If you want to have a healthy baby, it may not be enough to just pop a folic acid tablet in the three months leading up to conception and then abstain from booze, coffee, soft cheeses and processed foods during your pregnancy.
A series of three new studies, published in The Lancet today, shows that the diet and weight of both parents in the years prior to conception – not just a few months before – could impact the long-term health of a child.
Even though three months is the average time it takes for fertile couples to become pregnant, the authors say it takes most people much longer than that to make serious long-term changes to their health, lifestyle and diet.
Study co-author and Professor of Life Course Epidemiology at University of Queensland (UQ), Gita Mishra, explains it may take months or years to lose weight and reverse obesity status.
“We need to consider the time taken to reach health or lifestyle objectives well before conception,” says Prof Mishra, deputy head of UQ’s School of Public Health.
“For instance, taking folic acid tablets is a relatively easy step to take, once women have the knowledge and means to do this, whereas reaching a healthy body weight may require a far longer period over months or years.
“We need to consider the time taken to reach health or lifestyle objectives well before conception."
“Some pregnancies will always be unplanned, which underlines the need for action to improve diet and health behaviours at population level – irrespective of pregnancy planning – and particularly during adolescence when young women often adopt unhealthy behaviours.”
The international research also takes the pre-pregnancy health spotlight off just the mother and shines it on both parents over the long-term.
“The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring,” one of the studies reads.
“Since not all pregnancies are planned, it is best to adopt a healthy lifestyle as early as possible.”
Prof Mishra says although it’s unknown whether a father’s diet and health is equally influential on a child’s development as the mother’s, paternal health before conception – in particular paternal weight – could still affect an unborn child’s future health.
“A father’s obesity has been shown to associated with impaired fertility and has been shown be linked with increased risk of chronic disease in offspring,” Prof Mishra says.
The authors have called for greater attention to be paid to the fertility health of both men and women, well before pregnancy occurs. They even go so far to suggest that preconception health could be promoted in the teen years.
“I think that everyone should be encourage to adopt a healthy lifestyle during adolescence – since this is a time when poor health behaviours are adopted,” says Prof Mishra. “Since not all pregnancies are planned, it is best to adopt a healthy lifestyle as early as possible.”
The authors calculated the proportion of women of reproductive age (18-42 years old) in the UK who were nutritionally prepared for pregnancy, using data from 509 women of reproductive age in the UK National Diet and Nutrition Survey.
They estimated that many UK women are not nutritionally prepared for pregnancy.
Around 96 per cent of women of reproductive age had iron and folate dietary intakes below the recommendation for pregnancy (14.8mg per day, and 400µg per day, respectively).
Taking this into account, the series authors redefine the preconception period biologically – as the days to weeks before and after fertilisation; individually – as the weeks or months when a woman or couple decides to have a child; and at a public health level – as the months or years needed to address preconception risk factors, such as diet and obesity, before pregnancy.
Around 96 per cent of women of reproductive age had iron and folate dietary intakes below the recommendation for pregnancy.
Maternal obesity is also thought to increase levels of inflammation, hormones and metabolites, which may directly alter the development of the egg and embryo to increase the risk of chronic disease in later life.
Evidence suggests that smoking, high alcohol and caffeine intake, diet, obesity and malnutrition potentially cause genetic, cellular, metabolic and physiological changes during the development of an unborn baby.
The research suggests these dietary measures may have lasting consequences into adulthood and increase the child’s lifelong risk of cardiovascular, metabolic, immune, and neurological diseases.