Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition

Chapter 1

Why You Should Have a Real Food Pregnancy?

“Whilst good nutrition is important at all life stages, it is increasingly recognised that the nutritional environment and individual experiences before birth and in early infancy is of particular importance for their later metabolic health, and that exposure to an inappropriate nutritional supply during critical windows of development can predispose an individual to obesity and type 2 diabetes later in life. By extension, the diet consumed by pregnant and breastfeeding women is a key determinant of metabolic health.” - Dr. Beverly Muhlhausler, University of Adelaide

There’s something miraculous about pregnancy. The fact that we have the power to literally grow a new human is still mind-boggling to me. When I was pregnant, I remember being keenly aware that all sorts of complex processes (both known and unknown in the scientific literature) were going on inside my body every second of every day. And I didn’t even need to consciously think about it; my body just knew what it was doing. It knew to create five fingers on each hand, where to place fingernails, where to grow hair, where the heart went, where each and every blood vessel should go, and on and on.

Sometimes this line of thinking—the idea that your body will take care of all the needs of fetal development without your input—is extrapolated to mean that you have no control over the trajectory of your pregnancy or the future health of your baby. Your body will just “do what it’s gonna do” and all you can do is hope you were dealt a good hand of cards and pass along good genes.

But that’s only partly true.

Allow me to share a quick metaphor. Anyone who has ever had a garden understands that when you plant a tomato seed, you can expect a tomato plant to grow (not a pea vine or a broccoli plant). The seed has the blueprints, and even if you’re not a very good gardener, that seed will grow given the bare essentials: some soil, water, and light. However, what separates a novice from a master gardener is their attention to optimal conditions. They have learned that amending the soil with nutrient-dense and microbe-rich compost will provide the plant with more of the raw materials for growth. They understand that there’s a sweet spot in the amount of water and light that helps a tomato plant not just survive, but thrive. Ultimately, they know that with a little TLC, they will have a healthier plant with vibrant green leaves and plentiful, delicious tomatoes.

This same line of thinking applies to pregnancy. Simply put, humans are wired to reproduce successfully. Even when conditions aren’t optimal, your body will do everything in its power to follow the blueprints and carry your precious baby to term. If that weren’t the case, there would be no way we’d have so many humans on the planet despite all sorts of common interferences, like malnutrition and toxin exposure. The problem is that chronic diseases are on the rise, especially among children, and a number of researchers have linked the development of things like heart disease, hormonal imbalance, diabetes, and obesity to exposures in utero. Unfortunately, it takes decades for this type of research to make it into clinical practice and public policies. That’s why you have to really search to connect the dots—and that’s exactly what I did while writing this book

Don’t get me wrong, there are a lot of things in pregnancy that are out of your control (your genetics, your age, your family history of disease, just to name a few). But, the things that are within your control—your diet, exercise, sleep habits, the way you handle stress, your exposure to toxins, and more—can have significant effects on your pregnancy and may leave a permanent imprint on your baby’s health. It’s called “fetal programming,” a decades old hypothesis (now well-studied and well-accepted in scientific research) which proposes that inadequate nutrition during pregnancy can impair the development of your baby and lead to lifelong metabolic changes that increase the risk of diseases, like heart disease, diabetes, high blood pressure, and the risk of obesity.

Though most of us view our genetics as a solid blueprint, researchers have found that genes can be turned on or off by certain exposures in utero, such as levels of nutrients, a mom’s blood sugar and insulin levels, exercise habits, stress hormones, toxins, and much more. That means that even if you think you have “bad genes,” you have the ability to minimize the impact of these on your baby with optimal nutrition and informed lifestyle choices. On the flipside, even if you have “good genes,” they could be turned off to some degree if your diet and lifestyle aren’t healthy.

When it comes to your experience of pregnancy, you have the power to lower your chances of developing gestational diabetes, preeclampsia, delivering prematurely, becoming anemic, and gaining too much or too little weight during your pregnancy, all by the way you live your life. How empowering is that?

Ask any pregnant woman and she’ll tell you the most important thing to her is to have a healthy baby and an easy pregnancy, so NOW is the time to do everything in your power to “stack the deck” in your favor.

Why Real Food?

When I first ventured into the world of prenatal nutrition, I was shocked by how little is actually known about fetal development. Researchers are still piecing together what exactly is happening and when. Believe it or not, we’re still uncovering which nutrients are needed, in what amounts, and at which stage in pregnancy. Even the recommended dietary allowances (RDAs), which tell you how much of each nutrient you require on a daily basis, are best guesses. Until we have better information (and perhaps we never will), we need another plan. One option is to look at the diets of traditional cultures who have long histories of having healthy babies and to learn from them. The work of Dr. Weston Price, a dentist and nutrition researcher from the early 1900s, found that traditional cultures prized certain nutrient-dense foods during the preconception and prenatal period. Dr. Price traveled the globe and investigated the dietary practices of numerous cultures, the nutrient-density of their foods, and their overall health. The groups studied included the Swiss, Gaelics, Eskimos, Malay tribes, Maori of New Zealand, Native Americans in Canada and the U.S., tribes in Eastern and Central Africa, Pacific Islanders (Polynesians and Melanesians), Australian Aborigines, South Americans of the Amazon basin, and ancient civilizations and their descendants in Peru. He found remarkable differences in the nutrient content of traditional foods compared to imported foods.

He also found that the health of these populations was a direct reflection of what they ate, noting that people who followed their ancestral diet remained disease-free and had robustly healthy children. In contrast, relatives who incorporated modern foods into their diet suffered more health problems, as did their children. Tooth decay, narrow palate, crooked teeth, deformities (like club feet and neural tube defects), poor immune health (higher rates of infectious diseases, like tuberculosis), psychological problems, and numerous other health problems were more prevalent in children of people who ate more “foods of modern commerce,” like sugar and refined grains, and less of their traditional foods. What struck me most about his work was that the negative consequences of a bad diet affected more than just their children, but also their children’s children.

Dr. Price’s observations have been replicated in animal studies and it’s now more widely accepted that exposure to positive influences like a nutrient-dense diet and exercise have beneficial effects on pregnancy outcomes, while exposure to toxins, stress, and processed foods have the opposite effect. There’s currently a whole field of research devoted to the study of what’s called “epigenetics,” or how your genes (or your children’s genes) are affected by your lifestyle choices and other exposures.

It was from reading Price’s research (and learning which foods were most prized in these cultures) that I began to question what I had been previously taught about prenatal nutrition in my conventional dietetics training. How could a low-fat diet be acceptable if it means the richest food sources of vitamin A, choline, iron, and zinc are limited? Traditional cultures did the exact opposite. Conventional nutrition heavily advocates for fortified foods in pregnancy—like cereal fortified with folic acid and iron—while frequently ignoring foods that are naturally good sources of those same nutrients. In fact, consumption of certain nutrient-dense foods, like liver and full-fat dairy, are commonly discouraged. How did traditional cultures ensure they had healthy pregnancies when fortified foods didn’t exist?

Modern nutrition research tends to isolate and study single nutrients instead of whole foods, resulting in a lot of attention given to prenatal vitamins or individual supplements. That approach—often called “nutritionism”—has never made much sense to me. Why not, instead, take the information we’ve learned from modern science and apply it to real food? In other words, let’s figure out which foods are naturally rich sources of the most important nutrients for fetal development instead of swallowing a bunch of pills. After all, nutrients work synergistically. Nature is not stupid. And a supplement is rarely superior to what’s available in real, whole foods.

That’s why my real food approach is to reverse engineer the perfect prenatal diet. We can take what we’ve learned from single-nutrient studies and combine it with what we know from traditional cultures.

The result? We have the best of both modern nutrition science and ancestral wisdom to help you “grow a healthy baby.” In the coming chapters, you’ll learn which foods, nutrients, and lifestyle habits to embrace and why—and which ones to avoid—so you can be assured that you’re doing everything within your power to have a healthy pregnancy. Like I said before, let’s “stack the deck” in your favor.