Is it okay to diet before trying to conceive?

Tuesday, 8 September 2009

Expert Answers
Bridget Swinney, nutritionist

Yes. Your chances of conceiving and having a healthy pregnancy are greater if you're close to your ideal weight. Being overweight can cause abnormal menstrual cycles, which can lead to infertility. Overweight women are also more likely to have pregnancy complications such as hypertension and diabetes and more difficult deliveries.

It's best to stay away from popular diet plans that eliminate certain foods or food groups (like carbohydrates). Low-carb diets work for many people, but diets that cut out milk products, fruit, and vegetables can rob your body of many important vitamins and nutrients that you need to sustain a healthy pregnancy.


A better diet would be one that concentrates on "good" carbs such as whole-grain breads, pastas, and brown rice. Also include plenty of lean protein (such as fish, chicken, and lean cuts of meat), as well as fruits, vegetables, and low-fat dairy products such as milk, yogurt, or cheese. The whole grains in your diet can make you feel full, as will drinking plenty of water.

A registered dietitian can help you design a diet that's right for you. (Check the American Dietetic Association's Web site for help finding a dietitian in your area.)

Here are a few guidelines to keep in mind as you try to reach a healthy body weight before you get pregnant:

* Pay attention to what you eat. Your daily diet should include: five or more servings of grains/starches (including at least three whole grains), 2 cups of fruit and 2 and a half cups of vegetables (be sure to include a variety, such as dark green and starchy vegetables, orange and vitamin C-rich fruits, as well as dried beans and legumes), 5 to 6 ounces of lean protein from a variety of sources (fish, beans, poultry, meat, pork, eggs, nuts), three or more servings of dairy or calcium-rich foods (milk, cheese, yogurt), 6 teaspoons of added vegetable fat from canola oil or olive oil, or products made with these oils. (Try to avoid trans fat, the "bad" fat found in many fried and fast foods.)

* Be active! Exercising tones your muscles, builds strength, and helps your body burn more calories — even when you're sleeping. Exercise also promotes strong bones and helps ensure that your weight loss isn't from the loss of muscle tissue.

Aim for 60 minutes of moderate to vigorous activity on most days of the week, even if you have to split that time into several sessions. Pick activities you like — hiking, bicycling, swimming, gardening, dancing, or weight training. Remember that once you lose the weight, exercise is still important for keeping the weight off.

* Aim to lose about 1 to 2 pounds a week. This will help guarantee that you're losing fat. Losing much more than a couple of pounds a week can mean you're losing fluid and burning muscle mass instead of fat.

* Remember that if a diet sounds too good to be true, it probably is. Stick with a sensible eating plan and regular exercise to achieve a healthy body weight.

read more...

How much folic acid should I take while trying to get pregnant?

Expert Answers
Jill Stovsky, exercise physiologist and dietician

The recommended daily intake of folic acid for all women of childbearing age is at least 400 micrograms (mcg), or 0.4 milligrams (mg). Taking folic acid for at least one month before conception reduces the risk of neural-tube defects, such as spina bifida, by up to 70 percent, according to the Centers for Disease Control and Prevention.

During pregnancy, the recommended dose jumps to 600 to 800 mcg, or 0.6 to 0.8 mg. Of course, some women's needs are different. If you have a family history of neural-tube defects, you should probably get 4,000 mcg (4 mg) of folic acid a day. Talk to your doctor about how much you need before and after you conceive.


You can buy folic acid supplements at the drugstore or you can just take a prenatal or regular multivitamin. If you do take a multivitamin, make sure it doesn't contain more than the recommended daily allowance of 770 mcg RAE (2,565 IU) of vitamin A unless it's all in the form of beta-carotene. (Getting too much of a certain kind of vitamin A can cause birth defects.) If you're unsure what to take, ask your healthcare provider to recommend a supplement for you.

Folic acid is a water-soluble vitamin, so your body will flush out the excess if you consume too much. For some women, however, getting too much folate may hide a B-12 deficiency, which is sometimes a problem for vegetarians. Ask your doctor or midwife if you think you may be at risk.

Be sure to take our folic acid quiz to find out more about this essential nutrient.
read more...

Can some foods increase our chances of conceiving?

Expert Answers
Bridget Swinney, nutritionist

Beliefs about the wondrous powers of so-called fertility foods such as shark's fin, camel's hump, ginseng, pine nuts, prunes, or even chocolate date to early civilizations. Unfortunately, most are pure fiction. Many are based on the simplistic notion that eating foods that look like sexual organs, such as figs or eggs, will help those organs function better. Also, no evidence proves the theory that eating spicy foods can increase sexual potency by raising your blood pressure and pulse rate.

There's some scientific proof that eating oysters can boost fertility. Oysters are packed with zinc, which plays a role in semen and testosterone production in men, and in ovulation and fertility in women. That doesn't mean you should down a plate of oysters on the half shell at every meal. Maintaining the recommended dietary allowance of zinc (9 mg a day) can help keep your reproductive system working properly, but excessive amounts of zinc (or any nutrient for that matter) will not turn either of you into a babymaking machine. In fact, super-high doses of vitamins and minerals may actually reduce your fertility

read more...

Can herbal supplements boost my chances of getting pregnant?

Expert Answers
Helen Kim, reproductive endocrinologist

The verdict is still out on this one. Although there have been some small, promising studies, there simply isn't enough definitive research to say for sure that herbs can help you get pregnant. And there's one important cautionary caveat to keep in mind: Some of the herbs that have been linked to increased fertility may pose a risk to your unborn child if you do become pregnant.

A team of researchers at Stanford University studied an herbal supplement called Fertility Blend to see if it would help women who were having a tough time getting pregnant. The supplement contains chasteberry (an herb thought to improve ovulation and hormonal imbalance), L-arginine (an amino acid that improves circulation to the reproductive organs), green tea extract, and a host of vitamins and minerals.

In the study, published in the April 2004 issue of the Journal of Reproductive Medicine, a third of the 15 women taking the supplement were pregnant after five months, while none of the 15 women taking a placebo had conceived.

The researchers point specifically to chasteberry as a key player when it comes to boosting fertility. But the study is too small to say for sure that the herbal blend improves fertility.

A follow-up study published in the Journal of Women's Health in May 2005 included a much larger group of 93 women. The women in this study did not experience an increase in pregnancy rates, but they did show a tendency to have more regular menstrual cycles, which can certainly aid in conception.

Other small German studies suggest that chasteberry can help regulate imbalances in reproductive hormones and ovulation, and that black cohosh stimulates egg production. But once again, there are no large, well-controlled studies on these herbs to say they'll really give you the boost you need to conceive.

If you do want to try an herbal supplement, be sure to check with your healthcare provider first. Some of the herbs that have been linked to fertility — chasteberry and vitex, in particular — are contraindicated during pregnancy and lactation.

The Web site for Fertility Blend, the supplement studied, recommends discontinuing the supplement as soon as your pregnancy is verified. And since the Food and Drug Administration doesn't regulate herbs, you can't be sure of the exact dose you're getting.

Finally, just because herbs are natural doesn't mean they don't have potential side effects and drug interactions that you should be aware of. For example, researchers recommend against using a fertility-boosting supplement blend if you are also taking fertility drugs, as the herbs might interfere or interact with the medication.

If you're under 35 and have been trying for about a year without conceiving (or three to six months if you're 35 or older), your best bet is to see a fertility specialist.

read more...

Besides taking vitamins, what other nutrients do I need before I get pregnant?

I plan to begin trying to conceive in four to five months. Besides taking my prenatal vitamin, what other nutritional guidelines should I follow?

Expert Answers
Bridget Swinney, nutritionist

Start by paying more attention to what you eat, because your overall nutritional status can affect your hormones and your ability to get pregnant. Many women find it helpful to keep a food diary to help them keep on track.

As you focus on making healthy food choices, make an effort to follow the new U.S. Dietary Guidelines and include these foods in your daily diet:

• Five or more servings of grains and starches, including at least three whole grains

• 2 cups of fruits and 2 and a half cups of vegetables (be sure to include a variety, such as dark green and starchy vegetables, orange and vitamin C-rich fruits, as well as dried beans and legumes)


• 5 to 6 ounces of lean protein from a variety of sources such as fish, poultry, meat, pork, eggs, beans, and legumes. (Limit fish to 12 ounces per week.)

• Three servings of dairy or calcium-rich foods (milk, cheese, yogurt)

• 6 teaspoons of added vegetable fat from healthy vegetable sources like canola, olive, flaxseed, or nut oil, or products made with these oils. Avocados and olives are other sources of healthy fats. (Try to avoid trans fat, the "bad" fat found in many fried and fast foods.)

Here's an example of how to incorporate these foods into a daily menu (modified from a menu in my book Eating Expectantly, Meadowbrook Press, 2001):

Breakfast

• Raisin bran cereal with fresh blueberries and milk

• Whole-wheat toast with jam

Snack

• Apple slices

Lunch

• Spinach salad with dried raspberries and grated cheese with vinaigrette dressing

• Grilled chicken sandwich or veggie burger with mushrooms, lettuce, and tomato

• 1 cup vegetable or tomato juice

Before-dinner "mocktail" hour

• Mimosa Mocktail: ½ cup fresh squeezed orange juice with a large splash of club soda. Serve over crushed ice in a chilled martini glass with fresh mint and an orange slice

• Serve with: pistachios and cashews, red pepper slices, carrot sticks, and ranch dip

Dinner

• Poached salmon

• Steamed asparagus with lemon

• Whole-grain roll with soft canola oil margarine

• Oven-roasted potatoes with olive oil and rosemary

• Fresh mango

• Milk

Before bed

• Steamed milk with hazelnut flavoring

read more...

What I wish I'd known about postpartum weight and body image

What I wish I'd known about losing baby weight

"Don't go on fad diets. As a new mother you have enough stress in your life — you don't need to add the strain and mood swings of a yo-yo diet."

"Tell friends and family the best way to support you is to help you get some gym time! Emotionally, it'll do wonders for you, too. I ended up losing more weight than I had gained and love my body now more than at any other point in my life."

"You don't have to give up everything you like or exercise seven days a week to lose weight. Little things make a difference — so take the stairs, cut back on take-out, switch from white breads to whole grains, and so forth. Don't try to make life changes all at once, as it can be too stressful. Start walking this week, cut out white bread the next week, take your lunch to work the following week; whatever it takes to get used to the changes without overwhelming yourself."

"I discovered that my baby loves to bounce, so I do a lot of deep squats while holding her — it does a good job of firming up my thighs and rear!"

"Don't drink your calories. For instance, eat an orange instead of drinking a glass of orange juice. You'll get fiber and it will fill you up more."

"I drank water every time I craved a soda. I lost a lot of weight and was less awake at night, so I slept better, too."

"Learn what emotions trigger overeating for you — stress, fatigue, or depression — and learn how to deal with them without food."

"Meet a friend at the mall and walk around for an hour or more instead of sitting and having a coffee."

"I hated exercising before I had kids, but now I've discovered that the more I exercise, the better I feel, and the better I'm able to deal with the stresses of being a mom. Once it became a routine for me, I actually wanted to go to the gym. My pregnancy weight disappeared and then some, and I look better one year after having a baby than I looked before I got pregnant!"

"I found it really hard to motivate myself to lose those last pounds, so I initiated a 'biggest loser' contest at work recently. It was what I needed to make me start watching my food intake and exercising regularly."

"If you start an exercise regimen, start slow and build. Nothing can stop you quicker or make you hate exercise more than overexerting yourself too soon."

"For inspiration to eat healthy, just remember that whatever you are eating is exactly what you are feeding your baby if you're breastfeeding."

"Keep moving! I keep my diaper pail upstairs in the baby's nursery even though I do most diaper changes downstairs."

"Once your baby starts to sit up by herself and hold objects, make sure you get active, too — get down on the floor and play with her, chase her around when she gets more mobile, crawl, jump up and down, and so on — you get exercise while teaching her physical tricks."

"Simply cutting back on sugar and only eating when I'm hungry has helped me shed pounds very quickly. And exercise is key — I go out after the kids are sleeping for a walk or jog and it helps me de-stress."

"Don't start working out until you are mentally ready for the challenge. Taking care of a newborn is fatiguing, and attempting to lose the weight before you're truly ready will ultimately fail. Do it when you're ready, not when everyone else thinks you should do it."

"Don't cut calories too much. After my second pregnancy I ate only 1,100 calories a day while nursing, and it left me depressed, shaky and not in good health. I'd love to lose the weight from my fourth pregnancy immediately, but now I know that it's better to lose a little at a time."

"Get all the junk food and soda (including diet soda — water is better) out of the house. Make a list of things to do or low-cal things to eat if you feel the urge to snack."

"When winter hit, I checked out workout videos from the library for free. Once I found the one that was the most effective I bought it so I could do it every day!"

"While nursing, it's easy to get caught up in the idea that you need a lot of extra calories to produce enough milk. You do need a few extra calories, but they do not have to be milkshakes, candy bars, and other unhealthy 'quick calories.' It is important to get enough food, but it's also important for it to be food that is healthy for your body."

"Carrying my son around everywhere has really helped me lose the weight. We didn't use a stroller until he was 20 pounds, and my arms look great and my back and legs feel much stronger. We also took long walks every night before dinner — 45 minutes or so. It was a great way to connect as a family."

"If you can afford it, buy a gym membership that includes childcare — and use it. Beyond helping me lose weight, working out has greatly improved my self-esteem, energy levels, and overall mood, even when I am sleep deprived. I only wish I had joined sooner than I did!"

"Do something that is physical but fun for you. I don't like the gym scene, so I do construction and stage managing at my local theater. I'm constantly moving around, and I'm slowly losing the weight."

"Someone told me that it would be easy to lose weight after the baby was born, since I was breastfeeding. I was supposedly burning an extra 500 calories a day. However, I discovered I was hungry all the time — therefore countering the 500 calories. So now I've started an aerobic and weight program six days a week and cut my sugar intake. That is working!"

"After you stop nursing, it's possible to gain weight back. The nursing helped me burn extra calories, but once I stopped, I gained five pounds instantly! I am still trying to lose those five pounds."

"It takes time to wean your body from the cycle of eating more calories than you normally would because of pregnancy and nursing."

"Just like it took months to gain the weight, it can take months to lose it. All I heard was stories from my mother's friends about how they went home from the hospital in their pre-pregnancy jeans, and it made me feel awful. It took me eight months to lose it with my first pregnancy. I know now that it will eventually come off, and I don't worry quite so much about it."

"I thought that breastfeeding would be the magic solution for postpartum weight loss. It seemed to be for friends of mine, who were fitting back into their former wardrobe after only a month or two. My baby is 13 weeks old, and I still have at least ten more pounds to lose. I've started exercising, and it seems to be helping. I just had unrealistic expectations about how long it would take."

"After having a baby, it's impossible for your body to be exactly what it was before, but it can still look really, really great and in some ways even better!"

What I wish I'd known about dressing my postpartum body

"Try a new style of clothing. I always bought the same kinds of jeans, but with this new belly, I started trying on different styles and found two new styles that I never would have thought would flatter my shape. Every time I wear them, I get compliments!"

"If you wear clothing that you look your best in, you will feel good about your new shape. I wear pants with loose elastic waists and shirts that flare at the bottom. No one sees that I'm in elastic, the flared shirt hides the mommy fluff in my middle, and the length of the shirt reveals the bottom of my buttocks, thus giving the sense of a curvy woman."

"The thrift store is a great place to shop for transition clothes. Get a few outfits that fit you now and make you feel good about yourself."

"When you've weaned the little one, find a good bra fitter, get fitted (you'll be surprised!), invest in some good bras, and just lift those babies back up every morning. It will change your whole outlook, foxy mamas!"

"Buy something that accentuates your best feature. If it's your feet — buy shoes."

What I wish I'd known about body image

"Love yourself. A mother's body is an amazing place. After all, it is where the world began."

"Try not to focus on the weight you've gained. Instead, think about how cool it is that your body is capable of creating life. You can lose the weight. For many people it naturally falls off in the few months after the birth. If it doesn't, you will have to work harder, but you can do it. If you hear negative comments or start feeling bad about yourself, just keep telling yourself it's because you had a baby, and almost every woman has to deal with the changes. People realize that and still think you look beautiful."

"If you're having trouble with a negative self-image, make a little style change. I was very down about my weight and new shape, but then took out my frustration by dying my hair. Just that small change made me feel so much better about myself!"

"Having a baby put my priorities in perspective. I definitely wanted to be a healthy mom, but I didn't care as much about being skinny because it looked good. I think about my daughter and what a heartbreak it would be to me if she didn't think she was beautiful because of her body type. I want to set a good example."

"If you were on bedrest, cut yourself some extra slack when it comes to regaining your pre-baby figure. You have to regain all your lost muscle mass."

"If your friends or family make mean comments, ask them, 'Did you really mean to tell me that I look fat? That's pretty rude. ' I think sometimes people don't realize how awful their comments sound until you say them back."

"I've never seen a grave marker that said 'She looked great in her bikini after giving birth to three kids.' Being thin is not what being a family is all about. The important thing is to be healthy for yourself and your family, to have a good body image (and teach that to your kids as well), and to be a good and loving mother. You can lose the weight, but if you don't, know that your weight doesn't define who you are."

"Nothing stays the same after you have a baby — not your relationship with your partner, not your body, not your approach to anything. It's a lot to take in, especially if this is your first time. Go easy on yourself. Remember, you just made a whole human being. Put it in perspective. Be proud!"

"If a man makes a negative comment about your body, tell him he can chastise you about your weight only after he's been pregnant for 40 weeks, bled for six, had a little mouth contort his nipple into an ungodly shape, and experienced childbirth.

read more...

Pregnant and underweight: How to get the nutrients you need

How much weight should I gain if I started off my pregnancy underweight?

Most women who start off their pregnancies underweight are advised to gain between 28 and 40 pounds — a bit more than the recommendation of 25 to 35 pounds for an average woman. However, your doctor or midwife may make different recommendations based on your individual situation, particularly if you have a history of eating disorders such as anorexia or bulimia.

Not sure if you were underweight before getting pregnant? View a body mass index (BMI) chart to find out. You're considered underweight if you have a BMI of less than 18.5.

Does being underweight pose any risks to me or my baby?

"An expectant mom who is deficient in some key nutrients puts her baby at risk for serious birth defects," says Heidi Reichenberger, a registered dietician and spokesperson for the American Dietetic Association. For instance, if your diet doesn't provide you with at least 400 micrograms (mcg) of folic acid, or folate, your baby is at an increased risk for being born with a neural tube defect such as spina bifida. During pregnancy you should be getting between 600 and 800 mcg of folic acid daily. Foods including beans and legumes, spinach, asparagus, and orange juice are all rich in folic acid. And many breakfast cereals and breads are now
fortified with folic acid. Other dietary shortcomings, from vitamins such as A, E, K, and B2, and the minerals iron, copper, calcium and zinc, have been linked to a range of medical problems, including anemia in mothers and impaired brain function in babies.

If you don't gain enough weight during pregnancy, you also risk giving birth prematurely. But even if they're not premature, babies who are born to moms who gain too little weight are often considered "small-for-gestational-age" (SGA) meaning they may have been malnourished during pregnancy. This condition puts them at risk for a host of problems later in life, including eating disorders.

How can I make sure I stick to a sensible diet?

If you're not sure you can stick to a healthy diet on your own, a registered dietician can help you come up with a sensible meal plan and even provide you with simple recipes that include the foods rich in the vitamins and minerals that are essential to a healthy baby. (Ask your healthcare provider for a recommendation or find a dietitian in your area.)

"Women who are underweight tend to consume a lot of low-calorie foods, like lettuce, and small servings of the other foods they eat," says Reichenberger. What they should be doing is eating vitamin- and nutrient-packed foods that contain some healthy fat rather than going fat-free with everything.

"During pregnancy underweight women usually need more protein," she says. (Reichenberger recommends this protein-packed snack: two slices of whole wheat toast slathered with peanut butter and a layer of sliced bananas, plus a glass of milk.)

Ideally the bulk of your nourishment will come from whole foods, but a vitamin/mineral supplement can help make up for some shortcomings; your doctor or midwife will probably recommend you start taking one as soon as you find out you're pregnant, if not before.

Here are four easy ways to get more calories:

• Eat breakfast every day. Add some peanut butter or a slice of cheese to your morning toast for an extra protein boost.

• Add a couple of slices of avocado and a handful of nuts or seeds to your salads for extra protein and (good) fat.

• Eat two or three snacks between meals. Choose foods like yogurt (for protein and calcium), dried fruits (for vitamins, minerals, and fiber) or a fruit and yogurt smoothie (for protein, calcium, vitamins and minerals).

• Replace soda with juices that are high in vitamin C or beta carotene, an antioxidant. Grapefruit juice, orange juice and papaya nectar are rich in C; apricot nectar and carrot juice have lots of beta carotene.

read more...

Your pregnancy food diary

Keeping a food diary may sound like a hassle, but you'll be amazed at how easy it is to get a real look at your eating patterns in just a few days, and make changes for the better.

Simply print out our food diary template (you'll need Adobe Reader to view and print it), fold it up in your purse, and jot down what you eat during the day. We guarantee it will be eye-opening, and very helpful in setting you on the road to better pregnancy nutrition.

Some basic guidelines

• Write as you eat. Don't depend on your memory at the end of the day — or worse, the end of the week.

• Write it all down. Keep the diary in your bag and write down everything you eat or drink, from a can of soda to a handful of pretzels from your co-worker's desk. Those "little eats" are easiest to forget, but they can make a big impact on health.


• Be specific. Indicate whether there's mayo on your bread, cheese on your burger, or crackers in your soup.

• Be honest. No one's judging you on this — it's for your eyes only — so don't worry about trying to look like a more healthy eater.

Daily recommendations

To help your baby grow and feed your body during pregnancy, you need a variety of important nutrients. Among these are protein, fiber, omega-3 fatty acids, and vitamins and minerals such as calcium, iron, vitamin C, and folic acid. Read our chart of important nutrients and their food sources to help you pick the right foods for your daily intake.

You also need at least six to eight 8-ounce glasses of water a day. Find out how water really benefits you during pregnancy.

Your week in review

At the end of the week, take a look at your diary. What eating habits can you now see? How often did you eat when you weren't that hungry, or because your mood was low? Did you manage to check off all the items in the nutrient checklist? Did you get in some exercise at least a few days a week?

Ask yourself what you did well this week, and what you'd like to improve. Then write down your goals for next week: what you might do more or less of, do differently — or do just the same!

read more...