, nutrition is perhaps the most important and is also one we have the most control over. Good nutrition is essential during the preconception period and beyond. Nutritional supplements are often recommended for certain nutrients which are often lacking in the modern diet and essential to the health of a developing baby. Folic acid can prevent spina bifida if taken during preconception and early pregnancy. However, there are other nutrients that are equally important to the health and development of the foetus that should ideally be supplied from a nutrient dense diet. Supplements will never replace the need for a really healthy diet – which should be a major focus for both couples before conceiving and during pregnancy. Some of the key nutrients for optimising fertility that are often overlooked include vitamin A, zinc, magnesium, iodine, B complex vitamins, antioxidants and omega 3 fats.

Foods that are rich in the essential nutrients of preconception and pregnancy are listed below:

• Iron: beef, dried fruit, green leafy vegetables, properly prepared and soaked seeds, nuts, legumes, prune juice, beetroot, eggs, chicken (esp. thighs) NB: Include vitamin C rich foods to increase absorption.
• Folic Acid: raw vegetables (esp leafy), endive, sprouts, nuts, grains, strawberries, avocado, bananas NB: Easily destroyed by cooking – salads provide the highest amounts.
• Zinc: seafood, meats, eggs, properly prepared seeds, nuts, legumes, grains
• Vitamin A: organ meats (esp. liver), cod liver oil, butter, cream, free range eggs
• Iodine: seafoods, seaweed, leafy greens
• Magnesium: leafy greens, properly prepared nuts, seeds, legumes & whole grains
• Calcium dairy, bok choy, kale, tofu, broccoli, nuts, seeds, dried fruit, salmon & sardines (with bones), bone broths
• Vitamin B: complex brewers yeast, whole grains, meat, organ meats, eggs, avocado, banana
• Antioxidants in foods – green tea, grapes, berries, vegetables, tomatoes, garlic, ginger, turmeric
• EFAs (essential fatty acids)
  omega 3 : fatty fish, seafood, grass fed beef/free range chicken, flaxseed, walnuts
  omega 6: nuts, seeds, whole grains, cold pressed oils

Caffeine should be avoided as it has been linked to infertility and impaired foetal brain development as well as decreasing iron absorption. Alcohol should also be avoided as it increases the risk of miscarriage & failure to thrive. It also decreases absorption of B vitamins & increases the excretion of the important minerals, magnesium & zinc.

A pre-pregnancy check-up with a health care practitioner is advisable – this may include referral for blood tests to check folate and iron levels, rubella immunity and a PAP smear.

Environmental factors are especially important during the preconception period – with many modern chemicals playing havoc with the hormone system. Reproductive cells are particularly vulnerable to damage by chemicals in the environment such as plastics, paints, cosmetics and cleaning materials. In many cases these are classified as xeno-ostrogens as they have the potential to interact with the oestrogen receptor and illicit damaging effects. These xeno-oestrogens have been linked to declining sperm counts and infertility in recent years. Heavy metals such as lead, cadmium and mercury are ubiquitous in the environment as well, but with adequate levels of minerals such as calcium and zinc, the absorption of many of these metals is inhibited. Antioxidants also protect healthy cells from damage by environmental toxins. Clearly a healthy diet that provides a high mineral and antioxidant intake will go a long way in helping to protect you against a toxic environment. There are tests, such as hair mineral analysis, that can assess the heavy metal load. In cases of toxicity, it is much better to detox for a number of months before trying to conceive, to aim for the best quality sperm and egg. Detoxing should never take place when planning to conceive or during pregnancy.

Wireless technology has meant that we are constantly bombarded with electromagnetic frequencies and these have a detrimental affect on many aspects of our physiology. New research has shown that mobile phones lower sperm count and couples should never wear mobile phones against their body and generally aim to limit usage. Anecdotally, I have seen in my clinic quite a high percentage of computer technicians with sperm count abnormalities. To date there is no research to show a link, but it may be pertinent to avoid excessive computer use and wireless technology in the home – as much as possible.

Couples may benefit from having a consultation with a naturopath specialising in fertility who can assess their diet and lifestyle and advise on any changes necessary and prescribe appropriate remedies. If there are any underlying health issues for either partner relating to reproductive health such as poor sperm count or gynaecological conditions and infertility, a holistic approach may include dietary changes as well as herbal and nutritional remedies to improve chances of conception – including for couples undergoing assisted reproduction such as IVF. Stress is a big factor for many couples and research has shown that it can impact on fertility. Couples suffering from acute and chronic stress will have an increased need for nutrients to help compensate for the extra demands placed on their bodies. Stress management techniques such as yoga, meditation, exercise and counselling can also help offset the potential impact of stress.

Our modern lifestyle is definitely contributing to a decline in fertility, as we have not had the time to evolve and adapt to the rapid onslaught of chemicals in the environment – including our precious food supply. The message is essentially back to basics: for optimum reproduction and healthy babies we need to aim for good nourishing food, regular exercise, fresh air & water, quality sleep and relaxation and time out from our hectic schedules.

Karen offers email and phone consultation on using Traditional Foods and Healing Principles to deal with fertility, women’s health and children’s health issues.

Contact her thought her Nourished Mini-site: karenmcelroy.nourished.com.au

About the Author...

Karen McElroy is a naturopath and medical herbalist offering an integrative and holistic approach to health care. Karen treats a wide range of disorders in women, men and children, offering naturopathic support for the whole family. Karen has a passion for natural medicine and strives to facilitate health, vitality and wellbeing in every individual.