What to eat when you're pregnant (you'll be surprised...)

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So much of what we teach as birth doulas is ancient wisdom from sources that have been all but forgotten. But as this wisdom becomes increasingly backed by science it is entering mainstream consciousness. Nichols (also the author of Real Food for Gestational Diabetes) methodically lays out both the diet myths and the alternatives, citing everything with research that backs-up her own extensive experience as a nutritionist and a mother. It’s a fabulous resource for any woman who wants to lower her chances of a difficult pregnancy and to stay healthy as she enters the most sacred, beautiful and potentially challenging of times.

Amongst the myths this book busts are:

  • Eating butter, double cream and lard is bad for you and will make you fat.

  • The best way to combat gestational diabetes is a diet high in carbohydrates.

  • You should maintain a low-salt diet during pregnancy.

And amongst the good news is:

  • Although 18% of women will receive a diagnosis of gestational diabetes, using the “real food approach” can cut the figure of those who require insulin or medication to manage blood sugar by half. Yep, you heard that correctly, by 50%.

  • It also leads to far fewer women who struggle with excessive weight gain and preeclampsia.

  • Which means more babies born at a normal weight and with normal blood sugar levels (facts that will influence their health for a lifetime).

So what IS real food?

Crazy that we even need to ask this question but living in the times that we do it’s a fact that many of us are turning to highly processed foods that, well, just aren’t that real. Real food is that which “…is as close to the source as possible and grown or raised in conditions to maximize nutrient density.” To take just one example of what that means, let’s look at the difference in nutrient density between eggs from pasture-raised hens versus commercially-rasied hens:

  • Vitamin A is 30% higher in pasture-raised hens

  • Vitamin E content is double.

  • Omega-3 content is 2.5x higher

  • Omega-6 content (the fats that cause inflammation) is less than half the ratio to omega-3 in pasture-raised hens

  • Vitamin D content is 3 to 6 times higher, due to regular sun exposure.

Crazy, huh?

Now let’s talk about carbs. Oh how we all love carbs. And if you eat cereal for breakfast, a sandwich for lunch and pasta for dinner (not to mention the yummy crunchy snacks we nibble on in between) then you’re going to get way too many of them.

Why is this important?

Because carbs are in fact the only macronutrient that significantly raises your blood sugar. So a diet like the one just mentioned is just begging for gestational diabetes in mumma and metabolic problems for baby later in life. This is surprising, given that conventional nutrition advice for gestational diabetes is a high carb diet. Nichols isn’t saying you have to eliminate ALL carbs but she does (like many others out there) suggest that we start to plan our meals around something else. In my opinion she goes a little overboard with this (in a climate where carbs form such a huge proportion of how we eat, it just isn’t realistic to ask a woman to eat crustless spinach quiche for breakfast) but that said, it’s not that hard to significantly lower your intake. For example, says Nichols, try a dinner of grass-fed beef meatloaf, roasted veggies and potatoes or a snack of apple and almond butter.

Fat is your friend. At least some of them are.

One of the most surprising parts of the book for many women will be the section on fat. We’ve been trained for decades now to think that eating fat makes you fat WHICH IS SO NOT TRUE. But it’s ingrained in us; even Nickols herself admits that it took her THREE YEARS of reading the research to give herself permission to use it liberally in her cooking. The short version is that there are good fats and bad fats. Bad fats include canola, sunflower, soybean and corn oil. Good fats include olive oil, coconut oil, dairy fats and animal fats. That means butter, lard, heavy cream and cream cheese (from pasture/grass fed animals) are good for you. YES YOU HEARD THAT CORRECTLY - slop on the butter and whipping cream. If you don’t believe me, read the book; she’s got TONS of research to back it up.

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As far as vegetables are concerned you can sum up her position in one sentence: you need to eat more of them. Half your plate at every meal to be exact. Choose organic and combine them with some sort of fat (like olive oil or butter on top).

And now let’s talk about salt. “To put it simply,” says Nichols “salt is your friend - not your enemy - when you’re pregnant.” Fifteen per cent of the population has ELEVATED blood pressure on a low-salt diet Nicols points out and for most of the rest of us, salt has little to no effect on blood pressure. On the positive side, salt is vital to a healthy pregnancy including your electrolyte balance, maintaining normal stomach acid levels and absorption of vitamins and minerals.

In addition to all this you need to be keeping up your protein levels, eating bone broth and liver and some wild caught fish (even sushi is considered acceptable for pregnant women in Japan, Nichols points out, rather controversially). Foods to avoid or dramatically decrease include refined carbs, sugar and the aforementioned vegetable oils. Moving your body is also super important; women who exercise regularly during pregnancy lower their chances of gestational diabetes by up to 78 per cent.

Included in the book are recipes and meal plans as well as a good deal of info on supplements, tests during pregnancy and tips on how to reduce your exposure to chemicals and toxins at home.

This book is an absolute gem if you want to commit to giving yourself the best chances of a healthy pregnancy. Though if we’re being real, the cost of this kind of diet is out of reach for SO MANY women in the US. Eating organic and having time to cook just isn’t on the cards for a lot of families and much broader social and economic changes are needed if this country is to get serious about the health of its women and babies. Still, pregnant mummas can make small changes - replacing the canola oil with coconut oil or butter, remembering to get enough salt and upping your proteins intake as opposed to carbs - even if they can’t afford to make all of the changes recommended by Nichols. This book is a keeper and I’d recommend it to any mumma-to-be.

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