1. Aim for a healthy weight
In your 20s and 30s it’s common to have “weight creep”, an extra kilogram or two gained each year, without realising. Carrying too much weight increases the risk of pregnancy complications, including gestational diabetes, pre-eclampsia and delivery complications. So, it’s worth trying to shift some of the “extra kilos” before trying to conceive.
A mother’s pre-pregnancy weight also has a direct effect on her baby’s birth weight. Compared with mothers who are in the healthy weight range, mothers who are overweight or obese are 1.5-2 times more likely to have babies with a high birth weight, increasing the risk of birth complications. For these infants, there is an increased risk of developing obesity, heart disease and type 1 diabetes later in life.
But improving eating and physical activity helps you achieve a healthy weight right for you. For women carrying excess weight, a loss of 5-10% of pre-pregnancy weight is enough to improve fertility and reduce the risk of weight-related pregnancy complications.
2. Improve your food and drink choices
Increasing the variety of food you eat each week across the basic food groups – vegetables, fruit, wholegrains, vegetarian foods (including legumes like baked beans, kidney beans, lentils, eggs, nuts and seeds), lean meats/poultry/fish and dairy foods – also boosts the vitamins and minerals needed from the very beginning of pregnancy.
Start by assessing the quality of your diet using the free Healthy Eating Quiz and check how it suggests you boost your score. You can also use the eat-for-health calculator linked to the Australian Guide to Health Eating. This calculates recommended daily serves from each of the five basic food groups, and gives an idea of daily serves to aim for to optimise your nutrients.
Getting your nutrients from food in the first instance is recommended, but some nutrients do need extra attention before conception and early in pregnancy.
3. Take a folate supplement
Folate is a B-group vitamin. It is needed to complete the development of the neural tube, which forms the baby’s brain and spinal cord in the first few weeks of pregnancy. This can be before you even know you’re pregnant. If the neural tube doesn’t close it can cause a neural tube defect like spina bifida.
Taking a folate supplement (in the form of folic acid) from one month before pregnancy until the end of the first trimester is the best way to make sure you meet folate requirements during early pregnancy.
Choose a supplement with at least 400 micrograms of folic acid. Talk to your doctor if you have a family history of neural tube defects as you will need higher levels of folic acid.
A folate supplement is in addition to eating good food sources of folate, like green leafy vegetables, fruits, lentils and breadmaking flour, most of which is fortified with folic acid in Australia). Organic breadmaking flour and most regular flour is not fortified, so check the ingredient list on flour you buy for home cooking.
4. Take an iodine supplement
In pregnancy, iodine is needed to support the baby’s developing brain and nervous system. Good food sources of iodine include seafood, dairy foods, eggs and iodine fortified breadmaking flour (except for regular and organic flour).
Although seafood is high in iodine, some types such as shark and swordfish should be avoided before and during pregnancy as they may contain large amounts of mercury.
In Australia it is recommended that women planning to become pregnant, take an iodine supplement containing 150 micrograms of iodine daily and to continue this while pregnant or breastfeeding.
Talk to your doctor or pharmacist about vitamin supplements to meet your needs. For more personal advice on nutrition consult an Accredited Practising Dietitian.
5. Avoid alcohol
All health authorities agree it is best to avoid alcohol from the time you start thinking about having a baby. There is no known safe level of alcohol during pregnancy. Alcohol consumed in moderate-to-large quantities can cause foetal alcohol syndrome and increase the risk of having a baby preterm birth and of low birth weight, which increases the chance of the baby having medical problems. The risks to the baby at lower levels are less clear. The safest option is drinking no alcohol if you are pregnant, planning a pregnancy or breastfeeding.
Putting it all together
Now is the time to start make changes to improve the nutritional quality of your food. And it’s not all about mum.
Dads-to-be can benefit from eating a variety of nutritious foods, cutting down on alcohol, and dropping a pants size. One study found that overweight men were 1.2 times and obese men were 1.3 times more likely to be infertile. But some good news in our study was that overweight and obese men who shed a few kilograms reported better erectile function.
Any improvements you make to your food and lifestyle habits today will benefit you and your family in the future.
Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research fellow. She has received a range of research grants including NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, the Heart Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers and the Sax Institute. She is a spokesperson for the Dietitians Association of Australia on some specific nutrition issues, including Australia's Healthy Weight Week.
Jenna Hollis is affiliated with the Priority Research Centre for Physical Activity and Nutrition and the Priority Research Centre for Health Behaviour, at the University of Newcastle (Australia). She is a Project Officer at Hunter New England Population Health. She has received an Endeavour Postdoctoral Research Fellowship from the Department of Education and Training (Australian Government). She has also received funding from the Hunter Medical Research Institute (HMRI) and University of Newcastle, Australia.
Siân Robinson is supported by the UK Medical Research Council and by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre.
Authors: Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle