The importance of a good diet and a good prenatal during pregnancy

There is a magic formula for a healthy pregnancy diet, you have to eat well and supplement!   As in previous posts, the nine months in utero can be the most consequential in a person’s life determining genetic predisposition, illness and even the hard wiring of the brain, so it makes sense to have laid the ground work before even trying.  If you have,  the basic principles of  healthy eating remain the same as when you were eating well and supplementing prior to trying for a baby. Nutirient needs do change a little at each trimester. However, a few nutrients in a pregnancy diet do deserve a special mention. Here's what tops the list.

Iron

The recommended daily intake (RDI) of iron during pregnancy is 22-36mg (10-20mg more than the non-pregnant state). The amount needed depends on the amount of iron the mother has 'stored' in her body prior to pregnancy. If a woman's iron stores are very low, she may need to get more from a supplement. I have a client at the moment who is carrying twins and her iron levels at first trimester are very low. Iron supplements are regularly recommended to pregnant women, as it's often difficult to get enough iron from food, especially if the woman does not like or eat red meat. However, iron supplements in the inorganic ‘sulphate’ format, often given by doctors can cause constipation, so seek out a professionals help here and don’t routinely add iron as this builds up in the body and too much isn’t good!  Never self-prescribe with iron as some people have an issue with iron build up in the body and unless you routinely test its not wise to keep on loading up!

If you want to read more on this click the link below

http://healthybabycode.com/5-myths-about-pregnancy-nutrition-2-all-women-should-take-iron-during-pregnancy

 

Calcium

The RDI of calcium during pregnancy is 1200mg per day; 300mg per day more than for non-pregnant women. During the third trimester of pregnancy, there is a large shift of calcium to the baby as it starts to develop and strengthen its bones. If the mother isn't getting enough calcium in her diet, the calcium needed by the baby is drawn from the mother's bones. This may have a negative effect on the woman's bone health in later years. Low calcium intake  during pregnancy may also cause the baby to have weak bones and impaired bone development. Dietary sources of calcium are: pine nuts, tahini, sardines with bones, seaweed  ( nori), salmon, almonds, figs, yoghurt, spinach and watercress. These are all higher than milk!

http://pepperbuttons.blogspot.co.uk/2011/09/plus-1-more-than-pregnancy-announcement.html

Zinc

Is a very important mineral to take in all trimesters and should be in a good prenatal also.  Prior to preconception zinc is involved in over 100 enzyme reactions in the body and is vital for immunity, hormones and bone development. Its is also vital for male fertility as it helps to improve motility sperm count and the morphology of the sperm. http://www.clinicians.co.nz/the-importance-of-zinc/ If you are low in this mineral it can affect your mood. Mothers with Post Natal Depressions have been tested  and have very low levels of zinc. http://www.ncbi.nlm.nih.gov/pubmed/16963806 Zinc is also needed to help heal and repair after birth and a massive dose is taken from the mother by the baby prior to birth which can leave the mother very low. Zinc is needed specifically by new-borns. If you have low levels if breastfeeding this can lead to a unsettled and unhappy baby, however if you have adequate levels in a decent prenatal this should not be a problem. 

Omega 3

A decent  intake of Omega 3 fat is essential to maintaining the balanced production of the hormone-like substances called prostaglandins. Prostaglandins help regulate many important physiological functions including blood pressure, blood clotting, nerve transmission, the inflammatory and allergic responses, the functions of the kidneys and gastrointestinal tract and the production of other hormones.

Large amounts of Omega 3 are needed during pregnancy to help ensure the growing foetus has enough fats to develop, Omega-3s have been found to be essential for both neurological and early visual development of the baby. However, the standard western diet is severely deficient in these critical nutrients. This omega-3 dietary deficiency is compounded by the fact that pregnant women become depleted in omega-3s, when the foetus uses omega-3s for its nervous system development. Omega-3s are also used after birth to make breast milk. So unfortunately if you don't like the taste, you still need to take this until you decide to stop breastfeeding!  Research has confirmed that if pregnant women supplement their diet with EPA and DHA it has a positive effect on visual and cognitive development of the baby. Studies have also shown that higher consumption of omega-3s may reduce the risk of allergies in infants. Omega-3 fatty acids have positive effects on the pregnancy itself. Increased intake of EPA and DHA has been shown to prevent pre-term labor and delivery, lower the risk of pre-eclampsia and may increase birth weight.  

Folate 

Folate is a B-group vitamin. Insufficient folate intake during pregnancy has been linked to neural tube defects, such as spina bifida, in the unborn baby and other issues such as facial clefts. To counteract the higher levels of spina bifida pre 1990s some governments apply a mandatory enforcement of fortification of flour with folic acid.  In the UK some food industry giants have adopted this on their own, but in countries like the USA, Canada  and Costa Rica this has been in place for some time.  Australia introduced mandatory folic acid fortification in 2009. In the UK there are some concerns that folic acid on its own increases colorectal cancer and also cause B12 deficiency, so the debate continues.

Folate should be taken before conception and  during the whole pregnancy ( contrary to advice!) If this is implemented it can prevent seven out of 10 cases of neural tube defects. Low folate intake also increases the risk of multiple births, such as twins. Women who are in the early stages of pregnancy (or likely to become pregnant) should take folate supplements  daily and a good prenatal should provide this. I wouldn't advise you to take folic acid on its own as this imbalances the other B vitamins and isn't in nature meant to be isolated. Have it as part of a good prenatal. Good food sources of folate, which should be included in everyone's diet, include leafy green vegetables like spinach, broccoli and asparagus, and legumes, nuts, and avocados.

Issues with Folic acid

Some people may not be able to absorb folic acid, and in many cases without knowledge of this, giving them the synthetic form of folate ie folic acid as a supplement may be very detrimental to them.

' About 40% to 60% of the population has genetic polymorphisms that impair the conversion of supplemental folic acid to its active form, l-methylfolate in the body.

In vivo, the body converts dietary folic acid to l-methylfolate through a series of enzymatic processes. The final stage is done with the enzyme methyltetrahydrofolate reductase (MTHFR). Those with certain polymorphisms have inadequate MTHFR activity'.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250974/
More on how this can impact fertility  in my next post!

Other vitamins and minerals that are important

As well as iron and calcium, the other nutrients that should be boosted in the first, second and third trimesters include vitamin C,  B vitamins like B1, B2, B3, B6 and especially B12), and magnesium, vitamin D. Vitamin D deficiency is at quite an alarming rate particularly in the UK, so get your levels tested for this and if low supplement with a therapeutic amount of Vitamin D3 suggested by your nutritionist or naturopath. 

Sperm Health - what's in and what's out!

Ice cream, tofu, low-fat milk, to use or not to use fish oils, Vitamin C?There is a wealth of information on this about and I have put together most of the more prevalent and researched arguments around food vitamins and minerals and environmental issues that can have an effect on sperm health.

Fish oils

Almost every aspect of our health is related to the types of fatty acids that make up our cells and tissue. And it appears that most of us are not having the right kinds of fatty acid or enough. There is debate among the medical community as to the benefits of fish oils obtained as a supplement  rather than through food. Studies have shown conflicting results. I think the benefits of these supplements could well be enhanced when dietary changes are made that reduce sugar intake or other simple carbohydrates and unhealthy foods.

Fish oil is harvested from cold-water fish. Some great examples of this are salmon, trout, sardines and anchovies. These oils contain high concentrations of omega-3 fatty acids, which is made up of eicosapentaenoic acid (EPA) and docosahexaenoic acid.(DHA) These two major hitters play a role together with other key nutrients in overall fertility for both women and Men, however today is all about the Men! Often neglected in fertility but with recent reports on the ever decreasing sperm levels in the Western  world, it is time we looked into this fully!

Omega 3 for the Men

Docosahexanoic acid, which is a component of omega-3 fatty acids, play a key role in movement of sperm or its motility – often measured on sperm test.  The journey sperm face which was recorded in a recent Channel Four production’ The Great Sperm Race’ was likened to climbing Everest with a super heavy load!  Sperm hasn’t been studied at great depths until more recently in the last few decades but during these studies it is calculated that of the many million produced in ejaculation only a hundred or so make the long and arduous journey and like any budding Mountain climber, preparation is key!

Docosahexanoic acid plays an huge role in the development of healthy sperm. Studies have found that males deficient in this Fatty Acid produce poor sperm that are less able to fertilise the egg. Other studies also noted the role of omega-3 fatty acids in thinning the blood which then allows blood flow to the genitals which leads to better production of sperm and also better performance during sex.

http://oldhollywood.tumblr.com/post/26258734574/woody-allen-cowardly-sperm-robert-walden

Omega 3 - Fish oil versus flaxseed oil

There are several Omega 3 fatty acids. They are named ALA (alpha linolenic acid ), EPA    (eicosapentaenoic acid ) and DHA (docosahexanoic acid). ALA is found in flaxseed oil whereas EPA and DHA are found in fish oils. ALA is able to convert into EPA and then into DHA, but this takes several enzymatic steps in the body, and not everyone efficiently converts ALA into EPA and DHA, particularly with aging. So, the bottom line, I prefer fish oils to flaxseed oil, although a small amount of flaxseed oil are useful. For those of you who don't want to take any fish products, DHA, extracted from algae, is sold by itself.

 DHA from algae

Whether marine algae supplements provide the same health benefits as fish oil is still unclear. There are certainly  lots of alternatives if Vegan, however Marine algae and Fish oil  vary so greatly in both the amount and ratio of EPA and DHA. Most marine algae supplements provide more DHA than EPA.

Although DHA is the predominant fatty acid recommended for fertility, some EPA is needed as well, and algae oil does not have any so often they will add another plant oil fatty acid not from algae - SDA - which can be converted in a smaller amount to EPA. Due to this, it may not be quite as good as a very high quality fish oil since the ratio of the two might not be as optimal

http://www.huffingtonpost.com/ashley-koff/what-is-algal-dha_b_792183.html

http://www.nutraingredients-usa.com/Research/Harvard-meta-analysis-supports-benefits-of-algal-DHA-omega-3  however it does have benefits in regards to reducing cholesterol!

Vitamin C, Vitamin E and folate for sperm health

In a study of 80 healthy men, aged 22 to 80, those older than 40 who consumed the most vitamin C, vitamin E, zinc and folate had less sperm DNA damage than those who consumed the lowest amounts. http://newscenter.lbl.gov/news-releases/2012/08/27/nutrition-dna-quality/

Diet and sperm, role of food intake

Diet may also play a role in sperm count. It is possible that high sugar intake or high blood sugar may damage sperm. A diet heavy in soya products could also reduce sperm count. 


Sperm count and beef consumption
In a recent study - U.S. women who eat a lot of beef while pregnant gave birth to sons who grew up to have low sperm counts. This may be down to hormones or contaminants in cattle feed, as well as the GMO soya that is fed to cattle in larger farms. Chemicals can build up in the fat of animals that eat contaminated feed or grass, and cattle are routinely given hormones to boost their growth. In sons of 'high beef consumers' (more than seven beef meals a week), sperm concentration was lower. http://www.reuters.com/article/2007/03/28/us-sperm-beef-idUSN273873720070328

Cola as a cause or just bad diet and lifestyle?

Dr. Tina Kold Jensen of Rigshospitalet in Copenhagen, Denmark  included 2,500 young men in their study. Those who didn't drink cola had better sperm quality, averaging 50 million sperm per millilitre semen and tended to have a healthier lifestyle. In contrast, the 93 men who drank more than one litre a day had only 35 million sperm per millilitre. http://aje.oxfordjournals.org/content/171/8/883

They also ate more fast foods, and less fruit and vegetables. When looking at caffeine from other sources, such as coffee and tea, the decrease in sperm quality was much less pronounced. It is still not clear if the cola or the unhealthy lifestyle, or both, is to blame. American Journal of Epidemiology, online March 25, 2010

Overweight? -  shed those extra pounds

Obese men tend to have less motile sperm than the thinner males in a study of. 'Fertility and Sterility, online January 7, 2010'.Fertility and Sterility, online July 29, 2010.

Exercise

Men who get moderate amounts of exercise have better motility than men who are less active. Sitting for prolonged periods, such as watching TV, reduces sperm count. http://www.abc.net.au/radionational/programs/healthreport/the-role-of-diet-and-watching-tv-on-human-fertility/4592394

Soya products and sperm count

Eating excessive amounts of soya based foods could  also lower a man's sperm count. Soya based foods contain phytoestrogens which has an affect on sperm health. Dr. Jorge Chavarro of the Harvard School of Public Health in Boston, found that men that consumed the highest amounts of soya foods had a lower sperm count compared to those who did not consume soya foods. Men in the highest intake category of soya products had 40 million sperm per millilitre less than men who ate no soya foods. 

Overweight men tended to have lower sperm counts which could be due to oestrogen production by fat cells. Journal Human Reproduction, 2008. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721724/

 http://articles.mercola.com/sites/articles/archive/2010/09/18/soy-can-damage-your-health.aspx

Eat more vegetables and fruits

Dr. Jaime Mendiola, of Instituto Bernabeu in Alicante, Spain believes men who eat lots of processed meat and full-fat dairy have poorer quality sperm than those who eat more fruit, vegetables and low-fat diary. He did a study with 61 Spanish men visiting a fertility clinic. Half of the men had poor semen quality and generally had a higher intake of processed meat and high-fat dairy than did the 31 men with normal sperm counts. The men with higher-quality sperm tended to consume more fruits, vegetables and skim milk. The antioxidants found in fruits and vegetables may help protect sperm from damage. Meat and high-fat foods may expose men to higher levels of substances known as xenobiotics -- including steroids and various chemicals in the environment that have oestrogen-like effects, such as certain pesticides and PCBs. Xenobiotics tend to accumulate in high-fat foods, which in turn accumulate in men with high-fat diets. Fertility and Sterility, March 2009.http://channels.isp.netscape.com/whatsnew/package.jsp?name=fte/damagesperm/damagesperm&floc=wn-nx

Chemical Accumulators and Subfertility

Many of you are here because you want to become Mothers or Fathers. All of you will have had an interest in this as you may have had problems conceiving. For some, the journey down the road to parenthood is easy. But for others, conception can be an immensely challenging process for both body and mind.

The natural approach to treating infertility looks the at the root causes of infertility, by addressing all body systems, rather than just focusing solely on the reproductive system.

I’ve talked a lot about diet so far and things we have more control over. Some things like environmental toxins we have less control over, however we can make some choices about most of these issues once we know what we are dealing with.

A recent report in the UK from the Royal College of Gynaecologists confirmed many of the concerns I have as a nutritionist around limiting your chemical exposure during pregnancy. The truth is this journey should really start before conception instead of the advice given to avoid during pregnancy: http://www.rcog.org.uk/womens-health/clinical-guidance/chemical-exposures-during-pregnancy-scientific-impact-paper-37

I often refer to environmental toxins with clients as the silent accumulators as they can be responsible for sub fertility.  Accumulated toxins from our diet or environment can build up over time and unfortunately they will stop nutrients from getting to a woman’s reproductive organs and interfere with sperm health.

Acording to http://blog.naturalhealthyconcepts.com/2012/07/16/what-toxic-chemicals-is-your-body-absorbing-infographic/ 

"More than 80,000 chemicals permitted have never been fully assessed for toxic impacts on human health and the environment. Under the current law, it is almost  impossible to take regulatory action against dangerous chemicals, even those that are known to cause cancer or other serious health effects"

 We absorb almost 60% of what we put on our skin and if we take just a quick snapshot of the chemical bath we are exposed to just in body care, it is quite easy to rack up an impressive chemical count within hours of waking. By the time we eventually go to bed, we will be exposed to many hundreds of chemicals just in one area such as body care.

Many couples have unexplained infertility and cleaning up their exposure to chemicals is one component of an overall plan and used in conjunction with others will help them become more fertile.  Everyone has a different physiology so as a rule I always recommend an overhaul of body, home and lifestyle.

Exposure to chemicals used to preserve lotions and potions  heavy metals, radiation, and toxic chemicals in some foods, drugs and other products can damage DNA and can influence our gene structure and expression. 

Here are a few things to help you clean up your act in regards to chemicals prior to conception:

1. Minimize your exposure to toxic chemicals

Once pregnant exposure to environmental toxins (in the form of industrial chemicals) both in utero and neonatally may dramatically affect the growing child.  There appears to be less stringent controls on them as there are for medicines. Consequently, poisonous chemicals end up circulating in our environment, food supply, air and water.

Heavy metals and environmental pollution  can alter hormone function and result in adverse reproductive health effects. These include:

• Ovotoxicants:  which can disrupt or even stop ovulation.
• Endocrine disruptors: Which can interfere with hormone function and cause endometriosis and PCOS.
• Phthalates: in plastic food containers, cling film,  bags, medical supplies, vinyl flooring and packaging at high levels have been associated with miscarriage and testicular toxicity. At low levels they disrupt hormonal balance.
• VCH chemicals: used in rubber tires, plastics and pesticides.
• PAH: released from cigarettes, car fumes and road tar

Men are also affected

Studies confirm male sperm counts are declining, and environmental factors, such as pesticides, exogenous oestrogens (Xenoestrogens), and heavy metals may negatively impact spermatogenesis (formation of sperm).

Sperm seems to be more sensitive to heavy metals and industrial pollutants than Ova. Many sperm abnormalities have been linked to these toxins. The majority of these chemicals can be found in the atmosphere, on the ground in cities and in the waterways.

They have also been termed “reprotoxicants” for their negative effects on sperm development and maturation.

What can we do about this - The top 7 environmental toxins to avoid

• Pesticides: found on non-organic fruit and vegetables, meat, dairy and unfiltered tap water
• Formaldehyde: found in air fresheners, deodorants, floor polish, upholstery cleaners
• Bisphenols: found in plastic containers and can leach into food and water.
• Organic solvents: petroleum based liquids found in household products, electronics, car repair, health care, photography, agriculture, printing, construction and cosmetics and many more
• Parabens used in common shampoos, conditioners and body care items.
• Dry-cleaning chemicals
• Paint fumes

Occasional exposure to one or the other toxic chemical is not of concern. What is of concern is accumulation of these chemicals over a long period.

2.  Water

Our waterways are constantly being polluted by industrial waste and by-products, pharmaceutical drugs, pesticides and herbicides and commercial cleaning products.

How to minimise this = use a filtration system

Buy a filtration water system that filters particles smaller than 1 micron (this will filter out the drugs as well as heavy metals). Use the filter in your shower and your kitchen. Shower steam contains the same chemicals, which you can end up inhaling and can be absorbed through your skin.

Conclusions

It can be difficult to totally banish chemicals from our life, as after all we do live in a modern society; however we can make a big dent on our chemical exposure by:

1.  Minimising and switching to natural products for body hair and teeth

2.  Making sure the majority of your food is chemical free

3.  Not obsessing about using plug in air filters and using harmful chemicals to clean your house

4.  Filtering your water with a really good filtration system