Does a pregnant woman have to “eat for two”? And how about nutrition before and after conception of the baby? We discussed this topic with nutrition therapist Šárka Knížková, who revealed valuable information from the world of nutrition. Our attention was not missed by men, who can significantly contribute to the positive outcome of the whole process of reproduction — both natural and assisted.
Your education and professional direction is quite extensive, you are literally a renaissance man. What brought you to the topic of nutrition in connection with conception and pregnancy?
Thank you so much for such a beautiful designation, you can see me smiling. As it happens, my personal experience of dealing with hormone levels and potential (in)fertility issues in my teens led me there. At the same time, in my practice I see clients with irregular or abnormal menstrual cycles, where we try to look for the buried dog in the diet. So when I was offered the opportunity to work with PFC externally, there was nothing to think about.
There is still not much known about the impact of proper nutrition on the ability to get pregnant. Most women have never heard of it. How much effect does a woman’s diet have on her ability to conceive a baby?
A lot of things about women’s health are generally not talked about. Irregular cycles or painful periods are often normalized, which I think is absolutely not okay. A functional menstrual cycle is one of the best indicators of a healthy female body. If the body doesn’t like something, like a poor diet, it usually shows it right there. The effect of diet on a woman’s fertility is enormous, for example an adequate supply of antioxidants can increase the chance of pregnancy by up to 25%, but diet certainly cannot be considered in isolation and in isolation from other aspects of a healthy lifestyle and overall fitness.
When a woman succeeds and becomes pregnant, she is then subjected to all sorts of well-meaning advice — for example, that she should eat for two, or that she can now indulge in whatever she wants, and much more. Which of these pieces of advice are myths and how should a pregnant woman eat to support the health of her baby?
This is really a very complicated and complex topic, but I will try to summarize it. A pregnant woman really doesn’t need to “eat for two”, especially in early pregnancy. In the first trimester even the energy requirements are very similar to those before pregnancy, in the second trimester the requirements increase by about 1 small snack a day and in the third by 2 snacks. But no double portions. The composition of the diet is very important. It should be varied, with an emphasis on folic acid, which is often supplemented before conception. In general, the diet should include plenty of dairy products (for protein and calcium), meat and eggs (for iron), lots of fruit and vegetables (for vitamins) and sea fish (a source of omega‑3 fatty acids and iodine). These are all essential nutrients for fetal development.
Have you come across any really strange superstitions in your practice about nutrition for expectant women? Which one has taken your breath away the most?
I have to say that the things that sometimes circulate on social media really strike me. Marketing-wise, pregnant women are a very sensitive group, because when someone makes a “bububu, without this the baby won’t be healthy”, they immediately buy it under pressure. A few years ago, there was a huge controversy about an influencer recommending freeze-dried liver. Yes, it’s true that liver is a great source of iron, which pregnant women need significantly more of than non-pregnant women. However, liver also contains vitamin A, and this can be teratogenic in high doses (which can be achieved by unthinking consumption of freeze-dried liver) and cause severe fetal developmental disorders.
Even the attempt to conceive and the desire to have a girl or a boy is surrounded by many ‘guaranteed tricks’. What is your opinion about the possibility of “eating” one’s way to a girl or, on the contrary, to a boy? Can a couple’s diet affect the sex of the future offspring?
Unfortunately, it is not entirely possible to eat your way to your dream baby. In fact, the sex is already determined at the moment the egg is fertilised by the sperm, depending on whether the sperm carries an X chromosome (for a girl) or a Y chromosome (for a boy). But that certainly does not diminish the importance of a balanced diet in pregnancy.
What about pregnancy cravings? What should an expectant mother do if she has uncontrollable cravings for sweet, fried or spicy or very salty foods, but wants to eat really healthy?
The first thing to do is to find out what causes the uncontrollable cravings. Whether it is really the raging hormones that are to blame or whether it is not, for example, an unbalanced diet. It is often an unbalanced diet that causes uncontrollable cravings even outside of pregnancy. However, if the diet is balanced, it is not a problem to indulge in something “just for the taste” once in a while. After all — lunch goes to the stomach and dessert to the heart.
How to deal with the craving for coffee or a glass of wine? Is there an acceptable level of alcohol and caffeine during pregnancy or while trying to have a baby?
Let’s look at alcohol first. Research shows that the beneficial amount of alcohol is 0 drinks and that increased consumption of alcohol while trying to conceive can be counterproductive. Alcohol should be completely avoided during pregnancy as it crosses the placenta and can affect fetal development. Coffee should be consumed at a maximum of 4 cups per day during the period of preparation for conception. Even so, caffeine should be consumed in moderation, as, for example, poor quality and inadequate sleep due to increased caffeine intake can adversely affect the likelihood of conception. During pregnancy, it is advisable to limit coffee to about 1 cup per day, but it is not necessary to cut it out completely like alcohol.
Does a woman’s weight have any impact on her ability to conceive?
Yes, and huge! That would take a whole chapter in a book. An underweight woman often goes hand in hand with a low body fat percentage and a disturbed hormonal balance that can lead to loss of menstrual cycles. Frankly, I deal with this problem in my practice very often, especially with female athletes. However, the other extreme, when the weight is too high, is also not ideal. This is because adipose tissue is hormonally active and can mess with hormone levels. At the same time, it produces inflammatory cytokines, makes rote changes in blood sugar levels, and these are all factors that can negatively affect a woman’s fertility.
The effect of free radicals on conception and pregnancy is a topic that few people in this country have heard of. Can you explain how this relates to diet and how it translates into successful conception and subsequently a healthy pregnancy?
That’s a great question! If I were to focus purely on diet, the sources of free radicals are mainly highly processed foods (semi-processed foods), overcooked fats, alcohol and cured meats. Increased intake of foods that aggravate oxidative stress in the body can reduce sperm and oocyte quality and negatively affect conception itself and subsequent fetal development. The level of oxidative stress can be reduced by increasing the intake of antioxidants. These are found, for example, in fruits and vegetables. In summary, if one eats healthily, one need not worry too much about free radicals.
Many women who walk a long way to get pregnant are then afraid of moving so as not to hurt the baby in the tummy. What kind and amount of exercise do you recommend?
As long as the pregnancy goes without complications, there is no reason to avoid exercise, it benefits both mum and baby. However, it’s important to approach it sensibly and respect your body’s signals. Examples of suitable exercise include walking, swimming, yoga, pilates, cycling or light weight training. However, expectant mothers should definitely not throw themselves into the boxing ring, ride horses, jump on trampolines or lift extremely heavy weights. After all, she has another life inside her that is very fragile.
Is there something in nutrition that every woman trying to have a baby should definitely pay attention to, and also something that every pregnant woman should follow?
The basis for both is a varied balanced diet with a limitation of junk (such as spoiled) foods. It is important to emphasize folic acid, iodine, omega‑3 fatty acids, protein, calcium, iron, zinc, and alcohol restriction.
How big a role does a man’s nutrition play in trying to conceive?
Men often think they are off the hook, but the recommendations for a varied and healthy diet apply to them too. In fact, a poor quality diet can negatively affect sperm count and motility. It is important to limit alcohol, smoking and highly processed foods. Again, antioxidants from fruit and vegetables play a major role and should be abundant in the diet. For men, zinc and selenium, which are essential for the production of healthy sperm, are also increasing in importance.
What nutritional transgression do you encounter most often in your practice for couples trying to have a baby?
It’s a paradox, but probably the most common is that women simply don’t eat enough. They’re so worried about weight gain that their daily energy intake often matches the needs of a one-year-old baby. Unfortunately, this reflects very negatively on the body’s willingness to undergo such a demanding period as pregnancy. Men, on the other hand, think that it doesn’t affect them and that while their partner is munching on fruit and vegetables, they can have a pizza and a bucket of ice cream next door. This is a common pattern that, when I point it out, earns me many a hurt male look.