Preconception Nutrition Flashcards
What are the 2 major causes of infertility?
- Resorption into the uterine wall within first 6 weeks
2. Miscarriage in first 20 weeks
What conditions can increase the risk of miscarriage in the first 20 weeks?
- Severe foetal defects (m.c)
- Maternal infection
- Uterine abnormalities
- Endocrine or Immunological disturbances
- Other random pathologies
What improvements can be made in order to reduce fertility problems?
- Diet
- Weight status
- Lifestyle changes
What are the topics covered in Preconception Nutrition?
- Causes of infertility
- Age and other factors
- Weight, body fat and fertility
- Nutrition and fertility
- Lifestyle factors and physical activity (RED-S)
- Medical conditions that influence fertility
Describe ‘Fertility’
The actual production of children
Describe ‘Fecundity’
The biological capacity to bear children
Describe ‘Fertility rate’
The actual production of children amongst a population group
or
Describe ‘Infertility’
the lack of conception after one year of unprotected intercourse
Describe ‘Sub-fertility’
delayed time to conception (over 12 months)
or
repeated pregnancy losses
What is the estimated rate of infertility worldwide?
approx. 9%
What nutritional factors can affect fertility?
- Dietary patterns
- Nutrient intake from foods and supplements
- Calorie intake
- Body fat levels
How can nutritional factors affect fertility?
- Altering the environment in which eggs and sperm develop
- Modifying levels of hormones involved in reproduction
What nutritional factors before conception influence the mother’s health during the pregnancy?
- Nutrient intake
- Body fat
Does fertility return to normal after the correction of nutritional factors?
Yes
What is the effect of undernutrition on fertility?
Decreased rate of fertility
Some examples include
-17th and 18th-century food shortages in Europe
-WWII famine in Holland > 53% decrease in the birth rate
At what age does fertility begin to decline in Men and Women, and why?
Men (35 years old)
- Reduced testosterone levels
- Reduced sperm production
- DNA damage
Women (30 years old)
- Reduction in the number of egg cells (oocytes)
- Increased risk of chromosomal abnormalities
At what body fat levels does fertility decrease?
- Very high levels of body fat
- Extremely low levels of body fat
What hormones do ‘Fat cells’ produce
- estrogen
- testosterone
- leptin
What hormonal and physiological changes occur amongst obese women?
BMI >/= 30kg/m2
- Higher levels of oestrogen, androgens, and leptin
- Favours the development of irregular menstrual cycle, ovulation failure and amenorrhea
What hormonal and physiological changes occur amongst obese men?
BMI > 30kg/m2
- Lower levels of testosterone, increased levels of oestrogen and leptin
- Reduces the level of sperm production, increases rates of erectile dysfunction
What physiological improvements occur once returning to a normal weight?
Improvements in
- hormone levels
- oxidative stress
- chronic inflammation.
What is the critical level of body fat needed to trigger and sustain normal reproductive functions?
BMI >20kg/m2
What could happen to female adolescence with low body fat?
- delayed onset of menstruation
- reduced fertility later in life
What could happen to males with low body fat?
- lowered libido
- reduced sperm production
What will happen to NORMAL weight females who lose 10-15% of body weight?
- decrease oestrogen
- LH (Luteinising Hormone)
- FSH (Follicle-Stimulating Hormone)
which can cause amenorrhea, anovulatory cycles and short or absent luteal phases - Decreased bone density and stress fractures in athletes
True or False
Weight gain back to normal weight will see a reverse of hormonal issues in both males and females, and restore fertility
True
List 4 micronutrients that have a more significant impact on conception
- Antioxidants
- Males and zinc status
- Females and iron status
- Females and folate status
Caffeine has been shown to increase the time to conception and the risk of a miscarriage.
What amount has been shown to increase risk, and what drinks make up this amount?
100mg
- 1 strong instant coffee
- 1 weak espresso coffee
- 2 cans of cola soft drink
What effects does alcohol have on the female and male reproductive system?
- Affect sperm count in men
- Affect blastocyte in women
What are six lifestyle and other factors that negatively impact fertility?
- Stress
- Smoking
- Drug use
- Heavy metals
- Contraceptive pill
- Physical activity
What effects can physical activity have on these people-
- Overweight/Obese men&women
- Healthy weight individuals?
- In overweight/obese men and women, physical activity that results in weight loss has positive effects on fertility - In healthy weight individuals, moderate activity has positive effects on fertility
- In healthy weight males and females, excessive exercise that induces negative energy balance can negatively impact fertility
What 3 consequences comprise the female athlete triad?
- RED-S
- Menstrual function
- Bone health
What does (LEA) stand for?
Low energy Availability
Name 4 causes that lead to LEA
- Changes to training/competition load (including short turnarounds
- Lack of skills, time, and/or money for meal planning and preparation
- Not understanding individual energy needs for sport
- disordered eating
What are signs to look out for people with LEA?
- Weight loss
- Disordered Eating or an Eating Disorder
- Lack of normal growth and development
- Menstrual dysfunction
- Recurrent injuries and illnesses
- Decreased performance
- Mood or social, behavioural changes
Name the core focus when treating LEA
improving energy balance through
- dietary changes
- the restoration of ovulation
- bone mass accretion
Name 3 ways to help treat LEA
- Vitamin D, calcium supplementation, and other supplements to facilitate bone development
- Increasing current EI ∼300–600 kcal/day (1,200-2,500 kJ/day)
- Addressing suboptimal practices related to energy spread over the day and around exercise sessions, dietary composition, and food-related stress
- Restoration of energy balance can reverse disruptions in reproductive hormones and bone formation
Name 3 existing medical conditions that can affect fertility
- Polycystic Ovarian Syndrome
- Coeliac Disease
- Diabetes
Define Polycystic Ovarian Syndrome (PCOS)
- When a woman’s ovaries produce higher than normal levels of androgen hormones
- Interfering with the development and release of eggs
- resulting in the growth of cysts within the ovaries
What are the symptoms of Polycystic Ovarian Syndrome (PCOS)?
- Abdominal obesity
- acne
- male-pattern baldness
- increased hair growth on the face, chest and back
- thick dark patches of skin, skin tags
- pelvic pain
- irregular menstrual cycle and infertility.
Associated with insulin resistance.
How can Polycystic Ovarian Syndrome (PCOS) be managed?
- dietary changes, focusing on abdominal obesity and insulin resistance
- changing dietary patterns,
- physical activity routines
Define ‘Coeliac DIsease’
- An autoimmune disorder of the small intestine occurs in genetically predisposed people.
- The digestive system reacts to gluten found in foods.
- Gluten is a protein found in wheat, rye, barley and oats, causing damage to the bowel of affected individuals
What are the major and associated symptoms of Coeliac Disease?
Major -
Gastrointestinal problems such as
- abdominal bloating, pain and diarrhoea
- impaired absorption of nutrients
Associated –
- amenorrhea and subfertility in men and women
- high risk of miscarriage for those able to conceive
How can Coeliac Disease be managed?
Dietary management through gluten-free eating
Define ‘Diabetes’
- (disease) body’s ability to produce or respond to the hormone insulin is impaired
- results in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood
What are the symptoms of Diabetes?
- hyperglycaemia (high) or hypoglycaemia (low) blood sugar levels
- Poorly controlled blood glucose levels during the periconceptional period increase the risk of pregnancy complications.
High BGLs during the first two months =
+ incidence of foetal malformations,
congenital abnormalities of the pelvis, heart and CNS.
+ increased risk of miscarriage.
Management
weight loss if necessary
regular exercise
healthy dietary pattern -
(reduced intake of sugary foods and beverages, high fibre intake, use of low GI carbohydrate foods, regular fruit and vegetable consumption)
What are some factors that may disrupt foetal growth and development?
Nutrient status
Alcohol
Health conditions
Is Iodine important to supplement during pregnancy?
Yes
Iodine should be supplemented preconception and throughout pregnancy and breastfeeding
