Optimizing Preconception Health Through Nutrition

Vicki Kobliner, MS RDN, CD-N, discusses steps for optimizing preconception health through good nutrition and healthy environments. She discusses the US healthcare systems and statistics and asserts that, although the numbers can be scary, taking preventive action is often simple. The speaker outlines steps for personal health risk assessment and self-advocacy with family and healthcare providers. Kobliner discusses aspects of a nutritious diet and best practices for protein and produce consumption. She considers environmental exposure to chemicals and pesticides and provides alternatives for household products and foods. The presenter highlights the need to “keep it simple” and summarizes the healthy baby road map before the Q & A. 

In this webinar: 

1:10 – Introduction and disclaimer
2:16 – Healthy Baby Roadmap and presentation goals
4:04 – US health statistics
7:00 – Study – Folate deficiencies and risk of autism
8:08 – Study – Maternal diet and fetal microbiome
8:45 – Placental microbiome
9:22 – Study – Toxins and chemical and umbilical blood
10:45 – Study – Body burden of chemical exposure
11:35 – State of women’s health care in the US
13:22 – Assessment and action steps for a healthy baby road map
16:40 – Health history and clues to look for
20:00 – Medications and supplements
21:50 – Study – Acid-suppressive drugs and childhood asthma
22:37 – Gut health during pregnancy
23:59 – MTHFR gene (Methylenetetrahydrofolate reductase)
25:35 – Genotypes for CT variant of MTHFR
26:38 – Testing
27:30 – What matters for nutrition
28:10 – Proteins, produce, and fats
32:11 – Dirty Dozen and Clean Fifteen
32:58 – Water
33:34 – Priority preconception nutrients
34:26 – Omega 3s, Vitamin D, and Choline
38:07 – Inflammatory triggers
38:41 – Study – Maternal inflammation and chronic illness risk
39:29 – Pitch the parabens, toxic bedding, and kitchen storage
42:11 – Cleaning supplies and air filters
43:40 – Reducing stress
44:37 – Steps for advocacy
45:40 – How to keep it simple
46:23 – Q & A

Background and introduction

Kobliner defines the healthy baby road map (2:16) with reference to preconception planning for chronic illness risk reduction (1:10). She explains that 38% of children in the US have one or more chronic illnesses and that more than one in five kids have a mental, emotional, developmental, or behavioral problem (4:04). The presenter outlines studies investigating folate deficiencies and risk of autism (7:00), maternal diets and infant gut microbiota (8:08), and the levels of toxins and chemicals present in umbilical cord blood after birth (9:22). Kobliner discusses body burden and explains the different effects of chemical exposure on a mother (150 – 200 pounds) and a fetus (one pound) (10:45). The presenter details how women are treated within current US medical systems (11:35) and asserts that “women need facts so they can be empowered to make the choices that align with their pregnancy goals” (13:00). This knowledge, she continues, must be acquired via personal research (13:22) and discussions with family and health care providers (16:05).

Assessing and planning for risks

Health history information, like genetics, supplements, and family and personal medical history, is vital for understanding what risks to consider (16:40). The speaker discusses critical factors and clues in medical histories (17:50) and suggests investigating the sources and intake amount of essential vitamins and nutrients in one’s diet (20:00). Kobliner discusses birth control and vitamin B (21:40) and summarizes the first study that significantly associated acid-suppressive drugs and the risk of childhood asthma (21:50). The speaker demonstrates how changes to gut microbiota during pregnancy often lead to increased lactic acid and have been linked to an elevated risk of gestational diabetes, autoimmune diseases, and preterm pregnancy (22:37). 

The MTHFR gene (Methylenetetrahydrofolate reductase) is integral to the body’s ability to process folate, which is necessary for producing DNA and modifying proteins (basis of fetal development) (23:59). Kobliner details the difference between active folate and folic acid (synthetic), noting that children may inherit folate mutations (24:45). She outlines potential genotype mapping for the MTHFR CT variants and underscores that such mutations do not indicate disease but mean that the body needs support for normal folate processing (25:35). To investigate potential risks further, the speaker advises asking one’s doctor to test levels of various vitamins and thyroid panels and conduct a comprehensive digestive stool analysis before conception (26:38). 

What matters for nutrition

Kobliner dives into aspects of a quality diet (27:30) and discusses differences in protein sourced conventionally, organically, and pasture-fed (28:10), noting that truly grass-fed animals are the most nourishing. She considers pesticides in produce and stresses their correlation with developmental disabilities (30:06). The Environmental Working Group’s annual Dirty Dozen and Clean Fifteen is a good reference for understanding which produce is safe to purchase conventionally and which is not, based on known pesticide levels (32:11). Kobliner provides sources and ideas for buying affordable pasture-fed protein and clean produce. The speaker gives examples of inflammatory and anti-inflammatory fats and highlights the need to consume the correct type (not avoiding fats) and add lacto-fermented foods to one’s diet (31:18). She also suggests using a good water filter as water generally lacks minerals and contains chlorine, fluoride, pesticides, antibiotics, and BPA which seeps from plastic bottles as well (32:58). 

The speaker lists priority preconception nutrients (33:34), underscoring Omega 3s as “hands down the most important thing to do to support preconception and periconception health” (34:26). Kobliner explains that up to 60% of the US population is vitamin D deficient as the recommended levels, between 30 and 70, are insufficient to support optimal health and should be between 50 and 75 (35:30). Choline, she continues, is under-appreciated for its effect on neurological health and is often chronically deficient in women (37:06). The presenter reminds viewers that such deficiencies are generally an easy fix as long as one is aware of one’s risks and needs. 

Lifestyle and body burdens

Maternal inflammation has been linked to autism, asthma, obesity, tics/OCD, gestational and childhood diabetes (38:41). Kobliner notes that common inflammatory triggers include sugar, processed foods, and stress (38:07). To reduce bodily stress and burden, it is vital to account for toxins present in one’s environment and lifestyle (38:52). The speaker advises viewers to “pitch the parabens” as they can disrupt hormones and interfere with fertility and reproductive health and increase cancer risk (39:29). She lists bedding and furniture labels that indicate they are free of toxins associated with neurobehavior, reproductive health, and cancer (40:29). The speaker suggests using steel or glass containers, parchment paper, and silicone bags for kitchen storage, instead of plastics (and soft plastics) which are known endocrine disruptors with links to cancer, diabetes, and fertility issues (41:30). Household cleaning supplies are high in chemicals and toxins, but most can be replaced with a mix of vinegar, lemon juice, baking soda, and water (42:11). Kobliner suggests indoor plants and filters for cleaner air (42:55) and highlights reducing stress as a necessity that should be done however and whenever one can (43:40). 

Advocacy and moving forward

Kobliner lays out four steps to successful self-advocacy in conversations with family and healthcare providers (44:37): 

1. Do your research
2. Ask a lot of questions
3. Use a decision tree
   1. H: Healthiest option for me and my baby
   2. B: Best choice and possible alternatives
   3. R: Risk involved in my choice
4. Show evidence

The speaker gives examples for each step and reminds viewers to keep it simple. She suggests starting with the “low-hanging fruit” (easiest thing to accomplish) and asserts that progress will grow from there, one day at a time. Kobliner reviews the health baby road map before opening the Q & A.