Eating for Two: the Pregnancy Diet

This article first appeared in ICAN.

Eating for two? No deli meats? Which fish is it that’s toxic? Hold the blue cheese please! Navigating nutrition in pregnancy can feel like a fear-based prescription that leaves no room for the vast body of knowledge supporting robust health for mother and child. How did we perpetuate ourselves as a species for millions of years without the modern American guidelines? How have varied cultures around the world supported fertility and optimal obstetrical outcomes that make our modern-day statistics scream out: we’re doing something wrong, here, people!

Given the limitations of nutrition research, and the absence of it in pregnant populations, some of the most useful dietary information was amassed and analyzed by a pioneering researcher/clinician named Weston A. Price. He found that, traditional cultures that were marked by the absence of degenerative disease all consumed animal products, fermented foods, raw foods, and did not consume flour, processed foods, or sugar. There were specific nutrient-dense foods such as egg yolks, organ meat, and fish eggs that were reserved for the preconception couple, perhaps for their high fat-soluble (A, D, K2) vitamin content, now known to facilitate micronutrient absorption, immune modulation, growth and development.

Since do’s and don’ts always appeal to our “please make this simple” sensibilities, here is a list:

Do Eat While Pregnant:

1. All natural fats

The polyunsaturated fat, omega 3s, have gotten their share of well-deserved positive press because of what fish and fish oil (EPA and DHA) can do to promote anti-inflammatory mediators, cell membrane fluidity, and counter the effects of vegetable oils in our American diets.  Humans consumed high natural fat diets until the inception of the anti-fat campaign in the 1950s. In fact, the perfect food – breastmilk is 55% fat! A high natural fat diet stabilizes blood sugar, supports hormonal and brain health, and supports the absorption of nutrients. An array of fats including saturated fat, the preferred energy source for the body, can be derived from pastured meat including organ meats, wild low contaminant fish, eggs, nuts, and seeds.

1. Probiotics

There is now ample animal research and preliminary human trials to support the importance of our bodily cohabitants – bacteria. Cultivating your optimal microbiome can begin with your vegetables – fermented ones, that is, such as sauerkraut, pickles, kimchi.  All traditional cultures fermented their foods, lived in and with nature, and ate from it in a way that promoted a now endangered diversity of gut microbes.  Medications, sedentary lifestyle, stress, and processed diet contribute to deleterious changes in our flora.  Most recently, pioneering work has implicated pesticides in the disruption of our beneficial bacteria, so be sure to consider the importance of organic to your gut.

1. Pastured animal products, wild fish

A number of nutrients are uniquely bioavalable in animal foods, including B12, vitamin A (in its usable form), D, and K2, in addition to B6 and B12, choline, zinc, and amino acids like taurine and methionine. We must support the beauty of a sustainable organic farming system, it’s rejection of petrochemicals and industrial grains, and the myriad benefits that come from humane cultivation of healthy beings.   I recommend eating meat 5-6 days a week, organ meat twice weekly, and fish 2-3.  I like the Perfect Health Diet image to help keep things simple.

Don’t Eat While Pregnant:

1. Refined carbs/flour

Flour, the way most people eat it, is bad for health for (at least) these reasons: it promotes unstable blood sugar, it is processed with genetically modified trans-fat containing vegetable oils, and it contains allergenic grains.  In my practice, I focus on the ways in which unstable blood sugar can masquerade as psychiatric conditions.  When some people eat high glycemic index foods like bread, their pancreas is stimulated to release insulin at levels that end up plummeting blood sugar.  The experience of transient hypoglycemia is one of discomfort and anxiety – jitteriness, nausea, irritability, cloudiness, fatigue – and the short-term antidote (think the midmorning snack that follows your bagel breakfast) perpetuates the cycle of  inflammation, a major no-no in pregnancy.

1. Allergens

Gluten, soy, and corn have been identified as allergenic foods, and a leading speculation as to how these foods became and are becoming more allergenic is the nature of their processing, hybridization, and genetic modification rendering them unrecognizable to our immune systems and vehicles of unwelcome information. Gluten (and processed dairy) contains peptides that, once through the gut barrier can stimulate the brain and immune system in inflammatory ways.

1. Sugar

It’s in almost every packaged food.  Seriously.  Look for it and you will find it.  It may come with different labels – cane sugar, crystalline fructose, high fructose corn syrup – but it’s all sugar. In addition to the above mentioned mood and anxiety rollercoaster, sugar causes changes in our cell membranes, in our arteries, our immune systems, our hormones, and our gut.  It’s pretty much the purveyor of evil and we just aren’t built to tolerate it.

And what of our toxic world, one so different from that our ancestors birthed in? Does this change these recommendations? As I discuss in this article, there are reasons to believe that it is no longer fully possible to meet our physiologic needs from our current farming practices, even the best of the best. Non-local produce, depleted soil, and loopholes in labeling suggest that we may benefit from a nutrient safeguard. In fact, a tacit acknowledgement of our nation-wide nutrient deficiencies underlies the current recommendation of a prenatal vitamin to all pregnant women. We just want one that will do more good than harm, so it is important to consider nutrients in their most bioavailable form (methylated b vitamins, mixed tocopherols, etc) and to check for any added tar-based dyes, preservatives, and fillers.

So what does this all boil down to?  Eat sustainable, organic meat, fish, eggs, veggies including root vegetables and squash, fruit, nuts, and seeds!  Leverage the complexity of food-based information to promote optimal gene expression in that growing baby, and support a healthy delivery and postpartum experience in that glorious mama.

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