Real Food For Pregnancy

RootCause Dispatch #19

If there is one book that I recommend to all women thinking about pregnancy, currently pregnant or post partum, it is Lily Nichols’ book Real Food For Pregnancy.

In the West we have collectively lost our ancestral wisdom surrounding optimal human nutrition. This book provides an instruction manual for eating correctly during this critical period of a woman’s life.

Unlike the vast majority of dietitians who simply regurgitate high-carb dietary advice influenced by the processed food industry, Lily is a registered dietitian who delved into the scientific literature and did some first-principles reasoning.

Lily’s approach is based on identifying all the essential micro-nutrients for an optimal pregnancy (many of which are omitted, incorrectly and/or inadequately specified by offical guideline RDAs) and basing the diet around the richest sources. This inevitably leads to a diet high in animal foods — which contain the most bio-available sources of fat-soluble vitamins, water soluble vitamins and trace minerals —and low in carbohydrates.

Everything needed to prepare the female body for pregnancy and grow a healthy baby without the processed junk that causes metabolic dysfunction. An approach that completely reflects ancestral dietary habits as (re)discovered by Weston Price. Funny that.

Specific topics covered include:

• misconceptions surrounding liver consumption and Vitamin-A toxicity

• the importance of choline, glycine and omega-3 fatty acid DHA to optimal development of the fetus

• toxins like aluminum, fluoride and BPA

• folic acid, MHTFR mutations and why methylfolate from food is superior

In my opinion there is a massive unmet for her book, for three key reasons.

1. Obesity and Metabolic Dysfunction

A growing number of pregnant women we see on the maternity ward are overweight or obese. A direct consequence of consumption of ultra processed food like seed oils, refined grains, sugar and liquid calories like sodas and juice.

Maternal obesity is associated with a range of pregnancy disorders including gestational hypertension, pre-eclampsia and thromboembolic events (blood clots)¹.

Perhaps most importantly, obese women are more likely to develop gestational diabetes, which a state of insulin resistance and metabolic dysfunction temporarily induced (or unmasked) by pregnancy.

Gestational diabetesis associated with increased risks of fetal malformations, fetal macrosomia (large baby) and birthing injuries like shoulder dystocia. Being diabetic during pregnancy also confers an epigenetic legacy that predisposes your child to becoming obese and diabetic themselves later in life².

2. Nutrient deficiency

High calorie malnutrition occurs today with consumption of modern Western diet high in refined grains and sugar.

But even those who maintain a ‘healthy diet’ by the mainstream recommendations are likely to be deficient or inadequate in a range of nutrients that aren’t found eating just whole grains, vegetables and occasional portion of lean meat— like choline, glycine, DHA, Vitamin K2, zinc, heme iron — many of which become conditionally essential during pregnancy. Not to mention protein itself.

As for a vegan or strict vegetarian pregnancy? That’s like trying to build a Lamborghini out of parts scrounged from the scrap metal junkyard.

This problem seems to be getting worse as more young people, particularly girls have their empathy hijacked by propaganda surrounding plant-based dieting for ‘planet health’.

3. Mainstream medical ignorance of nutrition

Mainstream obstetric approach to nutrition is highly reductionist. Your run-of-the-mill OBGYN seems to be content checking for overt serum deficiency of Vitamin B12, folate, iron and Vitamin D and then recommending nutriceutical supplementation.

There is no appreciation of the spectrum of nutrient repletion nor the fact that manufactured pills of elemental minerals are no substitute for food sources, which contain numerous co-factors and other substrates that aid absorption.

The mainstream approach to treating gestational diabetes is a travesty, a topic upon which some heads will need to roll at some future date. There is active promotion of carbohydrate consumption and a heavy bias towards insulin use instead of effective low-carb strategies. I have personally seen dietitians spout the nonsensical circular reasoning recommending ‘a minimum carbohydrate intake because you are now on insulin’, advice that ignores the most obvious #rootcause solution which is simply avoiding foods that provoke hyperglycemia.

RCMD’s point of difference

I differ slightly to Lily in my view of the value of regular vegetable consumption. As Bill Schindler eluded to in Eat Like a Human, and as Dr Paul Saladino has emphasized extensively, plants do not want to be eaten.

Many contain plant defense chemicals (oxalates found in spinach and soy, isothiocyanates found in cruciferous vegetables) that are either directly harmful to humans or impair the absorption of micronutrients from those plant foods when eaten in large amounts.

Not to say that plants can’t be safely eaten or that one should completely avoid vegetables during pregnancy, if you like them and don’t have severe autoimmune disease by all means go ahead. But don’t force yourself. And if you are eating vegetable consider how you are preparing them in order to de-activate their toxins – usually by cooking or fermentation.

When should I read the book?

As Weston Price noted among the native tribes he visited, pre-pregnancy feeding periods commonly commenced at least a year prior to conception.

It is always a good time to take charge of your health, but the average woman eating a Standard American Diet would do well to read the book and implement its recommendations 1-3 years prior to pregnancy.

For those wanting to hear Lily talk on the topic, I highly recommend her recent discussion with Dr Jaime Seeman. Check out her blog which contains a trove of informative articles and lets you read the first chapter for free.

While you wait for the book to arrive in the mail, I’ll give you some actionable advice:

• limit your carbs if you have gestational diabetes, obesity or strong family history

• incorporate organ meats, particularly heart and liver

• incorporate a source of Vitamin K2 – organic grass-fed butter, liver, hard cheeses

• incorporate bone broth for highly bio-available collagen and glycine

• buy organic wherever possible

• meet your rancher and stock up on a regeneratively raised, fully grass-fed whole beast with bones, organs and fat included. Or send your husband hunting.

The Rest Is Up To You…

— RootCause MD

July 9, 2022

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1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954173/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008467/