By: Josie Mangano
Reviewed By: Anabelle Clebaner MS, RDN

It’s commonplace for women to are trying to conceive to track their menstrual phases. However,
did you know that whether or not you’re trying to conceive, tracking the phases of your
menstrual cycle can be a valuable tool for assessing overall health and wellbeing? If you have
PCOS or are experiencing symptoms related to hormone imbalance, fertility awareness may
help you understand the cues your body is giving you in order to address the root causes.
Irregular menstrual cycles are linked to nutritional deficiencies, energy deficits, hormonal acne,
and even loss of bone density in the long-term. Put simply, your hormone health is important
even before you are trying to conceive.

What is Fertility Awareness?

Fertility awareness — is a set of practices that are used to determine the fertile and infertile
phases of your menstrual cycle.
The techniques used to track menstruation and ovulation are known as Fertility Awareness
Methods (FAMs). But first, let’s review what you should know about the menstrual cycle, the
fertile window, and what the patterns of a normal cycle look like.

What You Need to Know About the Menstrual Cycle

A normal menstrual cycle lasts anywhere between 24-35 days. The first day of your period
(when flow begins) is always considered day 1 of your cycle. Normal menstruation lasts
between 3-7 days.

In the days following menstruation, your ovaries release an egg into the fallopian tubes — this
process is called ovulation. This egg stays in your fallopian tubes and, if not fertilized by a
sperm, will dissolve after 12-24 hours. Contrary to the myth that ovulation occurs 14 days after
your period starts, ovulation typically happens between days 10-23, depending on the length of
your cycle. It is essential to note that sperm can survive in the female reproductive tract for up to
5 days. Therefore, your fertile window is classified as the 5 days before ovulation, the day of
ovulation, and the following day (7 days total).

During the fertile window, the sperm present in the female reproductive tract may fertilize an egg
and implant itself in the uterine lining, thus marking the beginning of pregnancy. If the egg is not
fertilized and the egg is reabsorbed, hormones drop, and menstruation occurs, marking the
beginning of a new cycle. After the fertile window passes, pregnancy is not possible because
the egg is no longer present for fertilization. The days after ovulation and before menstruation
are referred to as the post-ovulatory phase.

With that covered, we can dive into the science-backed tools we use for fertility awareness cycle
tracking.

The 3 main fertile signs to pay attention to are:

1. Cervical mucus
2. Basal body temperature (BBT)
3. Cervical position

Let’s review each of these signs more closely and learn how they may be related to underlying
causes such as hormone imbalances, nutrient deficiencies, and/or underlying health conditions.

Cervical Mucus

The presence of cervical mucus (CM) is indicative of your fertile window. CM plays an essential
role in natural conception by matching the pH of sperm, creating the perfect environment for it to
stay alive for up to 5 days in the otherwise hostile female reproductive tract.

There are two kinds of cervical mucus that are often referred to when it comes to reproductive
health. The first is “peak mucus” which is an optimal environment for sperm and is also an
indicator of a healthy cycle when present in the fertile window. Peak mucus is clear, stretchy,
and is comparable to egg whites. There is also “non-peak mucus” which is cloudy, white, and similar to creamy hand lotion. Non-peak mucus is not as optimal because it is hostile to sperm.
It is usually present shortly after menstruation and later in the menstrual cycle (luteal phase).
However, it is important to note that all mucus is fertile in the pre-ovulatory phase! Pregnancy
can occur in the presence of either kinds of CM in the fertile window

If your experience with CM differs, there are some red flags we can look for to assess
underlying hormonal imbalances and/or health conditions.

Cervical Mucus Red Flags

Limited or no mucus — can indicate an issue with hormone production, the cervix, or other
related issues including HPV, cervical dysplasia, or use of medications like hormonal birth
control, fertility drugs, or antihistamines. Can indicate inadequate nutrient intake of cholesterol
(to support estrogen and progesterone production), vitamin A, and B vitamins (folate). Can
indicate endocrine issues such as thyroid disorder, HPA axis dysregulation, hypothalamic
amenorrhea, etc.

Continuous mucus — can indicate an issue in the cervix, or presence of infection,
inflammation, or hormone imbalance.

Continuous creamy/lotiony (non-peak) mucus — may indicate an overgrowth of
yeast/bacteria. During the luteal phase, low progesterone production may contribute to
continuous non-peak mucus.

Continuous clear/stretchy (peak) mucus — seen in women with PCOS and/or women
experiencing food sensitivities, IBS, and other gut-related issues in the pre-ovulatory phase.

Yellow-tinged mucus – can be indicative of infection.

Basal Body Temperature (BBT)

Basal Body Temperature can be measured by taking your temperature first thing in the morning,
before getting. It is important that you do this immediately after waking up for an accurate
reading, before eating or drinking.

Tracking these temperatures provides us with the information we need to confirm when
ovulation occurs, but keep in mind that there is no way to predict when ovulation will occur due
to extraneous factors like travel and stress which may delay ovulation. You can keep track of
your BBTs by either logging them manually on a BBT chart or by using a fertility tracking app.

Normal pre-ovulatory temperatures should consistently be above 97.5° F ranging up to about
98.2 °F. Normal post-ovulatory temperatures should be higher than the pre-ovulatory range with
at least one temperature higher than 98.6 °F. Temperatures that fall consistently lower than this
range indicate potential health issues and nutrient deficiencies.

What are Some Possible Causes of Low Basal Body Temperatures?

Possible causes of low BBT include nutrient deficiencies of nutrients involved in thyroid function
such as zinc, iron, selenium, and iodine. Iron deficiency may also contribute to low BBTs since
iron is highly involved in body temperature regulation. Zinc and iron supplementation have
independently been shown to improve thyroid hormone levels and thus increase BBTs in
deficient women.

Low BBTs may also result from inadequate calorie consumption from skipping meals or failing
to consume enough calories to offset exercise levels. Poor sleep may also contribute to low
BBTs by offsetting natural circadian rhythms. Finally, thyroid disorders such as hypothyroidism
and Hashimoto’s thyroiditis play a role in lowering BBTs.

Cervical Position

The final indicator of fertility is cervical position, which changes throughout the menstrual cycle.
By regularly checking cervical position we can better understand our bodies through common
patterns that we notice throughout our cycles.

But what is the cervix and how can we use it to track our cycles?

The cervix is the small, muscular organ that connects the vagina to the uterus. It’s a round,
prominent structure with a hole in the middle that’s roughly an inch in diameter. It produces
cervical mucus, expels menstrual flow, allows sperm to pass through during ovulation, and acts
as a barrier against infections.

During ovulation, high estrogen levels cause the cervix to rise closer to the top of the vagina.
The cervix often feels softer during the fertile window. As mentioned previously, the cervix is
responsible for producing peak CM during this time.

After ovulation (luteal phase), the position of the cervix lowers to prepare for menstruation. This
cervix tends to lower or “drop” on average a week to 10 days before menstruation begins.

During menstruation, the cervix remains low and opens slightly to release the menstrual blood
flow. The cervix feels firm to the touch during this time and will continue to feel this way until
after your period ends.

In early pregnancy, the position of this cervix is high in the vagina, similar to its position during
ovulation. The cervix is known to feel soft during this time, however it is important to use a
pregnancy test to confirm pregnancy as cervical position is not a guarantee in confirming early
pregnancy.

For more information on how to check your cervical position, click here.

Now that we’ve laid the groundwork of cycle tracking, let’s discuss some specific nutrients and
how they uniquely benefit cervical health!

Key Nutrients to Support Cervical Health

1. Folate — has been shown to reverse abnormal (precancerous) cervical cells and reverse
cervical dysplasia. Folate plays a key role in supporting healthy cell division, most notably
during early pregnancy in the formation of the spinal cord.

2. Vitamin A (retinol) — has been shown to reverse abnormal cervical cells when applied
topically to the cervix. Vitamin A is critical for fertility and plays a role in preparing the uterine
lining for implantation. Pregnant women should avoid all forms of vitamin A supplementation.
Dark leafy greens, red/orange vegetables, beef, eggs, and dairy products are rich in vitamin A.

3. Indole-3-Carbinol – has been shown to reverse abnormal cervical cells in clinical trials.
I3C plays a role in modulating estrogen metabolism and is a compound found in cruciferous
vegetables like broccoli, brussels sprouts, kale, and cauliflower

There you have it — the 3 main fertile signs to pay attention to and related cues that can give us
powerful insights into our hormonal and reproductive health. If you feel passionate about using
fertility awareness as a guide to managing hormonal imbalances, managing PCOS, or preparing
your body for the healthiest pregnancy possible, consider reaching out to our team at Wellspring
Nutrition for 1:1 functional nutrition counseling and a personalized plan to achieve your unique
health goals.

References

Hendrickson-Jack L. Women’s Health Nutrition Academy (WHNA). “Unlocking the Secrets of the
Menstrual Cycle: How Fertility Awareness Cycle Tracking Can Help Your Nutrition Practice”.

Sumner C. Cervix positions: What they mean & how to check them. Natural Cycles. Published
June 28, 2022. https://www.naturalcycles.com/cyclematters/cervix-positions-explained

Pregnancy is a season when your body simply needs more—more rest, more support, and yes, more nutrients. During this time, demands for key nutrients like folate, iodine, choline, and vitamin D increase significantly. If these needs aren’t met, deficiencies can have long-term effects not only for you, but for your growing baby as well.

Nourishing your body during this incredibly important and transformative time isn’t optional—it’s foundational to supporting a healthy pregnancy.

Is a healthy diet enough?

Even when you’re eating a well-balanced, nutrient-dense diet, it can still be difficult to meet all of your increased nutrient needs during pregnancy through food alone. This is where a high-quality prenatal vitamin becomes an essential part of your pregnancy toolkit.

Let’s break down a few of the most important nutrients to look for—and why they matter.

Folate

Folate (vitamin B9) is a critical micronutrient for fetal brain and spinal cord development. In the very early weeks of pregnancy—often before someone even knows they’re pregnant—the neural tube forms and closes, eventually developing into the brain and spinal cord. This process typically happens within the first 3–4 weeks of pregnancy.

Folate plays a central role in this process by supporting rapid cell growth and division, as well as methylation—a biochemical process that is essential for proper neural tube closure and healthy brain and spinal cord development.

A quick (and gentle!) biochemistry moment—bear with us. Many supplements and fortified foods use folic acid, which is a synthetic form of vitamin B9. Folic acid must be converted in the body to its active form, methylfolate, before it can be fully utilized. Some individuals have a harder time completing this conversion, which can lead to less-than-optimal absorption.

To bypass this conversion step altogether and support optimal absorption, it’s ideal to choose a prenatal that contains methylfolate rather than folic acid.

Current Recommended Dietary Allowances (RDAs) in the U.S. are:

• 400 mcg/day for women of childbearing age who are not pregnant
• 600 mcg/day for pregnant women

Iodine

Iodine is a crucial micronutrient for thyroid health and function. If you want a deeper dive into iodine’s role in fertility, thyroid health, reproductive health, and hormone balance, be sure to check out our earlier blog: Iodine and Women’s Health: What You Need to Know.

When it comes to pregnancy, iodine deserves special attention. It plays a key role in fetal brain and nervous system development, as well as in thyroid hormone production and regulation for both mom and baby.

The current RDAs in the U.S. are:

• 150 mcg/day for women of childbearing age who are not pregnant
• 220 mcg/day for pregnant women

Because iodine intake varies widely based on diet and food sourcing, it’s an especially important nutrient to confirm is included in your prenatal.

Vitamin D and Calcium

Calcium is essential for bone health, and during pregnancy, needs increase to support fetal skeletal development. At the same time, adequate calcium intake helps protect and maintain mom’s own calcium stores.

During breastfeeding, approximately 3–5% of a mother’s calcium stores can be depleted through breast milk production. While these losses haven’t been directly linked to an increased risk of osteoporosis later in life, ensuring adequate calcium intake before, during, and after pregnancy is still incredibly important.

One of the best ways to support calcium absorption? Vitamin D.

Vitamin D is a fat-soluble vitamin that plays a role in fetal immune system development, overall fetal growth, and—importantly—calcium absorption.

Without getting too deep into the weeds, the active form of vitamin D (calcitriol) helps activate receptors in the intestines that increase the production of calcium-transporting proteins. These proteins work together to improve calcium absorption into the bloodstream—essentially helping your body actually use the calcium you’re consuming.

Current RDAs in the U.S.:

• Calcium: 1000–1300 mg/day (pregnant and non-pregnant women)
• Vitamin D: 15 mcg/day (pregnant and non-pregnant women)

 
Many perinatal practitioners recommend higher levels of vitamin D for optimal lab levels.

So… which prenatal should I choose?

Understanding nutrient needs is one thing—actually choosing a prenatal is another. With so many options on the market, it’s no wonder this step feels overwhelming.

One important thing to know: many prenatals still rely on outdated RDAs that were originally based on research conducted in men’s bodies—not women’s, and certainly not pregnant women’s.

This is where Needed stands out.

Needed recognized this gap and created prenatals that are science-backed and designed with women’s unique needs in mind—especially during preconception, pregnancy, and postpartum, when nutrient demands are higher across the board.

Needed Prenatal Multi provides 5x more nutrition than outdated RDAs, helping better meet the increased nutrient demands of pregnancy.*

How does Needed compare to other prenatals?

Needed Prenatal Multi Essentials delivers *8x more nutrition than other leading prenatals on the market.
It includes 551 mcg of folate in the methylated form, to support healthy neural tube development and methylation..

And yes—it really is that good.

Needed prenatals are third-party tested, meaning an independent, unbiased organization verifies the safety, quality, and accuracy of all label claims. In short: what’s on the label is exactly what’s in the product.

Needed offers multiple prenatal options: capsules and a vanilla powder, so you can choose what works best for you. I used the vanilla powder during my first pregnancy when I simply couldn’t swallow any pills and it was such a game changer for me personally. 

You can easily purchase Needed prenatals directly through their website:
https://thisisneeded.com/products/prenatal-multi-essentials

Looking for More Support? 

Navigating prenatal nutrition—and figuring out how to best support both you and your baby—can feel confusing. You don’t have to do this alone.

Using every tool available to you, including personalized nutrition guidance and high-quality supplementation, is one of the simplest ways to support a healthy pregnancy. Our 1:1 coaching services are designed to be that extra layer of support—someone firmly in your corner.

Let’s do this together. Reach out today to begin your journey toward nourishing and supporting your growing life with expert guidance every step of the way.

---

This post is sponsored by Needed, a brand I genuinely recommend to my patients and personally use.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

*Based on the total daily dosage of nutrients provided compared to leading prenatals as determined by IRI sales data as of December 2025

Sources:
https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4933077/
https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
https://www.niams.nih.gov/health-topics/pregnancy-breastfeeding-and-bone-health

Written by: Lauren Chamberlain 

Edited and Reviewed By: Anabelle Clebaner MS, RDN 

Did you know that your gut health could impact more than just digestion? From immunity to mental clarity, a healthy gut plays a pivotal role in overall well-being—and even fertility. Emerging research suggests that a balanced gut microbiome influences hormone regulation, immune function, and inflammation, all of which are crucial for reproductive health. Whether you’re looking to optimize fertility or improve general health, supporting your gut can be a game-changer for both your body and mind.

The Basic Functions of the Gut

Before diving into the more intricate details of gut health, it’s essential to understand the basic functions of the gut and why it plays such a crucial role in your overall health.

1. Digestion

The gut is responsible for breaking down the food we eat, allowing nutrients to be absorbed into the bloodstream. This process starts in the mouth and continues through the stomach and small intestine. Enzymes and acids help break down food into smaller molecules for absorption.

2. Nutrient Absorption

Once food is broken down, the small intestine absorbs essential nutrients—like vitamins, minerals, and amino acids—into the bloodstream. These nutrients are then transported throughout the body to fuel our cells and organs.

3. Immune Function

A large portion of the body’s immune system resides in the gut. It acts as a barrier to harmful pathogens, such as bacteria and viruses. A healthy gut microbiome— the community of beneficial bacteria—supports immune function and helps protect the body from infections and inflammation.

4. Detoxification

The gut plays a vital role in detoxifying the body by processing and eliminating waste. The liver, bile, and gut work together to filter out toxins, which are then excreted through the stool. This process helps maintain a clean internal environment.

5. Hormone Regulation

The gut is involved in hormone production and regulation. It helps control hormones related to digestion, hunger, and metabolism. Additionally, the gut microbiome can influence hormonal balance, which is vital for reproductive health.

6. Gut-Brain Connection

The gut and brain communicate through the gut-brain axis, a direct link between the two. This connection influences mood, mental clarity, and stress levels. Research suggests that an imbalance in the gut microbiome can impact mental health conditions like anxiety and depression.

By understanding these basic functions, we can see why maintaining a healthy gut is essential for overall well-being and fertility. Now, let’s dive deeper into how to support these functions for optimal health.

Understanding Gut Permeability and Leaky Gut

Leaky gut occurs when the intestinal barrier becomes compromised, allowing undigested food particles, toxins, and microbes to enter the bloodstream. This process can trigger systemic inflammation and is implicated in conditions like autoimmune diseases, irritable bowel syndrome (IBS), and even neuroinflammation. The protein zonulin regulates tight junctions in the gut lining, and its overproduction is associated with increased gut permeability.

Dietary choices, stress, and environmental toxins all influence this delicate balance.

The Role of Diet in Gut Health

Diet plays a crucial role in shaping gut microbiota and maintaining a strong intestinal barrier. Research suggests that:

• High-fiber foods (e.g., fruits, vegetables, whole grains) support beneficial bacteria and help regulate gut permeability.
• Healthy fats, such as omega-3s, promote anti-inflammatory gut conditions, whereas excessive saturated fat intake can negatively impact gut flora.
• Akkermansia muciniphila, a beneficial bacterium, is linked to improved gut barrier function, reduced inflammation, and better metabolic health.
• Bovine colostrum supplementation has been shown to decrease intestinal permeability and lower zonulin levels, particularly in athletes.

Small Intestinal Bacterial Overgrowth (SIBO) and Gut Dysfunction

SIBO occurs when there’s an overgrowth of bacteria in the small intestine. This can lead to bloating, malabsorption, and digestive discomfort. It’s often associated with IBS, celiac disease, and metabolic syndrome.

Managing SIBO:

• Get proper testing to identify SIBO.
• Modify your diet, focusing on low FODMAP foods.
• Consider probiotics to restore balance.
• Work with a healthcare provider to determine if antibiotics are necessary.

Gut Health and Systemic Wellness

Emerging research highlights the gut-brain connection, linking gut health to cognitive function, mood regulation, and neurological diseases like Alzheimer’s. The gut microbiome also plays a role in cardiovascular health, obesity, and diabetes. Fecal microbiota transplants (FMT) have even been explored as potential treatments for age-related cognitive decline and metabolic disorders.

Gut Health and Fertility

Emerging research suggests that gut health plays a crucial role in reproductive health. The gut microbiome influences hormone regulation, immune function, and inflammation, all of which impact fertility outcomes. Dysbiosis, or an imbalance of gut bacteria, has been linked to conditions like polycystic ovary syndrome (PCOS), endometriosis, and unexplained infertility.

• Hormonal Balance: The gut microbiome helps regulate estrogen levels through the estrobolome, a collection of bacteria involved in estrogen metabolism. An imbalance can lead to estrogen dominance, which is associated with infertility and conditions like PCOS.
• Inflammation and Immune Function: Chronic inflammation, often driven by poor gut health, has been implicated in endometriosis and implantation failure. A healthy gut barrier helps regulate immune responses and supports a favorable reproductive environment.
• Microbiome and Pregnancy Outcomes: Research suggests that a balanced gut microbiome contributes to healthy pregnancy outcomes, reducing the risk of gestational diabetes, preeclampsia, and preterm birth.

Supporting Digestion

Efficient digestion breaks down food properly, allowing for optimal nutrient absorption and minimizing digestive distress.

Ways to enhance digestion include:

• Incorporating bitter foods: Foods like arugula, artichoke, bitter melon, dandelion greens, Brussels sprouts, coffee, and grapefruit stimulate stomach acid and bile production.
• Using digestive aids: Digestive enzymes, HCl supplements, apple cider vinegar, or digestive bitters may be beneficial.
• Relaxing at meals: Stress can negatively impact digestion, so mindful eating practices are essential.
• Consuming adequate minerals: Sodium (from sea salt) and zinc (from oysters and red meat) support stomach acid production.

Supporting Healthy Bile Flow

Bile is critical for fat digestion and detoxification. Signs of inadequate bile include bloating, floating stools, nausea after eating fats, and vitamin deficiencies. To support bile production:

• Consume fiber-rich foods: Legumes, beans, and avocados help bind to excess bile.
• Eat bitter foods: These naturally promote bile flow.
• Use cholagogue herbs: Globe artichoke, dandelion, burdock, and Oregon grape enhance bile movement.
• Ensure adequate taurine intake: Meat, fish, shellfish, and eggs aid in bile salt production.

Supporting Beneficial Bacteria

A balanced gut microbiome is essential for digestion, immunity, and gut barrier integrity. To nurture beneficial bacteria:

• Prioritize digestion first: Ensuring proper food breakdown is key before increasing fiber intake.
• Incorporate prebiotic foods: Apples, asparagus, garlic, onions, oats, and legumes serve as fuel for gut bacteria.
• Limit excessive alcohol intake: Alcohol can cause dysbiosis and inflammation.

Supporting Liver Detoxification

The liver plays a crucial role in gut health through bile production and detox processes. To support liver function:

• Include Phase 1 detox foods: Magnesium (leafy greens, avocado), B vitamins (liver, eggs, seafood), vitamin C (citrus, bell peppers), and zinc (oysters, beef).
• Incorporate Phase 2 detox foods: Glycine (bone broth), glutamine (beef, spinach), cysteine (broccoli, eggs), and taurine (meat, fish).

Strengthening the Gut Lining

A strong intestinal barrier prevents harmful substances from entering the bloodstream. Factors that contribute to a leaky gut include stress, poor digestion, processed foods, overuse of medications, and imbalanced gut bacteria. To support gut integrity:

• Limit inflammatory foods: Avoid heavily processed and inflammatory oils.
• Boost beneficial fibers: Prebiotic and resistant starch-rich foods enhance gut lining health.
• Consume gut-supportive nutrients: Glutamine (cabbage, fish), zinc (beef, crab), and colostrum aid in healing the gut lining.
• Use gut-healing herbs: Marshmallow root, slippery elm, aloe vera, and licorice can be beneficial.

Strengthening the Immune System

A well-functioning immune system relies on strong digestion and a balanced gut microbiome. Factors that deplete immunity include poor digestion, chronic stress, hormonal imbalances, and long-term medication use. To support immune health:

• Improve digestion and gut microbiome health
• Incorporate immune-boosting foods: Colostrum, mushrooms (reishi, shiitake), and vitamin C-rich foods (citrus, mango, papaya) support immune function.
• Use supportive herbs: Andrographis, elderberry, echinacea, and astragalus help strengthen immunity.

Prebiotics & Resistant Starch

Prebiotics are fibers that feed beneficial bacteria and help produce short-chain fatty acids, which support gut integrity and immunity.

• Prebiotic foods: Apples, asparagus, garlic, onions, oats, and legumes.
• Resistant starch sources: Cooked and cooled potatoes, green bananas, and legumes.

By focusing on these key areas, you can create a solid foundation for optimal gut health and overall well-being. Making small, sustainable changes to your diet and lifestyle can have lasting positive effects on digestion, immunity, and energy levels.

Conclusion

Maintaining gut health is essential for overall well-being, from digestion and immunity to mental clarity and chronic disease prevention. By making mindful dietary and lifestyle choices, you can support a resilient gut microbiome and improve long-term health outcomes. The science is clear: a healthy gut is a foundation for a thriving body and mind.

Sources 

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996528/ 
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305009/  
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313445/  
4. https://pubmed.ncbi.nlm.nih.gov/38790992/  
5. https://pubmed.ncbi.nlm.nih.gov/32023228/  
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058106/  
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8. https://pubmed.ncbi.nlm.nih.gov/25290618/  
9. https://pubmed.ncbi.nlm.nih.gov/35874661/  
10. https://pubmed.ncbi.nlm.nih.gov/34623232/  
11. https://www.imrpress.com/journal/FBL/26/5/10.52586/4921/htm  
12. https://www.nia.nih.gov/news/beyond-brain-gut-microbiome-and-alzheimers-disease  
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Written by: Lauren Chamberlain 
Edited and Reviewed By: Anabelle Clebaner MS, RDN 

Thinking about starting a family? Have you ever wondered what you can do before trying to conceive to boost your chances of a healthy pregnancy? Your fertility journey starts long before a positive pregnancy test. Preparing for pregnancy isn’t just about tracking ovulation and taking prenatal vitamins—it’s about optimizing your entire body for conception and a healthy pregnancy. Scientific research increasingly shows that preconception health plays a crucial role in reproductive success and fetal development. Here are five key areas you can’t afford to skip when getting ready to grow your family. 

1. Support Your Gut Health 

Your digestive system isn’t just about breaking down food—it’s a complex ecosystem that plays a central role in your overall health, including fertility. A healthy gut microbiome, which refers to the trillions of bacteria, fungi, and other microbes living in your digestive system, influences numerous physiological functions, from hormone regulation to immune function and even mood. 

The connection between gut health and fertility is emerging as an important area of study. Research increasingly shows that an imbalanced gut microbiome, also known as dysbiosis, can have a significant impact on fertility. When the gut microbiome is out of balance, it can lead to inflammation, hormonal imbalances, and poor nutrient absorption—all of which can affect your ability to conceive. 

The Gut Microbiome and Hormone Regulation 

A healthy gut microbiome is essential for maintaining hormonal balance, which is crucial for fertility. The gut bacteria help metabolize estrogens, which are important for regulating the menstrual cycle and maintaining a healthy ovulation pattern. Dysbiosis has been linked to estrogen dominance, which can interfere with ovulation and lead to conditions like polycystic ovary syndrome (PCOS), a common cause of infertility. 

The microbiome also plays a key role in detoxifying estrogen and other hormones, helping to prevent an overload of hormones that can disrupt your reproductive system. When the gut is not functioning optimally, it can lead to a build-up of excess estrogen in the body, a condition known as estrogen dominance, which can impact fertility and cause other reproductive health problems. 

Gut Health and Immune Function

In addition to influencing hormones, the gut microbiome also affects your immune system. Around 70% of the body’s immune cells reside in the gut, and the microbiome plays a vital role in maintaining immune balance. A healthy immune system is essential for fertility because an overactive or dysfunctional immune response can interfere with embryo implantation and fetal development. Chronic inflammation in the gut can trigger an autoimmune response, leading to complications in fertility and pregnancy. 

Studies have shown that women with autoimmune diseases, such as endometriosis or thyroid disorders, often have gut dysbiosis, which could be contributing to their fertility struggles. This means addressing gut health may also help reduce inflammation and autoimmune responses, creating a more favorable environment for conception and pregnancy. 

The Role of Diet in Gut Health

Your diet plays a crucial role in shaping your gut microbiome. The foods you eat provide fuel for your gut bacteria, and by choosing nutrient-dense, whole foods, you can encourage the growth of beneficial microbes that support both gut and reproductive health. 

To promote a healthy gut microbiome and support fertility: 

• Eat fiber-rich foods: A diet high in fruits, vegetables, whole grains, and legumes provides the necessary fiber to feed beneficial gut bacteria. Fiber acts as a prebiotic, helping to nourish the good bacteria in your gut that help regulate hormones and immune function. 
• Include fermented foods: Fermented foods such as yogurt, kefir, sauerkraut, kimchi, and kombucha contain probiotics, which are live beneficial bacteria that help restore balance to the gut microbiome. These foods support the growth of healthy bacteria, improve digestion, and reduce inflammation, all of which are essential for fertility. 
• Limit processed foods and sugar: Processed foods, refined sugars, and artificial sweeteners can encourage the growth of harmful bacteria in the gut, leading to an imbalance in the microbiome. This imbalance can contribute to inflammation and poor immune function, both of which can hinder fertility. 

Addressing Gut Dysbiosis for Fertility 

If you suspect that gut dysbiosis may be affecting your fertility, it’s important to work with a healthcare professional, such as a dietitian or functional medicine practitioner, to assess and address the issue. Common signs of dysbiosis include digestive symptoms like bloating, gas, constipation, diarrhea, and food intolerances. A professional can help guide you through dietary changes and supplements, such as probiotics or antimicrobial herbs, to support gut health and restore balance to your microbiome. Some studies have suggested that the use of probiotics and other gut-healing supplements may improve fertility outcomes, particularly in women with PCOS and other reproductive health conditions.  

By supporting your gut health, you’re not just promoting better digestion and immune function—you’re creating a favorable environment for fertility.  

Learn more about gut health and fertility 

2. Balance Blood Sugar 

Maintaining balanced blood sugar is crucial for overall health, especially when preparing for pregnancy. Blood sugar imbalances, such as insulin resistance and high blood glucose levels, can interfere with ovulation, hormone production, and overall fertility. In fact, managing blood sugar levels can be one of the most effective ways to optimize reproductive health and enhance fertility. Here’s why blood sugar balance matters and how you can achieve it. 

How Blood Sugar Affects Fertility 

Blood sugar imbalances, particularly insulin resistance, can have a significant impact on fertility. Insulin is a hormone that regulates blood sugar levels, and when the body becomes resistant to insulin, it needs to produce more of it to maintain normal blood glucose levels. High insulin levels can disrupt the balance of other hormones that regulate reproductive function, such as estrogen, progesterone, and testosterone. In addition to disrupting ovulation, high insulin levels can also impact the quality of the eggs and the ability to support a pregnancy.  

The Link Between Blood Sugar and Hormone Imbalance 

The relationship between blood sugar and hormone balance is intricate. Insulin not only regulates glucose levels but also interacts with other hormones like cortisol, leptin, and thyroid hormones, all of which play essential roles in fertility. High insulin levels can lead to an imbalance in these hormones, affecting reproductive function. 

For example: 

• Cortisol: Chronic stress and high blood sugar levels can elevate cortisol, a stress hormone that disrupts hormone production and reduces fertility. High cortisol levels can lead to irregular menstrual cycles and impair ovulation. 
• Leptin: Leptin is a hormone produced by fat cells that helps regulate appetite, metabolism, and reproductive function. Imbalances in leptin levels, often seen in individuals with insulin resistance, can interfere with ovulation and menstrual regularity. 
• Insulin resistance can also disrupt thyroid function, which is crucial for fertility. Studies have shown that insulin resistance can lead to hypothyroidism (low thyroid function), which can cause menstrual irregularities, poor egg quality, and difficulty getting pregnant. 

How to Balance Blood Sugar for Fertility 

Achieving and maintaining stable blood sugar levels is a key factor in preparing for pregnancy. Here are some practical steps you can take to balance your blood sugar: 

Prioritize Protein, Fiber, and Healthy Fats 

Including a balance of protein, fiber, and healthy fats at each meal can help stabilize blood sugar levels. These nutrients slow the absorption of glucose into the bloodstream, preventing spikes in blood sugar. Focus on lean protein sources (such as chicken, fish, tofu, and legumes), fiber-rich vegetables and whole grains, and healthy fats (like avocado, nuts, and olive oil). 

Minimize Refined Carbs and Sugar 

Refined carbohydrates (such as white bread, pasta, and baked goods) and sugary foods cause rapid spikes in blood sugar, followed by crashes that can lead to insulin resistance over time. Instead, opt for whole grains, vegetables, and fruits that release sugar more slowly into the bloodstream, providing a steady supply of energy. 

Regular Physical Activity 

Exercise, especially strength training, helps improve insulin sensitivity, meaning your body uses insulin more effectively to regulate blood sugar. Studies have shown that regular physical activity, including moderate aerobic exercise and strength training, can improve metabolic function and support healthy hormone levels, thereby enhancing fertility. 

Manage Stress 

Chronic stress can elevate cortisol levels, which in turn disrupt blood sugar regulation and fertility. Incorporating stress-management techniques such as deep breathing, meditation, yoga, or spending time in nature can help lower cortisol levels and improve overall hormonal balance. 

Consider Supplements 

Certain nutrients, such as magnesium, chromium, and omega-3 fatty acids, may help support healthy blood sugar metabolism. Magnesium, in particular, is important for insulin function, and research has shown that adequate magnesium levels are associated with better fertility outcomes. 

Managing blood sugar not only supports fertility but also helps set the stage for a healthy pregnancy by lowering the risk of complications like gestational diabetes. 

Explore blood sugar management strategies 

3. Detox Your Environment 

Endocrine-disrupting chemicals (EDCs), found in plastics, pesticides, pollution, and personal care products, can interfere with hormone balance and reproduction. Research shows that exposure to EDCs—such as BPA, phthalates, and pesticides—can affect fertility by disrupting hormone production and ovarian function.

The 4 P’s to Avoid: 

• Plastics: Opt for glass or stainless steel for food storage and drink containers to reduce exposure to BPA and phthalates, which have been linked to reduced ovarian reserve and lower sperm quality. 
• Pesticides: Choose organic produce when possible and thoroughly wash fruits and vegetables. Pesticides can disrupt estrogen and progesterone levels, hindering reproductive success. 
• Pollution: Use air purifiers and avoid high-traffic areas to minimize exposure to air pollution, which can lower fertility rates and increase miscarriage risk. 
• Personal Care Products: Swap conventional beauty, skincare, and cleaning products for non-toxic alternatives. Parabens and synthetic fragrances found in many products are linked to hormone disruption and reduced fertility. 

Reducing your exposure to these toxins can help protect your hormones and reproductive health. 

Learn more about reducing toxic exposure 

4. Optimize Sleep & Manage Stress 

Poor sleep and chronic stress can raise cortisol levels, negatively impacting reproductive hormones and fertility. Disrupted sleep patterns—such as waking up between 1-3 AM—may indicate liver detoxification issues, while difficulty staying asleep or waking up feeling unrested often correlates with low progesterone levels. Stress can lead to irregular cycles, making conception more difficult. 

Studies show that sleep disturbances and high stress levels can disrupt menstrual cycle regularity, reduce ovarian function, and even affect early pregnancy outcomes. 

To improve sleep and reduce stress: 

• Stick to a consistent sleep schedule, even on weekends. 
• Avoid blue light exposure from screens at least an hour before bed. 
• Create a calming nighttime routine—try magnesium, herbal teas, or journaling. 
• Get sunlight exposure in the morning to regulate circadian rhythms. 

Stress-reducing activities like meditation, breathwork, and yoga can support your fertility by lowering cortisol levels. 

5. Assess Your Partner’s Health 

Fertility is a team effort! Around 40% of infertility cases involve male factors, and sperm health plays a major role in conception. Changes in diet, lifestyle, and environmental exposure can improve sperm quality, motility, and count. Since sperm takes about 74 days to regenerate, it starts by making changes at least three months before conception. 

To support male fertility: 

• Nutrient-dense foods rich in zinc, selenium, omega-3 fatty acids, and antioxidants are essential for sperm health. Zinc and selenium, in particular, play critical roles in sperm formation and motility. 
• Limit alcohol and cannabis use, as both can reduce sperm concentration and motility. 
• Avoid excessive heat—hot tubs, saunas, and even laptops on laps can lower sperm count. The testes require a cooler temperature for optimal sperm production. 
• Reduce stress—high cortisol levels can lower testosterone and sperm quality. 

The father’s lifestyle before conception can influence the baby’s long-term health through epigenetic changes, which may affect gene expression in both parents. 

Learn more about understanding cortisol  

The Bottom Line 

Prepping for pregnancy isn’t just about waiting for a positive test—it’s about creating the healthiest possible environment for conception and beyond. By addressing gut health, blood sugar balance, environmental toxins, sleep, and both partners’ health, you’re laying the groundwork for a smoother fertility journey. Small, intentional choices today can make a big difference tomorrow. Take control of your health today! 

Start your journey to optimal fertility 

Sources  

https://pmc.ncbi.nlm.nih.gov/articles/PMC9603966

https://pmc.ncbi.nlm.nih.gov/articles/PMC5052775

https://www.sciencedirect.com/science/article/pii/S245196502030079X

https://www.cdc.gov/genomics-and-health/epigenetics/index.html

https://pmc.ncbi.nlm.nih.gov/articles/PMC6075697/#:~:text=Cohort%20studies%20have%20suggested%20that,pregnancy%20%5B48%E2%80%9350%5D%20and

https://www.hopkinsmedicine.org/health/wellness-and-prevention/planning-a-pregnancy

https://pmc.ncbi.nlm.nih.gov/articles/PMC6075697

https://pmc.ncbi.nlm.nih.gov/articles/PMC4145858

https://pmc.ncbi.nlm.nih.gov/articles/PMC10965710

https://pmc.ncbi.nlm.nih.gov/articles/PMC11287620

By: Anabelle Harari Clebaner MS, RDN

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Diet impacts everything

Want to boost fertility? 🌟 Start with what’s on your plate. Yep, your diet can make a HUGE difference.

When it comes to fertility, adequate nutrition plays a pivotal role. The right nutrients can significantly influence your reproductive health, improving your chances of conception and a healthy pregnancy.

As a fertility dietitian, I know firsthand just how much nutrition makes an impact on your reproductive health, after working with hundreds of women in my private practice, Wellspring Nutrition.

Think of it this way – you have three opportunities every single day to make a healthy choice that nourishes your body for fertility and pregnancy.

So let’s get right into it – here are 5 foods you can start to incorporate or increase in your diet to start to see positive changes in your fertility.

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Leafy greens: The superstars 🌿

Spinach, kale, and their leafy friends are packed with folate, iron, and antioxidants.

Folate is essential for: DNA synthesis and repair, embryonic development, and preventing neural tube defects.

Folic acid is crucial for both men and women. For women, it helps create a healthy environment for egg fertilization and early embryonic growth. For men, it supports healthy sperm production.

Iron is essential for: Hemoglobin production and oxygen transport.

Adequate iron levels prevent anemia, which can affect ovulation and overall energy levels, making your body more conducive to conception.

These nutrients are your fertility BFFs. Add them to salads, smoothies, or soups. Easy peasy!

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Fatty fish: Omega-3 magic 🐟

We can’t have a conversation about Omega-3 fats without also talking about Omega-6 fats.

Both Omega-3 and Omega-6 fatty acids are essential polyunsaturated fats, meaning your body cannot produce them, and they must be obtained through your diet. Despite being in the same family of fats, they have different roles and effects on the body. 

The three most important types are:

 – **EPA (Eicosapentaenoic Acid)**: Found in fatty fish such as salmon, mackerel, and sardines. – **DHA (Docosahexaenoic Acid)**: Also found in fatty fish and is a crucial component of brain and eye health. 

– **ALA (Alpha-Linolenic Acid)**: Found in plant sources like flaxseeds, chia seeds, and walnuts. 

ALA can be converted to EPA and DHA in the body, but this process is relatively inefficient.

Health Benefits

**Anti-Inflammatory**: Omega-3s help reduce inflammation in the body, which can lower the risk of chronic diseases such as heart disease and arthritis. – **Cardiovascular Health**: They are known for their heart-protective effects, reducing blood pressure, and improving cholesterol levels. – **Mental Health**: Omega-3s play a crucial role in brain health and have been linked to reduced symptoms of depression and anxiety. – **Fertility**: As mentioned earlier, they improve egg quality, regulate ovulation, and reduce the risk of endometriosis.

Omega-6 Fatty Acids

Types

The most common type is: – **LA (Linoleic Acid)**: Found in vegetable oils like sunflower, soybean, and corn oil. – **AA (Arachidonic Acid)**: Found in meat and eggs; it is derived from LA. – **GLA (Gamma-Linolenic Acid)**: Found in evening primrose oil and blackcurrant seed oil; it’s a less common omega-6.

Health Benefits

**Pro-Inflammatory and Anti-Inflammatory**: Omega-6 fats can produce both pro-inflammatory and anti-inflammatory compounds. The body’s balance of omega-6 to omega-3 determines the effect. – **Skin Health**: Omega-6 fatty acids can help support skin barrier function and hydration. – **Growth and Development**: Essential for normal growth and brain function, particularly in children.

Key Differences

**Balance and Ratio** – **Ideal Ratio**: Historically, humans consumed Omega-3 and Omega-6 fats in a balanced ratio of about 1:1 to 1:4. However, modern diets tend to have a ratio closer to 1:20 or 1:30, significantly skewed towards Omega-6, leading to an imbalance.

**Health Impact**: An imbalanced ratio (high in Omega-6 and low in Omega-3) can promote inflammation and contribute to chronic diseases. Ensuring an adequate intake of Omega-3s while reducing excessive Omega-6s can optimize health.

Sources

**Omega-3s**: Primarily found in fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, walnuts, and algae.

**Omega-6s**: Found mostly in vegetable oils, nuts, seeds, and processed foods. They are more prevalent in the typical Western diet.

While both Omega-3 and Omega-6 fatty acids are essential for health, maintaining a proper balance between them is crucial. Increasing your Omega-3 intake and being mindful of Omega-6 consumption can help in achieving better overall health and reducing the risk of chronic diseases.

Omega-3 Fatty Acids are Essential for: Reducing inflammation, hormone production, and cell membrane function.

Omega-3 fatty acids are known to improve egg quality, regulate ovulation, and reduce the risk of endometriosis. For men, they improve sperm quality and mobility.

So where do you find Omega-3 fatty acids? Salmon, mackerel, and sardines are where it’s at. These fatty fish are fertility wonders. Grill ’em, bake ’em, or toss ’em in a salad. Your future self will thank you.

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Nuts and seeds: Tiny powerhouses 🥜

Pumpkin seeds, walnuts, and almonds are considered tiny powerhouses because they are bursting with zinc and selenium. When it comes to fertility, both zinc and selenium play critical roles in ensuring optimal reproductive health. These essential trace minerals are involved in numerous bodily functions, specifically those related to reproductive health for both men and women.

Zinc

Zinc is vital for:

• Hormone Regulation: Zinc helps in regulating hormone levels, particularly testosterone in men and estrogen and progesterone in women. Balanced hormone levels are crucial for a healthy reproductive system.
• Sperm Production and Quality: In men, zinc is essential for spermatogenesis, the process of sperm production. It also enhances sperm motility and morphology, crucial factors for successful fertilization.
• Ovulation: For women, zinc supports the maturation of eggs and ensures regular ovulation, which is essential for conception.
• DNA Synthesis: Zinc is involved in DNA synthesis and cell division, processes that are fundamental during the early stages of fetal development once conception occurs.

Selenium

Selenium contributes to fertility by:

• Antioxidant Support: Selenium acts as a powerful antioxidant, protecting reproductive cells from oxidative stress, which can damage sperm and eggs.
• Thyroid Function: Proper thyroid function, supported by selenium, is crucial for fertility. The thyroid gland regulates many metabolic processes, including those that affect reproductive health.
• Sperm Quality: In men, selenium is essential for the formation and motility of sperm. It helps in maintaining the integrity and function of sperm cells.
• Development: Selenium plays a role in the early stages of embryo development by ensuring proper DNA synthesis and protecting against cellular damage.

Snack on them, throw them in your oatmeal, or mix them in a trail mix – there’s no way to go wrong here! And if you want to learn more about seed cycling, check out this blog right here.

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Berries: Antioxidant champs 🍓

Blueberries, strawberries, and raspberries are loaded with antioxidants. These little champs keep your reproductive system in top shape. Enjoy them fresh, frozen, or in a smoothie. Yum!

Antioxidants are compounds that help protect the body from oxidative stress, which is caused by an excess of free radicals—unstable molecules that can damage cells.

 Free radicals are naturally produced during metabolism, but environmental factors like pollution, UV exposure, and poor diet can increase their levels.

Berries Images – Free Download on Freepik

Importance of Antioxidants for Fertility

1. **Protecting Reproductive Cells**: Antioxidants help neutralize free radicals, reducing oxidative stress on reproductive cells like sperm and eggs. This protection is crucial for maintaining the health and viability of these cells.

2. **Improving Egg Quality**: Oxidative stress can negatively affect egg quality, leading to issues like chromosomal abnormalities. Antioxidants can improve the quality and viability of eggs by reducing this stress.

3. **Enhancing Sperm Health**: In men, antioxidants play a vital role in protecting sperm from oxidative damage, which can affect sperm count, motility, and overall fertility.

4. **Supporting Hormonal Balance**: Certain antioxidants, like vitamin E and Coenzyme Q10, are involved in hormone production and regulation, which is essential for fertility.

5. **Reducing Inflammation**: Antioxidants like vitamin C, E, and selenium have anti-inflammatory properties, which can help reduce inflammation in the reproductive organs, supporting overall fertility.

Including a variety of antioxidant-rich foods like berries, nuts, seeds, leafy greens, and colorful vegetables can be beneficial for those looking to optimize their fertility.

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Eggs: The complete package 🍳

Eggs—especially organic, free-range ones—are amazing. They’re packed with choline and protein, both super important for fertility. Scramble them, poach them, or make a frittata. So versatile!

Eggs are an excellent food for fertility, and one of the key reasons is their high content of choline, an essential nutrient that plays a significant role in reproductive health.

Eggs Pictures [HD] | Download Free Images on Unsplash

Choline and Fertility

1. **Cell Membrane Formation**: Choline is crucial for the formation and maintenance of cell membranes. This is particularly important during pregnancy, as it supports the development of the baby’s brain and nervous system. In the context of fertility, choline ensures the health and integrity of reproductive cells, such as eggs and sperm.

2. **Gene Expression**: Choline is involved in methylation, a process that regulates gene expression. Proper methylation is essential for DNA synthesis and repair, which is vital for healthy cell division and the development of a viable embryo.

3. **Reducing Neural Tube Defects**: Adequate choline intake during pregnancy is associated with a lower risk of neural tube defects in the developing baby. For those trying to conceive, ensuring sufficient choline intake can help prepare the body for a healthy pregnancy.

4. **Supporting Hormone Production**: Choline is a precursor to acetylcholine, a neurotransmitter that plays a role in muscle control and memory but also supports hormone production and regulation. Balanced hormone levels are crucial for ovulation and overall reproductive health.

Other Nutrients in Eggs

In addition to choline, eggs are packed with other nutrients that support fertility:

– **Protein**: Eggs are an excellent source of high-quality protein, essential for the growth and repair of tissues, including reproductive tissues.

– **Healthy Fats**: The healthy fats in eggs, including omega-3 fatty acids, support hormone production and reduce inflammation.

– **Vitamins and Minerals**: Eggs are rich in vitamins like B12, D, and A, as well as minerals like selenium and zinc, all of which play important roles in reproductive health.

Practical Tips

– **Whole Eggs**: Most of the choline in eggs is found in the yolk, so it’s important to consume whole eggs rather than just egg whites.

– **Balanced Diet**: Including eggs as part of a balanced diet can provide a variety of essential nutrients that collectively support fertility. Pairing eggs with other fertility-boosting foods like leafy greens, avocados, and whole grains can further enhance their benefits.

Incorporating eggs into your diet, especially for those looking to boost fertility, is a simple and effective way to ensure you’re getting enough choline and other vital nutrients.

Conclusion: Make it a habit

So, there you have it—the top 15 fertility-boosting foods – phew! That was a lot. Start adding these to your daily meals to reap all the benefits!

And if you’re looking for a super easy way to incorporate these foods, and so many others that are vital for fertility, check out my four-week fertility meal plan.

It was designed to take all of the nutrients important for fertility and translate it into delicious, healthy, and simple recipes to naturally nourish your fertility.

Whether you’re planning your next IUI cycle or are just getting started on your preconception journey, investing in your health is always worth it!

CHECK OUT THE WELLSPRING FERTILITY MEAL PLAN RIGHT HERE

If you are currently pregnant, the journey of sustaining a whole other life in your body probably feels like an extraordinary experience but at the same time, a great deal of responsibility ( in a positive way of course! ) 

Although there are many aspects relating to the healthy growth and development of the fetus that are beyond our control, one of the main factors that we do have control over is our lifestyle choices- namely our diet. 

There are a handful of nutrients that you do not want to be missing out on during your pregnancy to ensure the best possible health outcome for your baby. These include choline, iron, calcium, Vitamin D, iodine, and folate to name a few. 

If you recently found out that you are pregnant or are planning on conceiving, you are in luck! Today, Wellspring Nutrition is specifically going to highlight the importance of folate, and how this nutrient can be a powerful ally for preventing a common type of birth defect- the neural tube defect.     

What is a Neural Tube Defect?

Neural tube defect is a birth defect that affects the central nervous system of the baby. In a developing embryo, the neural tube is the precursor to their brain and the spinal cord. Neural tube defect occurs when the neural tube does not properly go through the closure process to complete its formation. The two common types of neural tube defect include: 

• Spina bifida (swelling or protrusion of spinal cord or fluid in the back) 
• Anencephaly (exclusion of a major segment of the brain) 

What is folate?

Folate, otherwise known as vitamin B-9, is found in various foods. As they play an important role in the nucleic acid (DNA and RNA) production and amino acid (the building blocks of protein) metabolism, they are crucial to the functioning of cells.    

Folic acid is its synthetic form- meaning folate that is found in dietary supplements and fortified foods. 

Why folate is important

The need for folate significantly increases during pregnancy especially because the event of a neural tube defect is closely linked to maternal folate deficiency. Inadequate folate intake can lead to a high homocysteine level in the blood, which is considered to be a risk factor for neural tube defect. Homocysteine is an amino acid and as it is broken down by the vitamin B-complexes, having a high level of this usually indicates deficiency in vitamins. 

According to a recent study, another risk factor for neural tube development is the lack of DNA repair function. Since folate is crucial to DNA synthesis, folate deficiency can lead to a loss in the integrity of DNA. Thus, the mechanism for DNA repair is going to be negatively impacted. Genome stability is an important aspect of neural development for the embryo, and adequate folate intake is necessary for a properly functioning DNA repair mechanism. 

The timing of sufficient folate intake is important to consider. Neural tube formation of an embryo is completed around three to four weeks after conception. This means that anyone trying to conceive should ideally start incorporating folate in their diet as soon as possible, even if pregnancy is yet to be confirmed. 

Even if you are reading this much further into your pregnancy, there are still reasons to consume an adequate amount of folate.  

Other than lowering the risks of neural tube defects, research shows that sufficient folate intake during pregnancy is beneficial for the neurodevelopment of the child. There is a study that links prenatal folic acid supplementation to a lowering of the risk of Autism Spectrum Disorder (ASD), and advancements to the cognitive, motor and intellectual functions of the child.     

What food should I eat for folate?

Although the general recommendation is about 400 micrograms a day, pregnant women are advised to consume about 600 micrograms of folate every day.   

Here are some food items that are good sources of folate to help meet this target:

• Beef Liver 
• Spinach
• Black-eyed peas
• Chickpeas 
• Asparagus
• Brussel sprouts
• Romaine Lettuce
• Broccoli
• Eggs

As you can see, leafy greens, legumes, and liver are the best sources.  

Moreover, it is important to note that folate tends to be sensitive to heat and oxygen.  Especially for the leafy greens, it is advised to eat them fresh or have them lightly cooked. In a study that compared the folate retention for different food products, for spinach, boiling led to only 49 percent retention of folate. On the other hand, steaming proved to be the best way to preserve folate in vegetables. Another good news is that the same study found that grilling beef for an extended period of time did not result in much loss of folate as well. 

Other than foods naturally present with folate, consuming grain products may be helpful as well. This is because starting in 1998, the U.S Food and Drug Administration (FDA) mandated a folate fortification of grain products such as bread, rice, cereal, flour, and pasta.

However, consumption of refined grain products should be limited during pregnancy to prevent significant spikes in your blood sugar levels.  

Looking for more support? 

Our fertility dietician Anabelle is available for one-on-one consultation and can help you address any of your concerns regarding fertility, pregnancy or hormonal imbalances like PCOS! 

References

1. “Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt.” https://fdc.nal.usda.gov/fdc-app.html#/food-details/173757/nutrients

2. “Embryology, Neural Tube.”  https://www.ncbi.nlm.nih.gov/books/NBK542285/

3. “Folate.” https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

4. “Folate and Folic Acid on the Nutrition and Supplement Facts Labels.”https://www.fda.gov/food/new-nutrition-facts-label/folate-and-folic-acid-nutrition-and-supplement-facts-labels#:~:text=For%20folate%2C%20the%20DV%20is,consume%20500%20mcg%20DFE%20daily.

5. Gao Y, Sheng C, Xie RH, Sun W, Asztalos E, Moddemann D, Zwaigenbaum L, Walker M, Wen SW. “New Perspective on Impact of Folic Acid Supplementation during Pregnancy on Neurodevelopment/Autism in the Offspring Children – A Systematic Review”PLoS One. 2016 Nov 22;11(11):e0165626. doi: 10.1371/journal.pone.0165626. eCollection 2016.PMID: 27875541 PMCID: PMC5119728 https://pubmed.ncbi.nlm.nih.gov/27875541/

6. “Homocysteine” https://my.clevelandclinic.org/health/articles/21527-homocysteine

7. McKillop DJ, Pentieva K, Daly D, McPartlin JM, Hughes J, Strain JJ, Scott JM, McNulty H.“The effect of different cooking methods on folate retention in various foods that are amongst the major contributors to folate intake in the UK diet.” Br J Nutr. 2002 Dec;88(6):681-8. doi: 10.1079/BJN2002733. PMID: 12493090 https://pubmed.ncbi.nlm.nih.gov/12493090/

8. “Pregnancy diet: Focus on these essential nutrients.”https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082

9. Smith A, Colleen A, Spees C. “Wardlaw’s Contemporary Nutrition, 12th Edition.” McGraw Hill, 2022. 

10. Wang X, Yu J, Wang J.“Neural Tube Defects and Folate Deficiency: Is DNA Repair Defective?” Int J Mol Sci. 2023 Jan 22;24(3):2220. doi:10.3390/ijms24032220. PMID: 36768542 PMCID: PMC9916799 https://pubmed.ncbi.nlm.nih.gov/36768542/