Did you know that good eating habits can help you get pregnant faster? Here’s how!

Globally, approximately 15% of couples of reproductive ages are seen as infertile and rather more show fertility problems. The extent to which nutrition can play a role in this has been investigated in many studies. However, studies in this field are often of low-quality. The randomized clinical trials were often carried out with small groups of participants and had different designs – partly with nutritional supplements and partly with different nutritional questionnaires.

In recent years, more dietary factors have been studied more specifically. But here, too, more comprehensive data and more complex analyses are needed to be able to make precise statements.

Generally, it can be said that the dietary recommendations, which are also made for the prevention of “civilization diseases” and for the promotion of health, in the same sense improve some fertility conditions of women and men.

In the following, I highlight a few points that showed a clearer correlation in positive or negative context. In general, however, it must be emphasized that there are certainly always several factors interacting, just as these topics have already been dealt with in previous lesson units – e.g., the quality and combination of food, the pollution and production conditions, etc. – see previous teaching letters)

Since one knows that the healthy and optimal conditions cannot be achieved by single nutrients or supplements, but in numerous studies the effects regarding fertility relationships, in both women and men, have been investigated by looking on single substances or dietary supplements, such study designs are not suitable from the outset to cover all important aspects. Such study concepts cannot analyze the natural food conditions, since many thousands of substances interact with the diet and there are thus so many variables that do not allow it to define precisely, which particularly promotes the desired effect.

In prospective case-control studies with the use of defined doses of a selection of nutrients (to maintain clarity and correlation determination), one can better guess possible interactions, but even these cannot capture the complex interaction of the thousands of nutrients of a healthy diet.  The studies are based on pharmacological concept, on a design that wants to determine and define effects on specifically used mono substances or only few interacting substances.  Nature, however, does not work in this way.

Despite these immanent difficulties, I give in this teaching letter an insight into data obtained on the question of better pregnancy planning or reduction of infertility in the context of nutrition. However, you should always be aware that, as mentioned, many more factors canplay decisive roles and that the supplementation of single substances or also multivitamin preparations is generally not a solution and may have at most occasionally only a limited support.

Generally, and with limited expressiveness (reduced significance), the following can be observed about better fertility:  A healthy diet that provides a good supply of omega-3 fatty acids and phytochemicals (secondary plant substances) as well as vitamins (more frequently were studied, cryptoxanthin, lycopene, β-carotene, vitamin E, vitamin C, vitamin D, vitaminB9 (folate) selenium and zinc,) – this can be translated to food given by eating fish respective seafood, poultry, whole grains, cereals, vegetables and fruits, legumes, low-fat dairy (low fat milk etc.). In contrasts fertility was reduced by: diets rich in processed meat (e.g. sausage products) and especially red meat, as well as full-fat dairy products, fast carbs (rapidly absorbable sugars) especially sugar-sweetened beverages and sweets, and alcohol.

In the past, soya and dairy products were described as detrimental to fertility. Better research does not prove this link. In the contrary soya and soybean products seem to have benefits in women in therapeutic infertility treatment.

Also, the consumption of moderate doses of coffee as well as even small doses of alcohol does not seem to have any disadvantages in terms of fertility. Here, too, attention should always be paid to the entire diet and consumption of semi luxury food, since, if the diet is already poor and other risk factors, even a small dose of alcohol can cause disadvantages. It should always be thought and analyzed more “holistically”.

Antioxidants, Omega-3 fatty acids, Vitamin D

It is commonly written that antioxidants improve fertility. The administration of antioxidants as food supplements was occasionally seen to improve sperm quality; for the better fertility of the woman, this did not show a significant benefit.
Note: Also, with regard to antioxidant effects (e.g., by foods containing abundant phytochemicals and thus also antioxidant vitamins in the natural matrix of foods) the benefit cannot be limited to the biochemical antioxidant effects; these nutrients always develop many other important functions at the same time. In addition, based on the study results it is not possible to define which antioxidants are responsible for the benefit or which doses are responsible for this benefit.

This is explained by the fact that the synergic interaction of the many substances is needed, and individual substance analyses are not so meaningful.

Thus, antioxidant preparations are partly helpful, but partly not. Biology shows the need of the natural matrix and complex biochemical reactions catalyzed by many different substances!

If one nevertheless wants to make statements about individual substances, one can determine the omega-3 fatty acids and the folic acid as a mono-substance with a probable benefit in terms of fertility.

The extent to which omega-3 fatty acids can potentially benefit from the consumption of fish and seafood must be considered as a benefit-risk assessment if there is a risk of higher heavy metal pollution (e.g., mercury in some marine animals). The risk here does not only concern successful fertilization, even after that there is a significantly higher risk for e.g. an abort (heavy metals such as mercury pass through the placenta and develop on the fetus a 5-10times higher toxic effect compared to adults).

The additional folic acid intake (also as a supplement), which is above the dose of 400-450 g/day, as it is an evident recommendation for the prevention of spinal malformation (Spina Bifida with neural tube defects), seems to increase fertility in women.

Since folic acid doses up to 800 g/day are recommended anyway, if the early enough supplementation for the prophylaxis has been missed at least with 400 g folic acid /day minimum one month before pregnancy, and the higher dose did not show increased risks *, an intake approximately of 600 µg folate/day (in total from food and supplementation) can certainly be recommended in pregnancy planning.   *a link with increased cancer risks, as in animal experiments, could not be substantiated in humans.

Although vitamin D is known to have much more important functions than previously researched mainly in terms of “bone health”; and although animal studies have seen links to better fertility, for humans studies vitamin D no benefits for better fertility were shown if there is no deficiency for vitamin D.
In the case of vitamin D deficiency, which in any case comes only to a small proportion from the usual diet, but via the production in the skin during sun contact, vitamin D should be supplemented.

“Balanced healthy diet, supplementation of Folate, avoidance of pollutants, weight management and work life balance are key factors of getting pregnant.”

Of course, there should also be no insufficient supply of other nutrients (e.g., proteins, fatty acids, long-chain carbohydrates, phytochemicals, vitamins, fiber, etc.), as there may always be disadvantages for various organ functions from the deficiency situations, which also play a role in fertility.  Just as the slogan about nutrition during pregnancy is true “not twice as much, but twice as good” applies, so does this already apply to better fertility.

The many effects of nutrition and the consumption of luxury foods are far from being fully analyzed, but many points can nevertheless show plausible, which can be rather disadvantageous or rather beneficial. In the same sense, this can be explained in the context of fertility.

Orientated, the so-called “Mediterranean Diet” (lots of vegetables and fruits, fish, legumes, herbs, whole grains, healthy vegetable oil such as olive oil) is good!

The intake of excessively high vitamin doses should also be avoided (especially vitamin A and especially isolated high dose vitamins in preparations or nutritional supplements), as these can damage the fetus. An exception to supplementation is folic acid (folate or Vitamin B9). To ensure adequate folic acid supply and to avoid spina bifida malformation in the child, a higher intake of folic acid should take place at least already one month before fertilization (for safety as a supplement of at least 400µg/day). As mentioned above, a higher intake of folic acid may also increase fertility.

In addition to nutrition, other lifestyle factors, such as sufficient physical activity, avoidance of pollutants, reduction of stress and increasing resting time periods (work life balance) should promote health and thus fertility.

Avoiding obesity and achieving normal weight even before pregnancy is another especially important factor, as with greater overweight, many risk factors for the mother and child can increase during pregnancy and persist beyond that (see the article about Gestational Diabetes).

At least, women who are planning a pregnancy should be very careful when taking medication (always consult your gynecologist or other doctor).

In summary, it can be said and plausibly explained that, also in context of better fertility for both women and men, is important

• a balanced, healthy diet, as recommended in the food pyramid.

• The good composition with a clearly predominant vegetable content.

• Vegetable foods with a great variety of flavors and colors (great diversity – goal: at least red-yellow-green fruits and vegetables daily), which ensures the supply of phytochemicals (secondary plant substances), plays an important key role.

• Plenty of pulses and salads as well as culinary herbs complement the recommendation of at least “5 servings of vegetables and fruit a day” (3 vegetables and 2 fruit).

• In addition, there should be a supply of good fatty acids and good protein sources, which is why white, low-fat meat (poultry meat) and even better fish (especially the smaller sea fish that come from non-polluted seas) – via such cold sea fish (herring, salmon, cod), the bioactive forms of omega-3 fatty acids (DHA and EPA) are well supplied – if supplementation is required, oils from special microalgae are good vegan DHA and EPA sources.

• In all these points, attention should always be paid to the quality, which concerns the avoidance or reduction of pollutants (the dose makes the poison) and the hygienic, transport and storage conditions.

• Sufficient physical activity and avoidance of obesity (with its higher risk of diabetes and other diseases) must always be considered; the nutritional effects (risk factors or protective factors) cannot be seen separately from physical activity and weight management.

As we can see, it is always the same multifaceted interacting factors that are naturally important for the human organism and that play important key roles when considering special functional areas – such as better fertility ratios here.

For some people, therefore, only single areas need to be optimized (with low deficits or a few unfavorable conditions); for others, several interventions or optimizations are required, some of which can only be achieved with extended therapeutic measures.

In addition to lifestyle factors, success can always depend on individual genetic constitutions. The lifestyle factors play important roles for the basic requirements of well-functioning organs and homeostasis (balance of physiological body functions) e.g., blood flow and metabolic conditions as well as immune reactions and numerous protective mechanisms.
Lifestyle factors, such as the diet and physical activity, even have epigenetic effects (they can modify gene functions – i.e., for example, mute some “risk genes” (gene silencing) or strengthen “repair genes”).