Preparing for pregnancy? Your nutrition matters before you see those two lines.
When you're trying to conceive, it's easy to become overwhelmed by lists of fertility foods, supplements and foods you're apparently supposed to avoid.
But preconception nutrition doesn't need to be complicated.
Rather than focusing on individual “fertility foods”, the evidence is increasingly looking at overall dietary patterns. A Mediterranean-style, anti-inflammatory dietary pattern provides a nourishing foundation for preconception health, while avoiding the need for restrictive or highly prescriptive eating.
Research in this area is promising, although it is important to remember that diet is not a treatment for infertility.
What Is an Anti-Inflammatory Diet?
An anti-inflammatory diet isn't a specific diet plan.
It describes an overall pattern of eating that prioritises:
- vegetables and fruit
- whole grains and high-fibre carbohydrates
- legumes
- nuts and seeds
- healthy fats, particularly unsaturated fats
- fish and other nutrient-rich protein sources
- minimally processed foods
while reducing frequent intake of:
- highly processed foods
- fast food and takeaway
- sugar-sweetened beverages
- processed meats
- foods high in trans fats and excessive saturated fats
The Mediterranean diet is is the most researched example of this type of dietary pattern.
Importantly, anti-inflammatory does not mean severe restriction.
You don't need to eliminate sugar, avoid every processed food or follow a rigid fertility diet. The goal is to create a nourishing dietary pattern that is realistic and sustainable.
Can an Anti-Inflammatory Diet Improve Fertility?
This is where the evidence needs some nuance.
A 2023 systematic scoping review of 36 observational studies found that adherence to a Mediterranean-style diet had the strongest and most consistent association with improved clinical pregnancy rates among the dietary patterns examined. Reducing trans fats, saturated fats and discretionary foods was also associated with some improved fertility and assisted reproductive outcomes.
Why Might Nutrition Matter Before Pregnancy?
Your nutritional status doesn't suddenly become important when you see a positive pregnancy test.
The preconception period, specifically 3 or more months before conception, provides an opportunity to:
- build nutrient stores
- support metabolic health
- optimise dietary quality
- address nutritional deficiencies
- optimise egg and sperm health
- improve metabolic health
A varied dietary pattern can provide important nutrients including folate, iron, iodine, choline, zinc, vitamin B12, vitamin C, vitamin E, magnesium and omega-3 fatty acids.
However, nutrition is only one part of fertility.
Age, genetics, ovulation, sperm health, endometriosis, PCOS, tubal factors and many other factors can influence conception.
Advanced Glycation End-Products (AGEs) and Egg Health
Another emerging area of interest in preconception nutrition is advanced glycation end-products, or AGEs.
AGEs form naturally within the body when sugars react with proteins and fats. They can also form in foods during cooking, particularly with high-temperature, dry cooking methods such as grilling, barbecuing and frying.
AGEs are of interest in reproductive health because of their relationship with oxidative stress and inflammatory pathways.
Research examining AGE concentrations in follicular fluid has found associations between higher AGE levels and markers including ovarian response, oocyte characteristics, embryo development and pregnancy outcomes during assisted reproductive treatment.
However, these findings are associations, not proof that dietary AGEs directly cause poorer egg quality or that reducing dietary AGEs will improve fertility.
Should you avoid foods cooked at high temperatures?
No.
Instead, think about variety in your cooking methods, and sustainable ways to reduce AGEs.
AGE formation tends to be greater with high-temperature, dry cooking such as:
- grilling
- barbecuing
- frying
- broiling
- roasting
Moist cooking methods such as steaming, poaching, stewing and slow cooking generally produce fewer AGEs.
Marinating foods, particularly with acidic ingredients such as lemon juice or vinegar, can also reduce AGE formation during cooking.
What Should You Eat Before Pregnancy?
Rather than following a strict list of fertility foods, think about the overall pattern of your diet.
Aim to regularly include:
Plenty of plant foods
Seasonal vegetables and fruit, legumes, whole grains, nuts and seeds provide fibre, antioxidants and a wide range of vitamins and minerals.
Healthy fats
Prioritise unsaturated fats such as those found in olive oil, eggs, avocado, nuts, seeds and fatty fish.
Adequate protein
Include a variety of protein sources across the week, such as fish, poultry, lean meat, eggs, dairy, legumes, tofu or other suitable alternatives. Choose pasture-raised and organic if possible.
Nutrient-dense, fibre-rich carbohydrates
Whole grains, legumes and other high-fibre carbohydrate foods can provide fibre and important micronutrients.
A few examples are vegetables, buckwheat, quinoa, oats, millet, legumes and spelt.
What Foods Should You Reduce Before Pregnancy?
You don't need a long list of forbidden foods.
Instead, consider reducing your overall intake of highly processed and discretionary foods, particularly when they are replacing more nutrient-dense foods.
This includes frequent intake of:
- fast food and takeaway
- sugar-sweetened beverages
- highly processed snack foods
- processed meats
- foods high in trans fats
Research in preconception nutrition has found associations between lower intake of discretionary foods, trans fats and saturated fats and more favourable fertility-related outcomes.
This doesn't mean you can never eat chocolate, takeaway or dessert. But consider frequency, timing and portion.
Your overall dietary pattern matters more than any individual food.
What About Male Fertility?
Preconception nutrition isn't just relevant to women.
Sperm development also occurs over time, meaning nutrition and lifestyle are relevant to both partners.
Research in men suggests that reducing inflammation, improving metabolic health and healthier dietary patterns, including greater consumption of fish and lower intake of sugar-sweetened beverages and processed meat, may benefit sperm health.
Preparing for pregnancy can therefore be an opportunity for both partners to improve their overall dietary pattern.
How Long Before Pregnancy Should You Start?
If possible, I recommend beginning your preconception preparation at least 6 months before trying to conceive, with the goal of being in your healthiest and best-nourished state at least 3 months before conception.
Why?
The development and maturation of eggs and sperm occurs over an extended period, meaning the months leading up to conception provide an important window to optimise the health and nutritional environment in which they develop. Preconception health is also increasingly recognised as an opportunity to influence not only fertility and pregnancy outcomes, but the health of the future child.
If you have 6 months, use them.
The six months before conception can provide an opportunity to:
- optimise nutritional status
- address nutrient deficiencies
- reduce chronic inflammation
- establish nourishing dietary habits
- review supplements and medications
- support metabolic and reproductive health
- reduce exposures that may negatively affect fertility
- prioritise sleep, movement and overall wellbeing
Then, by the 3-month mark before conception, the goal is for you and your partner to be at your healthiest and best-nourished state.
This isn't about achieving perfection. It's about giving your body time to make meaningful changes rather than trying to address everything once pregnancy has already occurred.
Preconception nutrition isn't simply about preparing for pregnancy. It's about preparing the egg and sperm that may become your baby, and creating the healthiest possible foundation for your future child's development and long-term health.
Ready to Prepare for Pregnancy?
Preconception nutrition is about more than fertility.
It is an opportunity to assess your nutritional status, address deficiencies, build sustainable eating habits and make sure you're entering pregnancy feeling well nourished.
If you're preparing for pregnancy and aren't sure where to start, personalised preconception nutrition support can help you understand what your body needs before pregnancy, rather than trying to navigate another generic fertility food list.
Your preconception nutrition plan should be personalised to you, your health, your history and your pregnancy goals.