Culinistas's Kitchen,  Health

In the Beginning

by The Culinistas

Before we can talk about postnatal or even pregnancy, we need to start at the beginning: preconception. Preconception, which refers to a woman’s health before getting pregnant, can in a lot of ways be an afterthought. We spend so much time thinking about the finish line (oh, baby!), yet it’s crucial to think about health during this journey from the very start. 

One out of every eight couples faces fertility issues. And when it comes to ovulation-related fertility hurdles, diet and nutrition can play a key role in improving fertility (and not just for women either — a nutrient-rich diet can lead to healthier sperm as well).

To help get the conversation started, we asked some of our most trusted sources in the field to share their thoughts on what you need to know (and eat!) if you or someone you know is beginning a preconception journey of their own. 

What’s one thing people get wrong about preconception?

Alexandra Bandier (MS, RD, CDN), founder or Senta Health and registered dietitian who specializes in prenatal, postnatal, and pediatric nutrition: In a general sense, many women start out thinking they can plan exactly when they’ll get pregnant. Freeing yourself from the belief that you can or need to control such timing is crucial to your wellbeing. 

I think people assume or are taught that every woman’s cycle is 28 days and ovulation occurs at the midpoint. However, 28 days is the average length of a cycle, and many women have cycles ranging from 21 days to 35 days. This is why it is very important to track your individual cycle and determine your ovulation window from there. 

Carson Meyer, L.A.-based birth doula and childbirth educator: In my opinion, preconception starts when you are in your mother or even grandmother’s womb. (Did you know that your grandmother carried your mother’s eggs in her womb?) Thinking about preconception as a blip in time disregards the importance of lifelong health practices, epigenetics and environmental health, all of which contribute to a healthy pregnancy.   

Sarah Rueven (MS, RDN, CDN) is the founder of Rooted Wellness and specializes in wellness counseling for women: Oftentimes, we don’t give ourselves enough of a runway to prepare for conception. I recommend that you give yourself at least six months to prepare your body — including cleaning up your diet, getting into a solid workout routine, and taking a good quality prenatal vitamin. 

What’s a low-stress step you can take to get yourself ready for preconception?

SR: Take an internal inventory of your health. Are you getting enough sleep? Are you eating a good variety of fruits and veggies? Focusing on the things you CAN control — your health, sleep and stress levels — are all actionable ways to prepare that also help reduce your stress.

AB: Acupuncture is an amazing tool to use in the preconception stage. We’re learning that acupuncture may help to improve energy flow to reproductive organs, balance hormones, and strengthen the immune system. It’s also extremely relaxing and really feels like a treat! Other things I love are going on a walk, doing some light stretching, or taking a few deep breaths. Anything that gets you out of your head can help to lower stress and improve your mindset.

CM: Start detoxing your personal care routine. Swap out cleaning products, skincare, cookware and fragrances for non-toxic options. The EWG’s SkinDeep database is a great place to start. It is also important to eat organic fruits and veggies, wild fish and pastured/grass-fed meat to reduce your exposure to pesticides, antibiotics and foodborne illness. 

What’s the biggest impact of prioritizing nutrition during preconception?

AB: There’s strong clinical evidence that healthy dietary patterns can help with fertility. Focusing on eating a balanced diet and prioritizing vegetables, fruits, and proteins while minimizing refined sugars is a good goal.

SR: Beyond the physical impacts — such as improved egg (and sperm!) quality, healthier ovulation and improved hormonal regulation — your nutrition is one of the only things you can directly control that improves your conception odds. 

Eating a nutrient-dense diet is important for more than just conception. During pregnancy, your body requires more nutrients to support the healthy growth of your baby. If you aren’t eating a nutrient-dense diet prior to pregnancy, it can be hard to catch up and meet your requirements during pregnancy. It’s really important to set the stage for a healthy pregnancy (and subsequently a healthy baby!) by consuming a well-balanced, nutrient-dense diet prior to conception. 

What’s the biggest myth about getting pregnant?

CM: That it will happen quickly. Although it does for some, for others it can take time! That time doesn’t always mean there is something wrong. Our bodies are not machines. 

SR: That it’s easy!! We spend so much of our adult life trying to NOT get pregnant — it’s not just a switch that you can flip on when you’re ready. Oftentimes, our bodies need time to adjust, especially if you’re coming off hormonal birth control.

AB: That if you are struggling with infertility it’s only a woman’s issue. As both men and women contribute to making a baby, both can contribute to fertility issues as well. Regardless, there’s nothing to be gained by blaming either. Working together and exploring your options is the best path forward.

Any go-to resources for information when getting through the preconception period? 

CM: The books Spirit Babies by Walter Makichen, Awakening Fertility: The Essential Art of Preparing for Pregnancy and The First Forty Days: The Essential Art of Nourishing the New Mother by Heng Ou with Amely Greeven and Marisa Belger, and the EWG Skin Deep database.

SR: I love the Robyn network (their Instagram is also super helpful) for all their information and resources. The Calm App is fantastic for guided meditation and helping to promote good sleep. If you’re located in NYC, I highly recommend Lara Rosenthal for acupuncture.

AB: Doctors and other qualified medical professionals. I always make sure to research someone’s credentials before trusting them. And unless you enjoy unnecessary anxiety, avoid Dr. Google at all costs!

Looking back, what helped you through the preconception phase?

AB: It seems like many people choose not to talk openly about the preconception phase and even early pregnancy. But for me, talking with my family and close friends during these phases was really beneficial. Having a support system can definitely help with the inevitable highs and lows of the process. 

SR: I really leaned into all the self-care modalities that I knew would help me feel grounded during what can often be a stressful time. Things like yoga, acupuncture, getting good sleep (a MUST!), massages, exercise and eating well all helped me to feel more empowered and centered. I also really made a point to try to connect with my partner outside of the bedroom — which helped keep things spicy and feeling less like a monthly “chore” we needed to complete!

What big changes would you like to see around the conversation about preconception?

SR: I would love to see a lot of the secrecy around trying to conceive (referred to as TTC in the fertility world) disappear. I think people feel a lot of shame when they aren’t able to conceive right away — so normalizing the preconception experience would make a huge difference in helping women feel less alone and more supported on their journey to becoming a mom.

AB: Removing the stigma! No matter how you have a child — on your first try, through IVF, with a surrogate, through adoption, or otherwise — it’s all wonderful and worth celebrating.

CM: I wish we looked at preconception as every year of our life before pregnancy, not just the few months or years leading up to motherhood. I also hope that we take the pressure off of the female body and place the pressure onto the institutions that have contributed to our environmental health crisis. 

What are the top foods to eat, and not to eat during preconception?

Stephanie Rapp, co-founder of Embody Wellness: Healthy fats like nuts and seeds, wild salmon/sardines, ghee, avocado, olive oil, etc.; foods high in iron such as eggs, grass-fed meats, leafy greens; foods containing choline: eggs, organic grass-fed dairy, grass-fed meats; and foods with folate, such as eggs, lentils, dark leafy greens. 

I am currently pregnant with my fourth child. I’ve had very hard pregnancies. I’ve been nauseous, exhausted, fatigued… I’ve had migraines and aversions. My goal is to do the best I can, nutritionally. For months, I could not look at a raw vegetable. All I wanted was bread, chips and noodles. So, I ordered gluten-free sourdough or local whole grain sourdough breads, I made lentil pasta, added broccoli to my pizza and topped my toast with avocado and eggs and purchased organic and quality “comfort food.” Now, when I’m having a decent day, I add in more fruits and veggies. And when I’m nauseous, I have a PB&J and that’s ok! 

AB: Focusing on eating a high-quality diet before, during, and after pregnancy is beneficial for the mother and child. Intake of folate has been associated with lower rates of infertility and greater success in infertility treatments. It also helps to prevent neural tube defects during your baby’s development. Some foods high in folate include eggs, legumes and leafy greens such as spinach, swiss chard and kale. 

Additionally, omega-3 fatty acids appear to improve fertility. Omega-3 fatty acids cannot be made by the body so we must consume them through food. Some foods high in omega-3 fatty acids include chia seeds, flax seeds, walnuts, and cold-water fatty fish such as salmon and sardines. 

In terms of what not to eat, I recommend limiting refined sugar, caffeine, and alcohol in moderation.

SR: Overall, a fertility-supportive diet closely resembles the Mediterranean diet, which is a healthy eating pattern that anyone should follow, regardless of age or gender. 

Complex carbohydrates (like whole grains, fruits, vegetables and legumes) are a great source of fiber and are digested more slowly than refined carbohydrates (like white bread, white rice, sweets and soda). Slower digestion stabilizes blood sugar and increases satiety, which can in turn balance reproductive hormone levels, lead to weight loss (if warranted) and optimize fertility. 

Healthy fats enable us to absorb fat-soluble vitamins, regulate hormone levels, balance blood sugar and build cell membranes. When it comes to fertility, it is important that women are eating monounsaturated and polyunsaturated fats. I recommend including a serving of unsaturated fat (about 2 tbsp), like nuts, seeds, fatty fish, olives or avocados, at every meal for their fertility-boosting benefits. 

Ditch the skim milk and low-fat yogurt and enjoy their full-fat counterparts. When full-fat dairy is processed to low-fat dairy, additives such as whey protein are added to improve the taste. These additives can disrupt hormonal balance and interfere with fertility. 

Plant-based diets are higher in antioxidants, which deactivate free radicals in the body. If left active, free radicals can damage sperm and egg cells. Some of my favorite plant-based protein sources include chickpeas, lentil, quinoa, nuts, seeds and beans.

Fruits and vegetables are excellent sources of antioxidants and phytochemicals. These compounds, which are only found in plants, can help curb inflammation and destroy free radicals. Certain vegetables, like dark leafy greens, are also high in folate. Folate is critical in the first months of pregnancy for the development of the baby’s neural tube. Any woman attempting to conceive should be getting folate from her diet and from a prenatal supplement.

Foods to avoid: Trans fats (like partially hydrogenated oil, which is found in processed foods, certain baked goods, margarine/shortening and fried food) cause systemic inflammation which can damage sperm and egg cells, making it harder to conceive. Excessive alcohol consumption in women can interfere with ovulation and disrupt hormone levels. Alcohol can also harm sperm production in men. Women should stick to one drink per day while men should stick to two drinks per day. Studies looking at the role that caffeine plays in fertility are conflicting. To play it safe, I recommend that women attempting to conceive should limit caffeine intake to less than 200 mg per day, which adds up to about two 8oz cups of coffee per day.