The food you consume and the lifestyle you lead have a big say on conception and pregnancy. Regardless of your gender, there is a strong relationship between what you eat and your fertility. A healthy diet also helps set the environment for a healthy pregnancy and a healthy baby.

Dreaming of Baby discusses the nutritional aspect to fertility and pregnancy with Carolyn Gundell, M.S., a fertility nutritionist at RMACT. Carolyn shares tips on what to eat to conceive and the best diet for a healthy pregnancy.

Daniela: We have with us today Carolyn Gundell, M.S., fertility nutritionist at Reproductive Medicine Associates of Connecticut (RMACT) with whom we shall be discussing the nutritional aspect to fertility and pregnancy, with a particular focus on the role of folic acid. Good morning Carolyn, and welcome to Dreaming of Baby! Before we start with our discussion, it would be great if you could introduce yourself and your experience in this field to our readers.

Carolyn Gundell, M.S.: Thank you, Daniela. I have worked in the medical endocrine side of Nutrition for over 30 years. I have developed a great passion in the fertility nutrition field. Couples can have such a great influence on pregnancy outcomes by optimizing their overall health through quality nutrition and lifestyle choices. This population also includes singles moms-to-be and even gestational carriers.

Carolyn Gundell, M.S.: I presently work for Reproductive Medicine Associates of CT, a fertility center that offers whole patient infertility care from nutrition to medically advanced fertility treatments. We work with patients to improve their egg and sperm quality and overall health to shorten time to pregnancy and support a healthy baby.

What to Eat to Conceive

Daniela: Great, thank you for this overview, Carolyn. I would like to look into the whole process of preparing for pregnancy and fertility considerations, as well as the pregnancy itself, from a nutritional perspective. Let’s say we have a couple – Pat and Anthony – who are trying to conceive. They have heard of the importance of eating right to conceive but are quite green as to what foods they should be incorporating into their diet and aren’t quite sure if their past eating habits have affected their current fertility. What foods should they be including in their diet and to what extent do past dietary habits affect fertility?

Carolyn Gundell, M.S.: An integrated approach is taken to optimize health to improve fertility. This includes taking a look at lifestyle habits, including daily movement, stress management, quality sleep, body composition, health concerns such as hypertension or elevated blood sugars, and nutritional intake.

Carolyn Gundell, M.S.: Let’s take a moment to discuss dietary intake specifically. RMA of CT structures our fertility nutrition education around the groundbreaking research of “The Fertility Diet” by Walter Willett, MD and Jorge Chavarro, MD. Their scientific studies support how a balanced dietary intake of low processed foods can support ovulatory function, egg quality, and quality spermatogenesis.

Carolyn Gundell, M.S.: Specifically, we discourage fad diets and concentrate on complex carbohydrate intake, heart-healthy fats, and low-fat proteins. Overall, we recommend a slightly low carbohydrate intake from limited fresh fruits, unlimited vegetables, complex starchy grains, and limited whole milk dairy.

Carolyn Gundell, M.S.: Research supports that avoiding processed foods will help to improve fertility. This supports the concept of eating nutrient dense foods over taking megadose supplements.

Carolyn Gundell, M.S.: “Research supports that avoiding processed foods will help to improve fertility.”

Folic Acid and Your Fertility

Daniela: Thank you for this insight – you mention supplements. How does folic acid come into play at this stage, and does it have a role in terms of improving fertility?

Carolyn Gundell, M.S.: Yes, absolutely. Folic acid is a B-vitamin. Its main role in the body is DNA synthesis of red blood cells and for the nervous system and protein synthesis. Adding folic acid with a prenatal prior to pregnancy is so important to help prevent spina bifida and other neural tube defects. The neural tube is the foundation for fetal brain and spinal cord formation that occurs within the first 28 days of conception.

Carolyn Gundell, M.S.: Folic acid also helps to support the placenta, prevent miscarriage, maternal anemia, and preterm delivery. Low levels of folic acid have also been associated with low sperm count and low egg quality.

Daniela: From a nutritional perspective, in terms of a couple still trying to conceive, how can they ensure that they are getting enough folic acid in their diet. Is supplementation the only way to go in this case or adding specific foods helps?

Carolyn Gundell, M.S.: The importance of taking a quality prenatal while trying to conceive cannot be overstressed. A minimum of 800 mcg folic acid is found in most over the counter prenatals and up to 1000mcg folic acid in prescription and some over the counter prenatals. All men can also benefit from a basic men’s multi-vitamin which usually contains 400 mcg folic acid.

Carolyn Gundell, M.S.: In addition to supplementation, including food rich in folic acid is also very helpful. Foods that have naturally occurring folic acid are lentils, split peas, beans and all legumes, green leafy cooked spinach, collards, asparagus, oranges, nuts, and wheat germ. There are also many complex starchy food items such as cereals and pasta that are also enriched with folic acid. Since the US government started enriching our food supply the occurrence of neural tube birth defects in the US dropped by 70 percent.

Carolyn Gundell, M.S.: “Foods that have naturally occurring folic acid are lentils, split peas, beans and all legumes, green leafy cooked spinach, collards, asparagus, oranges, nuts, and wheat germ.”

Your Diet and Fertility Treatment

Daniela: Thank you for this insight; very good to know. Let’s say that for Pat and Anthony, fertility treatment is a part of their path to parenthood. Once they approach a clinic, is testing done to identify any nutritional deficiencies prior to starting treatment?

Carolyn Gundell, M.S.: To my knowledge, most clinics will order a basic CBC to evaluate Red blood cell status. Only if this testing suspects anemia, then an iron, folate, and B12 panel may be drawn. I do like to assess B12 and folate levels in individuals on restricted dietary intake such as vegetarian or gluten-free. I also take a look at Vitamin D status because low Vitamin D has been associated with poor egg and sperm quality.

The link between a gluten-free diet and folate deficiency

Daniela: This is very interesting, especially the note on gluten-free. Does this mean that individuals following a gluten-free diet are more susceptible to a B12 or folate deficiency?

Carolyn Gundell, M.S.: Yes, many gluten-free products are still processed and are not enriched with added iron, folic acid, and other B vitamins. Additionally, many organic products can still be processed and be of low nutrient standards.

Carolyn Gundell, M.S.: If a patient wants to be gluten-free, I will reinforce that it is very important to substitute gluten intake with gluten-free whole foods such as quinoa, buckwheat, legumes, winter gourd squash, sweet potatoes, non-GMO corn, and wild rice.

What to Eat for a Healthy Pregnancy

Daniela: This is very important information to have, thank you. Continuing with our Pat and Anthony scenario, once they are pregnant, what kind of nutritional advice is given to create an optimal environment for a positive pregnancy?

Carolyn Gundell, M.S.:

  • Well-balanced meal plan with prenatals and DHA.
  • Weight gain of only 0-4 lbs. is recommended for the first trimester for ideal and overweight women. Total weight gain will be dependent on pre-pregnancy stat weight.  It is hence the quality and variety of nutrients that are important in the first trimester and throughout the pregnancy.
  • Food rich in low-fat protein, low mercury fish, complex carbs, including grains, vegetables, and fresh fruits, nuts, seeds, and dairy and heart-healthy oils.
  • Calcium intake of at least 1000 mg is important.
  • Protein intake for cellular development will rise as the pregnancy moves into the second trimester.
  • Carbohydrate intake from complex grains, vegetable and fruits will provide essential B-vitamins, iron, and energy.
  • Heart-healthy oil support hormones and energy.
  • Pregnancy also benefits from daily movement approved by the woman’s MD or OB/Gyn.

Folic Acid in Pregnancy

Daniela: With regards to folic acid, are the requirements the same as those referred to for before pregnancy occurs?

Carolyn Gundell, M.S.: No, each baby needs a minimum of 600 mcg folic acid at conception and throughout pregnancy. There are some circumstances when a woman would require more folic acid prior to pregnancy and during pregnancy, such as in the case of a baby with spina bifida, epilepsy medication, and positive for genetic mutation MTHFR. It is important to note that food-based folate is not a good source of folic acid if it is the only source. Some prenatals have food-based folate. Absorption is less with this form of folic acid. The synthetic version is highly absorbable and called folic acid. Also- a highly bioavailable version is a methylated folate.

Daniela: You’ve given us much information, so many thanks for that. On a final note, what would be one last piece of take-home nutritional advice that you’d give to individuals embarking on this journey to parenthood?

Carolyn Gundell, M.S.: Lifestyle and Nutritional balance. We live in a fast-paced world with many responsibilities. Finding time to feed our bodies with “balanced” meals low in added hormones, pesticides and processing supports our fertility, physical and emotional health, and in turn our child’s health. Thank you, Daniela.

Daniela: Many thanks, Carolyn, the insight you have shared with us today will be helpful to many!

Carolyn Gundell, M.S. leads RMACT’s Fertility Nutrition Programme. Read more, here.

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