Life Stages Nutrition Needs During Preconception

Exam 2

Fertility

the actual production of children

Infertility

absence of production of children

Infecundity (more proper term to infertility)

biological inability to bear children after 1 year of unprotected intercourse

Subfertile

multiple early pregnancy losses, male sperm abnormalities, women who ovulate infrequently

Miscarriage

loss of a conceptus in the 1st 20 weeks of pregnancy

Stillbirth

loss of baby after 20 weeks of pregnancy

Females are born with a complement of ____ and males with ___ capabilities

immature ova, sperm-producing

Approximately ___ ova are formed in early development, but only ____ per ovary remains by onset of reproduction

7 million, ½ million

During the fertile years for women, ___ ova will mature and release for possible fertilization, leaving very few by menopause

400-500

For men, sperm numbers and viability may start to decrease after ___, but sperm is produced from puberty until death

35 years

The quality of sperm and eggs slightly decreases with age as damage to these cells’ ___ accumulates

DNA

Infertility affects ___ of US couples of reproductive age

10-12%

Nutrient intake from food and dietary supplements, calorie intake, and body fat affect fertility by altering the ____ in which eggs and sperm develop and modifying ____

environment, levels of hormones

Nutrient intake and body fat before ___ also influence the mother and fetus’ health while pregnant

conception

Fat cells produce _____, and their availability changes with body fat content

estrogen, testosterone, and leptin

Changes in the availability of hormones interferes with….

follicular development, ovulation, and sperm maturation and production

____ and ____ is associated with a dramatic decline in fertility that recovers when ____

undernutrition and inadequate body fat, food intake does

A critical level of body fat, usually indicated by a BMI over ___, is needed to trigger and sustain normal…

20, reproductive functions in women

Obese women have higher levels of _____

estrogen, androgens, and leptin

Obese men have lower levels of ____ and increased ____ related to reduced sperm production in ____ and higher than average rates of ____

testosterone and increased estrogen and leptin levels, 16%, erectile dysfunction

Intake of antioxidants plays an important role in ____ in men and women, as antioxidants are needed to protect cells of the _____, including ___, from damage due to oxidative stress

fertility, reproductive system, eggs and sperm

Zinc plays important roles in the reduction of ______, ____ maturation, and ____ synthesis, and deficiency in men has been related to poorer ____

oxidative stress, sperm maturation, and testosterone synthesis; sperm quality and concentrations

Vitamin D deficiency in men and women can be associated with ____.

• In women, may be associated with….

• In men, associated with…

infertility

• insulin resistance and metabolic syndrome in PCOS

• lower testosterone levels and sperm quality

Calcium is shown to be important in males for _____, and acrosome reactions

spermartogenesis, sperm motility, hyperactivation

Calcium and magnesium for women are taken together for…

synergistic effect and balance of each mineral

Folate

• should by consumed by women prior to ____

• shown to help with a healthier ___

• Better to consume in ____

• conception

• sperm count

• active form, folate, vs inactive form, folic acid

In the US, ___ of women of childbearing age have ___ deficiency and ___ have low ___ stores, related to…

9-16%, iron, 14%, iron, reduced fertility

Soy isoflavones through a high soy diet may affect…

fertility

Caffeine should be limited to fewer than ___ per day during pregnancy and can decrease the change of….

200 mg, conceiving

A higher intake of ___ results in a higher risk of infertility in men and women

alcohol

Alcohol intake has been found to reduce fertility only in women with a specific ___ that reduces the rate of ____ in the body

gene variant, alcohol breakdown

Intake of 5-25 drinks per week in men increases _____ and reduces ______

testosterone levels; sperm concentration, total sperm count, and the % of sperm with normal shape

Father’s regular pre-conceptual smoking is associated with ____

DNA damage to the sperm

Women may be at risk for entering pregnancy with toxic levels of ____, which is highest in…

mercury; shark, swordfish, king mackerel, and tilefish

The FDA recommends eating ____ of fish low in mercury per week, around ___ servings per week

8-12 oz, 2-3 

Lead is related to decreased ___ production and abnormal ____

sperm production, sperm motility and shape

Inhaled or ingested lead is transported to the ___, where it disrupts hormonal communication to the ___

pituitary gland, testes

Heavy metals may build up in the male reproductive system through the inhalation of ____ or through long-term use of _____

fumes or dust containing particles; supplements, industrial pollution, or contaminated water

Of environmental toxins, the strongest evidence of adverse effect is with…

pesticides and lead

Pesticide exposure affects….

semen quality and increases risk of sterility

Very high levels of exercise can interrupt previously established normal ___, or delay ____ if training at extreme levels before it would normally begin

menstrual cycles, menarche

Delays and interruptions in normal menstrual cycles appear to result from ____ related to ___ rather than intense exercise

hormonal and metabolic changes, caloric deficits

Periconceptional period is a critical period of time when ____ exposures can impact ____, ____ maintenance, and the growth, development, and health of the…

nutritional and other exposures; conception, pregnancy maintenance; offspring

Low energy intakes during the periconceptional period or exposure to high amounts of ____ in the form of ____ can modify gene functions in a developing embryo

vit A, retinol or retinoic acid

Inadequate folate early in pregnancy is related to the development of ___ of NTD (neural tube defects) such as…

50%, spina bifida

NTDs develop between the ____ after conception

3rd and 4th week

MTHFR- body cannot convert ____, must try a ____ form

folic acid, methylated form

High carb intake causes ___

glucose spikes

What increases cortisol?

high stress, and high blood glucose which increases insulin

Between ___ of women of reproductive age have PCOS

5-10%

What is the leading cause of female infertility?

PCOS

PCOS is not a ____, but a syndrome that consists of a variety of clinical signs such as….

disease

–Outer layer of the ovaries is thick and hard

–Irregular menstrual cycles

–Half of the women are overweight or obese

–Some have excess body hair

–Acne; high blood levels of insulin, triglycerides, and androgens; and low levels of HDL CHOL

What is the primary goal in the treatment of PCOS? How can this be done?

increase insulin sensitivity through weight loss and exercise

Dietary recommendations for PCOS

lean protein, whole grains, fruits and vegetables high in antioxidants, ample fiber, regular meal intake, nonfat dairy products, Vit D adequacy, and low GI carbohydrates.

Celiac disease is related to higher rates of ____, and substantially higher rates of…

infertility, subfertility

In males, untreated celiac disease is related to alterations in the actions of ____, delayed ___, and ____

androgens, sexual maturation, hypogonadism

In women, untreated celiac disease is associated with ___, increased rates of ___, and a short duration of ____

amenorrhea; miscarriage, fetal growth restriction, LBW deliveries; lactation

Sources of gluten

wheat, barley, rye

What should we recommend during preconception?

–Healthful diet with fiber and antioxidants

–Self-care / Decrease stress

–Exercise

–Limit toxins

–Avoid alcohol and tobacco

–Remove distractions during meal time

–Proper hydration

–Prenatal or multivitamin with folate

–Cod liver oil or DHA source

–Calcium + Magnesium supplement

–Antioxidants!!!!