Diet and Miscarriage: Can a Balanced Diet Lower the Risk?

Diet and Miscarriage: Can a Balanced Diet Lower the Risk?

Experiencing a miscarriage is a deeply emotional journey that impacts many women and their partners. While the reasons behind miscarriage are often complex and varied, emerging research suggests that our dietary choices may influence the risk of miscarriage. As a dietitian who has personally navigated the challenges of miscarriage, this research resonated deeply with me.

The findings echoed the dietary shifts I embraced before achieving a successful pregnancy. Specifically, I incorporated more fruits, grains, and dairy products into my diet. For the past decade, I had restricted my fruit intake due to my PCOS—a choice I no longer recommend to my clients dealing with PCOS. I had also replaced traditional yogurt with coconut yogurt and consumed fewer grains overall.

However, in preparation for my successful IVF retrieval and transfer, I reintroduced fruit and diversified my grain intake to include options like rice, brown rice ramen, oatmeal, and quinoa. I also returned to consuming dairy yogurt, aligning more closely with the balanced diet highlighted in the recent research on reducing miscarriage risk through nutrition. 

In this blog post, we'll explore the potential association between a diet abundant in fruit, vegetables, seafood, dairy, eggs, and grains and lower miscarriage odds.

Understanding Miscarriage

Miscarriage, refers to the loss of a pregnancy before the 20th week. Common causes of miscarriage include chromosomal abnormalities, hormonal imbalances, uterine abnormalities, and other medical conditions. Lifestyle factors, including diet, may also influence miscarriage risk. 

Achieving a chromosomally normal embryo is pivotal for a successful pregnancy, and this involves enhancing both egg and sperm quality—areas where diet and lifestyle changes can make a significant difference.

During my first IVF retrieval, following seven miscarriages, we were able to create seven embryos. However, only two were chromosomally normal. My medical team believed this could be a contributing factor to my recurrent first-trimester miscarriages.

In preparation for my second IVF retrieval, my focus shifted towards optimizing egg quality, while my husband took proactive steps to enhance his sperm quality. Despite previous tests indicating his sperm health was satisfactory, we recognized that there are limitations to what testing can reveal, prompting us to leave no stone unturned in our pursuit of a healthy pregnancy. I also prioritized enhancing my gut health, recognizing that the right dietary choices—such as incorporating more carbohydrates and fiber—can significantly impact overall gut health. I had been eating fairly low carbohydrate during my years of recurrent loss. 

The Role of Diet in Miscarriage Risk

Emerging research has begun to explore the relationship between diet and miscarriage risk (1). A balanced diet rich in essential nutrients may help support a healthy pregnancy and reduce the risk of miscarriage.

Key Dietary Components and Lower Miscarriage Odds

This new meta analysis was published in 2023 with a sample size of over 13,000 women which provides us with good data and higher statistical significance. 

• Fruits and Vegetables: A diet abundant in fruits and vegetables provides essential vitamins, minerals, and antioxidants that support reproductive health. Antioxidants, such as vitamin C and beta-carotene found in fruits and vegetables, may help reduce oxidative stress and inflammation, potentially lowering miscarriage risk. The study showed a 61% reduction in miscarriage rate if you had a diet high in fruit. Vegetables showed a 41% reduction in miscarriage rate if you had a diet high in vegetables. Bonus: they are both also high in fiber which can help nurture your gut health. Gut bacteria ferment fiber to produce short-chain fatty acids, which help reduce inflammation. Reducing inflammation is always a goal before trying to conceive naturally or prior to an IVF retrieval or transfer. 
• Seafood: Seafood is a rich source of omega-3 fatty acids, particularly EPA and DHA, which are essential for fetal development and may help reduce inflammation and support a healthy pregnancy. The study showed a higher intake of seafood was associated with a 19% reduction in miscarriage. However, it's essential to choose low-mercury seafood options and avoid high-mercury fish during pregnancy. If you do not like seafood, a good quality omega-3 is something I recommend to clients. 
• Dairy: Dairy products are a valuable source of calcium, protein, and vitamin D, which are essential for bone health and may support a healthy pregnancy. The study showed a 37% reduction in miscarriage risk for those with a high intake of dairy. This finding is significant, especially considering that many individuals are advised by healthcare professionals to eliminate dairy from their diets. If dairy isn't well-tolerated, lactose-free yogurt could be a suitable alternative, as lactose intolerance might be the issue rather than a broader dairy intolerance. However, if someone has a dairy allergy, avoidance is essential. If you're advised to cut out dairy due to recurrent pregnancy loss, it's worth questioning whether this advice is evidence-based as it contradicts this new study. I'd also suggest that those with multiple food intolerances focus on fixing their gut health, as improving tolerance to various foods over time is possible! 
• Eggs: Eggs are a nutrient-dense food that provides high-quality protein, vitamins, and minerals, including choline, which is essential for fetal brain development. The study showed a 19% reduction in miscarriage risk for those with a high intake of eggs. Incorporating eggs into a balanced diet may help support a healthy pregnancy.
• Grains: Whole grains, such as brown rice, quinoa, and whole wheat bread, are rich in fiber, vitamins, and minerals, including folate, which is crucial for fetal development and may help reduce the risk of neural tube defects and miscarriage. The study showed a 33% reduction in miscarriage risk for those with a high intake of grains. This is also something I see people being told to avoid fairly regularly assuming that grains are pro-inflammatory. 

Conversely, the review found a diet high in ultra-processed foods was found to double the risk of miscarriage. There is a growing body of evidence suggesting that lifestyle changes, including dietary adjustments, quitting smoking, and abstaining from alcohol, before and during early pregnancy can have an impact on reducing miscarriage risk. A major cause of miscarriages can be chromosomally abnormal embryos, it’s important that BOTH partners are making changes to their diet and lifestyle to improve egg & sperm quality. This may give you a better chance at creating healthy embryos which have a chance to develop into a healthy pregnancy. 

Conclusion

While the relationship between diet and miscarriage risk is complex and multifactorial, emerging research suggests that a balanced diet abundant in fruit, vegetables, seafood, dairy, eggs, and grains may be associated with lower miscarriage odds. Adopting a healthy and balanced diet, along with other lifestyle modifications, may help support reproductive health and reduce the risk of miscarriage.

If you're planning a pregnancy or currently pregnant, it's essential to consult with a healthcare professional or a registered dietitian to develop a personalized nutrition plan tailored to your needs and preferences. There should be no one size fits all approach to nutrition and it should be tailored to each person. There is a lot of misinformation online, so make sure you're getting advice from trusted sources. 

References:

1. Chung Y, Melo P, Pickering O, Dhillon-Smith R, Coomarasamy A, Devall A. The association between dietary patterns and risk of miscarriage: a systematic review and meta-analysis. Fertil Steril. 2023 Aug;120(2):333-357. doi: 10.1016/j.fertnstert.2023.04.011. Epub 2023 Apr 13. PMID: 37061157.