Bite Back with Abbey Sharp - Pregnancy Nutrition DOs & DONTs (without the Fearmongering Diet Culture) with Dr. Jess Knurick
Episode Date: March 11, 2025In todays episode of Bite Back with Abbey Sharp, I chat with Dr Jessica Knurick, a fellow registered dietitian who specializes in pregnancy nutrition with a PhD in physical activity, nutrition and w...ellness. We will be discussing how diet culture and wellness culture loves to pray on pregnant people. We will chat about the actual impact of mom’s diet during pregnancy on baby’s health and development, and which foods you should absolutely avoid vs which are a risk/benefit analysis. We will be debunking myths around the glucose tolerance test and so called “toxins” in baby formula (and Jess will explain why they include sugar and seed oils). And we will chat about when to be concerned about pregnancy weight gain, and tips for making peace with your changing body and food. Note: This episode includes exclusive woman language, but we acknowledge that not everyone who is a mother or experiences pregnancy identify as a woman. Check in with today’s amazing guest: Dr. Jessica KnurickFollow @drjessicaknurickhttps://www.jessicaknurick.comReferences:https://pmc.ncbi.nlm.nih.gov/articles/PMC6526983/ Disclaimer: The content in this episode is for educational and entertainment purposes only and is never a substitute for medical advice. If you’re struggling with with your mental or physical health, please work one on one with a health care provider.If you have heard yourself in our discussion today, and are looking for support, contact the free NEDIC helpline at 1-866-NEDIC-20 or go to eatingdisorderhope.com. 🥤 Check out my 2-in-1 Plant Based Probiotic Protein Powder, neue theory at www.neuetheory.com or @neuetheory and use my promo code BITEBACK20 to get 20% off your order! Don’t forget to Please subscribe on Apple, Spotify or wherever you get your podcasts and leave us a review! It really helps us out. ✉️ SUBSCRIBE TO MY NEWSLETTERS ⤵️Neue Theory newsletterAbbey's Kitchen newsletter 🥞 FREE HUNGER CRUSHING COMBO™ E-BOOK! 💪🏼 FREE PROTEIN 101 E-BOOK! 📱 Follow me! Instagram: @abbeyskitchenTikTok: @abbeyskitchenYouTube: @AbbeysKitchen My blog, Abbey’s Kitchen www.abbeyskitchen.comMy book, The Mindful Glow Cookbook affiliate link: https://amzn.to/3NoHtvf If you liked this podcast, please like, follow, and leave a review with your thoughts and let me know who you want me to discuss next!
Transcript
Discussion (0)
So I think people just really need to understand that.
If you have a placenta, you can have gestational diabetes.
Welcome to another episode of Bite Back with Abbey Sharp, where I dismantle diet culture
rules, call it the charlatans spinning the pseudoscience, and help you achieve food
freedom for good.
Happy Nutrition Month my friends!
This month I am going to be featuring a bunch of my fellow dietician colleagues and really
just drawing on their unique areas of expertise.
And if you've ever been pregnant or are are thinking about being pregnant, or know someone
who has been pregnant, you are going to really appreciate today's episode.
You know, us women are subject to so many body pressures throughout all stages of our
lives, but society has like a very unique penchant for policing pregnant bodies.
From societal expectations to medical interventions, pregnant women are often subject to scrutiny
over their every decision.
What they eat, how much weight they gain, how they deliver, and what they feed their
newborn.
This non-stop surveillance teaches us that when something goes wrong, whether that's gestational
diabetes, miscarriage, or a child with developmental delays, it's because of something we didn't
do right.
You know, in an era where choice and personal agency are supposed to be celebrated, most
pregnant folks often feel completely incapable of making decisions that are best for them.
If we drink coffee, or are too tired to exercise, or give in to those McDonald's cravings,
we are branded as bad mums before we even give birth.
That fear, guilt, and shame teaches us to be fearful of our changing body, to distrust
our innate intuition, and to clamp down even harder
on diet culture rules. Thankfully, my guest today is here to provide us with science-based
information during this tumultuous and confusing time. Dr Jessica Nurick is a fellow registered
dietitian who specializes in prenatal nutrition with a PhD in physical activity, nutrition and wellness.
We'll be discussing the actual impact of mom's diet
during pregnancy on baby's health and development.
We'll be debunking myths around the glucose tolerance test
and so-called toxins in baby formula.
And we'll be chatting about when to be concerned
about pregnancy weight gain and any tips for making peace
with your changing body and food. A quick disclaimer that for simplicity we will
be using exclusionary woman language but I fully appreciate that that does not
encompass all of the identities affiliated with motherhood. And also my
general disclaimer that the information in this episode is never a replacement
for personalized health care And finally, I would
love if you would follow or subscribe to the podcast and leave me a review because as a new
podcast, it really, really does help me out. All right, folks, let's get into it.
Thank you so much for joining me, Jessica, and for being part of this big science communicator
army just to help with the take down die culture and pseudoscience misinformation online.
I'm so happy that you're here.
I'm so excited to be here.
Thanks for having me.
Excited to talk to you about this stuff.
Oh, yeah.
So, I mean, I'm a mom of two and I know, you know, I'm just so grateful that I had my first pregnancy,
like seven years ago, pre-TikTok days. So it was just really like the Facebook mom group
that I had to wade through and that was like problematic and stressful enough. Like, you
know, as you know, so much judgment, so much sharing, so many arguing about like very sensitive
topics like formula, bed sharing, sleep training, etc. Women telling you to put breast milk on everything and any brush, right?
But I feel like the mom group has nothing on the advice of TikTok experts that new moms are exposed to today.
And I thought, you know, before we kind of set the record straight on some very specific messages that we are seeing coming up often in this space, why do you think that expectant and new moms are
just such a target for all this quackery?
Yeah, I mean, well, first I would agree with you because I had my first pregnancy in 2019
and even then it wasn't as prevalent because I think TikTok just really, really exacerbated
a lot.
And then my second
pregnancy was in 2022. And that was when I really started realizing just how much misinformation was
targeted at pregnant women and new moms. And that's when I started that I got kind of, I was like,
kind of late to the TikTok game, but that's when I started going on social media. Because I was
just like, this is wild. Like we need like people who are actually kind of like combating some of
this stuff, because it's just taking over and it's so terrible. Women are already so anxious, right,
of everything that is going on. And so I think that it's an opportunity for people in a negative
way to take advantage of kind of a vulnerable population who is going through a period of time
where they are hyper fixated on
learning, by the way, right? They're probably reading more and trying to absorb more information
than they ever have because who knows how to be pregnant and have a baby, right? We don't just
know that, so we have to learn. And so when you become pregnant or you're trying to conceive,
like you're really absorbing a lot of information and people know that. And so they're putting out
a lot of information and they're targeting them with a lot of misinformation, unfortunately.
And it is a vulnerable time where we are very susceptible to misinformation.
100%.
Because really we want to all just do what's best for our babies. And if someone is telling you that
this is so dangerous for your baby or so on and so forth. It can be very easy to
just kind of eat that up and take it at face value.
A hundred percent. And I always think about my own experience too. There's just all these
rapid unpredictable changes happening during pregnancy. And like you said, this just heightens
anxiety and this need for control. And what's one of the best and only ways perhaps that
we can feel like
we are in control of this new uncharted territory is what we eat or our lifestyle. And you know,
the anxious mind craves control. And so, you know, by making all of these sacrifices to
have this clean, non-toxic diet during pregnancy, at least we have this sense, this feeling
that we're doing everything we possibly
can to control the outcome. And that, like in some ways, it's meant to be empowering,
but it's actually very much disempowering because, you know, in a lot of ways, you're
teaching yourself to kind of quiet your own natural intuition. And I also just think there's so much
pressure on moms to be perfect. And that
starts with this like, idyllic pregnancy, it follows with like, you know, to produce this healthy,
developmentally normal child. And if anything goes wrong along the way, it is because of something
we did or did not do. And I see this so clearly with all of these kind of clean eating, you know, diet protocols that moms are
putting themselves on to prevent different problems like autism or ADHD, for example.
Right. A lot of things that really are not in your control nutritionally, right?
Exactly. So this kind of brings me to, I guess, what might be a controversial and sensitive kind of topic or question about the impact of mom's diet
on baby's health. And I just want to flag that, you know, before we get into that, I want to make
it super, super clear that Jess and I are dietitians, right? So of course, we cannot deny
that nutrition is important during this phase, and obviously every other phase of life. But
during this phase and obviously every other phase of life. But for a lot of women, this can be a very, very hard time to even think about optimizing nutrition. And you're not a failure if you can
only stomach saltines or like in my case, salt and vinegar chips. Like even dietitians don't
always eat the way that we know may be most beneficial. So like, Jess,
what was your imperfect diet staples in pregnancy?
Yeah, I mean, my first pregnancy, I ate ice cream every single day. So, and I'm not even,
I don't really even like ice cream. Like I don't even eat it that much outside of pregnancy.
But I had to have something like creamy or like that every day and take my husband. And I actually, there's a story that sticks out
of my brain of like one time my husband came with me to get ice cream and he didn't get
any himself. And I was so irrationally upset at him for not eating the ice cream with me
only in pregnancy.
I mean, I probably would do that still now. But yeah, like we all have these stories.
Again, I'm a dietician.
I had the best intentions of eating well in my pregnancy.
In my second pregnancy, I would wake up and I would think, okay, today is the day I'm
going to eat vegetables.
And I would order myself a Greek salad with the best intentions of eating it.
And as soon as I saw it, I was like, my body was like, hell
to the no. I would eat the feta cheese pieces off and then give the salad away because I
could not even be in the presence of those greens. And I did this like multiple times
a week being like, today's the day, today's the day I'm going to eat salad. And then
I would just eat feta cheese for dinner. I tell pregnant moms that your body is super
scrappy and it will pull from your resources to get baby what it needs during those periods when
your diet is beige and bland. Feta is best. Yeah, absolutely.
All calories are good calories at this stage. For a lot of women, getting anything in is a huge accomplishment.
Plus, we take a prenatal vitamin for a reason, right?
Yeah.
I mean, especially in that first trimester, like there's just so many symptoms and just
getting any energy, as you say, is really the key.
Yeah, exactly.
What with that kind of disclaimer put in there, How much and in what way does what we eat
when we are pregnant actually affect baby's health?
Yeah, I mean, so as you say, our bodies are very resilient
and they can really be scrappy and produce a healthy baby
in pretty extreme conditions.
But that being said, there are optimal,
there's a way to optimize nutrition for optimal outcomes.
And you know, all things being equal,
there's a number of different ways
that we can optimize your nutrition during that time.
But I do wanna say all things aren't equal for everyone,
right, and so that even down to some people experience
morning sickness or nausea their entire pregnancy, right? And so, so that even down to some people experience morning sickness
or nausea their entire pregnancy, right? Those of us who are lucky experience it maybe for
a few weeks, maybe just in the first trimester and then it kind of goes away. And then others
really it's for that whole, whole entire pregnancy. And so, you know, when I'm working with those
types of people, it's, it's more trying to get any kind of energy in. And then as you
say, using a prenatal vitamin to help kind of fill in some of those gaps.
But there's a lot of research out there in terms of the importance of perinatal nutrition,
both in the pregnancy period and in the postpartum period, on neonatal outcomes and on outcomes
for the mom.
And so nutrition, when we're talking about nutrition, we're thinking of energy,
macronutrients, different fats, proteins, carbohydrates, and then also micronutrients
and different vitamins and minerals. And there's a lot of research to indicate that pregnant
people are deficient in a lot of these nutrients, not only during pregnancy, but also going
into pregnancy. And so that's why one of the strategies to help combat that
is to recommend some people get on a prenatal vitamin
even before they're pregnant, right?
I like to say when you start thinking
about trying to conceive, that's a really good time
to start getting on a prenatal vitamin
so that you can optimize those nutrient stores
going into pregnancy.
Because when a lot of the data kind of shows when they're looking
at outcomes, I mean, it can affect things like obviously macrosomia, which is having a large baby
or a low birth weight or small for gestational age, but also things like cognitive development
in the offspring. And then also into childhood and even adulthood, pregnancy nutrition can have an impact on metabolic health in the offspring into adulthood. And there's lots of research
to show there's lots of longitudinal studies that have looked at this and some very interesting
data looking at kind of low energy when fetuses receive low energy in pregnancy, and then
also a lot of deficiencies in those micronutrients
and how that has an effect on things like hypertension and diabetes and cardiovascular
disease and then also dementia and mood disorders as well. And so really optimizing those nutritional
stores can be very impactful on the baby and then also on the mom.
Wow. And are there any particular vitamins that we see come up more frequently in the
literature that are particularly important for long-term health benefits?
Yeah. Yeah. So energy is one of them, right? So just getting calories. So that's why we
say, sometimes it's literally just helping the mom to get calories. But then when we're
looking at actual nutrients, omega-3 fatty acids is a big one, DHA.
A lot of people are deficient in DHA, and it has a strong link to neurodevelopmental
and cognitive outcomes in the offspring.
Vitamin D is also one.
There's a really good longitudinal study out of the Boston area.
It's called Project Viva, and they looked at about 2,000 different infants starting in 1999 and
still going on, it's still ongoing. And they found a lot of different impacts, specifically with
vitamin D and later asthma and wheezing in childhood. They also looked at things like
the diet quality, so making sure you're getting a lot of nutrients, like nutrient
density in your diet on lower risk of preterm birth and then healthier birth outcomes as
well. And then the omega-3 as well and looking at neurodevelopmental outcomes. There's a
lot of good data on that.
Amazing. That's super helpful. Now, I want to kind of like flip this for a second.
We just kind of talked about like the nutrients that are, you know, beneficial.
I want to talk about the laundry list of foods that apparently are no-nos for pregnant folks
because if you did a Google search of basically any food ever, you're going to find it on
some kind of list of why you should not eat it during pregnancy.
What do pregnant people actually need to know when it comes to like unsafe foods during
pregnancy?
Yeah.
So I actually just gave a talk on this last week in a medical conference
on kind of refocusing on nutrition advice in pregnancy on using a more inclusive approach
versus an exclusive approach, which is what's done right now. A lot of the times they're given,
you know, a foods to avoid list without a lot of context on why to avoid it. And I'll tell you,
one time I had a message from a woman, and I've received many of these
since but this is the first time I ever did, and she had forgotten she was pregnant.
And I know that kind of seems like, how could you do that?
But she was just mindlessly at a party and she ate a sandwich, a deli meat sandwich.
And she sent me this message just literally so scared.
And she was like, did I hurt my baby, you know, from eating this
deli meat sandwich? It was very, that became very clear to me that like, people aren't
understanding why these recommendations are made, right? Right. And so if you just tell
somebody not to eat deli meat, it's like, well, why? And then, and then if they do eat
it, it's like a terrifying experience, right? And they're like, what, what just happened?
So right now, a lot of the times they're given these,
and you're right, if you Google anything in pregnancy,
you can find an article on Google
that tells you it's dangerous.
Like I get like, can I have grapes in pregnancy?
Don't Google stuff.
Don't Google stuff.
Exactly, but a lot of the reason
that a lot of these recommendations are made
are for food safety reasons. So the vast majority of them are for food safety reasons. But what
we've found is that, you know, particularly Listeria, because pregnant people are at a
higher risk of Listeria infection because you're immunocompromised when you're pregnant.
But Listeria, I think people think it's a lot more common than it is.
Listeria infection is not that common, listeriosis.
I think the CDC numbers are something like 1,500, around 1,500 cases a year.
The last research I saw, it results in about 15 total cases of fetal loss per year.
So 15 total cases of fetal loss.
That is not
a very high rate, right? And so I think we tend to think it's a lot more impactful than
it is. But having said that, you still want to be careful with food safety in pregnancy,
right? Just like we would be more careful driving in pregnancy, which is way riskier than eating.
So a lot of them come from food safety and just being able to reduce the risk of foodborne
illness. But foodborne illness is really, and if you've followed kind of outbreaks over the
last five to 10 years, you've probably noticed they are random and in all foods. So from leafy greens to mushrooms to
ice cream to deli meat to cheese, like just all foods. Deli meat really, you know, in the 90s,
it really was out, how would I say it? It was more proportional in terms of like the foodborne
illness risk, but there's been a lot of people putting higher regulations on deli meat manufacturers. And so it's come
down quite a bit. So I like to not think of like, in terms of food safety, I like to teach
food safety principles versus telling people they can't have specific foods because there
are higher risk of food safety for most foods. There are some that are really unpasteurized
dairy products or really just the relative risk is so high
that it makes sense to avoid in pregnancy.
High mercury fish is one that we all should avoid anyway, but in pregnancy you would want
to do that.
But this is a good example of using inclusive language instead of exclusive with fish.
A lot of people say avoid high mercury fish and people here avoid fish.
Instead of saying, you know, include low mercury fish because fish is so important.
And we just talked about DHA and it's a wonderful source of DHA for cognitive neurodevelopmental
benefits.
And so kind of just changing that language can be really helpful, I think.
Yeah, so helpful.
Because you're right, like I think all of these food rules are so stressful
to keep up with. Like, it really weighs on us. Like, I just remember in my second pregnancy,
and I had already like gone through this roto, and I'm a dietician. So, you know, I was having
kind of severe anxiety and I went to dinner. And without thinking, I ordered pasta alla
vodka because it is my favorite pasta dish of all time.
And then of course, when I got home,
I was struck with this realization that,
holy shit, this made with vodka and no website.
I Googled every recipe, every website,
and no website could tell me how much vodka,
like it was such a range
and nobody could say how much was retained after cooking.
So I am not joking when I say,
I did not sleep a wink that night. I laid on the couch and I just with my eyes open convinced that
I had just killed my baby. And it was like, you know, even the people like me who understand
science, who understand the dose makes the poison, we fall victim to this unspeakable anxiety around food when we're pregnant. It's
hard to shake. It's hard to escape because it is everywhere.
It's just a unique period of time where I feel like you're more susceptible than ever.
Anyone can just now, unfortunately with the way social media is, literally anyone
can just get on and make a video telling you, which I see all the time because they're sent
to me, like to avoid pineapple because it's going to lead to miscarriage.
And it's like when you see that and you don't know that that's not true, you're very susceptible
to seeing it and then being like, oh my gosh, I can't have pineapple.
And then it's like a minefield, like what can't you eat? And it just becomes exhausting.
It is. And I think what unfortunately, and this is true for basically all wellness culture and all
pseudoscience that gets proliferated online, is it starts with like this like teeny tiny kernel
of truth, or like a teeny tiny like mechanism that may be truthful, but then nothing else is considered. How much you would
need to eat to actually cause harm. Are you eating thousands of pineapples? Because I think
you'd be harmed by the acidity, basically, before your baby would die of a miscarriage because of
it. And that must be true for these things, right? No one's understanding
the absolute risk here. Absolutely. And to your point, like with pineapple, I mean, this comes
from studies in rats showing that a little bit of pineapple extract that's literally placed onto
uterine tissue of pregnant rats cause contractions. And so that's extrapolated in this world to mean
like pineapple is going to lead to miscarriage,
which is just silly if you understand anything about like how humans digest pineapple and how
the dose makes the poison and all of that. Right. We're not rats. We don't put pineapple
extract on our uterus cells. Like a lot of things would have to fall into place for this to be a
legitimate concern. But I want to talk about kind of neurodevelopmental
health because we kind of talked more about kind of like the physical health, like there's so much
misinformation and fear mongering around, for example, neurodivergence, like autism and causing
neurodivergence by something you eat or don't eat. And of course, like this is now seeping into
conversations just around like clean eating
and toxin-free living during pregnancy.
Can you speak to the facts here?
Like, you know, is what women are eating
or not eating causing autism?
Yeah, I mean, I'll put a disclaimer
that I'm not an autism researcher
and that's not super my area of expertise,
but there's not data to indicate
that diet is related to autism
and certainly not the increase in autism rates
that people are seeing.
It's much more the case that we're seeing
an increase in detection and ability to diagnose autism.
Autism has a very, very strong genetic component to it.
And so this fear-mongering that's going around
about how, you know, our kids are getting autism. I saw a video the other day about
how because kids are drinking formula, our formula is causing these autism rates. And
it's just like, first of all, that doesn't make any sense because breastfeeding rates
are significantly higher than they were in the 70s, 80s, and 90s today. So, I mean, it just,
it falls apart right there, but even to think that it has this genetic or this diet component
is just ridiculous. And it's just fear-mongering and playing on people's emotions.
It is. And it's also offensive and very discriminatory. You know, like you mentioned, like autism
and other neurodivergences influenced
by a complex interplay of genetic predispositions, some environmental factors, maybe, but there's
never been a single dietary factor that's been proven to cause or prevent autism, never.
And you know, honestly, what this narrative does is pass so much shame on moms specifically,
if their kids do present as neurodivergent,
when there was nothing that they could have done differently
other than, I don't know,
maybe mate with like a neuro-typical partner.
Like that exactly, right?
So frustrating that that's, you know.
Choose your parents differently.
Yeah, yeah, choose your parents.
Like exactly, like that's what unfortunately
a lot of health outcomes come down to. Like, yeah, well, okay, Choose your parents. Like exactly. Like that's what unfortunately a lot of health
outcomes come down to. Like yeah, well, okay, choose your parents differently. We can't
really do that.
You know what the most ironic thing is too, is that all of these people are really targeting
this group of people with this fear mongering, saying that like all of these different things
out here are going to negatively impact your baby while causing them so much stress
and anxiety from all of this, which actually that stress and anxiety could have negative
impacts on their babies. You know what I mean? It's just like, it's ridiculous.
Exactly. I mean, just look at my example of the pastel of vodka. I didn't sleep. Of course,
that not sleeping is far worse than whatever minute amount of vodka
may have been left like residual in the pasta sauce.
Like, so I just feel like, you know, we're doing people such a harm to them and to their
babies by kind of perpetuating some all of this misinformation and fear mongering.
Okay, so I want to talk some other dangerous kind of pre postnatal
recommendations and myths that I know that you see a lot online that a lot of these kind
of pseudoscience peddlers are pushing. One is that you should refuse the glucose tolerance
test. So first of all, why is the test important? And why do so called experts suggest you should
skip it?
Okay, so the oral glucose tolerance test,
it's given between 24 and 28 weeks of pregnancy generally, because that's when we see insulin
resistance. I mean, insulin resistance increases. So your bodies, your cells resistance to insulin
increases in all normal healthy pregnancies. And so around that 24 to 28 week mark in that
second trimester is about the time
where we see insulin resistance increase enough
where we could detect blood glucose regulation issues
in individuals with gestational diabetes.
The oral glucose tolerance test is used,
it's the gold standard all around the world, by the way,
not just in the United States, all around the world
to screen for and diagnose gestational diabetes.
And it's used because it really stresses the system.
And so you need a stress to the system.
If you're just kind of looking at your blood glucose
with what you eat daily,
you may miss those underlying issues that are happening
maybe at the 24 to 28 week mark
that then increase maybe by 35 weeks.
And if you're not monitoring throughout the rest of your pregnancy, you would miss that
case of gestational diabetes.
So we're really trying to stress the system with the oral glucose tolerance test.
And so that's what we're doing.
So you take, it's a 10 ounce drink and for the screen in the United States, it might
be different in Canada, but in the United States, we do a two-step screening process
where we do a one-hour test. And then if you screen out of that, you're done. And if you don't,
you go on to a three-hour test. And so what we're looking at is, is your body making enough
insulin to meet the demands of insulin resistance that is occurring in your pregnancy? And that's
what that allows us to do. So it's a 10-ounce drink, it's 50 grams of sugar, straight dextrose, which is glucose
for the test. It's an oral glucose tolerance test, so we need that glucose. And you drink
it and then you get your blood drawn at a couple of different time periods. There is a strong, I have no idea how it started, but a strong effort on social
media to discredit the glucose test to make people scared of the glucose test. It is a
concentrated amount of sugar, but it's not like that outlandish. Like people, if you
have like a Frappuccino, you know, I'm not saying everyone drinks Frappuccinos or a soda, it's about
comparable to that. Actually, I think it's way less than what a Frappuccino is. I'm not
sure the sugar content is.
It is, I think. Yeah.
I'm not 100% sure where it comes from. I do think that it makes for good content. Lots
of people get lots of use when they fearmonger the glucose test.
I also think that a little bit of chemophobia comes into play, a little bit of orthorexia
comes into play because of drinking this concentrated drink, like glucose drink, which we wouldn't
drink otherwise, right? But I like to think of it, it's a medical test. We also wouldn't
drink oral contrast for a CT scan every day, right? Just like we wouldn't drink glue cola every day.
But yeah, yeah, it's definitely an area that I battle a lot.
And there are also like healthcare providers that kind of buy into this idea and like offer
these alternatives.
And the alternatives, you know what, if we need alternatives for people who, because
some people really, they have a hard time stomaching this drink, I think that that's
fine, but we have to be honest that the alternatives are not as good as the oral glucose tolerance
test and they will miss more cases of gestational diabetes.
Right.
Yeah.
And I've been in a lot of mom groups where people are like sharing tips on what to eat
and not to eat before the test to basically cheat it so that they pass.
And first of all, that's a bad idea because you want to know what's going on.
There's no point in taking the test if you're not going to do it perfectly or properly.
And again, I just really think it comes down to this like there's so much shame in failing the test
because gestational diabetes for a lot of folks is seen as something that
we are in control of with our diet. But the reality is, I mean, I worked with folks with
gestational diabetes running workshops for them. And I remember seeing all their diet
recalls every day and thinking, holy shit, these women's diets are way healthier than
mine. Like loads of women with healthy
diets and healthy body weights will get gestational diabetes. So I do think there's that kind
of shame that like, oh, I clearly wasn't treating my body well enough because I got gestational
diabetes. And there's that fear of that kind of having to grapple with that for a lot of
people. So they'd just rather cheat it or not do it.
Yeah, you're absolutely right. I mean, that's where a lot of these videos come from that
are like how to pass the gestational diabetes test. And I try to drive home this idea. The
goal is not to pass. The goal is to identify if you have gestational diabetes, right? If
you do or do not. But so this also comes into play when like women are trying to cheat the
test or I'm sorry, when they're thinking that there's all this shame wrapped up in it.
And I think that is a reason that a lot of people are looking for these alternatives
or looking to skip the glucose test as well, because I get a lot of comments on some of
my videos that are like, well, I'm skipping the test because I'm healthy, right?
Or I eat really healthy, so I don't
have gestational diabetes, so I don't need to do it. And it's this thought process. And
I don't think that people understand. And this is kind of why I try to tell people,
you know, if you have a placenta, you can have gestational diabetes, right? Because
you're, and as you mentioned, there's lots of people who are seemingly very low risk
who get gestational diabetes. And that's why we screen everybody.
That's why we started doing that in the United States was doing this like full screen.
And so I think people just really need to understand that.
And I think some of that shame is wrapped up in diet culture.
So unfortunate, but you know, that's the culture we live in right now and it's very vicious
during pregnancy and after.
Well, I want to talk about baby formula for a second because it's such a painful subject for so many women. Despite this movement to de-stigmatize bottle feeding, it has been drilled into us that
breast milk is the perfect baby food.
Of course, we want perfection for our baby.
That said, for a lot of women, breastfeeding is just not going to be a viable option, even
if we desperately want it to be. So it's very painful
and shameful when we see some like charlatan in the grocery store going off about the dangers of
infant formula or calling it poison or toxins because unlike breast milk, it has this like
long list of chemical sounding ingredients, oils, sugars. Just to kind of set the record straight,
why is infant formula formulated the way it
is?
Yeah. I mean, so infant formula is meant to mimic breast milk. And the science behind
the evolution of infant formula is just fascinating. And we're so lucky to live at a time where
we have this available because before, if there was no infant formula, a lot of babies didn't make it
if breastfeeding wasn't available.
And there were wet nurses who could step in
to breastfeed the infant.
And people don't realize that,
that there were plenty of women 100 years ago
who couldn't breastfeed
and different things needed to be done.
And they had to concoct their own formulations.
And a lot of things went wrong with that, like electrolyte imbalances and things like that, which we also see today
with people trying to make their own formula because it's not an easy thing to do.
And so, yeah, breast milk, the science behind it and the way that it's formulated is meant
to mimic breast milk as close to possible as it can.
And what's really cool, I mean, there's lots of research going on
because right now they can mimic
the nutritional components of it,
but there are some other components of breast milk
that you just can't mimic, right?
And that's why you do see a disparity a little bit
in terms of like health outcomes.
But in terms of the nutritional components,
the chemicals quote unquote that chemicals, quote unquote,
that you see in formula, if I listed out the chemical composition of breast milk, you would
see all of those chemicals in breast milk as well. And so I think that it's this idea,
for example, the fatty acid composition, those fats have to come from somewhere. And so in some of our like
gentle formulas that we use, because some babies can't have lactose in the formula,
in the formulation, like cow, cow, from cow milk, that you have to get the fats from somewhere.
And so a lot of the times those fats come from what is colloquially known as seed oils.
And so there, there is this outrage about seed oils right
now but I think there's a fundamental misunderstanding of seed oils and the impact that they have
on our health. But literally they're just being used in formula, in some of these infant
formulas to mimic the fatty acid profile of breast milk.
Right. Yeah. I know, again, a lot of people just get all up in arms about words that they
can't pronounce and they see them as chemicals, but like cyanocobalamin is literally vitamin D3.
And it's like most of the ingredients that you see in, you know, in a table for infant formula
are just like vitamins, the words for vitamins. And they are big words. I understand they're big words, but they're the vitamins that we would need to mimic breast milk. And I also just like,
you know, thinking about this, I want to point out that I feel like a lot of these common
recommendations that go against the scientific community, all stem from this appeal to nature's
fallacy. And we've talked about nature's fallacy on my podcast already, but it basically assumes
that something is inherently good or beneficial or better because it's quote unquote natural,
or conversely that something is bad or harmful because it is quote unquote unnatural.
And I think pregnancy and motherhood is just more susceptible to this fallacy in general
because it's just being, it is like being drilled into all of us that, you know,
everyone's motherhood experience is the epitome
of what nature has intended for women.
And, you know, and I think that's a really hard concept
for a lot of people to grapple with,
especially for those, let's say,
when we talk about breastfeeding,
I always said like breastfeeding
was the most unnatural feeling, like experience for me.
It was like the most humbling, most devastating,
most like so hard, the hardest thing I've ever done
in my life, it in no way felt natural to me,
at least not with my first.
Well, and I think people forget that like nature,
this might sound harsh, but nature
doesn't really care about keeping you alive.
Nature cares about keeping enough people alive to produce the next population of people,
but that doesn't mean that everybody has to live, right?
And so there's a lot of things in nature that can kill you.
Nature's cruel.
Yeah. can kill you. Nature's cruel. Yeah, and so we love, I mean, nature is great,
but also nature is cruel
and not everything that's natural is great.
And I think we see this a lot with like,
even with vitamins, right?
And people saying synthetic vitamins are terrible
and natural vitamins are better.
And that's not, I mean, and I always like to say,
you know, like synthetic vitamin D
can prevent rickets. Synthetic vitamin C is going to prevent scurvy, you know? And so,
I don't know what you mean when you say that it's not good. It's like it's not good.
It is. It's good. And it oftentimes can be actually absorbed even better than kind of the natural
sources. Totally. Now, I just want to put diet culture messages that we hear online aside for a second
and I want to kind of talk about what we hear from health care providers themselves especially
as it pertains to weight gain during pregnancy because you know typically we hear we're supposed
to gain this very specific narrow range of weight, we're supposed to gain a pound a week,
very specific narrow range of weight, we're supposed to gain a pound a week. And I know, because I hear this from a lot of women, that this can cause a lot of anxiety, especially for
women who have struggled with their relationship with their body and food in the past, when
things don't follow this predictable, perfect trajectory. And obviously, like, we're human,
so it never does. How much should women actually be worrying about their
weight when it comes to pregnancy?
Yeah. The research on weight gain in pregnancy is, what's important to understand is that
it's based on averages of populations and it's not based on the individual. And so we
can create, and we have to in research, we can create these stratifications, right? And so we, and we have those, you know, if you're
underweight and that's certain BMIs, if you're normal weight, if you're overweight, and then
if you're obese and those, those are like categorized based on BMI. And as I'm sure
you've talked about many times, BMI is a, you know, it, it's important in research and
we need it in research for these stratifications.
We don't really have a better metric in research to use for stratifying groups, but at an individual
level it can be very meaningless.
These weight gain suggestions, that's what they are.
They're based on large data sets that look at healthful outcomes in individuals and how
much weight they've
gained in a pregnancy. But that's, again, going to vary based on the individual. So
what I like to do is I like to talk, especially when I'm talking to healthcare providers,
is try to get them to understand that the emphasis should really be on the behaviors
that we're doing in pregnancy and focusing on nourishment, focusing on nutrient density, focusing on all of the things that are going to go into your
physiological health. Because weight is just kind of like a symptom of that, right, sometimes?
And so not focusing necessarily on the weight, but focusing on the actual nourishment of the
individual. Because again, at an individual level,
those numbers that we fixate so much on,
they can be meaningless for some person.
They can fall into a group and maybe their body,
for example, I gained more in my pregnancies, both of them.
I didn't weigh myself in my second pregnancy,
which is also something we could talk about
about how you don't have to do that.
I didn't weigh myself in my second either.
Yeah, I did in my first and I gained more than the recommended amount of weight, but
it was – that was totally fine for me.
I was metabolically healthy.
My babies were healthy.
I was healthy.
Like it was – it was fine.
And then in my second, I realized, oh, I don't actually have to weigh myself.
And so I just said to my – I had a midwife and I just asked them at each, when they went
to weigh me, I was like, can we just not weigh me?
Can you write that in my chart?
Now sometimes, and that's an option for you.
And sometimes, you know, sometimes physicians will need to, if there are like other issues
at play, but you also can have that blinded and you don't have to, you don't have to
hear the weight and they can just kind of look at it.
So that's an option too.
Totally. And you know, I feel like this discussion about our body just kind of seems to get worse
after the baby comes out. So just before we kind of close off here, I wanted to briefly
talk about the immense pressure that women feel largely due to social media, of course,
to bounce back after birth.
So what are some of the messages to new moms that you give who are struggling to just embrace
that postpartum body in the fourth trimester?
First, just block all those accounts that you see doing that.
But second, I really, really, I think some people don't even know, like I'll say fourth
trimester,
and they've never heard that term before.
And so I really try to like play up this fourth trimester because it's such a critical period
of time for nourishment, replenishing nutrient stores, recovering from a crazy experience
you just went through for nine months and your body just went through.
And then also bonding with your newborn baby, right? And just like soaking up that magical period of life that you don't get to experience
very often. And so when we think about the fourth trimester, that's the first 12 weeks after
pregnancy. And the focus really should be on what I just kind of talked about, really
replenishing nutrient stores that are depleted. And a lot of nutrients, if a person does breastfeed,
a lot of nutrient needs increase during that time.
And I don't think that people really realize that,
and this is kind of a gap in care that we see,
particularly in the United States.
I'm not sure how it is elsewhere, but you have like
one six-week follow-up appointment with your your OBGYN. And not a lot of emphasis
is placed on nutrition. And like I said, a lot of nutrients increase in need during lactation.
I mean, iodine, vitamin B12, vitamin C, vitamin D, well, vitamin D kind of stays the same,
but protein needs increase, just a lot of nutrients. And so staying on that prenatal
vitamin, focusing on nourishment, I think that the idea is to
change the narrative, right?
Change how we view it, change it as, again, this is one time in your life that you have,
and there's a lot of good data to show that this period of replenishment can affect your
health later in life.
And so really thinking, okay, I'm going to focus on replenishing my body. I'm going to focus on rest. I'm going to focus on bonding
with my baby. I'm going to focus on ensuring that my milk supply is good for my baby and
really keeping the focus on that versus getting back to my pre-baby body weight.
For sure. Yeah, I love this. And I think this really just so nicely sums up my approach
to nutrition as well as focusing on what we can add in that nourishing mindset rather
than just kind of like, okay, we need to start cutting things, I got to get back into, you know,
like that rush to kind of succumb to diet culture. But thank you so much, Jess. This was such a great
conversation. And I am sure it will be so helpful for so
many women listening, both who are pregnant, who are thinking about pregnant, who know
pregnant folks. I just think that this is something universally that we can all kind
of appreciate seeing here in diet culture. So thank you.
Yeah. I really appreciate you having me on. And I just love this group of people so much
and working with this group of people.
And it's just such a wonderful time period
that I think, unfortunately in this day and age
that we're dealing with a lot more
than I think other generations have
in terms of just messaging and information.
And so if I can help to alleviate some of that noise,
that's kind of what I'm here to do.
Amazing, well, thanks so much. Yeah. Thank you, Abby.
That was so cathartic actually for me. I'm sure it will resonate with so many other women.
Moms, moms-to-be, so many of us have been through this.
But if you've spent your whole young adult life trapped in diet culture, pregnancy can
obviously be a particularly triggering time. But with a very small little mindset shift, it can also be a uniquely powerful season
to start your intuitive eating journey and relearn your body's cues.
Even if those cues are at times more towards salt and vinegar chips instead of salad, as
was in my case.
But there's just something about growing a human inside you, along with all of the aggressive hormonal changes that come with it, that
helps us hone in on our body attunement skills. Just think about how intently
you're trying to pick up on that like first little baby flutter or kick. Or for
my fellow IVF infertility warriors, how badly you were like waiting for that
first little hint of nausea to
set in. I know it's hard to think about morning sickness in any kind of positive
light when you're really in the thick of it, but the point I'm making is that
pregnancy is a time of heightened awareness of our body sensations. We can
actually use this to kickstart our journey, collecting data on how foods make us feel
completely judgment free.
Now, maybe you're saying,
um, Abby, I am listening to my body
and all it's gotten me is saltines and Gatorade.
Even if I'm not judging myself
for these aversions and cravings,
I still wanna make sure I'm getting the nutrients that my baby needs. And that is the awesome thing about intuitive eating.
Gentle nutrition is baked into the framework. So if you're trying to
utilize this unique season of life to learn to leave diet culture behind, but
you still want to optimize nutrition as best as you can, here are some gentle nutrition tips.
First of all, just eat enough. Just eating enough calories is significantly more important for the
health of your baby than the minutia of what foods you do eat. Yes, there will be weeks, maybe even months, where you can't touch any of
your go-to sources of protein, or when the color on your plate is completely
non-existent. Unless, of course, you count like Flamin' Hot Cheetos. But if you're
listening to your hunger cues and simply eating enough calories to honor those
cues, chances are more than good that your baseline macros like your carbs, fat, and even protein needs are
going to be met. And where we fall short on micronutrients, that is what our
prenatal supplement is for. Number two, shift your mindset from one of food
shaming to food celebration. I hear from women all
the time how guilty they feel for not being able to eat as quote-unquote
healthy as they might want to. You know, they feel this tremendous amount of
shame when the only food that they can stomach is like a Big Mac and fries.
While diet culture may see quote-unquote junk or quote-unquote
toxins for your unborn child, I actually see a lot of amazing nourishment to
support growth. So in the Big Mac and fries we got protein and iron in the
beef, we got fat and calcium in the cheese, carbs in the bun, and a ton of
vitamin C and potassium in those fries. Plus, don't forget about tip one,
we want to just eat enough.
Sometimes we just gotta celebrate the wins
because honestly, pregnancy can be just hard enough.
And then finally, if you're feeling up to it,
think about the foods that you can tolerate
and how you could possibly give them
a little nutrition upgrade.
So for example, if all you can stomach right now
is like simple carbs like muffins or pancakes,
could you add some cottage cheese
or protein powder to your mix?
Or if you're living off saltines,
could you add some thinly sliced apple or cheese on top?
If you're struggling with like strong odors
and cooked meats or eggs, could you do a cold protein shake or smoothie? And if you cringe at the sight
of a vegetable, could you stomach a piece of fruit instead, which honestly offers
the same beneficial fiber and micronutrients as those greens? Not all of
these are going to be good options for you, but use this unique time to
experiment and collect data on how foods make you feel.
Think about every little piece of information that you manage to gather about your symptoms,
your cravings, your aversions, your hunger, as just getting you one step closer to having
a healthy, intuitive relationship with food long term.
And folks, that is all that I got for you guys today
I would love if you would share this episode with any of your fellow moms or moms to be
Who would appreciate some evidence-based facts and some gentle tips for helping them get through this
Particularly vulnerable time of life and a really really big
Thank you again to dr.
Jessica Nurik for joining me today in helping me bite back against diet culture. As always, I will leave a link to her platforms
below. And please guys don't forget to leave me your review, it really helps me
out as a new podcast to just spread the word. But signing off with Science and Be Sharp. Thank you for listening.