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On Nutrition

It’s not a big secret that eating a healthful, balanced diet during pregnancy is important. But from a nutrient point of view, what you eat before pregnancy is even more important.

For the best possible pregnancy and the healthiest possible child, the time to start thinking about what you put on your plate is before you become pregnant. There is a narrow window of time in the first few weeks after conception when good nutrition matters most. Once this window closes, there is no “do over.”

The starkest example of why good nutrition is vital at the beginning of pregnancy is the possibility of neural-tube defects. The neural tube is the embryo’s precursor to the spinal cord and brain. If cells don’t divide and multiply fast enough to form a closed, intact neural tube, it can result in traumatic birth defects. This process wraps up around day 21 of pregnancy, before most women know they are pregnant.

When a woman enters pregnancy well-nourished, her body is stocked up on nutrients necessary to get her child off to a good start. It also offers a sort of nutritional insurance against morning sickness, which may make eating a healthful diet difficult. As an added bonus, starting pregnancy on strong nutritional footing makes it easier to keep up with the huge nutrient demands of the second and third trimesters of pregnancy.

While many vitamins, minerals and other nutrients are important during pregnancy, a few play significant roles right out of the gate:

• Folate/folic acid: This B vitamin is important in helping prevent neural-tube defects. The 2010 Dietary Guidelines recommend that women who may become pregnant get at least 400 micrograms of folic acid from a vitamin supplement or fortified foods (many breads and cereals have added folic acid). That’s in addition to eating foods high in natural folate, which include dark leafy greens, lentils and beans.

• Choline: Evidence suggests that this vitamin also helps prevent neural-tube defects. Our bodies make some choline, but not enough to meet our needs. The richest food source of choline is egg yolk, with one yolk providing about 25 percent of the total 425 milligrams a pregnant woman needs daily. You can also find it in salmon, pork and cauliflower.

• Iron: A woman’s iron needs almost double during pregnancy (to 27 milligrams a day) in order to support rapidly expanding blood volume and tissue growth. This makes it easy for a woman to develop iron-deficiency anemia during pregnancy (the most common nutrition-related complication of pregnancy), which increases the risk of preterm birth. Entering pregnancy with low iron will make it very difficult to catch up. Discuss with your doctor whether you need iron supplements in addition to eating iron-rich foods.

If you are planning to become pregnant, consider whether your diet could use a tuneup. (This goes for fathers-to-be, too.) Research suggests that a nutritious, balanced, varied diet can enhance improve both egg and sperm quality and enhance fertility.

What happens if you learn you’re pregnant and your diet has been less than optimal? Start making more nutritious choices right away. You can’t change what you did yesterday, but you can change what you do today and tomorrow.

Carrie Dennett:

Dennett is a graduate student in the Nutritional Sciences Program at the University of Washington. Her blog is