Pre-conception Doctor’s Appointment
You may even want to visit your doctor before you conceive. He or she can advise you on a healthy diet, evaluate your overall health, and let you know if you should lose or gain weight before you begin trying to conceive. You can find out your ideal healthy weight by calculating your BMI (body mass index). Being overweight can decrease your chances of conception by as much as 29 percent.

Eliminate Fast Food
For many people, step one toward a healthier diet is to eliminate fast food from your weekly menu. Pricey, fried, loaded with trans fats, and mostly devoid of nutrients, fast food offers few benefits beyond convenience. If you find yourself at a fast food restaurant, order a salad with grilled chicken on top, and use dressing sparingly. This is a lifestyle change that will benefit your unborn baby and your infant. Some of the benefits of breastfeeding are negated if you eat fast food more than once or twice a week while breastfeeding.

Eat a Balanced Diet
A balanced diet consists of plenty of whole grains, at least five servings of fruits and vegetables, at least three servings of non-fat or low-fat dairy products, and small portions of lean proteins, such as chicken and fish. Don’t forget the healthy fats, too, such as those found in olive oil (and other nut and seed oils) and foods like avocado.

You can find out more about the USDA Food Pyramid and smart food choices at www.mypyramid.gov.

Pregnant women and those TTC need more folic acid (otherwise known as Folate or vitamin B9) in their diets and should be sure they are getting enough calcium and Vitamin D. Taking in no less than 400 mcg of folic acid per day can reduce the risk of serious neural tube birth defects such as spinal bifida. You can get folic acid from sources such as dark leafy vegetables like spinach, citrus fruits, and fortified breads and cereals.

The Good and Bad of Fish: DHA and Mercury
Studies show that DHA, an Omega-3 fatty acid, is important in the development of the brains of fetuses as well as infants and toddlers. DHA can be found in foods such as flax, pumpkin seeds and avocado, but one of the best sources of DHA is coldwater fish, including tuna and salmon.

Unfortunately, fish also contain levels of mercury, which has been linked to nervous system disorders. So, what’s a woman who’s TTC, pregnant or breastfeeding to do? Eat fish shown to have the lowest levels of mercury in moderation by following the EPA guidelines for fish consumption in pregnant and lactating women.

As a general guideline, stay away from tuna steaks, swordfish, and shark, which are high in mercury and limit consumption of low-mercury level fish, including salmon, shrimp, chunk light tuna (not albacore) to 12 oz. per week.

Get the balance of your DHA by taking a pre-natal multivitamin enhanced with DHA or taking a separate DHA supplement.

Pre-natal Vitamins
Most people’s diets don’t contain enough Vitamin D, folic acid, or DHA, along with many other essential nutrients. Even if you eat a balanced diet, it can be challenging to get sufficient quantities of these vitamins and nutrients every day. Your doctor may prescribe a pre-natal vitamin during your pre-conception check-up, but you’ll probably find prescription pre-natals don’t differ much from over-the-counter supplements.
Pre-natal vitamins should contain:

• Vitamin A

• Vitamin C

• Vitamin D

• Vitamin E

• Thiamin

• Riboflavin

• Niacin

• Vitamin B6

• Folic Acid

• Vitamin B12

• Calcium

• Iron

• Zinc

Take pre-natal vitamins with a meal or a glass of milk, as they may cause nausea on an empty stomach. If your pre-natals are causing constipation or an upset stomach, you may want to experiment with different brands. Again, it is better to start your vitamins while you are TTC, so that you know that any side effects are caused by the vitamins and not by pregnancy.

Exercise
Most doctors will tell you that it’s safe to continue almost any exercise program you were doing with proficiency before you conceived during your pregnancy. This includes bicycling, scuba diving, aerobics, yoga, tennis, weight training and countless other sports and activities. After you get pregnant, however, is not the time to learn a new sport or skill, which is why it’s a good idea to begin an exercise program you love while you are TTC. If you were not exercising regularly before you conceived—or did not have time to grow proficient in your chosen activities before you conceived–stick with walking and swimming, or even water aerobics if swimming is too taxing on your body, during pregnancy.

Author: Dawn Allcot

One minute you hear that eating fish is good for your heart. The next, you find out that eating certain types of fish can be harmful.

Actually, there are benefits and risks to eating fish. Fish and shellfish are an important part of a healthy diet. They contain high-quality protein, other essential nutrients, and omega-3 fatty acids, and fish are low in saturated fat. A well-balanced diet that includes a variety of fish and shellfish can contribute to a healthy heart and to healthy, well-developed children.

However, nearly all fish and shellfish contain traces of methylmercury, a type of mercury found in water that can be harmful, especially to unborn babies and young children whose nervous systems are still developing. Some types of fish and shellfish contain higher levels of mercury. The risks depend on the amount of fish and shellfish eaten and the levels of mercury in the seafood.

The Food and Drug Administration and the Environmental Protection Agency (EPA), through a joint consumer advisory, warn that women who may become pregnant, pregnant women, nursing mothers, and young children should avoid the types of fish and shellfish with higher levels of mercury and eat only those that have lower levels.

Here’s more information about the mercury in fish and shellfish, and what you should know.

Q. What is mercury and methylmercury?

A. Mercury occurs naturally in the environment and also can be released into the air through industrial pollution. Mercury falls from the air and can accumulate in streams and oceans. Bacteria in the water cause chemical changes that transform the mercury into methylmercury. It is this type of mercury that can be harmful to unborn babies and young children. Fish absorb the methylmercury as they feed in these waters. Methylmercury builds up in the tissue of some types of fish and shellfish more than others depending on what the fish eat. That’s why levels vary among species and locations.

Q. Should a woman who is not pregnant, but could become pregnant, be concerned about methylmercury?

A. Yes. If you regularly eat types of fish high in methylmercury, the substance can accumulate in your blood over time. Methylmercury is removed from the body naturally, but it may take more than a year for the levels to drop significantly. Therefore, it may be present in a woman even before she becomes pregnant. That is why women who are trying to become pregnant also should avoid eating certain types of fish.

Q. Do all fish and shellfish contain methylmercury?

A. Nearly all fish and shellfish contain traces of methylmercury. However, larger fish that have lived longer have the highest levels of methylmercury because it has accumulated over time. Large fish such as swordfish, shark, king mackerel, and tilefish pose the greatest risk. Other types of fish and shellfish may be eaten in the amounts recommended by the FDA and EPA.

Q. Where can I get information about the types of fish I eat?

A. Information about the levels of methylmercury in the various types of fish you eat can be found at the FDA food safety Web site: www.cfsan.fda.gov/~frf/sea-mehg.html or the EPA Web site at www.epa.gov/ost/fish.

Q. Should I be concerned about fish sticks and fast food sandwiches that are made with fish?

A. Fish sticks and fast food sandwiches are commonly made from fish low in mercury.

Q. Although advice is provided about canned tuna, what is the advice about tuna steaks?

A. Because tuna steak generally contains higher levels of mercury than canned light tuna, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces of tuna steak per week.

Q. What will happen if I eat more than the recommended amount of fish and shellfish in a week?

A. One week’s consumption of fish does not change the level of mercury in the body much. If you eat a lot of fish one week, you can cut back for the next week or two. Just make sure to average the recommended amount per week.

Q. Where can I get information about the safety of fish caught recreationally in lakes, streams, and rivers?

A. Before you go fishing, check the appropriate fishing regulations booklet for information about recreationally caught fish. You can also contact your local health department for information about advisories in your area. Check local advisories because some kinds of fish and shellfish caught in local waters may have widely varying levels of mercury, depending on the levels of mercury in the water. Fish with much lower levels may be eaten more frequently and in larger amounts.

Recommendations for Selecting and Eating Fish or Shellfish

Women and young children will receive the benefits of eating fish and shellfish and be confident that they have reduced their exposure to the harmful effects of mercury by following these recommendations:

Do not eat shark, swordfish, king mackerel, or tilefish because they contain high levels of mercury. Eat up to 12 ounces, two average meals, a week of a variety of fish and shellfish that are lower in mercury. Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. Albacore (white) tuna has more mercury than canned light tuna. When choosing your two meals of fish and shellfish, you may eat up to 6 ounces, one average meal, of albacore tuna per week. Check to see if advisories exist concerning the safety of fish caught in local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces per week of fish you catch from local waters, but don’t consume any other fish during that week. Follow these same recommendations when feeding fish and shellfish to your young child, but serve smaller portions.

During pregnancy, your baby receives DHA from you through the placenta. Transfer of DHA from mom to baby is greatest during the third trimester, a period of rapid development for the brain and nervous system. After birth, breastfed infants continue to receive DHA through their mother’s milk.

The potential benefits of a diet rich in DHA during pregnancy and while breastfeeding have been under investigation for many years. Studies comparing infants born prematurely with full-term infants have found that preterm infants tend to have lower DHA levels as well as delayed visual and cognitive development. Other studies looking at breastfed babies versus formula-fed babies (most formulas do not contain DHA) have found that breast-fed infants tend to have better visual acuity early in life.

DHA supplements are widely available. Some brands though, such as Nutrition for Two’s Vitrel-3, claim their active ingredient is “cervonic acid.” Cervonic acid is simply another name for DHA. These companies use the different name though to charge you twice as much for the same product.

Pregnant and breastfeeding mothers are encouraged to pay special attention to their diets to ensure an adequate consumption of foods rich in DHA. It is never too early to start helping your baby’s eyesight develop properly.

Cold-water fish, such as salmon, herring, mackerel and whitefish, are our best dietary sources of DHA. Indiscriminate consumption of fish, however, is not recommended for pregnant women. This is because many of our streams and oceans are contaminated with mercury, which can be harmful to a developing nervous system. While nearly all fish contain trace amounts of mercury, long-lived, larger fish that feed on other fish accumulate the highest levels and pose the greatest risk to people who eat them regularly. For these reasons, the Food and Drug Administration recommends that pregnant women or those thinking of becoming pregnant avoid shark, swordfish, king mackerel and tilefish. The FDA has determined that up to 12 ounces per week (3 ounces is a normal serving size) of other cooked fish is safe for pregnant and nursing women. A good substitute for women who choose not to eat fish are DHA-enriched eggs now available in many stores.

For the infant, breast milk is an excellent source of essential fatty acids, including DHA. While infant formulas supplemented with DHA and AA have been available for several years in countries throughout Europe, Asia, Africa, Australia and Latin America, they have not been allowed in infant formulas sold in the United States until recently. Currently, there are two brands of infant formula on the market in the United States that are supplemented with DHA and these can cost 10 percent to 20 percent more than regular formulas.

During pregnancy, your baby receives DHA from you through the placenta. Transfer of DHA from mom to baby is greatest during the third trimester, a period of rapid development for the brain and nervous system. After birth, breastfed infants continue to receive DHA through their mother’s milk.

The potential benefits of a diet rich in DHA during pregnancy and while breastfeeding have been under investigation for many years. Studies comparing infants born prematurely with full-term infants have found that preterm infants tend to have lower DHA levels as well as delayed visual and cognitive development. Other studies looking at breastfed babies versus formula-fed babies (most formulas do not contain DHA) have found that breast-fed infants tend to have better visual acuity early in life.

DHA supplements are widely available. Some brands though, such as Nutrition for Two’s Vitrel-3, claim their active ingredient is “cervonic acid.” Cervonic acid is simply another name for DHA. These companies use the different name though to charge you twice as much for the same product.

Pregnant and breastfeeding mothers are encouraged to pay special attention to their diets to ensure an adequate consumption of foods rich in DHA. It is never too early to start helping your baby’s eyesight develop properly.

Cold-water fish, such as salmon, herring, mackerel and whitefish, are our best dietary sources of DHA. Indiscriminate consumption of fish, however, is not recommended for pregnant women. This is because many of our streams and oceans are contaminated with mercury, which can be harmful to a developing nervous system. While nearly all fish contain trace amounts of mercury, long-lived, larger fish that feed on other fish accumulate the highest levels and pose the greatest risk to people who eat them regularly. For these reasons, the Food and Drug Administration recommends that pregnant women or those thinking of becoming pregnant avoid shark, swordfish, king mackerel and tilefish. The FDA has determined that up to 12 ounces per week (3 ounces is a normal serving size) of other cooked fish is safe for pregnant and nursing women. A good substitute for women who choose not to eat fish are DHA-enriched eggs now available in many stores.

For the infant, breast milk is an excellent source of essential fatty acids, including DHA. While infant formulas supplemented with DHA and AA have been available for several years in countries throughout Europe, Asia, Africa, Australia and Latin America, they have not been allowed in infant formulas sold in the United States until recently. Currently, there are two brands of infant formula on the market in the United States that are supplemented with DHA and these can cost 10 percent to 20 percent more than regular formulas.