Last updated April 17, 2018 at 10:17 am
Diet and lifestyle of both parents affect offspring.
One of the world’s top medical journals, The Lancet, has been investigating what changes parents can make before conception to give their children the best chance at long-term health.
First up is the need for better guidance when planning pregnancies, as well as increasing public health measures to reduce obesity and improve nutrition.
“The preconception period is a critical time when parental health – including weight, metabolism, and diet – can influence the risk of future chronic disease in children, and we must now re-examine public health policy to help reduce this risk,” says lead author of the three-paper series, Professor Judith Stephenson, of UCL.
“While the current focus on risk factors, such as smoking and excess alcohol intake, is important, we also need new drives to prepare nutritionally for pregnancy for both parents. Raising awareness of preconception health, and increasing availability of support to improve health before conception will be crucial.”
Before the beginning
The first paper reviews current evidence about nutrition and lifestyle in the preconception period.
It suggests new definitions of the preconception period, which has traditionally been seen as the three months before conception. However, this period doesn’t take into account some changes which may take several months or even years.
They suggest redefining preconception period:
- Biologically – days to weeks before and after fertilisation
- Individually – weeks or months when a person or couple decides to have a child
- Public health level – months or years needed to address preconception risk factors before pregnancy
One of the key messages is to identify people contemplating pregnancy as a window of opportunity for health interventions and improve health before conception.
Taking a population-based approach is important as few people plan a pregnancy several years in advance, especially when it comes to nutrition.
Studies in the UK and Australia, both revealed that many young women are not nutritionally prepared for pregnancy.
Causes and consequences
In the second paper, the authors review the induction of disease risk from four categories: maternal obesity and overnutrition; maternal undernutrition; paternal obesity and undernutrition; and assisted reproductive treatment.
The results are summarised in the image below.
Step-by-step fertilisation and effects of parental diet and health (figure 1 in paper 2): Reprinted from The Lancet, http://dx.doi.org/10.1016/S0140-6736(18)30311-8, Stephenson et al, Preconception health 1: Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health, Copyright (2018), with permission from Elsevier. Click to enlarge.
Obesity in both parents can have different effects, but are both linked to poorer birth outcomes and increased rick of chronic disease for the child later in life.
In mothers, obesity increases levels of inflammation, certain hormones and metabolites, which may directly alter the development of the egg and embryo.
In fathers, obesity is linked to poor sperm quality, quantity and motility.
It is not clear, however, how strong the relative influence from paternal is compared to maternal health.
Intervention strategies
In the third paper, the authors “propose a dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly”.
The conversation needs to begin at different stages in people’s lives. Even the food industry and retailers should be part of the solution, along with government and non-government organisations, and research institutions to be part of the change.
They suggest advice to teenagers to improve nutrition and lifestyle has numerous benefits beyond preconception health but for their overall well-being.
The paper also calls for social change that supports public awareness of preconception health for adults.
“Current preconception health interventions may be limited by their focus on individual responsibility, and not directly addressing social influences or the obesogenic environment. Improving the overall health of the population, as well as raising awareness of the importance of the preconception period could help improve the health of future generations,” says Dr Mary Barker, University of Southampton UK.
“It is everyone’s responsibility to support our young adults become successful parents of healthy, long-lived children. We have the infrastructure to do this in our existing health and education platforms and a global food system, but must now prioritise improving preconception health.”
The preconception health Series is published in The Lancet.
