Preconception is the time before pregnancy, while prenatal is the time before birth. Prenatal health measures are commonly discussed in health care. National healthcare recommendations often include healthy eating, avoiding cigarettes and alcohol, avoiding raw meats and fish, having enough folic acid, adding a prenatal vitamin, among others . Generally, individuals will start to adjust to healthier practices once they find out they are pregnant, but let’s discuss why it might be important to start even sooner.
Our bodies regularly depend on our dietary intake to thrive and survive. In pregnancy, the demands are increased to accommodate the developing baby. Pregnant women are encouraged to increase caloric intake, protein levels, healthy fats like omega-3 fatty acids, and to take a prenatal vitamin to provide the foundation of the micronutrients required . These essential micronutrients include folic acid/folate, calcium, vitamin D, iron, vitamin A, iodine, zinc and many more [2, 3]. Several of these can be found in a multivitamin, however, the main difference between a prenatal vitamin and a multivitamin is the amount of folic acid contained in each. Folic acid is important for ensuring proper cell division in the body; however it is also essential for the healthy formation of the neural tube which will form the brain and spine . Additionally, supplying folic acid in the preconception period may decrease the risk of miscarriage, low birth weight, small for gestational age, and stillbirth . But remember, the mother and the developing baby can only use what ingredients are provided by dietary and supplemental intake.
To create an analogy, think of these nutrients as currency. When we have eaten, we are flush with the nutrient “cash” we have absorbed. This is spent on the body’s needs, some gets lost in “processing fees” needed for breakdown and absorption, and any leftover that can be saved will be stored. Some things are stored better than others. Fat soluble ingredients will get stored in fat cells, while some water soluble nutrients will be flushed out with the urine . In pregnancy, the baby gets “paid” first, as nutrients will support the baby first. The remaining nutrients will be spent on the mother’s bodily needs. If there is anything to spare, it will be stored. The body will prioritize the needs of the growing baby above all, even if mild deficiencies are present, though this can cause health impacts on the child.
It is also important to remember that from the moment the baby starts growing, they need an abundance of nutrients. The mother’s nutritional status and storage will be essential for the growth and development. This is why it’s important not only to have a regular influx of proteins, vitamins, minerals and healthy fats, but to have a good baseline nutrient status before you become pregnant.
Health Canada estimates that half of pregnancies are unplanned . They also found that a percentage of Canadians don’t meet their daily nutrition minimums with their eating styles . As a result of common nutrient deficiencies across the country, in the 1960’s to 1970’s the Food and Drug Relations mandated the fortification of some foods with vitamins . For example, breads and cereals must be fortified with folic acid and some B vitamins and minerals, milk is fortified with vitamin D, and fruit-flavoured drinks with vitamin C .
Because of this, the incidence of neural tube defects decreased in numbers overtime . However, deficiencies are still possible for a variety of nutrients. The last Health Canada nutrient survey found that up to 35% of Canadians don’t meet their daily nutrient needs for folate, vitamin B6, and zinc . And up to 19% of Canadian women of childbearing age consumed inadequate amounts of iron .
This can be a problem if an under-nourished woman becomes pregnant, and doesn’t know it yet. It may take several weeks until a missed period is identified, a test has established the pregnancy, and any action is taken. In these cases, the developing baby is relying on whatever the mother-to-be is eating or has eaten and unfortunately, if these macro and micronutrient deficiencies aren’t corrected during the pregnancy it can lead to low birth weight, small for gestational age or stillborn .
It’s never too late to start incorporating healthy nutritional habits. And remember that there are many more factors that influence the health of the mother-to-be. Particular considerations include maintaining a healthy weight, exercising, regulating chronic disease, avoiding environmental toxicants, supporting mood, among others [1, 4]. On a positive note, your nutritional health can play a supportive role in the management of all of these things.The bottom line is there are many important aspects to address before you begin your pregnancy journey. Talk to your doctor, naturopathic doctor, or other health care practitioner about your plan for pregnancy.