Better Health Project

View Original

Optimizing Preconception Health for Men

Amanda Scott

The health of a man during the preconception period has important downstream effects on his family. His health and lifestyle factors can impact the health of the developing fetus from conception into adulthood and can even affect the mother's health while pregnant with their child.

As such, a man has an opportunity - by optimizing his health, he can positively impact the lives of his future children and help protect his partner during her pregnancy.

Fertility Rates Are Declining

Declining fertility rates alone should be enough of a concern to motivate men to take better care of themselves. A study in North America, Europe, Australia and New Zealand found that sperm count declined by 50-60% between 1973 and 2011 over about 40 years. 1 If this trend continues, most men will have little to no capacity to reproduce by 2060.

The suspected causes of sperm count declines include increasing exposure to endocrine disruptors and other environmental and lifestyle factors - many of which can be reduced with various interventions, which we will cover below.

See: Optimizing Preconception Health For Women

Chronic Health Conditions are Increasing

The decrease in health across the population is another worrying trend. Chronic health conditions among children have risen over the past 50 years - particularly asthma, obesity, mental health conditions and neurodevelopmental disorders. 10 Many of these conditions can be linked to the father's health in the pre-conception period. Considering this information, men should optimize their health to increase the chances of a healthy pregnancy and child.

Male Lifestyle and Health Impacts on the Mother’s Health in Pregnancy

A father’s health at the moment of conception will not only affect his future child both in the womb and after they are born - it can also impact his pregnant partner. Poor paternal health in the preconception period is linked to adverse complications during pregnancy, namely gestational diabetes and preeclampsia. 3 It can also impact the mother’s risk of postpartum hemorrhage. 6

Gestational Diabetes

Gestational diabetes is a form of diabetes that develops in pregnant women that did not have diabetes before pregnancy. Gestational diabetes can increase the mother’s risk of high blood pressure during pregnancy. Half of all women that develop gestational diabetes eventually develop type 2 diabetes. 13

Preeclampsia

Preeclampsia is a serious condition believed to stem from a problem with the health of the placenta. In addition to being dangerous to the fetus, it is also quite hazardous for the mother. Preeclampsia causes stress on the heart and other organs, affects the life-giving blood supply to the placenta, impairs the function of the liver and kidneys and causes fluid to build up in the lungs. 15

Postpartum Hemorrhage

Postpartum Hemorrhage is a complication associated with paternal obesity in the preconception period. 6 Postpartum Hemorrhage is a dangerous condition where the mother has abnormally high levels of bleeding post-birth. It is the 5th leading cause of maternal death. 16

Lifestyle and Health Impacts on Fertility

There are a few known risk factors associated with paternal health that impact fertility, the health of the baby, and the health of the pregnant mother. There is still much research left to be done in this area of study, so men should be mindful of optimizing their health overall.

Risk Factor: Excess Weight

In Canada, 64% of adults over 18 were overweight in 2017. 12 It is common knowledge that maintaining a healthy weight is preventative for a variety of diseases and conditions. This also applies to paternal health in the preconception period.

Examining the impact of the father’s health on his future offspring is a somewhat new and underdeveloped area of study - researchers suggest that the role of fathers in influencing early childhood obesity risk has been underestimated. 6

Impacts of Paternal Excess Weight on Fertility

Researchers have demonstrated that obesity harms sperm motility, which is the ability of the sperm to move correctly or “swim.” Obesity can also impact DNA damage and embryos in key early developmental stages and has been found to induce epigenetic changes in sperm. 6

High paternal BMI is not associated with average fetal birth weight but does increase the frequency of unhealthy extremes in birth weights (macrosomia and SGA). 6

Small for Gestational Age

SGA (small for gestational age) is a significant complication and is a major cause of stillbirth and death in a baby under one week old. SGA is mainly caused by an issue where the placenta cannot deliver the appropriate amount of nutrients and oxygen to the fetus. When the fetus adapts to this situation, it results in permanent changes to glucose-insulin metabolism. 6

Macrosomia

Macrosomia is a term to describe a baby who is born larger than average. Macrosomia can lead to complications during delivery, including becoming wedged in the birth canal, injury to the birth canal, bleeding after delivery and uterine rupture. 17

Impacts of Paternal Excess Weight on Childhood and Beyond

A man suffering from obesity may predispose his offspring to metabolic disorders later in their lifetimes. Increased paternal BMI is also associated with delayed personal and social functioning in three-year-old children and increases the incidence of type 2 diabetes and insulin resistance. 6

Risk Factor: Smoking

Smoking cigarettes is associated with reduced semen quality and is also associated with childhood obesity for the offspring of a man who smokes. 7

Risk Factor: Environmental Factors

Numerous environmental factors can impact male fertility and the health of his offspring. Reducing exposure to pesticides, air pollution, and endocrine disruptors may help improve health outcomes for both father and child.

Impact of Environmental Factors on Male Fertility

A study found that exposure to organic solvents and pesticides has been associated with reduced IVF implantation rates. 7 Pesticide exposure can occur through the foods we eat, as well as in the environment during or post application. Organic solvents are used in many applications, and hazards can vary by dose (found in paints, varnishes, glues, etc.)

Impact of Paternal Environmental Exposures on Childhood and Beyond

Paternal exposure to air pollution is also associated with his child’s health outcomes - long-term PM2.5 exposure was found to be linked to hypertension in male offspring in a study on rats. 8 PM2.5 is an air pollutant that is a fine, inhalable particle, generally 2.5 microparticles or smaller, which can enter the bloodstream due to its small size. You can monitor real-time levels in your area through apps like IQAIr.

If you are preparing to conceive, you may want to take proactive measures to reduce exposure to air pollution. Perhaps surprisingly, the highest air pollution does not always occur in the largest cities. In Ontario, Canada, Downtown Hamilton - a small port city near Toronto - actually had a higher mean PM2.5 than Toronto, Canada’s largest city. 9

Risk Factor: Processed Foods

There are many diets with conflicting doctrines - those who promote a vegan, paleo, or keto diet do not agree on much. Still, the almost universal belief across diet ideologies is that the less processed food you eat, the better.

Processed foods are often highly refined, stripped of nutrients, and filled with high amounts of sugar, salt, and unhealthy fats. Reports have demonstrated that epigenetic deviations result from exposure to processed food and environmental toxins 14. Fathers-to-be would be smart to reduce their consumption of processed food as much as possible since epigenetics can be passed down from the parents to their children.

Takeaways

A man’s health and lifestyle in the preconception period can profoundly impact the health of his child and the pregnant mother. To increase the likelihood of positive pregnancy and birth outcomes, as well as the health of their children, men should be careful to cultivate a healthy lifestyle in the preconception period. These are some actions that can give a man the best chance to contribute to a healthy pregnancy and child:

  • Optimize your BMI. Ensuring that you maintain a healthy weight in the preconception period may reduce the chance of encountering fertility challenges, extreme birth weights, and passing down metabolic disorders. Weight can be managed with a healthy diet and exercise.

  • Do not smoke. Paternal smoking has been associated with reduced semen quality and childhood obesity.

  • Reduce environmental exposure to toxins. Paternal exposure to pesticides, solvents, and air pollution has been demonstrated to have adverse effects on fertility and health of offspring.

  • Reduce (or eliminate) intake of processed foods. Since epigenetic changes have been demonstrated in response to processed food and environmental toxins (and can be passed down), fathers-to-be should be careful to ensure they follow a clean diet.

Note: The purpose of this article is not to blame parents for the outcome of a pregnancy - there are many factors that cannot be controlled, restricted resources, and limited knowledge, especially with science that is ever-evolving. Instead, the purpose of this article is to empower parents-to-be with information to help guide them to make the best choices that they can.

Disclaimer:

The information on Better Health Project is intended for educative and informational purposes only and is not intended to serve as professional or medical advice. The content of this site is not written by a medical professional. Always seek the advice of a trusted and qualified healthcare professional before making health changes.

Further Reading:

Deep Nutrition, Cate Shanahan, M.D

Countdown, Dr. Shanna Swan

Change your genes, change your life: creating optimal health with the new science of epigenetics by Dr. Kenneth R. Pelletier.

Sources

  1. Hagai Levine, Niels Jørgensen, Anderson Martino-Andrade, Jaime Mendiola, Dan Weksler-Derri, Irina Mindlis, Rachel Pinotti, Shanna H Swan, Temporal trends in sperm count: a systematic review and meta-regression analysis, Human Reproduction Update, Volume 23, Issue 6, November-December 2017, Pages 646–659

  2. Swan, S. H. (2021). Countdown. Scribner.

  3. Kasman AM, Zhang CA, Li S, Stevenson DK, Shaw GM, Eisenberg ML. Association of preconception paternal health on perinatal outcomes: analysis of U.S. claims data. Fertil Steril. 2020 May;113(5):947-954. doi: 10.1016/j.fertnstert.2019.12.026. Epub 2020 Mar 6. Erratum in: Fertil Steril. 2021 Mar;115(3):809. PMID: 32147174.

  4. du Fossé NA, van der Hoorn MP, van Lith JMM, le Cessie S, Lashley EELO. Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis. Hum Reprod Update. 2020 Sep 1;26(5):650-669. doi: 10.1093/humupd/dmaa010. PMID: 32358607; PMCID: PMC7456349.

  5. Chen T, Zhang CA, Li S, Schroeder AR, Shaw GM, Eisenberg ML. The association of preconception paternal metabolic syndrome on early childhood emergency department visits and hospitalizations. Andrology. 2022 Dec 21. doi: 10.1111/andr.13370. Epub ahead of print. PMID: 36542456.

  6. Lin J, Gu W, Huang H. Effects of Paternal Obesity on Fetal Development and Pregnancy Complications: A Prospective Clinical Cohort Study. Front Endocrinol (Lausanne). 2022 Mar 14;13:826665. doi: 10.3389/fendo.2022.826665. PMID: 35360083; PMCID: PMC8963983.

  7. Montagnoli C, Ruggeri S, Cinelli G, Tozzi AE, Bovo C, Bortolus R, Zanconato G. Anything New about Paternal Contribution to Reproductive Outcomes? A Review of the Evidence. World J Mens Health. 2021 Oct;39(4):626-644. doi: 10.5534/wjmh.200147. Epub 2021 Jan 8. PMID: 33474842; PMCID: PMC8443996.

  8. Hu C, Tao Y, Deng Y, Cai Q, Ren H, Yu C, Zheng S, Yang J, Zeng C. Paternal long-term PM2.5 exposure causes hypertension via increased renal AT1R expression and function in male offspring. Clin Sci (Lond). 2021 Nov 26;135(22):2575-2588. doi: 10.1042/CS20210802. PMID: 34779863; PMCID: PMC8628185.

  9. Air Quality in Ontario 2018 Report. (2018). In https://www.ontario.ca/document/air-quality-ontario-2018-report/appendix#annual-pm25. Ontario Environment and Energy. Retrieved December 27, 2022, from https://www.ontario.ca/document/air-quality-ontario-2018-report/appendix#annual-pm25

  10. Perrin, J. M., Anderson, L. E., & Van Cleave, J. (2014). The rise in chronic conditions among infants, children, and youth can be met with continued health system innovations. Health Affairs, 33(12), 2099–2105. https://doi.org/10.1377/hlthaff.2014.0832

  11. Liu, C, Cnattingius, S, Bergström, M, Östberg, V, Hjern, A. Prenatal parental depression and preterm birth: a national cohort study. BJOG 2016; 123: 1973– 1982.

  12. Public Health Agency of Canada. (n.d.). Tackling Obesity in Canada: Obesity and Excess Weight Rates in Canadian Adults - Canada.ca. https://www.canada.ca/en/public-health/services/publications/healthy-living/obesity-excess-weight-rates-canadian-adults.html

  13. Gestational Diabetes. (2022, March 2). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/gestational.html

  14. Soubry A. POHaD: why we should study future fathers. Environ Epigenet. 2018 Apr 26;4(2):dvy007. doi: 10.1093/eep/dvy007. PMID: 29732171; PMCID: PMC5920283.

  15. Preeclampsia: Symptoms, Causes, Treatments & Prevention. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17952-preeclampsia

  16. Belfort, M. A. (2022, November). Overview of postpartum hemorrhage. UpToDate. Retrieved December 30, 2022, from https://www.uptodate.com/contents/overview-of-postpartum-hemorrhage

  17. Fetal macrosomia - Symptoms and causes. (2022, June 3). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/fetal-macrosomia/symptoms-causes/syc-20372579