Realfoodology - How to Be Healthy Before, During & After Pregnancy | Lily Nichols

Episode Date: February 6, 2024

EP. 183: I sit down with Lily Nichols, acclaimed registered dietitian and author, about the importance of nutrition at every stage of motherhood. We delve into the key nutrients for fertility, pregnancy, and post-delivery recovery, drawing insights from Lily's work in "Real Food for Pregnancy" and "Real Food for Gestational Diabetes." This episode challenges common myths about pregnancy nutrition. Learn about prenatal and postnatal nutrition's impact on health and future generations, including the significance of organ meats and essential vitamins for developing embryos. We also discuss the high nutritional needs during the postpartum phase, comparing it to the demands on elite athletes, and share stories of dietary transformation and global postpartum care wisdom. This conversation offers an evidence-based guide for expectant and aspiring parents, highlighting nutrition's role in supporting life's early stages. Topics Discussed: 09:17 - Lily Nichols and her history in childhood nutrition, pregnancy and postpartum nutrition, and gestational diabetes 11:13 - Impact of Blood Sugar Level on Baby’s Development 13:16 - Testing for Gestational Diabetes 19:25 - The Importance of Nutrition Before Pregnancy 29:52 - Animal Sourced Proteins and Challenges of a Vegetarian Diet 40:07 - Foods to Avoid While Pregnant 44:20 - Where Your Food Comes From Matters 48:20 - The Science Behind Cravings 50:44 - Essential Nutrients During Pregnancy 55:13 - Postpartum Nutrition 01:02:58 - Eat Plenty of Protein 01:06:04: - Health Non-Negotiables Check Out Lily Nichols: Instagram Facebook Twitter Website Links Mentioned: Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition Real Food for Gestational Diabetes: An Effective Alternative to the Conventional Nutrition Approach Sponsored By: Cured www.curednutrition.com/realfoodology Code REALFOODOLOGY gets you 20% off Natural Cycles https://www.naturalcycles.com/  15% off with code REALFOODOLOGY Paleo Valley https://paleovalley.com/promos/realfoodology for 15% off Armra https://tryarmra.com/realfoodology 15% off first order with code REALFOODOLOGY Organifi www.organifi.com/realfoodology  Code REALFOODOLOGY gets you 20% Off Check Out Courtney: @realfoodology www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database Produced By: Drake Peterson Edited By: Mike Frey

On today's episode of The Real Foodology Podcast... Another really vital one is vitamin D. They've found that in mothers supplemented with 5,000 IUs of vitamin D per day, those who maintain their blood levels at about 40 nanograms per mil or higher, their rate of preterm birth is 60% lower. Hello, friends. Welcome back to another episode of the Real Foodology podcast. As always, I'm your host, Courtney Swan, and I'm so grateful that you're here today. Today's guest is Lily Nichols. She is a registered dietitian who specifically focuses on pregnancy. You may

know her by her book, Real Food for Pregnancy. She also has another book called Real Food for Gestational Diabetes. Both of these books are amazing. They're just everything you need to know, basically, about what to eat during pregnancy and also what to eat for gestational diabetes. I told her this in the episode, but I feel like Real Food for Pregnancy should be a must read for every single mother because it is so helpful. Navigating nutrition can be really hard during pregnancy, you know, and we talk about this in the episode too, that how important it is, you know, because we

were growing a baby and during those developing times, it's so imperative that we get the nutrients that our baby needs in order to have a viable pregnancy and in order to have a really healthy baby. She also has another book coming out for fertility, which I'm so excited about. We talk about that too. So definitely stay tuned to learn more about the book and also when it's coming out. But as for the episode,

I really, really enjoyed this episode. I've been wanting to do an episode like this for a while because we address nutrition preconception. We also address nutrition during pregnancy, and then also postpartum. And all of these are incredibly important, and there are different needs during different phases. We also talk about gestational diabetes. We talk about the test and ways that you can do it in a healthy way. We talk about specific nutrition needs during pregnancy, also preconception. A lot of people do not talk about this

or are even aware that what you're eating before you actually conceive is incredibly important. And not only for the woman, but also for the man. A lot of times when people are having fertility issues, it's more the man than it is the woman. And this is a statistic, a known fact. So it's incredibly important not only to get your nutrition in order,

but also making sure that your partner is really healthy too. So that's a really important piece of this when trying to conceive the nutrition. And also like, you know, we talk about this, but even like up to a year beforehand, getting your body in order, getting your nutritional needs in order,

filling in those nutritional gaps if you have any deficiencies, getting your A1C under control, which is your blood sugar, your metabolism. There's a lot of things that are important for our body to be in optimal health before we conceive. And look, I say all this and I want to be sensitive to the conversation because I know that this can be a really sensitive topic and rightfully so. There's no shame in the way that anyone's doing this. If you maybe did something different for other pregnancies because you didn't know and you want

to conceive again, or you did it already and you've already had kids, there's nothing good that's going to come out of wallowing in shame and guilt. I always remind you guys this, we do the best we can with the information we have at the time. And then once we learn better, we do better. There's only so much we can do. We are all humans trying our absolute best and you were doing the best that you could with the information that you had at the time. And that's okay.

That's amazing. Cause we're all out here just trying our best. And for those who haven't had kids yet, or maybe you plan on having more kids, this is a great way to learn how to do better for the future. I mean, for me personally, I'm so excited to have this information because now when I have kids,

I'm gonna know what to eat, what supplements to take, and really just how to be in my optimal health for a healthy pregnancy and a healthy baby, or hopefully healthy babies. One of the things that we really dive into that is so incredibly important is the topic of protein and how much protein we actually need. Just in general as humans, but also specifically during pregnancy and also postpartum, getting enough protein is so incredibly imperative. And there's this narrative right now in the mainstream

that we're quote unquote eating too much protein and it's so not true. And we dive into that as well. Well, that's all I have to say. I'm so excited for you guys to hear this episode. And if you were loving the podcast, if you could take a moment to rate and review it, it means so much to me. And it really helps the show a lot. Also, if you enjoy this episode

and you wanna share it on Instagram, tag me at realfoodology. I love to see all of your tags. It really means a lot to me. And I just wanna say, I appreciate you guys so much. Thanks for listening. Do you struggle with anxiety like I do? I have been pretty open about my journey and my struggles with anxiety throughout the years. And therapy is one of the things that has really helped me out a lot. EMDR therapy specifically has helped me through a lot

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Lily, thank you so much for coming on the podcast. I've really been looking forward to this episode because I've been wanting to do an episode about nutrition for pregnancy. I get a lot of questions. I have a lot of listeners that are either wanting to have kids or going to have more kids, you know, and this is a really, really exciting topic because I love that you wrote this book all about real food for pregnancy. It's very in alignment with everything I talk about. It's why I named my brand Real Foodology is because I think that obviously eating real food is incredibly important, especially during pregnancy. And I don't think that there's enough of a conversation around this really. So thank you so much for the work that you do. Yeah, I'm happy to be here.

I appreciate the invite. Okay, so let's dive in. So first of all, so how did you get into all of this? You're a dietician obviously, and you wrote a book. What motivated you to focus on prenatal and postnatal nutrition? Well, it's funny. Back when I was choosing to go to school for nutrition,

I wanted to focus on child nutrition, like reforming school lunches, because we were seeing this rise in childhood obesity and diabetes and how terrible. And I went through all my training and started working in the field and just ended up working in the pregnancy space. And that's where I learned the statistics around gestational diabetes, where children born to mothers who have poorly controlled blood sugar face anywhere from a six to 19 fold increased risk of type two diabetes and obesity by the time they're teenagers. development of the baby's pancreas and their metabolic function from in utero exposures, the whole epigenetics of it. And that's what really let me up and got me to stay in this field. Certainly the gestational diabetes advice can be greatly improved. That's why my first book was all about gestational diabetes and Real Food for pregnancy really looks at the gap between, this is what our current recommendations are. And hey, here's all this research and also this whole ancestral history of what humans used

to eat and maybe ideally should be eating that can optimize baby's development, optimize mother's health, reduce her risk of complications. So really, my career has focused pretty extensively on the prenatal nutrition aspect and also preconception, since that plays a role, and also postpartum recovery and breastfeeding nutrition as well. Amazing. Okay, well, I want to go over all of that that you just talked about, because I find it really interesting. Well, actually, before I go down this tangent, I want to go over all of that that you just talked about because I find it really interesting. Well, actually, before I go down this tangent, I want to bring up something really quickly.

So you were talking about the gestational diabetes and the impact that it has on the baby in utero. Is there any connection there with type 1 diabetes or is that just fully genetic? So type 1 diabetes, I think that one is more genetic in which like if a mother has type 1 diabetes, I think that one is more genetic in which if a mother has type 1 diabetes, the chances that her offspring will have type 1 diabetes is much higher, so much so that they're often testing these children's blood sugar and insulin levels at a more frequent interval or just testing it whatsoever where we don't do that with everybody else. So I think it's a different mechanism. But interestingly, the effects of blood sugar levels on a baby's development and their metabolic health is the same regardless of the mother's type of diabetes. It's really related to blood sugar levels. So you could have a woman with type one diabetes with really excellent blood sugar control. It's a lot harder with type one diabetes,

but they can have really excellent blood sugar control and their children might not face any of these adverse risk factors. And it's like the same for like type two diabetes or gestational diabetes. It's like the severity of the blood sugar levels is what is changing the development of that child's pancreas. With type one, there's those other like genetic risk factors, of course, that could be passed on as well. Yeah, that's really fascinating. I just, my science brain is always like asking why, like what's happening here, you know? Yeah.

And as far as the gestational diabetes for the testing during pregnancy, how do you feel about that drink that they give every woman that has flame retardant in it, by the way? Yeah. It's a hot topic. Yeah. The citrus flavored ones often do have the brominated vegetable oil in it, which, yeah. I've heard California is banning it. So I'm like, are they going to ban it? Is that getting an exception or are they

going to ban it in that too? We'll see. Interesting. Yeah. So it's a loaded topic because on one hand, I'm in the camp of, we need to identify gestational diabetes so we can improve outcomes by improving blood sugar levels. So if we don't test for it, we don't catch it. However, I do think there should be other options offered in lieu of the glucose tolerance test. Now, I should also say there are some that don't have the brominated vegetable oil. If that's a particular concern, there are others that are like cleaner ingredients that are available. But in addition to that, we should have other options routinely available. And actually in the state of California, I used to work for the

California Diabetes and Pregnancy Program. That program, also called Sweet Success, advocates for first trimester screening by just testing a hemoglobin A1C. And what that does is it catches any of the women who are pre-diabetic, essentially it's treated as gestational diabetes. They don't even have to drink the drink and they're simply treated like their whole pregnancy. They have two thirds longer of their pregnancy to optimize their blood sugar levels versus waiting to 24 to 28 weeks for the glucose tolerance test. And of course, I also am a big advocate for home blood sugar monitoring. So I think providers should be more willing to offer home blood sugar monitoring as an alternative as well. And having had two pregnancies myself,

it depends on your provider, how willing they are to accept alternative options. But I think those should definitely be options. And I also think certainly the terrible stuff in the drink should be removed. I think it's ridiculous that they would even have those ingredients. But even with all the icky ingredients removed, the point of the test is to see how your body responds to a large bolus of sugar all by itself. And so if you're going to do a glucose tolerance test, it's going to be a large amount of sugar all at once. That's the point of the test. So I think also there can be alternatives because people who eat naturally a low carb diet, you're more likely to get a false positive on it unless you carb load leading up to

the test. And that's a major concern. Yeah, that's interesting. Well, and the only reason I brought it up is I think there's probably a majority of women that don't even know about that drink that they make you drink having those concerning ingredients. And I just wanted to provide women with alternatives. And I'm, I'm not saying like, I'm, I'm a proponent for everyone doing that test as well. I had to do one one time cause I was doing a CGM and they just had me put 50 grams of sugar in water and drink it. And then one of my girlfriends, when she got pregnant last year, she had to do the test and her provider let her, they gave her a meal to have in the morning with like orange juice and pancakes. And it was like all these things that added up to 50 grams. And then she did the test.

And then there's also a couple different drinks now. There's one in particular called the fresh test. So anyone listening that wants to check that out, I think a lot of providers are okaying the fresh test, which is great too. Yeah, that is a good option. I'm actually not a fan of the meal test or juice or jelly beans. I actually go into the research on this in Real Food for Pregnancy because the point of the test is to check your response to a specified amount of glucose. So if you're doing pancakes and orange juice, those foods are high in carbohydrates, but not all of the carbohydrates are glucose. You have some fructose in the orange juice, for example. And then if your meal has protein, like different amounts of protein or eating the foods in different order, that can affect it. And unless you're using a food scale,

everyone's pancakes are different sizes. Did you measure precisely the orange juice? I think the meal test can come as part of home blood sugar monitoring. If you want to do that option, I recommend people check their blood sugar for one to two weeks, first thing in the morning and after every meal. More specific instructions are in Real food for pregnancy. And then you compare it to what are the levels seen with gestational diabetes? What are the levels that we'd expect in a healthy pregnant woman? And compare it to those standards, essentially. Even the studies that have done a jelly bean as an alternative, they sent the exact jelly beans

off to a lab to be analyzed for their exact sugar content and their glucose content. And it's not as easy as counting out like, oh, you just count out like 50 jelly beans. They all have different formulations, they're different sizes. Are you using a gram scale? Is the jelly bean pure glucose? It's like if you're going to do an alternative, you could buy dextrose, powdered dextrose, which is also the same thing as glucose, different name, and measure out with a gram scale 50 grams and mix it in water. You could do that or the fresh test, but these like meal replacements and like candy replacements,

there's too much margin for error for not getting exactly 50 grams. And the foods in particular, it's not pure glucose. So I don't love those as alternatives. Sorry. No, no, no. Oh my God. No, I love this. I was just going to say, I'm so happy that you clarify that for people because I think that's really helpful. So now people know going in, like which options are the best that they're going to get, you know, the, the real tangible results that they're looking for. So that's really helpful. Yeah. Thank you. Okay. So let's start with preconception because this is something that I only more recently learned in the last couple of years. And just so you have an understanding of where I'm coming from, I'm not a dietician. I actually started on

the RD track and then I decided I wanted to go a more integrative route. So I got my master's of science in nutrition and integrative health. So I had a semester on nutrition for pregnancy. But what I find really interesting, and this is something that I only really started more recently in the last couple of years really understanding is that there's not a lot of conversation around getting healthy before you even start trying. And I think, and I'm really curious to hear what you think about this, is the importance of how important it is to really get healthy before you're even trying and how many years before, if you can, if you can, I want to be sensitive to that, when it's really important to start really focusing on your nutrition before you start trying to conceive. Yes, it's an excellent,

excellent point. So much emphasis is put on, oh, well, I'll just like get healthy when I get pregnant or I'll eat really well when I'm pregnant, but they don't really think about leading up to conception phase. And I mean, it's vital for both partners actually to be eating well. If you look at the timeframe it takes for a human egg to fully develop, I mean, arguably if you're talking all the way back to when it's recruited as a developed follicle, I mean, you're going back upwards of like eight months, but the three months immediately prior to ovulation of that specific egg is arguably the most sensitive to nutritional inputs and lifestyle factors. And similar for sperm, it's a little

over 70 days for the full development of sperm. So that three months is absolutely vital. Of course, it's ideal if you go back further in time. There's no downside to nourishing yourself well and keeping your hormones in a healthy range and having a healthy, normal menstrual cycle, and sleeping at regular intervals, and eating routine balanced meals so your blood sugar isn't a hot mess. There's no downside to doing all of that well, well, well in advance of conception. But if you have a very limited window or you really feel like you want to try sooner than later, I would say a three-month window leading up would be most important. That said, if there's underlying health issues, menstrual cycle issues, hormonal imbalances,

gut issues, nutrient deficiencies, the greater amount of time you have to address those, the better. Not just for optimizing egg quality and chances of conception, but we also want to think into early pregnancy as well. The first eight weeks of pregnancy are when that embryo is most sensitive to potential harm. So all of the major birth defects, those happen in the first eight weeks, like neural tube defects, because that's when cell differentiation is happening. So all these little cells in the embryo are being like, okay, you're a brain cell, you go here. Okay, you're a heart cell, you go here. Okay, you're a kidney, you go here. All of that happens in the first eight weeks. And just based on the way that pregnancy is calculated by last menstrual period,

you usually don't even find out until you're pregnant, until you're technically four weeks along, even though it's two weeks post ovulation, post fertilization. So those early stages are so sensitive to levels of nutrients. I think the only one we hear about is folate, but there's dozens of other nutrients that are absolutely vital to get in a healthy range prior to conception. And actually, my next book is all about fertility, so we'll be talking all about that in more detail there. What are some of the really big ones outside of folate that everyone knows? What are some of the really important ones people should focus on or women should focus on?

Yeah. So actually, all of the nutrients involved in methylation are vital. And methylation is a process that happens in every single cell, but it's especially like it's on overdrive immediately after conception. And as all these cells are like dividing and multiplying, all the nutrients that support methylation are vital. So in addition to folate, vitamin B6, B12, choline, glycine, which is an amino acid. I'm probably missing a couple, but those are some of the top ones to really pay attention to. It's really important to have your vitamin A levels

in a healthy range. People really don't think a lot about vitamin A. And in fact, there tends to be a lot of fear mongering about vitamin A, but 80% of women of childbearing age in the US are not consuming enough vitamin A. And there's quite a few birth defects that are actually related to vitamin A deficiency. We all hear about, oh my gosh, too much vitamin A can cause birth defects. There's been fewer than 20 cases of birth defects attributed to excess vitamin A in the last 30 years, but there's been over a million cases of congenital diaphragmatic hernia, CDH, which is very, very strongly linked to vitamin A deficiency. So

that's another one I think is really crucial. Well, you know what I was just thinking about as you were listing all those off, I'm like, okay, what are the foods that are richest in that? Meat sources, animal sources, eggs are really high in choline, B6, and a lot of what you were listening, vitamin A. Guess what is really rich in vitamin A and B6 and B12? Organs. And I know people don't really want to eat them. So if you don't want to eat organs, I mean, myself included, I really have a hard time

getting them down. You can also take the organ complex pills. Is that something you recommend for people? Yeah, if you don't like organ meats, that's certainly an option. And yes, I'm a big proponent of organ meat consumption. Snacks. Let's talk about snacks. Everyone loves snacks. And I feel like it's hard to find a good snack that actually fills you up and that you really crave and like to eat. I am obsessed with the grass fed beef sticks from Paleo Valley. If you guys follow me on Instagram,

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it is a really good high quality colostrum. I get so many DMs from you guys just specifically asking me if I use Armra Colostrum. And yes, I do. I've been taking Armra specifically for almost a year now. I travel with it everywhere I go. I bring the little individual packets with me and I especially take it while I'm traveling because that's when we are most susceptible to getting sick. And you know what's really cool? There's actually a study that's been done comparing the effects of the flu vaccine and colostrum and colostrum performed better in protecting the body from the flu. Isn't that wild? And this is a peer-reviewed study posted in a very well-renowned medical journal. So what is colostrum? It is the first nutrition we receive

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slash realfoodology, or simply enter code realfoodfoodology and you're going to get 15% off. Again, that's tryarmra.com slash realfoodology. Armra is A-R-M-R-A. Yeah, actually that's something I would love to talk about with you if you're down to talk about it because I know this can be kind of a sensitive subject for people. And I always like to remind the listener that at the end of the day, it is up to you, it's up to your body, your intuition to figure out what's best for you because we are all bio-individual. But I do like to talk about the importance of eating animal source proteins just because we do see a lot of vitamin deficiencies. And I will never forget this. I watched this video and it has been ingrained in my brain of this nurse that was comparing a

vegan placenta with a placenta of this nurse that was comparing a vegan placenta with a placenta of a woman that had been eating animal sources. And she was pointing out all the issues in the placenta of the woman that was eating vegan and it was showing all the nutritional deficiencies in it. And again, I want to be sensitive to people, but I also think this is a really important conversation to be having. So what's your stance on that? I mean, I think we're on the same page on it.

I think animal foods are absolutely vital. As somebody who has previously been vegetarian and I still have loved ones who are actually vegan, I deeply, deeply understand all the reasons that people choose to eat the way that they do. And I am of the opinion based on the data that I've read and as well as my lived experience personally and also with thousands of clients that animal foods are essential. It always feels funny to answer questions and interviews on it because I feel like you can't present data to the level that I like to present data in my writing. So there's a section at the end of chapter three of Real Food for Pregnancy on challenges of a vegetarian diet going micronutrient by micronutrient,

the nutrients that are of concern and why, and why it's challenging to meet those on a vegetarian diet. And yes, supplementation can come into play. And arguably, a lot of vegetarian vegan proponents do recommend certain supplements, but I find that their list of nutrients of concern is incomplete usually. So yes, they might be recommending supplementing with B12. And yes, they may be recommending supplementing with algae-based DHA. And that's great. I'm glad those two very important nutrient gaps can be addressed with those supplements, but they don't also address this laundry list of other considerations. Some of these nutrients aren't even acknowledged in the prenatal nutrition guidelines whatsoever,

especially some of the so-called conditionally essential amino acids like lysine or taurine or carnitine. Those are not even addressed in the guidelines because there are still people unaware of the research showing that those are actually essential, particularly at certain stages of life like pregnancy, and I would argue all the way back to preconception as well. And I actually, my forthcoming book on fertility, I decided to do an entire chapter on the issues with vegetarian diets that expands into more detail beyond just the micronutrient considerations. But there's like considerations with macronutrient balance, sufficient intake of protein. Yes, you can combine beans and rice and make a so-called complete protein. It's still low quality protein and it still doesn't have all of the amino acids

because new research is showing the concept of non-essential amino acids has never been scientifically proven. Okay. So we actually need all the amino acids. And the only way to get all the amino acids is to consume some animal foods. So again, it feels incomplete to kind of speak off the cuff and not have it in this very organized, and here's the reference, and here's the reference way that I normally go about it. But I think conversations around vegetarian and veganism often get so into the emotional aspect and beyond the individual person's nutritional status, it gets taken into a different level. It goes into the animal welfare and we don't want to kill things and the planetary health, even if I believe their interpretation of planetary health

by raising animals is incomplete or incorrect. It goes in all these other directions and they try to shift the conversation away from the nutritional consequences. And so I feel like that's where I take the reins as going into the nutritional consequences, the nutrients that can be challenging to obtain. Even if some plant foods have these nutrients like iodine, for example, iodine deficiency is wildly more common among vegetarians and vegans. And yes, the number one food source of iodine is vegetarian. It's seaweed. But in Western diets, nobody's eating enough seaweed to get their iodine or like vitamin K2. Yes, you can get vitamin K2 from natto. It's actually the number one food source. Who's eating natto? I'm sorry, who's actually eating natto outside of Japan and places where it is a traditional food? And so those are kind of

the areas like it's really nice to package it up with a nice bow and be like, yes, plant-based diets and vegetarian diets can meet your needs at all stages of life as long as they're well planned and supplemented, just like the dietetic associations say. But what's the practical, what does that actually look like in real life? Show me a meal plan that's providing the same nutrient density as a similar omnivorous one. And they can't do it. I have yet to have a plant-based proponent provide me with a meal plan, an unfortified meal plan that provides all of the... It's never nutritionally equivalent. So that's my long and short answer. I love it. I mean, you and I are on the exact same page. I get so frustrated when I see these comparisons online where people say like, oh, if you have six

cups of quinoa, it equals the same amount of protein as like a small steak. And I look at this and I'm going, but who in the world can ever stomach eating six cups of quinoa? And then you think about it too, that going back to what you were saying about the amino acids, unfortunately, the science is there that we know that with plant-based amino acids versus animal-sourced amino acids, unfortunately, the protein quality is just not the same. Protein quality is not there. Digestibility, absorption, utilization, a balance of amino acids, it's not the same. Yeah, it's just not. And you can say on paper that, for example, like let's say, again, using the quino. And you can say on paper that, for example, like let's say,

again, using the quinoa, they can say on paper that quinoa has six cups of protein or sorry, six cups of quinoa equals X amount of protein. But when you actually digest it in the body and you measure the bioavailability, it's totally dependent off people have like genetic mutations because sometimes they may not even be able to pull out all the protein from that. And when your body actually absorbs the nutrients from there and amino acids, they're not getting the same amount that it says on paper. They're just not. Correct. And on top of it, your body has to waste a high amount of the amino acids that you are absorbing from these plant foods to create these other amino acids that you're not consuming.

So one of the, I can't pull the stat off the top of my head, but one of the areas I go into in the new book on creatine and the vegetarian chapters, the amount of amino acids that you have to put towards the creation of creatine. Your liver is working overtime to try to take these little bits of amino acids and nutrients from other places and combine them into these proteins that are essential for your body to function. When they're not coming in in the diet, your body has a lot of extra legwork to keep up with. And then what are those nutrients then not available for? Some of these nutrients are the same ones involved in methylation. So now you're wasting all these nutrients that should be

doing one job to do this other job because you're not eating this nutrient. Again, that's way beyond how most people are even thinking about this topic, but it is important because a lot of these processes are the exact ones involved in maintaining optimal hormone balance, optimal egg quality, optimal sperm quality, optimal development of the placenta and prevention of pregnancy complications. I mean, that's where many of these nutrients play key roles. Yeah. And I would even add on to blood sugar balance. We were just talking about earlier how important that is. And if you think about if someone's eating so many of these plant proteins every day, in a way you're kind of carb loading too. If you're trying to get all this protein in from these carbohydrate rich sources, you're going to be getting in a lot of carbohydrates too.

And I will tell you, I was vegetarian for five years and I was like this, like a roller coaster of hormones, blood, sugar. And it was because I was not getting any animal source proteins. I was basically getting all of my proteins from really carbohydrate rich foods. And I'm not here to vilify carbohydrates. We of course need them, but we also need really rich, high quality proteins too. Yes, that is significant consideration. Average vegetarian is getting about 60% of their calories from carbohydrates and that just doesn't bode well for blood sugar levels whatsoever. Yeah. Yeah. Yeah. So it's a big concern. Okay. So let's start, let's talk about, so once someone has conceived during pregnancy, I know this is a really hot topic. There's a lot of foods that

women are told that they can't eat during pregnancy. Do you agree with that list? Or are there any ones on there that you're like, this is fine. I don't really, like you understand why they're on there, but like women can eat this. And then there are other foods that you're just like, no, they really, we should not be eating them when we're pregnant. Yeah. So the foods to avoid list. So, and it's different country to country I've learned. In other countries, they're not like, our list is almost all animal foods. It's the soft cheeses, raw milk, unheated deli meat, free prepared pâtés, smoked fish that hasn't been canned, eggs with runny yolks, trying to remember if there's a sushi, of course. Those are the ones that we in America tend to highlight. You go to

other countries and not all of those same foods are on the list necessarily. It depends. But oftentimes what's on their list is raw fruits and vegetables. There's especially salads. I've heard from women in Europe and South America that they're warned not to consume salad. And when you look at the rates of foodborne illness from different food types, and this is even in the US, like 46% are from raw fruits and vegetables. Wow. I mean, I'm not surprised. Yeah. So that's actually the majority, but nobody tells you to avoid those foods because of course those are nutritious foods, our fruits and vegetables, right? Everybody thinks our fruits and vegetables are the most nutrient dense foods and it's actually not. It's actually the animal

foods. So when I'm looking at these lists, I'm looking at, okay, what is the relative risk of food poisoning from these particular food items and in pregnant women in general? Is that abnormally high and are there ways to reduce the risk? And are there nutritional consequences for not consuming these foods? So I'll give like the eggs with runny yolks as an example. That is one that I definitely disagree with. The chances that an egg contains salmonella is like one in 12,000 to one in 30,000 eggs. It's very, very unlikely. Also that risk is about seven fold lower if you're getting eggs from chickens that were raised on pasture organically because the reason they have excessive salmonella in their

gut and the reason it's getting on the egg is because they're in crowded, inhumane, awful conditions. And when they have space to roam and free range and pasture and everything, they're just much less likely to be having that poor gut health, which then- Yeah, they're healthier. Yeah. Gets all the pathogenic bacteria and whatever. So if you don't like eggs with runny yolks, you're totally fine to consume them hard boiled or until the yolk is hard or whatever. But I've found that a lot of times women will hear, I can't have eggs with runny yolks. And what they actually hear is, I can't have eggs.

And then they stop eating eggs. And then you've taken out your number one food source of choline and many other nutrients, of course, but choline being the most important one for eggs specifically. And it's like, well, now what are you having instead of eggs for breakfast? Well, now you're having cereal or oatmeal or a bagel or something that's like a blood sugar disaster and significantly less nutrient dense um so my overarching opinion is that i think the the risks are way overstated for food poisoning i also of the opinion that um your nose and taste buds are so hypersensitive in pregnancy that like you simply will not be able to eat something if it is spoiled. And it's usually pretty obvious when something is spoiled. So like I continued to enjoy salami during my pregnancies, but if that salami package had been

open more than like two, maybe three days, it was like completely off-putting. I could not consume it. It was like, I'd give it to my husband to eat. Like it was probably fine, but my body was so sensitive to off flavors that it was just not going to happen. Yeah. That's really interesting. The smell test is, that's a really good one. I just think it's funny. I was thinking about when you were talking about the comparison between America and other countries, I would say, and I wanna know your opinion on this, my thinking is if you're buying from really good organic, hopefully locally sourced places,

like if you're living in a place like California and you get a lot of your stuff from the farmer's market or you're buying from really good places that you trust that do like regenerative farming, organic, pasture-raised, all of that, I feel like it's a lot safer to eat from those places really good places that you trust that do like regenerative farming, organic, you know, pasture raise, all of that. I feel like it's a lot safer to eat from those places because where we're getting all these foodborne illnesses is from these CAFOs that we should not be having anyways, you know, and it's those, they're really the factory farmed animals. So I feel like if you

want to eat those kinds of foods, just make sure you're getting them from a really good, high quality place and you're probably pretty safe. Yeah, I agree completely. It's all about how the food is grown and raised and then how it's processed and how it was handled and shipment and all of that. So if you're getting lettuce from a farm down the road versus lettuce that was washed in a vat with thousands and thousands of other heads of lettuce, that's where we get those huge E. coli outbreaks, right? So I think, yeah, sourcing is extremely important. I want to take a second to talk about some of my favorite Organifi products and why I love them. When I first started getting into health, I was an avid juicer. I was buying fresh veggies every

couple of days and wearing out my juicer and also wearing out myself by trying to constantly juice vegetable juices. Because I wanted to flood my body with all of the nutrients, the phytonutrients that you get from green juices. But after a while, I was like, I cannot keep doing this every day and also maintain my job, maintain my social life and everything else. But I really wanted to make sure that I had a good high quality green juice that was organic. And I knew that I could trust came from a good source. So when I discovered Organifi, I was so happy. They not only have a green juice, but they also have a red juice. And I really like to mix them together because it really helps with the flavor profile. And you're not only getting all of the green phytonutrients from the green juice, but you're also getting all the antioxidants

from the red juice. So it's like a win-win situation. I also really love their chocolate gold. It's their low sugar, hot chocolate mix. And it's loaded with ingredients like lemon balm, turkey tail, magnesium chloride, and reishi. Oh, there's also turmeric in there as well. So it really helps to calm down your nervous system before bed. And it really makes me sleepy. It also helps the digestion because you have the turmeric in there, you have cinnamon, you have ginger, black pepper. So it's helping with digestion and inflammation. I'm a really big fan of this. You can also put it in your coffee in the morning and it kind of helps to balance out the jitters that you might get from your morning coffee. And then another product that I'm really loving and taking every single day is their liver

reset. Modern living is incredibly taxing on our liver. Like just existing is hard on our liver because we are constantly being inundated with pesticides, heavy metals, environmental toxins, not to mention if we drink alcohol, that's also going to put a strain on our liver. So I think it's incredibly important that we take something every single day to support our liver health. This product has triphala in it. It also has dandelion, milk thistle, and artichoke extract, which all have been scientifically backed and proven to provide protection for the liver.

And then of course, the most important part about Organifi products is that they are all organic and they go a step further by guaranteeing that they are glyphosate residue free. Glyphosate is a known herbicide that is sprayed on a lot of our crops these days. It's also sneaking into organic foods

and it is a known carcinogen. So it's incredibly important to make sure that we limit our exposure as much as possible to glyphosate. If you guys wanna try any of the Organifi products and get 20% off, go to organifi.com slash realfoodology. You're gonna see all of my favorite products in that store and you're also gonna get 20% off. That's O-R-G-A-N-I-F-I.com slash Real Foodology.

Is there a science behind cravings during pregnancy? Because being with my best friend while she was pregnant and seeing her whole, go through all the different trimesters, it was so fascinating to me because like the very first trimester, and I've heard a lot of my friends say this, where they're like, she was like,

like I can eat like four things. She was like, I couldn't even open the fridge. Like I had to have my husband open the fridge for me. Like there were just certain things that I like could not stomach in the first trimester. And then she got to the second trimester and it was like, all of a sudden, she could eat all of her favorite foods again. Is there like an actual science behind that?

What's going on and what's happening with cravings? I wish there was an exact science with it, but there isn't. There's all sorts of theories. So, you know, usually as you're kind of mentioning the cravings tend to coincide with nausea or food aversion. So it's just like, nothing's tolerable except this thing. So that's certainly something to pay attention to. And just honestly, you just have to roll with it. Pregnancy is a wild ride of you have the best of intentions and sometimes it doesn't work out as well as you want, particularly with food choices during the most intense phase of nausea or food aversions, if you happen to experience that. I have found just anecdotally that sometimes it has to do with a person's dietary history. So I remember this so distinctly, there was a vegan woman who craved eggs, oysters,

and bone broth. Literally, the three foods that will probably fill all of the nutritional gaps on your diet, those were the things that she craved during the first trimester. Whereas I've had others who are, they've eaten paleo or carnivore or low carb. They usually eat tons of meat and animal products. And they do not want anything to do with meat or animal protein during that phase. And so it's like, is the body trying to make up for a specific nutrient deficiency here? What's going on here?

I think that's certainly possible. I also think there are cases where what we think are food cravings is just caused by pregnancy. It's just that those are highly craveable food. And our hormones are kind of all over the place. Yeah. So you have Doritos. They're designed to be addictive, right? What would you say are the essential nutrients during pregnancy that women really should be focusing on? I know we named some of them earlier, but maybe we can look at it from like a real whole food perspective and then maybe a couple supplements that you think is important. Yeah, sure. I think we've already talked about choline being important. That's a B vitamin-like compound, important for the

prevention of neural tube defects, optimizes baby's brain development, supports placental function, may reduce the risk of preeclampsia, is also just generally good for liver and brain health. That is one where 94% of pregnant women are not getting enough. And that's even by the current standard recommendation, which is from some new research, probably set like 50% lower than it should be. We should be recommending more than double. These are like randomized controlled trials. It's not like crappy observational studies. So definitely more choline and eggs are the number one dietary source. Like half of the choline in the US diet comes from eggs. Liver and organ meats, extremely high in choline.

Essentially all of your animal foods are pretty rich in choline, but liver, organ meats and eggs are like in their own much higher concentration category. And then certain plant foods, although the concentration in plant foods is just far, far, far less, it should ideally be part of your prenatal vitamin, but they oftentimes leave it out. It's an expensive ingredient. It's bulky, tends to have a smell. And so a lot of manufacturers leave it out or put in really small quantities to keep the capsule count down or the cost down. Another really vital one is vitamin D. Absolutely vital for your immune system,

for your baby's bone development, for just it's a hormone, essentially. So it does it honestly, it affects like 20% of the human genome. So name something that isn't affected by vitamin D, right? Perinatal mood, that's huge. Prevention of like helping a baby's teeth develop properly. They've found that when women are supplemented with vitamin D, the rate of dental enamel defects where like baby has weak enamel, then they're really prone to cavities, that goes down by 50% if we're supplementing mothers with enough. They've found that in mothers supplemented with 5,000 IUs of vitamin D per day, those who maintain their blood

levels at about 40 nanograms per mil or higher, their rate of preterm birth is 60% lower than unsupplemented women. Huge. So yes, we can get vitamin D from food, although our major source really is sun. So if you're in a southern climate and you can get it from the sun, great for everybody like Atlanta, Georgia and north or the equivalent in the southern hemisphere, closer to the poles, you're probably going to need a supplement at least in the winter months. And some of the best quality data we have is that a dosage of about 4,000 IUs per day, although like I mentioned, there's other studies that have done higher doses. So again, a good quality prenatal often has vitamin D at that level. Now, like five years ago, this wasn't the case, but now lots of them do have vitamin D at that level, or it can be

supplemented separately. I definitely recommend checking your blood levels so you can see whether you need a supplement in the first place or not, because so much of it is dependent on where we live and our sun exposure habits. But that's a huge one. I don't know, I could go on and on. Iron, copper, vitamin A, B12, all four of those are vital for your red blood cell production. So to prevent and or treat anemia, which you definitely want to avoid, just having sufficient iron levels is also really vital to baby's brain development. So gosh, that's key. I mean, you name one, if you want me to go into it, there's like, you can make the case for all of the essential nutrients, but I think like, definitely those two are some of the most important to consider. Yeah, no, I think that's really important and

helpful. The last thing I wanted to ask you about was, so postpartum, what would you say would be the most important? Again, it's similar question, like nutrients and foods that women really should focus on. I will tell you that I had a woman on my podcast last year who shared that she saw the most insane difference between her first pregnancy and her second pregnancy postpartum. Because the first pregnancy, I don't remember if she was like fully vegetarian or she was really trying to like not eat a lot of animal sources. And then the second postpartum pregnancy, she said that she went ham. She was like eating steak every day, like ground beef. And she said that the most significant differences that she saw between one and two was she healed a lot quicker because her wound, like she saw that it makes

sense, like when we think about it. So she healed a lot quicker down there, like post pregnancy, or sorry, post birth. And also her mood was a lot better. She said that she was a lot happier. She didn't deal with as much postpartum as she had with the first one. So I think that's really, that like blew my mind when I heard that. And I've actually heard a couple of women say that. Absolutely. Just protein, man. It makes a huge difference. So, you know, our protein needs are higher in pregnancy than they previously thought. They're also higher postpartum than we previously thought. So we now have data, and this came out after Real Food for Pregnancy was published. We now have data looking at protein requirements in women at three to six months postpartum.

And their protein requirements are at or above the level of an average female athlete. This is an exclusively breastfeeding women at three to six months postpartum. We don't have the same study at zero to three months postpartum in which I would argue that's when your nutrient needs are even higher because that's when all of the acute recovery, the transition from like pregnancy hormones to producing breast milk, remodeling of your thyroid gland. I mean, holy cow, so much is going on in that phase. The difference between how you feel from immediately post birth or those first couple days, even two weeks out or a month out is night and day. So I can only imagine if they were to ever

measure protein requirements during that time, I bet they would be astronomical. You are so hungry and you need so much food. And if you're not getting the protein in, which is very hard to do unless you have planned ahead by pre prepping meals or you have an ultra supportive partner. You don't have the wherewithal to be up on your feet, nor should you be cooking or preparing food. So you're very prone to under eating protein because almost all the grab and go options are just all carbs.

And so you have to have this support network to bring you food. And you look traditionally at postpartum recovery practices around the world, and there's a pretty standard 40 days, about six weeks of really intense in-home care, usually from a female, older female family member who's bringing you all of your food. And you look at the foods and it's all like slow cooked meat and stews and bone broth and eggs and well-cooked starchy porridges and things like that. Whatever's local to the region, it varies of course. But it's these easy to digest, often high protein, warming kinds of foods. And I can also attest to what your friend said, my postpartum recovery is,

especially with my second, when I was so much more diligent about pre-prepping the food and inviting more help and support into my home. I mean, I was just going ham on the protein and I felt great. I had so much energy. I healed so quickly. My midwife was like, how are you like up on your feet so quickly? I'm like, I feel great. I did try to rest for anybody listening who's all pro resting. I did rest, but I was also like not in severe pain or excruciating discomfort. Recovery was actually pretty easy breezy. And I think that had a lot to do with staying well nourished. And again, that is because there was support and help to do that because I prearranged it because I learned my lesson the first time you can't do it

all alone. I'm so glad that you brought that up because I think it's so important for people to hear because we did that for my best friend who I've referenced several times. Right when she came back from the hospital, we had a time period where our friends, we each had a day that we would drop off meals for them. And she still to this day mentions every once in a while, she's like, remember that time that you like created that meal train for me? She's like, I can't even tell you. She's like, it helped me so much. And I didn't even know I needed it. So if you have a friend that is giving birth, try to get like a group of friends where you guys are dropping off meals for them for a while, because it helped her family so immensely during

that time, because you, you're all your focus is on the baby. You can't even imagine or think about making food or ordering. And it's nice not to just order Postmates, to have people bring you really nourishing meals. So yeah, that's really important. Yeah. And for listeners, I do... I mean, there's a chapter in Real Food for Pregnancy all on postpartum, but I also have a blog article called Real Food Postpartum Recovery Meals that goes through some of the basics and things to emphasize that links out to like 50 plus recipes and has a whole bunch of different tips and options for how to make sure that you're well nourished, like from the meal train thing to postpartum doula to pre-prepping

food in your freezer to selecting recipes to have on hand for people to make to you know there's all sorts of different options given in there that really goes through the practical side of things um because that's really what you need and it does take it somebody taking it off your plate like you did for your friend. But you might actually need to ask. I mean, I feel so bad for my friends who had kids before me. I just didn't. You just didn't know. I just didn't know. I just didn't know. And then when I had my first, a friend of mine set up a meal train for us and I was like, I remember apologizing to her that I didn't do

the same for her because I was like, oh my gosh, now when I have friends who have babies, even if they live far away, I will actually order them a meal delivery service for a period of time. And sometimes these are even people who know well all the things you need to do for postpartum recovery and you're just not in a mental brain space to think to ask. And so I remember having a friend text me like, I can't imagine eating another bar. And I was actually about to put together a care package for her in the mail with bars. And I was like, oh, she doesn't need bars. She needs food. She needs food.

And I ordered her two weeks of meals from a meal delivery service, all all pre-cooked, you just reheat it, but like high protein, nutrient dense stuff. And yeah, I still receive thank yous for those sorts of things to this day. Like it only costs, of course, it's a little bit of a pricier gift, like maybe a few hundred dollars or something, but that is so much more important to you than receiving another onesie or, you know, it's like, you really don't need a bunch of stuff. You need to stay nourished. That's so true. Wow. Well, in the essence of time, is there anything we covered or that we didn't cover that you think is really important for people to hear? What do you want people to walk away with from this episode? I think we hit the protein conversation over the head. And that's always one that I really

want to emphasize because it's like a two birds with one stone thing. It's like our protein rich foods are our most nutrient dense. So you look at the most common nutrients lacking in a prenatal diet or the ones that women are most commonly deficient in, and those nutrients are generally provided by protein. So if you just like eat plenty of protein from as large of a variety of sources as possible, your chances of having an overt serious nutrient deficiency is much lower. and blood sugar, which then trigger all of the cravings and the, you know, mental emotional challenges, maybe not all the mental emotional challenge, but can be a factor in mental and emotional challenges just to be PC here. You know, protein really, really helps with that. I cannot overstate. I'm like such a broken record on protein because it's like, there's no skipping it. Like you skip it and everything else just falls apart. Right. So now I think we, I think we covered it.

Good. Well, I always like to bring up the animal sourcing of proteins and just the protein conversation in general, because the general mainstream narrative right now is that we quote unquote, don't need as much protein as we're told, which is a total lie. And we're also being told that plant-based proteins are a good, healthy source of protein. And that's also a lie. So I like to really hammer it in just because I want people to understand that what they're getting from the mainstream is not accurate. Yes, I completely agree. And I've been ranting on social media about this recently. There was like a what Nat Geo article saying, we're eating too much protein or we need to eat more plants or whatever. I'm like, okay, all these people saying that we eat too much protein. The reason they're saying this is because you're assuming the RDA is accurate. And there's like countless protein researchers

who are calling out the RDA for being set way too low, like probably at least 50% too low. Like we probably need double the amount of protein that the RDA is recommending. And for some even more than that, if they're super active or if you're postpartum, right? And so if that's your ballpark, then yes, of course, everybody is getting plenty of protein, but that's not accurate.

But we're starting out from a number that's already false. So yeah, I saw that article. They've been posting some stuff lately and I'm like, Matt Gio, just stick to the rivers and lakes that you're used to. Yes. Because like, what are you doing? Anyways, well, I just want to say thank you so much for your time. I always end my episodes asking my guests a personal question, which is what are your health non-negotiables? These are things that you do daily, maybe weekly to make sure that you're nourishing yourself. Okay. I do try to get to sleep at a reasonable hour. I've always been that way. So I don't stay up late. I am probably number two if I all just choose to. I always prioritize a protein-rich breakfast.

I remember years ago when intermittent fasting just started being the craze. And I was like, I tried it for a couple of days. I was like, man, I can literally feel my adrenals aching. And I'm anxious and I'm not a person prone to anxiety. And I'm like, this is not for me. I'm just going to go back to eating breakfast. And now it's funny, the health craze back to eating breakfast. And now it's funny, like the health craze has like gone full circle. And now people are like, it's intermittent fasting doesn't make sense for every single person, or it doesn't make sense for women in the way that we're doing it, this whole skipping breakfast thing. So breakfast for me is pretty much a non-negotiable, always high protein. Anytime I waver from that, I'm reminded

that I do not feel well if I either skip breakfast or have a low protein, high carb breakfast, I feel like a complete disaster. So those two things, sleep, high protein breakfast, absolute non-negotiables. I love that. Those are really good ones. Okay. Well, please let everyone know where they can find you online. Also, where can they find your books? And if you want to drop any information about your book that's coming out soon. Yes. So you can find me over at lilynicholsrdn.com. Up there, you'll find a free chapter to Real Food for Pregnancy. There's a freebies page with a whole bunch of other stuff and there's, gosh, 250 plus

blog articles. So many of the topics we talked about today, there's an accompanying article that goes into more detail. So protein and pregnancy, B12 and pregnancy, seafood, the postpartum blog that we talked about, there's just a ton up there. And then over on social media, you'll find me most active these days on Instagram. My handle's the same as my website. So Lily Nichols RDN. And either of those places you'll see when I come out with the new book, it's called Real Food for Fertility. I co-authored it with Lisa Hendrickson Jack, who's the author of The Fifth Vital Sign. And yeah, it's coming out mid-February. So keep an eye on it. We're very excited. It's been a long process to get here. But I think it's going to be a really useful resource. So I'm really excited. Yeah. Well, thank you so much. And thank you so much for your time and for writing these books,

because I really believe that real Food for Pregnancy needs to be like every single woman going through pregnancy needs that book. So hopefully, yeah, so hopefully everyone will get it. It's a great book. It's a great resource. And yeah, just so grateful for your time. Thank you so much.

This was such a great episode. Thank you so much for listening to this week's episode of the Real Foodology podcast. If you liked the episode, please leave a review in your podcast app to let me know. This is a Resonant Media production produced by Drake Peterson and edited by Mike Fry. The theme song is called Heaven by the amazing singer Georgie. Georgie is spelled with a J. For more amazing podcasts produced by my team, go to resonantmediagroup.com. I love you guys so much. See you next week.

The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice and doesn't constitute a provider patient relationship. I am a nutritionist, but I am not your nutritionist. As always, talk to your doctor or your health team first.