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Book Review: Real Food For Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition
In Real Food for Pregnancy, Lily Nichols reveals the contrast between conventional nutritional advice and traditional dietary wisdom. She stresses the importance of obtaining nutrients from nutrient-dense, real foods – including healthy animal fats – for fetal growth and development, and meticulously supports her assertions with hundreds of research citations. In the process, she shows that many of the supposed facts behind our conventional dietary guidelines are not borne out by evidence-based research. Moreover, Nichols points out, biased studies and flawed public policy have contributed to increased disease rates, especially in children.
Conventional guidelines based on the US government’s nutrition policies encourage people to eat less meat, limit saturated fat, and eat more grains. Unfortunately, these practices essentially limit nutrients that are already generally lacking in prenatal diets, such as vitamins A and B12, zinc, iron, DHA, iodine, and choline – all of which are needed for a healthy pregnancy. This approach has skewed our perception of the following conditions in pregnancy, leading us to accept them as common and inevitable: gestational diabetes, heartburn, constipation, hemorrhoids, excessive weight gain, high blood pressure, and high blood sugar. The truth is that these problems are often linked to conventional dietary recommendations. In fact, Nichols assures us – based on research and clinical experience – that real food diets and lifestyle changes can not only prevent but reverse these conditions.
The use of soybean, corn, cottonseed, and canola oil – rich sources of omega-6 fatty acids – is encouraged by conventional guidelines. However, high intake of these oils inhibits synthesis of DHA, an omega-3 fat that is critical to fetal brain and vision development. Infants of women with a high ratio of omega-6 to omega-3 fats in their diet are twice as likely to exhibit developmental delays. A baby’s brain, comprised of 60 percent fat, needs omega-3s as well as cholesterol, derived from animal-based foods in the mother’s diet, for brain and nervous system development.
Nichols also counters other common myths, such as the need to limit consumption of fish during pregnancy because of their mercury content. She explains that low-mercury fish, such as salmon, herring, and sardines, can be safe to eat because selenium (found in fish) binds to mercury and prevents its storage in the human body. She debunks the misconception that dietary cholesterol is harmful, showing that it is actually critical for pregnancy support. She also addresses the fallacy that soy is a health food, pointing out its thyroid-suppressing properties and the fact that the majority of it is genetically modified and treated with the herbicide glyphosate.
Although conventional prenatal guidelines recommend that carbohydrates make up the bulk of the diet, Nichols states that excess carbohydrate consumption can increase risk of pregnancy complications. It is linked to infertility, gestational diabetes, pre-eclampsia, and high blood pressure, among other conditions. She recommends a moderately low-carbohydrate diet that emphasizes unprocessed, low-glycemic carbohydrates.
Nichols proposes the following general meal guidelines: Half the meal should consist of nonstarchy vegetables, one quarter should be made up of proteins and fats, and the remainder should be carbohydrates. The carbohydrate category includes grains, beans and legumes, starchy vegetables, milk/yogurt, and fruit. The book also includes suggested meal plans and provides recipes for both snacks and meals.
In a conventional health setting, women are generally advised to reduce salt intake during pregnancy to prevent elevated blood pressure. Interestingly, this type of salt sensitivity only affects 25 percent of the population. In fact, salt restriction during pregnancy is associated with intrauterine growth restriction or death, or organ underdevelopment. Nichols recommends the use of unrefined sea salt in the context of a real food diet, rather than refined table salt.
The following foods are recommended as beneficial during pregnancy: eggs, liver, meat and poultry (particularly slow-cooked meat on the bone and bone broth), leafy greens, salmon, other fatty fish and seafood, and full-fat and fermented dairy foods. Higher amounts of nutrients needed for fetal development are found in grassfed meats and pastured eggs than in their factory- farmed counterparts; these nutrients include beta carotene, omega-3s, vitamin E, and choline. In addition, grassfed and pastured animal foods typically have less or no antibiotics, hormones, and other toxic residues that are associated with adverse pregnancy outcomes.
Throughout history, traditional cultures regarded animal foods as essential for fertility, pregnancy, and breast-milk production. Indeed, a diet of traditional foods including animal fats lowers risk of miscarriage, preterm labor, stillbirth, fetal growth restriction, brain development issues, and impaired thyroid function. Furthermore, animal foods contain complete proteins, while plant proteins are incomplete.
Nichols explains the challenges of maintaining a vegetarian diet during pregnancy, as it can be difficult or impossible to obtain nutrients such as vitamin B12, choline, glycine, preformed vitamin A, vitamin K2, DHA, iron, and zinc from the diet. She points out that the fat-soluble vitamins and antioxidants in vegetables are most effectively absorbed when consumed with some type of fat, such as grassfed butter or olive or coconut oil.
Maintaining a healthy microbiome can reduce the risk of pregnancy complications, and one way to benefit the microbiome is by consuming probiotics. Probiotics are found in fermented foods, such as sauerkraut, yogurt, kombucha, and water kefir. Prebiotic foods, such as vegetables, seeds, and nuts (including coconuts), sustain the friendly gut bacteria. For those who choose to take supplements, Nichols suggests specific strains and recommends quantities of each. She explains that another way to preserve the microbiome is to limit antibiotic use. Prenatal antibiotic exposure can harm a baby’s short- and long-term health, and is linked to asthma, eczema, and allergies in infants.
The book also covers prenatal vitamins and other nutritional supplements, as well as the safe use of herbs during pregnancy and postpartum. We learn that nutritional demands in the postpartum period, or the “fourth trimester,” are even higher than in pregnancy, due to the need to replenish one’s energy, as well as for breastmilk production. Postpartum weight loss and pregnancy spacing are discussed.
There are also chapters addressing exercise during pregnancy, stress and mental health, environmental toxins, and useful laboratory tests that are not typically ordered by conventional healthcare providers. In short, there is a wealth of knowledge for parents-to-be. Supported by rigorous investigation and research, this informative, easy-to-ready book provides valuable guidance on diet, nutrition, and lifestyle that can benefit all parents seeking to ensure an optimal pregnancy.
About the Author
Raine Saunders is a content developer, activist, and educator on the topics of nutrition, sustainable food, and holistic health alternatives. She has taught classes on gut healing and preparing traditional healing food, and produced a wealth of content on food politics, health freedom, nutrition, and other health-related topics. She is the creator of the blogs Agriculture Society (now in archive) and Heal Your Gut With Food. She lives in the Pacific Northwest with her family.
Published in the Price-Pottenger Journal of Health & Healing
Spring – Summer 2019 | Volume 43, Number 1
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