Genomics plays a role in influencing reproductive health and fertility. Epigenetic mechanisms influencing fertility can be influenced by nutrition, aging and environmental factors.
Consumption of omega-3 fatty acids and various nutrients, including vitamins B6, C, D, B12, biotin, folate, choline, iron, selenium, iodine zinc, and resveratrol have been shown to support fertility. Antioxidants – Vitamins A, C, E, glutathione, coenzyme Q10, carnitine, and lycopene have been shown to improve fertility by helping to counteract free radicals (ROS).
Vitamin D receptors are found in the ovaries, uterus, endometrium, and placenta. Vitamin D may influence infertility by reducing levels of interleukin-6 (IL-6), a pro-inflammatory cytokine. One study demonstrated that women with low vitamin D and elevated IL-6 levels had a 10.6 times higher risk of infertility. Zinc has also been implicated to have gut, hormonal, and neurotransmitter modulating roles, further highlighting its role in improved fertility.
Chronic stress alters reproductive function by impeding physiological processes in the body— affecting overall balance or homeostasis. GnIH plays a role in stress-induced fertility in males via a number of mechanisms. GnIH has been shown to inhibit gonadotropin-releasing hormone and hence suppressing the hypothalamic-pituitary-testicular axis and the synthesis of testosterone. These factors can affect the quality of sperm and function, influencing fertility.
Sufficient sleep and circadian rhythm balance is integral for reproductive health.The quality and diversity of the composition of the microbiome exerts powerful influence on reproductive health for men and women. Oxidative stress and environmental toxins can also impede fertility, as well as compromised immune and metabolic health.
Introduction
Pregnancy is a transformative journey filled with profound physical and emotional changes, and at its core lies the fundamental importance of maintaining a healthy diet. It is a period when the body’s nutritional needs expand to accommodate not just the mother but also the growing life within her. The significance of good nutrition during pregnancy cannot be overstated, as it serves as the cornerstone for the well-being of both the mother and the developing baby. During this remarkable chapter of life, the body’s requirements for essential nutrients increase, making it essential for expectant mothers to pay special attention to their dietary choices. While pregnancy nutrition may demand some extra effort, its rewards are immeasurable, promising a healthier journey for both mother and child.
Pregnancy Nutrition
Ensuring proper nutrition during pregnancy is imperative, as it directly impacts the health and development of both the mother and the unborn baby. A well-balanced diet is the building block for a healthy pregnancy journey, offering a multitude of benefits. It involves a careful selection of foods to provide the necessary nutrients for optimal growth and development of the fetus. Among these key nutrients are fruits and vegetables, lean protein sources, whole grains, and dairy products. These components form the foundation of a healthy diet for pregnantpregenent women, delivering essential vitamins, minerals, and energy.
It’s equally important for expectant mothers to be mindful of certain foods and drinks that should be limited or avoided during pregnancy. For example, caffeine intake should be monitored, and certain types of fish with high mercury levels should be omitted from the diet to prevent potential harm to the developing baby. Additionally, unpasteurized foods should be approached with caution to minimize the risk of foodborne illnesses and pathogens. Proper nutrition for pregnancy is a vital investment in the well-being of both the mother and child, and it sets the stage for a healthier and smoother pregnancy journey.
Anemia During Pregnancy
Definition
Anemia, a condition characterized by insufficient healthy red blood cells to carry adequate oxygen to the body’s tissues, is a concern that can affect pregnant women. Anemia during pregnancy occurs when there is an imbalance between these demands and the body’s ability to meet them.
Risk of Anemia
Pregnant women often experience a higher risk of developing anemia due to the elevated blood volume required to provide essential nutrients to the baby. This condition becomes especially relevant during pregnancy due to the significant changes the body undergoes to support the developing fetus. As the body produces an increased volume of blood to nurture the growing baby, it must also ensure a sufficient supply of iron and other essential nutrients to create hemoglobin, a protein in red blood cells responsible for transporting oxygen. Anemia is a condition that can have far-reaching consequences as it affects various organs and functions in the body. When tissues receive insufficient oxygen due to low hemoglobin levels, it can impact many aspects of maternal health. Anemia during pregnancy is particularly concerning because it has been associated with low birth weight, premature birth, and maternal mortality.
Complications
There are various types of anemia, with iron-deficiency anemia being the most prevalent during pregnancy. As pregnancy demands a substantial increase in iron, it is not uncommon for women to experience mild iron deficiency. However, more severe cases of anemia, whether due to low iron or other nutritional deficiencies, can result in significant health risks for both mother and baby. Therefore, it is crucial for pregnant women to understand the symptoms, risk factors, and available treatments related to anemia during pregnancy.
Diagnosis Through Blood Tests
Detecting anemia during pregnancy typically involves routine blood tests, such as measuring hemoglobin and hematocrit levels. These tests help healthcare providers identify any deviations from the normal range, signaling the presence of anemia. If anemia is suspected or diagnosed, timely treatment and intervention become imperative. Early identification allows for the implementation of dietary adjustments, iron supplementation, or other treatments to address the specific type and severity of anemia. Proper management of anemia during pregnancy is not only crucial for maternal well-being but also essential for ensuring the health and development of the growing baby.
Types of Anemia
Anemia during pregnancy can manifest in various forms, each with its unique causes and characteristics. The most prevalent type is iron-deficiency anemia, accounting for a significant portion of anemia cases in pregnant women. Insufficient dietary intake of iron or difficulty in absorbing iron can lead to this type of anemia. Additionally, folate deficiency anemia is another common variety. Folate, also known as folic acid, is a water-soluble vitamin crucial for preventing neural tube defects in the developing fetus. Lastly, vitamin B-12 deficiency anemia, while less common, can also occur during pregnancy. Vitamin B-12 is vital for the production of red blood cells, and its deficiency can lead to anemia and other health complications.
Iron-deficiency Anemia
Iron is a crucial component for the production of hemoglobin, a protein found in red blood cells responsible for transporting oxygen throughout the body. During pregnancy, the demand for iron significantly increases to support the growing fetus and the expansion of maternal blood volume. If a pregnant woman does not consume enough iron through her diet or has difficulty absorbing iron, she may develop iron-deficiency anemia.
The symptoms of iron-deficiency anemia include fatigue, weakness, pale skin, shortness of breath, and an increased heart rate. These symptoms can impact the pregnant woman’s daily life and overall well-being. Iron-deficiency anemia can also lead to complications such as preterm birth, low birth weight, and postpartum depression if left untreated.
Treatment for iron-deficiency anemia during pregnancy typically involves iron supplements and dietary changes. Healthcare providers may prescribe iron supplements to help replenish iron stores in the body. These supplements are generally well-tolerated but can cause constipation or gastrointestinal discomfort in some cases. Therefore, it is crucial to follow the healthcare provider’s recommendations and consider dietary modifications as well. Including iron-rich foods like lean red meat, poultry, fish, beans, peas, and iron-fortified cereals in the daily diet can complement iron supplementation.
Folate Deficiency Anemia
Folate deficiency anemia, also known as folic acid deficiency anemia, is another type of anemia that can occur during pregnancy. Folate, the bioactive form of or folic acid, is a water-soluble B-vitamin essential for the formation of red blood cells and DNA synthesis. Additionally, it plays a crucial role in preventing neural tube defects in the developing fetus. Folic acid is the synthetic form of folate often found in prenatal supplements.
Pregnant women need an increased amount of folate to support the rapid cell division and growth of the baby. A deficiency in folate can lead to anemia characterized by symptoms such as fatigue, weakness, and pale skin. Moreover, folate deficiency during pregnancy is particularly concerning due to the potential for neural tube defects in the baby.
To prevent and treat folate deficiency anemia, healthcare providers often recommend folic acid supplementation with folate. Prenatal vitamins typically contain an adequate amount of folic acid,( the synthetic form of folate) which is essential for pregnant women. 5-Methyltetrahydrofolate [methylfolate, 5-MTHF, -5-MTHF], has been evaluated as a better alternative to folic-acid supplementation, as it is the bioactive form of folate (and therefore does not need to be broken down). In addition to supplements, increasing the intake of folate-rich foods such as leafy green vegetables, citrus fruits, bananas, melons, and fortified cereals is advised. Ensuring sufficient folate levels during pregnancy is crucial for both the mother’s health and the prevention of birth defects in the baby.
Vitamin B-12 Deficiency Anemia
Vitamin B-12 deficiency anemia, though less common, can also occur during pregnancy. Vitamin B-12 is vital for the production of red blood cells and the proper functioning of the nervous system. While some pregnant women may consume an adequate amount of B-12 in their diets, others may face challenges in absorbing the vitamin, leading to a deficiency.
The symptoms of vitamin B-12 deficiency anemia include fatigue, weakness, pale skin, and neurological symptoms such as numbness and tingling in the extremities. If left untreated, severe B-12 deficiency can lead to neurological damage.
Pregnant women who are at risk of vitamin B-12 deficiency, such as those with certain dietary restrictions or absorption issues, may require B-12 supplements or vitamin B-12 shots. Ensuring adequate B-12 intake is essential to prevent anemia and support the overall health of both the mother and the developing fetus. It is worth noting that vitamin B-12 is naturally found in animal products like meat, fish, and dairy, so women following strict vegetarian or vegan diets should be particularly vigilant about their B-12 intake during pregnancy.
Anemia Treatment
Addressing anemia during pregnancy is of paramount importance to ensure the well-being of both the mother and the baby. Treatment strategies vary depending on the type and severity of anemia. Iron supplements and dietary changes constitute the majority of anemia treatment. For iron-deficiency anemia, healthcare providers often recommend iron supplements to replenish iron stores in the body. These supplements are typically paired with dietary adjustments, emphasizing iron-rich foods such as lean red meat, poultry, fish, iron-fortified cereals, beans, and peas. Furthermore, addressing underlying causes is essential in managing anemia.
Healthcare providers conduct thorough evaluations to identify and address any conditions or factors contributing to anemia. In cases of folate deficiency anemia, increasing folate intake through supplements or fortified foods can rectify the deficiency. Vitamin B-12 deficiency anemia may require vitamin B-12 shots or supplements. Prenatal vitamins, which typically contain iron and other essential nutrients, play a significant role in preventing and treating anemia during pregnancy. These supplements provide a comprehensive source of vital nutrients needed to support the health of both the mother and the developing fetus.
Proper Nutrition During Pregnancy
Pregnancy is a transformative journey for a woman’s body, and one of the most noticeable changes is the need for increased calorie intake. While “eating for two” is a common phrase, it’s essential to clarify that during the first trimester, calorie needs remain relatively consistent with pre-pregnancy levels. However, as pregnancy progresses, extra energy is required to support the growing fetus, the expansion of maternal blood volume, and the changes in a woman’s body.
The exact number of extra calories needed varies from woman to woman, depending on her pre-pregnancy weight and activity level. On average, during the second and third trimesters, an additional 300-500 calories per day may be necessary. It’s important to emphasize that these calories should come from nutrient-dense foods to ensure the proper growth and development of the baby, as well as the health of the mother.
The Importance of Specific Nutrients
Iron
Iron is a vital nutrient during pregnancy as it is essential for the production of hemoglobin, the protein responsible for carrying oxygen in the blood. Pregnant women need double the amount of iron compared to non-pregnant women to support the increased blood volume and oxygen needs of both the mother and the developing baby. Iron deficiency can lead to anemia, which can have serious health implications for both. Deficiency in iron is also relevant to mental health, further underscoring its value.
Calcium
Calcium plays a crucial role in the development of the baby’s bones, teeth, muscles, and heart. If a pregnant woman’s calcium intake is insufficient, the baby will draw calcium from the mother’s bones, potentially leading to bone density loss. To meet the calcium needs, dairy products, fortified foods, and leafy green vegetables are excellent sources.
Folate
Folate, also known as folic acid in its synthetic form, is vital for preventing neural tube defects in the developing baby. It is essential for proper neural tube formation during the early stages of pregnancy when many women may not even be aware of their pregnancy yet. Therefore, healthcare providers recommend folic acid supplementation before and during the early weeks of pregnancy.
Vitamins
A balanced intake of vitamins is critical during pregnancy. Vitamins such as vitamin A, vitamin C, and vitamin D are essential for the growth and development of the baby. Additionally, vitamin D supports calcium absorption, aiding in bone development.
Conventional & Functional Integrative Methods to Maintain Pregnancy Nutrition
Maintaining proper nutrition during pregnancy involves a combination of dietary recommendations, prenatal vitamins, and a balanced diet.
Dietary Recommendations
Pregnant women should focus on consuming a well-balanced diet that includes a variety of fruits, vegetables, lean proteins, whole grains, and dairy or dairy alternatives. Limiting processed foods, sugary snacks, and caffeine is advised. Hydration is also essential; staying well-hydrated supports healthy blood volume expansion and helps prevent issues like constipation.
Healthy protein and fat: plant-based protein and grass-fed meat, specifically internal organs like the liver, heart, and intestine.
Prenatal Vitamins
Prenatal vitamins are specially formulated supplements designed to provide essential nutrients needed during pregnancy. These vitamins often contain folic acid (or more recently folate), iron, calcium, and other key vitamins and minerals especially important for methylation. Prenatal vitamins can help fill nutritional gaps that may exist in a woman’s diet.
Balanced Diet
Striving for a balanced diet means focusing on a variety of foods that provide the necessary nutrients. This includes adequate protein, healthy fats, and carbohydrates. While it’s important to increase calorie intake, the emphasis should be on nutrient-dense foods to ensure the health and development of both the mother and the baby.
Mental Health Support
Postpartum depression is a prevalent, serious condition among women following birth. Variation in genetic make-up, environmental factors and vast changes in hormones. Neuroinflammation and neurotransmitter alterations have also been implicated in contributing pathophysiology.
In many instances, medication and psychotherapy may be warranted. Targeting these underlying factors with nutrition, lifestyle practices as well as largely emotional/psychological support is also significant. While addressing one’s own needs following childbirth can be challenging, it is imperative for the health and well-being of mother (and baby). Following an anti-inflammatory, nutrient dense diet can be valuable in addressing these physiological imbalances that may contribute to symptoms. Obtaining adequate sleep and supporting circadian rhythm balance with morning sunlight may further be supportive; this further highlights the importance of a supportive partner and family/community support.
References:
- Horowitz, K. M., Ingardia, C. J., & Borgida, A. F. (2013). Anemia in pregnancy. Clinics in laboratory medicine, 33(2), 281–291. https://doi.org/10.1016/j.cll.2013.03.016
- Sifakis, S., & Pharmakides, G. (2000). Anemia in pregnancy. Annals of the New York Academy of Sciences, 900, 125–136. https://doi.org/10.1111/j.1749-6632.2000.tb06223.x
Stanley, A. Y., Wallace, J. B., Hernandez, A. M., & Spell, J. L. (2022). Anemia in Pregnancy: Screening and Clinical Management Strategies. MCN. The American journal of maternal child nursing, 47(1), 25–32. https://doi.org/10.1097/NMC.0000000000000787
- Williams, M. D., & Wheby, M. S. (1992). Anemia in pregnancy. The Medical clinics of North America, 76(3), 631–647. https://doi.org/10.1016/s0025-7125(16)30344-3
- Payne JL, Maguire J. Pathophysiological mechanisms implicated in postpartum depression. Front Neuroendocrinol. 2019 Jan;52:165-180. doi: 10.1016/j.yfrne.2018.12.001. Epub 2018 Dec 12. PMID: 30552910; PMCID: PMC6370514.
- Stewart DE, Vigod SN. Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics. Annu Rev Med. 2019 Jan 27;70:183-196. doi: 10.1146/annurev-med-041217-011106. PMID: 30691372.
- Mate A, Reyes-Goya C, Santana-Garrido Á, Vázquez CM. Lifestyle, Maternal Nutrition and Healthy Pregnancy. Curr Vasc Pharmacol. 2021;19(2):132-140. doi: 10.2174/1570161118666200401112955. PMID: 32234002.
- Lindsay KL, Buss C, Wadhwa PD, Entringer S. The Interplay between Maternal Nutrition and Stress during Pregnancy: Issues and Considerations. Ann Nutr Metab. 2017;70(3):191-200. doi: 10.1159/000457136. Epub 2017 Mar 17. PMID: 28301838; PMCID: PMC6358211.
- Hussain T, Murtaza G, Metwally E, Kalhoro DH, Kalhoro MS, Rahu BA, Sahito RGA, Yin Y, Yang H, Chughtai MI, Tan B. The Role of Oxidative Stress and Antioxidant Balance in Pregnancy. Mediators Inflamm. 2021 Sep 27;2021:9962860. doi: 10.1155/2021/9962860. PMID: 34616234; PMCID: PMC8490076.
- Payne JL, Maguire J. Pathophysiological mechanisms implicated in postpartum depression. Front Neuroendocrinol. 2019 Jan;52:165-180. doi: 10.1016/j.yfrne.2018.12.001. Epub 2018 Dec 12. PMID: 30552910; PMCID: PMC6370514.
- Carboni L. Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health. Integr Med (Encinitas). 2022 Jul;21(3):36-41. PMID: 35999905; PMCID: PMC9380836.
- Gallaher KGH, Slyepchenko A, Frey BN, Urstad K, Dørheim SK. The Role of Circadian Rhythms in Postpartum Sleep and Mood. Sleep Med Clin. 2018 Sep;13(3):359-374. doi: 10.1016/j.jsmc.2018.04.006. PMID: 30098753.
- VitaleSG,FerrariF,CiebieraM,ZgliczyńskaM,RapisardaAMC,VecchioGM,PinoA,Angelico G, Knafel A, Riemma G, De Franciscis P, Cianci S. The Role of Genital Tract
Microbiome in Fertility: A Systematic Review. Int J Mol Sci. 2021 Dec 24;23(1):180. doi:
10.3390/ijms23010180. PMID: 35008605; PMCID: PMC8745627. - Chen W, Jiao X, Zhang J, Wang L, Yu X. Vitamin D deficiency and high serum IL-6 concentration as risk factors for tubal factor infertility in Chinese women. Nutrition. 2018 May;49:24-31. doi: 10.1016/j.nut.2017.11.016. Epub 2017 Dec 7. PMID: 29571607.