How to Prepare for Pregnancy: Diet, Lifestyle, and Supplementation

As you start planning for your future bundle of joy, there are a number of essential ways you can prepare for pregnancy through diet and lifestyle practices, as well as supplementation.

While often overlooked, preparing for pregnancy is an important consideration as nutritional needs are increased during pregnancy in order to meet the metabolic demands and changes in both the mother and growing fetus. Furthermore, poor lifestyle habits and nutritional status at conception can increase your offspring’s risk of cardiovascular, metabolic, immune, and neurological health issues. (19)

In this article, we’ll take a look at how to optimize your diet, lifestyle, and nutritional status to support your health and the health of your future baby leading up to conception.

Diet considerations

A nutritious and well-balanced diet is key to getting all the nutrients your body needs for pregnancy. These include macronutrients, specifically carbohydrates, protein, and fat, as well as micronutrients, which include vitamins and minerals.

Here are some important things to note about your macronutrient intake while preparing for pregnancy.

Carbohydrates

While carbohydrates are an important part of any diet, unbalanced carbohydrate intake can impact fertility and a woman’s ability to conceive. A large study was conducted on premenopausal women without a history of infertility as they attempted a pregnancy or became pregnant during an eight-year period. (10) The study found that high carbohydrate intake and glycemic load were associated with a higher risk of ovulatory infertility. (10) Hence, a diet with an appropriate amount of low-glycemic carbohydrates may benefit fertility. (24)

Low-glycemic carbohydrates include whole grains (e.g., brown bread, pasta, rice, quinoa, oats), non-starchy vegetables (e.g., leafy greens, broccoli, carrots, peppers, cabbage), fruits, healthy starches (e.g., beans, peas, lentils, sweet potatoes, acorn squash), and low-fat dairy. (24)

Protein

Consuming a diet with adequate amounts of protein is essential as too little or too much protein can lead to adverse health risks. Protein intake as part of a healthy diet should account for 20% of your calories or more prior to and throughout a pregnancy. (24) The daily recommended intake of protein for nonpregnant women is about 46 g per day, and this later goes up to approximately 71 g per day during pregnancy. (24)

As demonstrated by both human and animal studies, inadequate protein in a prenatal diet has been associated with lifelong health implications for children. (24) Specific damage has been shown at protein intake levels of 7.2% of total calories or less. (24) Adverse health outcomes associated with a low-protein diet include decreased brain size (32), altered fat distribution (5) , increased prevalence of obesity (41), shorter gestation and decreased birth weight (35), increased stress sensitivity (2), altered cardiac energy metabolism (38), and changes in muscular tone. (45) Additionally, animal models of maternal protein restriction during the preimplantation period has shown to cause adverse cardiometabolic and neurological outcomes in adult offspring. (18)

Additionally, the type of protein consumed has been shown to potentially be related to ovulatory infertility. (12) Sources of animal protein include meats, poultry, seafood, eggs and dairy products, while vegetable sources include beans, lentils, nuts, and seeds. A large study followed 18,555 women without a history of infertility, as they attempted a pregnancy or became pregnant during an eight year period and had them complete dietary assessments. (12) They found that consuming more vegetable protein, as opposed to animal protein was associated with a lower risk of ovulatory infertility. (12)

Furthermore, low protein intake can affect the fertility of men. One study showed that a low-protein diet decreased sperm quality in men. (44)

While fish can be a good source of protein, the American College of Obstetricians and Gynecologists have recommended how much fish to consume. They state that pregnant women and those who may become pregnant are encouraged to eat two to three servings of a variety of fish per week, with no more than one serving per week of fish with potential mercury contamination, such as albacore tuna. They recommend avoiding fish with the highest mercury concentrations, such as bigeye tuna, king mackerel, marlin, orange roughy, shark, swordfish, and tilefish. (47)

Fat

Fats are an essential part of a healthy pregnancy diet. Not only is fat used as an energy source by the body, but it is needed for the transport of fat-soluble vitamins, specifically vitamins A, D, E, and K, to the liver and fatty tissue, where they are stored for later use. Essential dietary fats (e.g., omega-3 and omega-6 fatty acids) provide us with the essential fatty acids alpha-linoleic acid and linoleic acid, which cannot be synthesized by the body. These fatty acids play important roles in reproductive function. For example, fatty acids are used as energy substrates during sex cell maturation and early embryo development. (40) They also play a vital role in implantation and maintenance of pregnancy. (29)
Although there is no RDA for fat specific to pregnancy, pregnant women should follow the current guidelines for Americans, which suggest consuming between 25% and 35% of total calories from dietary fat. However, as with carbohydrates and protein, a balanced approach is the best approach. Higher animal fats and cholesterol intake before pregnancy was associated with an increased risk of gestational diabetes mellitus (GDM). (7)

The quality of the fat is also an important consideration when looking at overall fat intake. Healthy fats such as omega-3 fatty acids have shown to be beneficial for pregnancy. (13)(24) Dietary sources of omega-3 include fish and other seafood, especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines, as well as nuts and seeds, such as flaxseed, chia seeds, and walnuts. (30)

Reducing intake of trans fat may also enhance fertility. (53) A large North American preconception cohort study found that trans fat intake was associated with reduced fertility. (53) Minimizing consumption of foods such as doughnuts, cakes, pie crusts, biscuits, frozen pizza, cookies, crackers, and margarine can help reduce your trans fat intake. (46)

Overall dietary patterns: what is the best diet for pregnancy?

The typical Western diet, high in refined sugars and processed foods and low in fruits and vegetables, is not ideal when preparing for pregnancy. Maternal diets high in sugar and fat can increase the likelihood of your baby developing conditions such as metabolic syndrome, diabetes, and cardiovascular disease later in life. (24) Another study showed that a higher frequency of fast food intake and lower consumption of fruit and vegetables increases the time it takes for women to conceive. (22)

While there are many different variations of healthy diets from which to choose, certain dietary patterns have been specifically investigated in women attempting pregnancy. One study showed that women with the highest adherence to the Mediterranean diet, a diet characterized by a high consumption of fruits and vegetables, fish and poultry, low-fat dairy, and olive oil, experienced less difficulties getting pregnant. (43)

Another study found that adherence to a “fertility diet”, which focused on the consumption of monounsaturated fat, vegetable protein, high-fat dairy, low-glycemic carbohydrates, multivitamins, and iron from plants and supplements, was associated with a lower risk of ovulatory infertility. (11)

Overall these dietary patterns have many similarities as they promote the intake of whole grains, fruits, vegetables, omega-3-rich fish, and olive oil rich in monounsaturated fatty acids. Therefore, aiming to include these foods in your diet may help improve fertility and provide the best health outcomes for pregnancy.

To learn more about foods that can boost fertility, visit the Fullscript blog.

Lifestyle considerations

There are a wide range of lifestyle factors that can help you prepare for a successful pregnancy.

Schedule a preconception appointment with your healthcare provider

Visiting your integrative healthcare practitioner is a great place to start when it comes to preconception and pregnancy planning. Your practitioner can provide support in many ways, such as by helping you manage pre-existing medical conditions, making adjustments to medications that may be unsafe for pregnancy, and assessing your nutritional status.

Track your cycle

Tracking your monthly cycle can help you maximize your chances of pregnancy. On average, a woman’s cycle is about 28 days long, with variations between 26 to 35 days still considered normal and healthy. The greatest chance for successful conception occurs in the days leading up to ovulation, typically around day 14 of your 28-day cycle. (51) To learn more about the stages of a woman’s monthly cycle, visit the Fullscript blog.

Exercise

Exercise can have a beneficial effect on reproductive outcomes in both men and women.

A systematic review and meta-analysis found that women who exercised regularly had pregnancy rates twice as high compared to those who did not exercise. (27) The benefits were most apparent in patients with obesity, polycystic ovarian syndrome, and insulin resistance. (27) However, too much exercise can also be problematic in women trying to conceive, as high levels of vigorous exercise has shown to have a negative impact on menstrual cycles, ovulation, and fertility. (50)

Similarly, physically active men who exercised at least three times a week for one hour had significantly better sperm morphology in comparison to men who participated in more frequent and vigorous exercise. (48)

Speak to your healthcare provider for guidance on the amount and type of physical activity is right for you.

Aim to have a healthy BMI

Weight can also play a role in pregnancy outcomes. A meta-analysis and systematic review showed that maternal pre-pregnancy weight is a significant factor in the preconception period, with underweight contributing to a 32% higher risk of preterm birth and obesity more than doubling the risk for preeclampsia and gestational diabetes. (14) Overweight women are more likely to undergo a cesarean delivery, and their newborns are at a higher risk of being born with a neural tube or congenital heart defect. (14) Consuming a balanced diet and engaging in regular physical activity can help you maintain a healthy BMI. (26)

Consider your partner’s health

Paternal health, specifically sperm quality, may also influence the health of your offspring. (37) Studies in animal models show that paternal obesity decreased sperm motility (17) and fertilizing ability (3), reduced fertility (21), resulted in delayed embryonic development, reduced placental size, and led to smaller offspring. (6) Therefore, men looking to conceive should also aim to maintain a balanced and healthy lifestyle.

Manage stress

Day-to-day stressors are inevitable, however high levels of stress can have implications for pregnancy. Evidence suggests that higher levels of stress are associated with delayed conception and an increased risk of infertility. (25) There’s a large variety of stress management techniques that can help reduce stress, ranging from yoga to massage. (9) Learn more about the various stress management strategies here.

Avoid substance use

Smoking, as well as alcohol and substance use, can not only have a negative impact on your overall health, but also on your ability to conceive.

Studies show that men who smoke tend to have a decrease in total sperm count, motility, normal morphology (8), as well as semen volume (23) and fertilizing capacity. (39) Similarly, women who smoked experience delayed conception (42) and a higher likelihood of infertility in comparison to non-smokers. (1) Chemicals in cigarette smoke may impair oocyte pick-up and transport of fertilized embryos within the fallopian tubes. (36)

Furthermore, marijuana contains compounds that bind to receptors located on reproductive structures, such as the uterus or the ductus deferens in males. (36) In males, such compounds have been reported to reduce testosterone and decrease sperm production, motility, and fertilization ability (4). Cocaine (20), heroin, and methadone (33)(34) also demonstrated similar effects on male reproductive functions.

Similarly, alcohol consumption has been linked with many negative side effects in men, such as reduced semen volume (23) and sperm count, morphology, and motility. (15)(28) Another study found that women who drank large amounts of alcohol had a higher chance of experiencing an infertility examination than those who consumed low amounts. (16) While it is clear alcohol can impact fertility, the amount it takes to negatively influence reproductive function is not yet clear.

Dietary supplement considerations

While meeting your nutrient requirements is best accomplished through the consumption of a balanced diet, dietary supplements may provide additional support and fill nutritional gaps when necessary.

Oral contraceptive use can contribute to a number of nutrient depletions, including depletion of several B vitamins (e.g., B2, B6, B9, B12), vitamin C, vitamin E, and the minerals magnesium, selenium, and zinc. (31) If you are planning for pregnancy after coming off of birth control pills, aim to restore nutrient status prior to conceiving.

It’s also important to note that if you are on any special diets that restrict the intake of certain foods, such as vegetarian or vegan diets, you may benefit from supplementation of specific nutrients, such as vitamin B12, if you are not getting enough from your diet. (49) If you do follow a restrictive diet, speak to your integrative healthcare practitioner to help you determine your individual nutrient needs.

To learn more about other specific medicinal herbs that may be helpful for enhancing fertility, visit the Fullscript blog.

The bottom line

There are many factors within your control that can optimize your chances of conceiving, as well as support your health and the health of your baby throughout pregnancy. Overall, aim to maintain a healthy diet and lifestyle, and speak to your integrative healthcare practitioner to find if supplementation is beneficial for you.