HOSPITAL BASED NUTRITION

PRACTICE

SUBMITTED TO: MISS SIDRA ATEEQ

TOPIC: NUTRITION IN FERTALITY
GROUP MEMBERS

Zainab khan DDNS02153104

Mahnoor Murtaza DDNS02153127
Rushna mubarik DDNS02153145
Fizza DDNS021531
CONTENTS

• Introduction
• BMI, Body fat & fertility
• Nutrition prior to pregnancy
• Vitamins & minerals role in pregnancy
• Effects of antioxidants on fertility
• Plant based foods and fertility
• Caffeine and fertility
• Recommendations
•
Nutrition During Reproductive
Age (Preconception And Fertility)

• The focus on preconception nutrition and

health is important for women and men
• Infertility affects 10% to 12% of U.S couples of
reproductive age and extremes in body mass
index (BMI) in either partner may be one
cause.
Cont.

• Women with a BMI less than 20 have an

increased risk of infertility.
• Men and women have increased rates of
subfertility when over weight and obese
Body Fat And Fertility

• Excessive body fat can changes hormone

concentrations
• Fat cell produce estrogen, androgens and
leptin
• changes n the availability of these hormones
interfere with reproductive processes
( follicular development, ovulation and sperm
maturation and production.)
Nutrition Prior to Pregnancy

Nutrition prior to pregnancy must, by its

nature, focus mainly on women. Both a man’s
and a woman’s nutrition may affect fertility and
possibly the genetic contributions they make to
their children, but it is the woman’s nutrition
that has the most direct influence on the
developing fetus.
Cont.

Her body provides the environment for the

growth and development of a new human
being. Prior to pregnancy, a woman has a
unique opportunity to prepare herself
physically, mentally, and emotionally for the
many changes to come.
VITAMINS & MINERALS ROLE
IN FERTALITY
Vitamin D In Reproductive
Age
• Vitamin D deficiency in men and women can
be associated with infertility
• For women, Vitamin D deficiency may be
associated with insulin resistance and
metabolic syndrome in polycystic ovary
syndrome (PCOS)
• For men vitamin D may be associated with
lower sperm quality
Role Of Calcium In Fertility

• Calcium is important during preconception

period in male for, spermatogenesis, sperms
motility, hyper activation and acrosome (area
of sperm that contain digestive enzymes to
break down the outer layer of the ovum)
Example Of Nutrients Likely
Important In Preconception

System or Function Nutrients

• Brain and nervous
• Iron, zinc, iodine, LCPUFA,
system
vitamins A, B6, B12, folic acid,
copper, protein, selenium
• Placental function
• Iron, LCPUFA, vitamins E, C,B12,
and structure
zinc, selenium, copper, omega-
3 PUFA, folate
• Inflammation and
• Vitamins A, D, zinc, fatty acids
immune function
• Vitamins C, E, B6, B12, folic acid
• Oxidative stress
• Vitamins A, B6, B12, folic acid,
• Embryogenesis
Effects Of Antioxidant Intake
On Fertility

Higher average intakes of antioxidants are

associated with:
Improvements in levels of oxidative stress in
infertile women.
Improved sperm maturation, motility,
concentration, and reduced DNA and
chromosome damage in men.
Cont.

• Intake of antioxidants such as vitamin E ,

vitamin C, beta-carotene, and selenium and
antioxidant-rich pigments in vegetables and
fruits plays an important role in fertility
• To protect cells of the reproductive system,
including eggs and sperm, from damage due
to oxidative stress.
State Of Vitamin E &
Selenium In Fertility

Supplemental intakes of vitamin E and

selenium improve sperm quality in infertile
men.
Regular intake of vitamin C, vitamin E, and
beta-carotene supplements have been related
to increased sperm number and motility.
Zinc Status And Fertility
In Men

Zinc plays important roles:

In the reduction of oxidative stress
In sperm maturation
In testosterone synthesis
Lower Zinc Status In Men

Related to:
Poorer sperm quality
Sperm concentrations
Abnormal sperm shapes
Zinc supplementation alone oe combined with
vitamin E and vitamin C supplementations
improve sperm quality.
Plant Foods And Fertility

• Vegans (who are thin, normal eight, or

overweight) are more likely to have irregular
menstrual
• Diets providing <20% of calories from fat
appear to lengthen menstrual cycle among
women in general
Cont.

• Regular intake of soy foods ( tofu, soymilk,

tempeh, and textured soy protein) appears to
be related to reduced sperm count in men
and to a one day increase in menstrual cycle
length in women.
Plant Foods And Fertility

Effects of high plant and soy food diets in

fertility may be related to the influence of
certain phytochemicals in plant foods on levels
of estradiol, progesterone and luteinizing
hormone.
Multivitamin Supplement
Folate Intake And Fertility

Multivitamin intake is associated with a lower

risk of ovulatory infertility
Higher level of dietary intakes of folate from
food and supplements in healthy men is related
to the presence of fewer chromosomally
abnormal sperm.
Folate Intake And Fertility

Although current public health

recommendations primarily promote folic acid
supplementation, many other nutrients are
also important in the periconceptual period.
Optimal intakes are associated with lower risk
of growth restricted babies (low birth weight
[LBW] or small-for-gestational age [SGA]) or
preterm births
Preconception Iron Status,
Fertility,& Pregnancy Outcomes
Infertility due to lack of ovulation is related to
iron intake.
Iron deficiency prior to pregnancy increase the
risk that iron-deficiency anaemia will occur
during pregnancy and that infants will be born
with low stores of iron.
Iron deficiency before pregnancy is also
increased rates of preterm delivery.
Cont.

It is easier and more efficient to build up iron

stores before pregnancy than during pregnancy
Take modest doses of iron supplements (18mg
a day) and by the regular consumption of
vitamin C-rich fruits and vegetables along with
plant sources of iron, iron-fortified cereals, and
lean meats.
Caffeine And Fertility

Should women concerned about

infertility consume coffee and other
foods with caffeine?
Cont.

Chances of conception within a 10 month

interval of unprotected intercourse was half as
likely among women who consumed over 4
cups of coffee per day (500mg caffeine) vs the
conception rate of women who consumed little
coffee.
Cont.

Intake of 300 mg of caffeine daily from coffee,

sodas, and tea decreased the chance of
conceiving by 27% per cycle compared to
negligible caffeine intake
May be due to one or more of the hundreds of
other biologically active substances in coffee.
Recommended Dietary Intakes
For Preconceptional Women

1. Consume 400 mcg of folate from fortified

grain products, vegetables, fruits or
supplements
2. Take no more than 5000IU of vitamin
A( retinol or retinoic acid) from
supplements daily
Recommendations For
Women
• Normal BMI
• Proteins
• Zinc
• Iron
• Choline
Optimal intakes are associated with lower risk
of growth restricted babies
Recommendations For
Improved Male Fertility
• Include:
• eating a higher fiber,
• lower glycemic index (including high-fat dairy
products and monounsaturated fats, but
reducing trans fats)
• lower animal protein diet,
• iron from plant sources,
• multivitamin daily,
• and being moderately physically active
Cont.

• Multi vitamins
• Lower animal protein diet
• Iron from plant source
• Moderate physical active
Exposure To Environmental
Chemicals

Exposure of men and women to environmental

chemicals, including pesticides, heavy metals,
and organic solvents, is associated with an
increased time to pregnancy.
Cont.

A father’s regular preconceptual smoking is

associated with DNA damage to the sperm.
Smoking also increases the risk that his child
will have acute lymphoblastic leukemia, but the
absolute risk is still very small, raising it from 27
per million births to 34 per million births
Preconception Educational
Programs

Preconception educational programs for both

parents are promoted, but evidence of benefit
is inconsistent. However, it appears that
nutrition interventions are more effective in
promoting change than those targeting
smoking and alcohol cessation
THANK YOU