The type of diet a woman consumes before pregnancy can influence fertility and pregnancy in multiple ways. Under the right circumstances, good nutrition can be a gift, an above-average start on life and health advantages that last for a lifetime.

Today we are experiencing an explosion in new information about nutrition, fertility and pregnancy. A renaissance in research is underway, and it is redefining what nutritional advice should be given to women who are attempting to conceive Advice previously based on clinical assumptions or personal biases is being replaced with recommendations supported by solid evidence. There are important advantages to the scientifically supported recommendations that are emerging from today's studies: They have been demonstrated to benefit health and they hold up over time.

It wasn't that long ago when nutritional factors were regarded as being unrelated to fertility. We now know that body weight, location of body fat stores, usual diet, and supplement use all influence fertility. It used to be thought that the fetus was a parasite, extracting from the mother whatever nutrients it needed for growth and development regardless of the mother's diet. (Some people still believe this is true today.) It is now commonly accepted that the fetus is not a parasite; it does not benefit while harming the mother. The nourishment of the fetus depends on the supply of nutrients from the mother's diet and her nutrient stores. In order to ensure survival of the species, it is the mother who gets primary access to most nutrients if nutrient supply is low. A healthy mother can reproduce again.

In the past, women were said to have maternal instincts that would direct them to select and consume nutritious foods during pregnancy. This notion is as valid as the ancient Roman belief that if you wanted a child with dark eyes you should eat mice often. Other common ideas such as the recommendation that all women should take multivitamins and mineral supplements, restrict their salt intake, and diet to keep their weight low in pregnancy are no longer supported.

New information about nutrition and fertility, pregnancy, and infant feeding emerges constantly, and it is difficult for health care providers to stay current on all the advances. Unfortunately, many providers are not up-to-date on the low-tech, nondrug nutritional improvements that could benefit the women they serve.

Much of the earlier advice given to women about nutrition and reproduction was insufficiently supported by scientific research and heavily biased by unproven assumptions. As knowledge expands, so should the specific recommendations given to women about nutrition. Some advances in nutrition information slowly seep into health care; others seem to be kept secret. A number of nutritional measures can be undertaken to enhance the chances of conception for many women. It is also clear that a growing and developing fetus is vulnerable to the influence of energy and nutrients it receives from the mother, and that excessive vitamins and minerals from supplements may be as hazardous to fetal well-being as deficient amounts. It is now known that a woman's intake of certain vitamins, such as folate, vitamin A, and vitamin D, very early in pregnancy can be related to the development of certain malformations in the baby. How much weight women gain in pregnancy, and the timing of the gain, have important effects on the risk of preterm delivery and the size and health status of infants at birth.

One of the most striking advances in research concerns maternal nutrition and the subsequent risk of certain chronic diseases. It appears that a predisposition for heart disease, diabetes, high blood pressure, and a number of other diseases and disorders may be "programmed" by inadequate supplies of energy or nutrients during pregnancy and early infancy. A large body of evidence indicates that newborns with optimal growth may be at lower risk for developing these health problems later in life.

Well-nourished women are also less likely to experience miscarriages, or to develop iron deficiency, suffer constipation or fatigue, and other common problems of pregnancy. Babies born to well-nourished women are more likely to be born in robust health, to feed vigorously, to grow optimally, and to be alert and responsive. Although there is much more to be learned about the effects of nutrition on fetal growth, development, and subsequent health, the influence of maternal nutrition is being recognized, and the advantages of optimal nutrition are more extensive than previously imagined.

One of the best things about nutrition is that the risks associated with poor eating habits can often be eliminated by fixing the weak link in nutritional health. It may be as simple as consuming more of your favorite fruits and vegetables, eating a breakfast cereal fortified with folic acid, or taking a low-dose iron supplement. By drawing up a pre pregnancy diet plan these steps can easily be followed. Some steps may be more difficult, such as gaining weight or cutting down on some of your favorite junk foods. But these gifts you give to your unborn baby will benefit you as well. Your reward may be a perfectly timed conception, higher energy levels during pregnancy, less intense side effects of pregnancy (such as nausea and vomiting, constipation, and heartburn), or a fully grown and developed newborn that is easy to care for.

Despite the best efforts, not everyone who wants to become pregnant will, and not all pregnancies will end in healthy newborns. Although it is very important, nutrition is not the only factor that influences fertility or pregnancy. Problems arise due to a myriad of factors that can be identified but not always remedied. In addition, there are probably hundreds of causes of infertility and pregnancy problems that have yet to be identified. These many unknowns make it impossible to chart a course that guarantees conception and a healthy newborn. With so many mysteries, blaming oneself for problems of uncertain origin is unreasonable and should be resisted with all the strength the spirit can muster. Keeping this in mind, the best course to chart is one that is within your control.

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