Optimizing Your Health for Preconception

It’s no surprise that good nutrition during pregnancy leads to better health outcomes for mom and baby, but what about nutrition before pregnancy? Often, doctors focus on suggesting a prenatal vitamin with folic acid for women who are planning to become pregnant. Not enough emphasis is put on optimizing nutritional health overall. Think about it in terms of preparing your body for a marathon. Many of us wouldn’t be able to wake up one morning and effectively run a marathon without training. This can be the same for growing a baby.

Improving your health for preconception can start anytime, but is most critical 3-4 months prior to conceiving. Focus on adding in nourishing foods and lifestyle activities, avoiding toxins and managing stress.

The following is an extensive list of things you can do to help prepare your body for pregnancy and potentially help your chances of conceiving. There is not a human out there who does everything perfectly - please do not feel you need to follow this 100%. Use this as information and decide how or if the recommendations can fit into your life.

Nutrition

Each nutrient has a role in keeping mom and baby healthy. Folate, along with vitamin B12 and choline are needed to help prevent neural tube defects. Adequate stores of iron are needed for increased red blood cell production and to support the growth of baby and the placenta. DHA, an omega-3 fatty acid is needed to create baby’s brain cells. Vitamin D is needed for bone formation and immune function. There are many more, which is why it is important to focus on nutrient dense meals with fresh, whole food ingredients.

To help your body get enough nutrient dense foods to supply the necessary macro and micronutrients (macronutrients are fat, protein and carbohydrates, which all supply calories; micronutrients are vitamins, minerals and phytochemicals) an easy way to think of meal planning is by dividing up your plate into 3 sections. Half of your plate will be non-starchy vegetables (think broccoli, dark leafy greens, carrots, cucumber, mushrooms etc.), one quarter will be carbohydrates (think whole grains, dairy, starchy veggies or fruit) and the last quarter will be protein (plant or animal). Also, include healthy fats/oils to your meals (extra virgin olive oil, grass fed butter/ghee, avocados, nuts/seeds, fatty fish).

Hydration

An easy way to calculate water needs is to drink half of your body weight in ounces. If you weigh 150 pounds, drink a minimum of 75 ounces. Hydration needs will vary with activity and the weather. Listen to your body and spread your water intake throughout the day. If you do not like the taste of plain water, try infusing it with fruits and herbs, try a flavored sparkling water or diluted juice. It is best to limit soda or sugar sweetened beverages, these do not hydrate as well.

Supplements

Prenatal vitamins are promoted to help bridge the nutritional gaps between food intake and nutrient needs. High quality supplements do have a place in pregnancy, but they should be used in addition to a nutrient dense diet, not the sole source of vitamins and minerals. You cannot out-supplement a poor quality diet.

Also, if you have been using them, oral contraceptives have been shown to deplete nutrients such as B vitamins, vitamin C and E and the minerals magnesium, selenium and zinc. Read this article to learn more about food sources of these nutrients.

Weight management

Maintaining a healthy weight that fits your body can help reduce health complications during pregnancy. Obesity has been linked to multiple conception and pregnancy complications. In addition, overweight individuals can be malnourished or deficient in multiple nutrients just as underweight individuals can. Food quality plays an important role here. If your BMI is in the overweight or obese range, focus on adding in more whole, fresh foods. If you need recipe ideas, we’ve got you covered!

On the other hand, being underweight can put you at risk as well. My recommendations are the same, include nutrient dense foods (limiting processed foods and fast foods). Make sure to include enough protein and overall calories in your diet as well. Build up those nutrient stores!

Stress management

Stress management is often overlooked. Avoiding stress all together is unrealistic, so finding ways to cope is the best way to manage. Exercise is a great way to manage stress. If you are not currently getting enough movement into your day try walking, simple stretches in the morning and evening or swimming. You can also try breathing exercises, meditation, yoga or anything that calms you down and gets you back to the present.

Environmental Toxins

Clean up your household and body products. Your skin is your biggest organ and it absorbs a lot from your environment. There are many harmful chemicals in our everyday products. BPA and phthalates in plastics (water bottles, plastic baggies, plastic wrap, shower curtains) have negative effects on hormones. Phthalates are also found in body products such as lotions, cosmetics and fragrances (perfumes, air fresheners and scented candles). The best way to determine whether a product is safe to use is by visiting the Environmental Working Group Verified webpage. This database is extensive and will show if your product contains harmful ingredients.

Along with cleaning up your household items try eliminating exposure to tobacco (including secondhand smoke), limiting alcohol and caffeine. Although it can be enjoyable, your body treats alcohol as a toxin and it can have negative effects on fertility. When working on cleaning up your diet, it’s best to avoid foods and drinks that cause harm. Caffeine on the other hand has been shown to be safe during pregnancy in moderation. If you are a heavy coffee, tea or energy drink consumer, you can start weaning yourself now to avoid caffeine withdrawal symptoms.

Become a Food Detective

Avoid or limit food allergies or intolerances. Eliminating foods that do not agree with your body allows your gut to heal and be in tip top shape to absorb nutrients! Be a food detective. Pay attention to when foods cause bloating, constipation/diarrhea, skin issues (acne or eczema etc.) or foods that just don’t sit right. Eliminate that food for a week or two and add it back in as a test. If you continue to have a negative reaction, try cutting it out for another month or two.

Also, if sugary foods and beverages make up the majority of your daily intake, its probably a good idea to start limiting foods with added sugar. Again, be a food detective and read labels - this includes artificial sweeteners such as aspartame, sucralose, saccharin and acesulfame potassium. The more sweet foods you eat, the more your body may crave that flavor. Cutting back prior to pregnancy can help prevent overconsumption of sugary foods during pregnancy, helping to reduce your risk for blood sugar issues and gestational diabetes. *Caveat - it’s all about moderation, enjoy your dessert, but eat veggies too ;)

Bottom line - Your Body Knows What to Do.

These suggestions are just that -- suggestions. Focus on what works for your lifestyle and your body. If you plan to make changes, they do not need to be done all at once. In fact, focusing on 1-3 small changes can lead to more successful outcomes.

For more tailored help, our annual subscription includes one-on-one sessions with a U.S. registered dietitian nutritionist! Check it out!

Resources

Petersen JM, Parker SE, Crider KS, Tinker SC, Mitchell AA, Werler MM. One-Carbon Cofactor Intake and Risk of Neural Tube Defects Among Women Who Meet Folic Acid Recommendations: A Multicenter Case-Control Study. https://doi.org/10.1093/aje/kwz040. Published February 19, 2019. Accessed October 17, 2020.
Stephenson J, Heslehurst N, Hall J, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health [published correction appears in Lancet. 2018 May 5;391(10132):1774]. Lancet. 2018;391(10132):1830-1841. doi:10.1016/S0140-6736(18)30311-8
Kiel DW, Dodson EA, Artal R, Boehmer TK, Leet TL. Gestational Weight Gain and Pregnancy Outcomes in Obese Women. Obstetrics & Gynecology. 2007;110(4):752-758. doi:10.1097/01.aog.0000278819.17190.87
Weight gain during pregnancy. Committee Opinion No. 548. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;121:210–2.