Fertility for Generations: Prepping Pre to Post Pregnancy.

Striving to attain or maintain optimal health bodes well for the future because we are giving future generations the best chance to thrive genetically. However, to make this happen, the most crucial age to be optimally healthy is the age where there is usually is the most neglect: men and women in their 20s and 30s.

Something as simple as women taking a prenatal vitamin with folic acid six months prior to conception can make a tremendous difference in the outcome of their offspring, that offspring's offspring, and beyond. Yet, it boggles the mind how few women actually do this and wait until after they get pregnant.

We have put together the most dynamite research to convince you, whether a teen, in your 20s or 30s, a parent or grandparent, that you need you to hold up your end of the bargain. For those not in their peak fertility years, that means making sure your children, grandchildren, friends, or coworkers in this age group reads this!

The Nutrient Above All Other Nutrients: Folic Acid
Before the 1960s, nearly all victims of Neural Tube Defects (NTDs) had fatal outcomes. In the 1960s, physicians introduced very early complex surgical and medical management, and the lives of victims were saved in the majority of spina bifida cases. In the 1970s, the selective criteria of surgical intervention were introduced to reduce the production of multiple handicapped children. In the 1980s, prenatal screening based on maternal serum alpha-fetoprotein (MS-AFP) and/or ultrasonography was introduced. This prenatal screening resulted in a significant drop in the birth of NTD fetuses. This approach increased the number of pregnancy terminations and was associated with some psychological and somatic complications of pregnant women. Finally, since the 1990s, we have had a chance to reduce the incidence of NTDs due to the intentional modification (supplementation) of the diet in the periconceptional period of the life.

Now, periconceptional folic acid or folic-acid-containing multivitamin supplementation as a primary preventive method of NTDs offers an appropriate alternative with the same efficacy of the elective abortion of NTD fetuses. Obviously, the primary prevention of NTDs and some other Congenital Abnormalities (CAs) is much better than the termination of pregnancy after the prenatal diagnosis of fetal defects from moral, medical (comparing the risk of pregnancy termination and folic acid/multivitamin supplementations), and financial (periconceptional folic acid/multivitamin supplementation is much cheaper than the combined method of prenatal diagnosis, mainly followed by pregnancy termination) aspects. Nevertheless, the reduced proportion of NTD births is explained in two thirds by elective abortion and only one third by folic acid/multivitamin supplementation. Thus, we have to change medical practice and to widen the use of folic acid/multivitamin supplementation because the proper preparation for conception is the earliest and most effective method for the prevention of NTDs and some other CAs. Therapeutic Advances in Drug Safety, August 2011

Folic Acid Vindicated
Several studies have challenged the efficacy of folic acid fortification. Recently there has been a bevvy of data thwarting these challenges. For example, folic acid intake during the first trimester of pregnancy is not related to asthma in young offspring, as was reported several years ago. According to the American Journal of Obstetrics and Gynecology, a research team searched for this effect in 1,499 pregnant women and their children through age six. There was a significantly decreased risk of asthma with folic acid supplementation.

In another example, folic acid had been linked to an increased risk of colon cancer. However, an American Journal of Clinical Nutrition study found a higher folate intake is associated with a decreased colorectal cancer risk in observational studies. Researchers examined the association between folate intake and colorectal cancer risk in the NIH-AARP Diet and Health Study—a US cohort study of 525,488 individuals aged 50–71 y initiated in 1995–1996. After 8.5 years of postfortification follow-up, folate intake was associated with a decreased colorectal cancer risk.

Optimize Your Environment
The exposure of pregnant women to certain environmental factors is associated with wheezing and asthma in their children. Researchers at the World Allergy Organization International Scientific Conference discussed the environmental factors that trigger epigenetic changes in the fetus, but which might not manifest until the children are 3 to 5 years of age, or even older. Factors that might present a risk to the developing fetus include acetaminophen, maternal vitamin D deficiency, domestic spray chemicals, tobacco smoke, and maternal use of antibiotics.

How can something that happens in the uterus have an impact on asthma in the child aged 6, 7, or 8? The explanation, if it is causal, is in epigenetic mechanisms. Early environmental exposure in utero plays a key role in activating and altering genes through histone methylation and acetylation of DNA, and alteration of chromatin structure. Once these have occurred in the fetus, they will be replicated throughout the infant's life, and may even be passed to subsequent generations.

Low intake of vitamin D by the mother might be associated with epigenetic changes in the fetus and that low levels of vitamin D are a major problem in people in temperate regions of the globe. By contrast, the Mediterranean diet, which is rich in oily fish, dairy, and produce, has been reported to be protective against asthma during pregnancy.

European data showed that exposure to domestic chemicals was associated with the early onset of persistent asthma, intermediate onset of persistent asthma, and late onset of wheezing.

As acetaminophen use by pregnant women has increased substantially since the early 1980s, asthma prevalence among children in the United States doubled. It has been suggested that acetaminophen interferes with the glutathione defense mechanism against oxidative stress in the lungs and with T-regulatory cell development.

Critical Nutrients for Optimal Fertility
EPA/DHA Fish Oil
If pregnant women, who do not regularly eat oily fish, eat two portions of salmon per week, they will increase their intake of EPA and DHA, achieving the recommended minimum intake; and they will increase their and their fetus’ status of EPA and DHA, according to a study in the August issue of American Journal of Clinical Nutrition.

When women take a supplement of the omega 3 fatty acid DHA during pregnancy, their babies have fewer cold symptoms and shorter illnesses, new research from the September issue of Pediatrics indicates. At 1 month and 3 months of age, about 38 percent of babies exposed to docosahexaenoic acid (DHA) in the womb experienced cold symptoms, compared to about 45 percent of the babies whose mothers were given a placebo supplement while they were pregnant.

Vitamin D
According to a statement published in the July issue of Obstetrics & Gynecology, the group acknowledges evidence suggesting that vitamin D deficiency is common during pregnancy, especially among "high-risk groups," including vegetarians, women with limited exposure to the sun, and minorities with darker skin. There is now a push to screen all pregnant women for vitamin D deficiency.

Vitamins A & E
High prevalence of vitamin A and vitamin E deficiency was found in very low birth weight infants starting from birth to term postmenstrual age. Therefore, a higher dose of vitamin supplementation is required postnatally as well as prenatally. Journal Perinatology

Vitamin B-12
Women who eat foods rich in vitamin B-12, during the first three months of their pregnancy are to eight times more likely to have babies who cry less, according to a new study published in the journal Early Human Development. Public Health Service researchers in the Netherlands measured the amount of B12 in the blood of nearly 3,000 pregnant women at their first prenatal appointment at three months. They then measured how often babies cried after birth and for how long. The babies of mothers whose blood contained the least amount of B12 at the three-month test were up to eight times more likely to cry for prolonged periods than those with the highest levels.

The sleep hormone melatonin may not be released fully causing longer crying episodes than exhibited by babies whose mothers had high levels of B12. Also a lack of B12 may reduce the brain’s production of myelin, which protects nerve cells, leading to more sleeplessness.

Multivitamins
The intake of periconceptional multivitamins may decrease the risk of preterm births (PTBs) or small-for-gestational-age (SGA) births. Regular preconception and postconception multivitamin use in women with a prepregnancy BMI 25 or below was associated with reduced risks of a PTB and preterm labor. The adjusted risk of an SGA birth was reduced in multivitamin users regardless of their prepregnancy BMI, with the strongest association in regular users in the postconception period. American Journal Clinical Nutrition

Use Ultrasounds Sparingly
A recent British Medical Journal study examine childhood cancer risks associated with exposure to diagnostic radiation and ultrasound scans in utero and in early infancy (age 0-100 days) in 2690 childhood cancer cases and 4858 age, sex, and region matched controls born 1976-96.

Although the results for lymphoma need to be replicated, all of the findings indicate possible risks of cancer from radiation at doses lower than those associated with commonly used procedures such as computed tomography scans, suggesting the need for cautious use of diagnostic radiation imaging procedures to the abdomen/pelvis of the mother during pregnancy and in children at very young ages.

Breast is Best
Bone Health
Researchers from American Journal of Clinical Nutrition have shown that bone mineral density at 17 years are positively related to body size and growth in infancy. Furthermore, breastfeeding in infancy seems to have a positive influence on later lumbar bone mass in adolescence. In this study, early bone turnover may also have a positive influence on later lumbar bone mass in adolescence. This is the first study to have term infants followed to adolescence. One reason for this is that Insulin-Like Growth Factor (IGF-I) concentration is lower in breastfed infants compared with formula-fed infants and that the stature later in life of earlier breastfed children is higher compared with earlier formula-fed children. The research corroborated this. Furthermore, duration of exclusive breastfeeding seems to be positively related to later lumbar bone mass.

Gluten Intolerance/Celiac Disease
Research published in the August 2011 issue of the journal Applied and Environmental Microbiology hypothesizes that changes in the intestinal microbiota of infants may directly influence the risk of celiac disease, and that if this is so, changes in diet -- particularly breast feeding -- could reduce that risk. The newborn intestine is colonized immediately after birth by microorganisms from the mother and the environment. Earlier research had shown that breast feeding protects against celiac disease as compared to formula feeding, as well as that the intestinal microbiota is less diverse in breast- than in formula-fed infants, with different genera predominating in each. The new research also shows that infants at high genetic risk of celiac disease have a high prevalence of certain Bacteroides spp that is different from the population in those at low genetic risk. The investigators report further that the type of milk influences Bacteroides species composition, in particular with breast feeding favoring the prevalence of B. uniformis, a species associated with the low risk genotype, and reducing differences in Bacteroides species composition between the two genetic risk groups.

Regardless Economic Demographic, Women Especially Need to Pay Attention.
Disadvantaged, unhealthy mothers are much more likely to have sickly children than are disadvantaged moms who are relatively healthy -- and this is not only due to genetics, suggests new research to be presented at the Annual Meeting of the American Sociological Association. Mothers who experience frequent or serious health problems may have a harder time monitoring their children or performing day-to-day caretaking tasks, including taking their children to regular medical checkups. Maternal health problems can also place emotional and material burdens on children and heighten their stress and anxiety. Finally, to care for herself, an unhealthy mother may have to use financial resources that could otherwise benefit her children.

Compared to children whose mothers are disadvantaged but relatively healthy, children whose mothers are both disadvantaged and unhealthy are more than five times more likely to have fair or poor overall health. They have significantly higher odds of having asthma and a learning disability, and are more likely to go to the emergency room.

Children whose mothers are neither disadvantaged nor unhealthy generally have the best health outcomes. These children have the lowest odds among all three groups of having fair or poor overall health, suffering from asthma, being overweight, and not having regular doctors' checkups. They also go to the emergency room significantly less often than the other groups. Knowing that maternal health strongly predicts child well-being could put additional pressure on policy-makers to help unhealthy mothers, particularly those who are disadvantaged.

Males: Your Role in Fertility is Crucial
A number of lifestyle choices, environmental factors and chance events can sabotage sperm quality: an adolescent groin injury, cigarette smoking, diet, heavy drinking, intense cycling and even using a laptop directly on the lap. Since men contribute to infertility at least half the time, couples investigating why they can't conceive should start with a simple sperm count. About 70% of male infertility is treatable, and in about 25% of cases, it could have been avoided with greater awareness of the lifestyle choices that can harm sperm. Even if sperm viability is normal, quality can still be an issue.

Smoking cigarettes, heavy alcohol drinking and using marijuana, cocaine and opioid painkillers can all lower the level of testosterone needed to make sperm or otherwise cut their quantity and quality. Commonly prescribed medications for high blood pressure, heart disease, stomach acid, gout, inflammatory bowel disease, enlarged prostates and baldness are indicated. Men trying to conceive should avoid hot baths, hot tubs and tight pants, since heating the testicles by even a few degrees can hamper or stop sperm production. Resting a laptop on the lap can raise temperatures in the scrotum as much as 5 degrees Fahrenheit in an hour. Intense cycling, obesity, sexually transmitted diseases, groin injury, pesticides, industrial agents, and untreated celiac disease round out the most common infertility causes.

Low antioxidant intake is associated with low reproductive capacity and quality in semen. This is finding from Fertility and Sterility showed that men who eat large amounts of meat and full fat dairy products have lower seminal quality than those who eat more fruit, vegetables and reduced fat dairy products.

Eating a half serving a day of soy-based foods could be enough to significantly lower a man's sperm count. The study is the largest in humans to look at the relationship between semen quality and a plant form of the female sex hormone estrogen known as phytoestrogen, which is plentiful in soy-rich foods. Men who consumed the highest amounts of soy foods had a lower sperm concentration compared to those who did not consume soy foods. Journal Human Reproduction

Conclusion
If we can do our part by striving for optimal health for ourselves, family, friends, coworkers, future generations will be beholden to us for this priceless public service.

For self-help, please order our Natural Fertility and Optimal Pregnancy Action Plans. These Action Plans are free to NCI Well Connect subscribers. For individualized counseling, please schedule an appointment with Bonnie Minsky.