Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition
By Lily Nichols, RDN, CDE
Published by Lily Nichols
Consider this pregnancy meal plan: A breakfast of oatmeal, low-fat milk and strawberries; a morning snack of trail mix; a turkey sandwich with “light” mayonnaise, a salad with French dressing, a banana and low-fat milk for lunch; an afternoon snack of carrot slices and whole wheat crackers; a dinner consisting of coleslaw with “light” mayonnaise, grilled salmon with oil, steamed broccoli, white rice and low-fat milk; and an evening snack of air-popped popcorn. This sounds like a recipe for a meltdown, right? Hardly any protein or fat, carb-centric and skimpy—not good for anybody. Definitely not nutrient-dense!
Believe it or not, the sample meal plan is from a policy paper titled “Nutrition and Lifestyle for a Healthy Pregnancy Outcome” published by the Academy of Nutrition and Dietetics, which governs the practice of registered dietitians and influences nutrition public policies in the U.S. This academy is likely made up of “diet dictocrats” (so dubbed by Sally Fallon Morell years ago) who are still at it in the year 2024. They are not only hurting the American public with their erroneous advice but also unwittingly targeting the most vulnerable among us: pregnant women and their developing babies.
When registered dietitian Lily Nichols came across these recommendations for pregnant women, she knew it was time to act. In 2018, she sat down to write Real Food for Pregnancy to offer a more reliable guide for a healthy pregnancy and baby, with a focus on nutrient-density based on ancient dietary wisdom. Nichols relies heavily on the work of Dr. Weston Price, citing his work in the early pages of Chapter One and sprinkling quotes and anecdotes throughout. She also emphasizes the scientific evidence that backs his findings and her own recommendations.
Along the way, Nichols dispels some common myths. For example, she notes that while “eating for two” implies that mothers-to-be need to eat double the quantity of food, in reality, a pregnant woman’s energy needs will go up by as little as an extra seventy calories per day, meaning that they need to “eat for 1.1.” Numbers aside, Nichols points out that mothers should think in terms of “quality over quantity,” keeping in mind that the baby is relying on mom for nourishment. And what “quality” foods does she recommend? Eggs, liver, bone broth, seafood—all the good stuff you’d expect from a self-avowed unconventional (Weston Price-y) dietitian.
Nichols also highlights foods pregnant women should avoid, though she is careful to point out that no food is inherently safe or dangerous. She points out, for example, that raw milk can be safer than fresh vegetables, if E. coli outbreaks are any indication. As for seafood, dietitians often tell pregnant women to avoid it because of the risk of food poisoning or excessive exposure to mercury. While Nichols does recommend proceeding with caution (especially for shellfish) and encourages women to make sure that the seafood is wild-caught and not farmed, she also observes that eating raw fish may be beneficial: “It turns out that in some types of fish, including salmon, bioavailability of selenium is higher when it is eaten raw. Given the role of selenium in preventing mercury toxicity, this could be your body’s way of protecting you.”
Included on the list of foods that do not build a healthy baby are alcohol, caffeine, highly processed carbs, sugar and certain artificial sweeteners. Unfortunately, and to my surprise, stevia makes her “okay to eat” list (WAPF recommends green but not white stevia). Another point of disagreement is that Nichols often mentions nuts as a source of protein and fat, but even in her meal plan in the back of the book, there is no mention of how to properly prepare them; that is, there is nothing on the importance of soaking and dehydrating them to neutralize antinutrients like phytates and enzyme inhibitors.
That said, overall, there is very little to quibble with here. Nichols recommends whole, real foods over supplements. And she knows her stuff. When covering which foods a woman should eat to get sufficient iron, the chart toppers include chicken and beef liver, oysters and beef heart. In a side note related to iron, Nichols points out that cravings for ice can be a sign of iron deficiency. There are helpful and practical bits of information like this throughout, as well as a bullet-point summary at the end of each chapter. This insightful and well-researched book is certainly one of the most practical and informative I’ve ever read on pregnancy, and one that WAPFers can purchase for mothers-to-be with confidence. It deserves a hearty thumbs up. For paperbacks, a free gift is on offer for those who purchase directly from her website (lilynicholsrdn.com/real-food-for-pregnancy/).
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