Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
2 May

5 Primal Superfoods for Fertility and Pregnancy

pregnant3This is a guest post from Chris Kresser of ChrisKresser.com.

As a clinician with a special interest in fertility and pregnancy nutrition, two of the most common questions my patients ask are:

  • Is a Paleo/Primal Blueprint diet safe during pregnancy?
  • What are the most important foods to eat for boosting fertility and ensuring a healthy pregnancy?

I’m going to answer these questions in this article. But before I do, let’s first take a moment to discuss the importance of proper nutrition for fertility and pregnancy.

Numerous factors determine our health as adults, including nutrition, exercise, lifestyle and genetics. But recent research suggests another powerful influence on lifelong health: our mother’s nutritional status during (and even before) her pregnancy.

In fact, some researchers now believe the 9 months we spend in the womb are the most consequential period of our lives, permanently influencing the wiring of the brain and the function of organs like the heart, liver and pancreas. They also suggest that the conditions we encounter in utero shape everything from our susceptibility to disease, to our appetite and metabolism, to our intelligence and temperament.

We’re only as healthy as our mother’s womb

The theory that the nutritional environment we encounter in the womb determines our lifelong health is known as the Developmental Origins Hypothesis. It was first proposed by British researcher David J. Barker in the 1980s to explain a seeming contradiction: as British prosperity increased, so did heart disease. Yet geographically, the highest rates of heart disease were found in the poorest places in Britain. Barker found that rather than smoking, dietary fat or some other lifestyle cause, the factor that was most predictive of whether an individual would develop premature heart disease (before the age of 65) was their weight at birth (PDF).

Barker found that infants carried to full term with birth weights between 8.5 and 9.5 pounds had a 45 percent lower risk of developing heart disease later in life than infants born at 5.5 pounds. (They also had a lower risk of stroke, a 70% lower risk of insulin resistance and a slightly lower risk of blood pressure later in life.) As the chart below demonstrates, the risk declined in a linear fashion between 5.5 and 9.5 pounds, but started to increase again as birth weight rose above 9.5 pounds.

ScreenShot2012 04 30at30106PM

How the first nine months shapes the rest of your life

Over the last 25 years, Barker’s original work has been reproduced and expanded. If you do a quick search on PubMed for “developmental origins of disease”, you’ll find references to the fetal origins of cancer, heart disease, allergies, asthma, autoimmune disease, diabetes, obesity, mental illness and degenerative conditions like arthritis, osteoporosis, dementia and Alzheimer’s.

The following list is just a small sampling of the literature on the subject:

  • The metabolic syndrome. In a 2011 paper, Bruce et al showed that the onset of metabolic syndrome is “increasingly likely following exposure to suboptimal nutrition during critical periods of development”.
  • Heart disease and diabetes. In a 2002 paper, Barker (the “father” of the Developmental Origins hypothesis) showed that slow growth during fetal life and infancy – itself a consequence of poor maternal nutrition – predisposes individuals to coronary heart disease, type 2 diabetes and hypertension later in life.
  • Breast cancer. In a 2006 paper Hilakivi-Clarke, et al. showed that maternal diet influences the risk of breast cancer by inducing permanent epigenetic changes in the fetus that alter susceptibility to factors that can initiate breast cancer later in life.
  • Polycystic ovary syndrome (PCOS). In a 2007 paper, Dumesic et al. showed that insulin resistance and resulting increases of testosterone during pregnancy promotes PCOS during adulthood.
  • Obesity. In a 2008 paper Kalliomaki et al. showed that simply by studying the composition of the maternal gut flora (influenced by nutrition, medications, stress, etc.) they could predict which children will be overweight by age 7!

These studies – and many more – have made it clear that the mother’s nutritional status leading up to and during pregnancy affects her baby’s health not only at birth and during early childhood, but for the rest of his or her life. This leads us to the obvious conclusion that proper maternal nutrition is crucial for boosting fertility and ensuring lifelong health for our children.

But what is proper maternal nutrition? And is the Primal Blueprint diet you’ve come to love safe during pregnancy?

If you listen to the mainstream authorities, they’ll tell you the best diet during pregnancy is one that’s rich in whole grains and low in fat and animal protein. Some of my patients have even been told by their previous physicians or nutritionists that it’s dangerous not to eat grains during pregnancy!

Sound familiar? This is the same misguided advice dietitians have been giving to the general public for decades – and it’s just as wrong for aspiring parents and pregnant moms.

Let’s break out that trusty analytical tool called “common sense” to combat the notion that the Primal Blueprint diet isn’t safe during pregnancy, and that it’s somehow dangerous not to eat grains during pregnancy. If that were true, we wouldn’t even be having this conversation. Why? Because humans have eaten a paleolithic diet (without grains) for the vast majority of our evolutionary history.

Imagine the timeline of human existence as a football field (100 yards from end-zone to end-zone). If you started walking at one end of the field, the first 99.5 yards would represent all of human history up until the last 10,000 years. During those first 77,000 generations of human history, we survived and thrived on a paleolithic diet. It’s only in the last one-half yard that agriculture was developed and humans started regularly consuming grains.

Perhaps the more appropriate question is whether the Standard American Diet is safe. Infertility rates are already high, and they’re increasing at an alarming rate. 1 in 7 women today have trouble conceiving, and a recent study in the U.K. predicted that number could more than double (to 1 in 3) by 2020. While there are probably several reasons for this dramatic increase in infertility, the Standard American Diet is almost certainly one of the most important.

How can you supercharge your fertility and ensure a healthy pregnancy and lifelong health for your baby?

The Primal Blueprint diet is an excellent starting place for those wishing to conceive, or for women who are already pregnant or nursing. But within the context of the Primal Blueprint diet, there are certain foods and nutrients that are particularly beneficial during these periods.

Traditional cultures have known this for millennia. That’s why they have sacred fertility foods they feed to mothers-to-be and even fathers-to-be. These include nutrient dense foods like fish eggs, liver, bone marrow, egg yolks and other animal fats. For example, the Masai tribe in Africa only allowed couples to marry and become pregnant after spending several months drinking milk in the wet season when the grass is lush and the nutrient content of the milk is especially high.

With this in mind, here are the top 5 “superfoods” I recommend for fertility, pregnancy and breastfeeding.

  1. Liver. Ounce for ounce, liver is one of the most nutrient-dense foods on the planet. It’s loaded with fat soluble vitamins like retinol (pre-formed vitamin A) that are crucial for reproductive health, and difficult to obtain elsewhere in the diet. Liver is also a great source of highly absorbable iron, which helps prevent miscarriage and maternal anemia, and B12, which is required for proper formation of red blood cells and DNA. Liver is also a good source of bioavailable protein, zinc, and folate.
  2. Egg yolks. Like liver, egg yolks could be considered “nature’s multivitamin”. But they are especially rich in a nutrient many people have never heard of: choline. Studies suggest that 86% of women don’t get enough choline in their diet. This is significant because choline helps protect against neural tube defects. It also plays an important role in brain development, helping to form cholinergic neurons and the connections between these neurons that are so crucial in the first few years of life.
  3. Cold-water, fatty fish*. Seafood is the exclusive food source of the long-chain omega-3 fats EPA and DHA. DHA is particularly important for fertility and pregnancy. It is preferentially incorporated into the rapidly developing brain during pregnancy and the first two years of infancy, concentrating in the grey matter and eyes. It’s also crucial to the formation of neurons, which are the functional cells in the brain, and to protecting the brain from oxidative damage. Salmon, mackerel, herring and sardines are excellent sources of DHA.
  4. Cod liver oil. Yep, grandma was right! Cod liver oil is a sacred fertility and pregnancy food that fell out of favor during the last couple of generations, but is making a comeback. It’s one of the highest dietary sources of vitamin A, which we discussed above. It has more vitamin D per unit weight than any other food. Vitamin D is crucial to fertility and pregnancy, and studies show that up to 50% of women are deficient in it. Vitamin D promotes proper development of the bones, especially during the 3rd trimester when the fetal skeleton begins to grow rapidly. Cod liver oil is also a good source of the long-chain omega-3 fats EPA and DHA.
  5. Grass-fed dairy. While dairy is not strictly a Primal food, it’s a great choice for fertility and pregnancy for those who tolerate it well. Dairy is rich in saturated fat, which is especially beneficial for fertility. It’s also a good source of the fat-soluble vitamins (A, D, K2 & E) and a healthy, natural trans-fat (not to be confused with artificial trans-fats, which are harmful) conjugated linoleic acid (CLA). Fermented dairy products – like yogurt and kefir – are also great sources of beneficial bacteria. This is important because a baby’s first exposure to bacteria is in his/her mother’s birth canal, and the mother’s gut health has a significant influence on the lifelong health of her baby.

*Some women are scared to eat fish during pregnancy because of concerns about mercury levels. It turns out those concerns have been overblown. Read this article for more information.

Want to supercharge your fertility and promote lifelong health for your baby? Check out the Healthy Baby Code.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Cod liver oil and liver, both extremely high in vitamin A, and possibly teratogenic to the fetus.

    Proceed with prudence and caution.

    Derek wrote on May 2nd, 2012
    • Synthetic Vitamin A is toxic. Also, if you don’t take it in the presence of other vitamins that occur with it naturally, like Vitamin D and Vitamin K, it can cause an imballance. That’s why properly prepared cod liver oil is so good for you because it’s natural not synthetic, and it is not seperated from it’s vitamin counterparts.

      Jana wrote on May 2nd, 2012
      • Exactly. Derek, I responded below but didn’t hit the “reply” button to your comment, so it went into the main comment stream.

        Chris Kresser wrote on May 2nd, 2012
        • Hi Chris,
          What about mercury levels in cod-liver-oil and fish?

          Conventional Wisdom usually suggests that pregnant women not eat or reduce fish unless they are sure that it is not high in mercury. And also that elevated mercury levels will directly affect brain development of fetus and of infants.

          Keerthy wrote on May 2nd, 2012
        • Chris, If taking a prenatal vitamin had 1700iu of vitamin A, and omega pill, do I still take the 5ml of the cod liver oil, or do I reduce it.

          Jacqie wrote on June 20th, 2012
        • Hi, I’ve been following you for several months now and love what knowledge you are sharing!!! I have a question…I have a 5 week old who seems to have colic…every night for a few hours he seems to be in great discomfort and very uncontentable, crying out in pain :( We eat a very clean/organic diet…NO wheat/gluten. All our meat and dairy comes from a local farmer who practices biodynamic farming… Everyone keeps telling me it’s the dairy, so I went off the dairy for almost 2weeks and it didn’t seem to help…I drink about a pint of keifer in the am… and milk through out the day!? I just started taking some “pro-zyme” two weeks ago to see if it would help. I’ve also been taking chamomile myself and rubbing it on his belly…I’m too scared to give him anything orally, except breast milk…I’ve been told to try gripe water…or even make him some cham tea…I do have some homegrown chamolile I was going to try one desperate night but didn’t. Could you please help! I am getting very un-nerved…it’s been about 3 weeks since this has started and it only seems to be @ night between 10 and 2…he’s usually a good burper …but just started spitting up…idk what to do. Everyone I ask tells me to give him something orally…? The only thing that seems to calm him is a warm bath, but as soon as were out he’s upset again. Sorry for the long history, just wanted to give you plenty of info :)Thanks, Sarah

          Sarah wrote on June 27th, 2012
        • Sarah, I hope you subscribed to your comment so you’ll see this.
          Your child may have fructose malabsorption. For some reason, onion and garlic also cause trouble for those with FM. If you are eating onion and garlic, the offending problems are in the breast milk. If you haven’t figured out the issue already, eliminate those and if it helps, be prepared to avoid anything with more fructose than glucose when he gets older.

          Joshua wrote on September 18th, 2012
      • But the form of vitamin A in Cod Liver Oil is retinol, which can be toxic if taken in very high amounts for a long time.

        David wrote on May 3rd, 2012
        • How many people a year die from CLO/liver overdose?

          Sampson wrote on May 6th, 2012
        • If you get 3rd party purity tested cod oil it is mercury free. You can buy it at a health food market.

          Trish wrote on July 8th, 2014
    • As with everything, common sense is the key. Don’t sit down and eat 3 pounds of liver and drink a bottle of cod liver oil then follow it up with the biggest plate of sushi you’ve ever had in your life. Eat regular portions, only when you are hungry, and eat until you’re full. Pregnant or not. Women may be hungry more often during pregnancy, which is normal, but gaining 50 pounds of body fat from sitting and eating constantly is not good for the mom or the baby. Too much sugar is bad for the fetus, yet women usually crave sweets during pregnancy. Too much of anything is bad for the fetus. Just eat a normal healthy diet with regular portions, and the foods listed above are good to eat for several reasons when eaten in moderation as they always should be anyway. :)

      Jo wrote on May 6th, 2012
  2. This is brilliant. Only if this article could be posted everywhere for parents-to-be to see. It kills me that families still think bread, oatmeal, cereal, pastries, pancakes/waffles, spaghetti/macaroni, etc. are the norm for a healthy diet. People should really open their damn eyes. Great article, none-the-less.

    Mark Pieciak wrote on May 2nd, 2012
    • While I agree that it is annoying that people still see grains as the main source of nutrients and energy, it’s not fair to blame people in general and tell them to “open their damn eyes.” For years we have been told a low fat, high carb diet is the way to go, and this is information from health professionals. Why wouldn’t people believe it? If you talk down to people and make them out to be idiots they’ll never listen to you. You’re no better or worse than anyone just because you’re primal. If you want people to see the truth then treat them as equals and don’t dis them on sites like this, it just makes primal advocates look like assholes.

      Hazel wrote on May 2nd, 2012
      • Precisely! You can catch more flies with honey than you can with vinegar. Of course, who wants to catch flies, eh?

        mdmhvonpa wrote on May 2nd, 2012
      • Eeeee. I disagree… I’m a health care provider & I’ve never had any MD or other provider tell me that eating a high carb diet low fat diet was good. Most docs that I’ve known & nurses encourage people to eat less sugar & carbs & more dense foods. I’m not sure where your getting your info… it’s ancient info.

        Jess wrote on May 6th, 2012
        • If you look at the food pyramid you will see that grains are at the bottom and it recommends that we eat at least 6 portions a day. This is regularly handed out to every kid in school. “Healthy Wholegrain” is a phrase used way too often by health professionals.

          Hazel wrote on June 22nd, 2012
    • I think the problem is they dont realize how easy it is to cook home made food that is actually home made. allrecipes.com has some awesome things for people that dont know where to start.

      Trish wrote on July 8th, 2014
  3. I purchased Kresser’s “Healthy Baby Code” for my then pregnant sister. The series is a great nutrition primer for anyone. As a single male with no plans to have children, I highly recommend the Healthy Baby Code for anyone who wants a layman’s crash course in nutrition.

    liberty1776 wrote on May 2nd, 2012
  4. I’m nine months pregnant right now, four more weeks to go, and finding good dietary advice for pregnancy is nearly non-existant. All advice out there right now is that paleo/primal and anything resembling LCHF is horribly dangerous. I think most of this is based on them not wanting women to gain weight during pregnancy and seeing fat as a prime culprit in weight gain. They seem to tollerate women gaining weight but would be even happier if they gained non at all (but don’t lose weight unless it’s due to morning sickness!). For some reason it is considered safer to be vegan, I shudder at the thought. The only organization that publishes dietary guidelines for pregnancy that make any sense at all is the Weston A Price Foundation. I hope a greater expansion of this blog post is forth coming as we lack good sound advice on this topic.

    Jana wrote on May 2nd, 2012
    • I’m also nine months pregnant and completely agree that there is a serious need for more information like this to be put forth. Just go to any parenting website with message boards and you will see how much bad dietary information there is out there for pregnant and lactating mothers. One user posted that she had to quit her low carb diet after the baby came, (which she was following due to gestational diabetes), because her doctor told her it was “dangerous” to nurse and continue to follow a low carb diet. And the advice about avoiding saturated fats and sticking to “healthier” vegetable fats and low-fat dairy is rampant.

      Tricia wrote on May 2nd, 2012
    • I ate a lot of fatty food and meats and hardly any grains in my last two trimesters (I craved carbs in the first few months!). I gained a total of 25 lbs during my pregnancy– most in the first trimester when I was eating a lot of grains. I didn’t gain anything in the third trimester despite eating way more meat and fat than ever (but almost nothing processed). My baby was 7lbs at birth and very healthy. I think her health had a lot to do with my diet. I was vegetarian for 7 years, had PCOS and trouble conceiving. When I changed my diet, conceiving naturally was easy.

      ctan wrote on May 2nd, 2012
      • I wondered if the paleo way of eating would help with conception as well. I am hoping that it will help me conceive easily as well.

        Kim wrote on May 24th, 2012
  5. Derek,

    That is a myth. I cover it in great detail in the Healthy Baby Code, but here’s the gist: vitamin A is only toxic in high amounts when vitamins D and K2 are also deficient.

    Supplementing with vitamin D radically increases the threshold for vitamin A toxicity. A 160 lb. person would need to take over 200,000 IU per day of vitamin A to reach a toxic level. Considering that a serving of cod liver oil has about 3-5,000 IU of vitamin A (depending on dose and product), it’s nowhere near the toxic range.

    This is another reason why it’s so important to obtain nutrients from food when possible. Cod liver oil is high in vitamin A, but it’s also high in vitamin D – which protects agains the potential toxicity of vitamin A. Nature’s wisdom, once again.

    Incidentally, the one study that showed that vitamin A is toxic during pregnancy has been roundly criticized and discredited. Several other studies have not shown any increase in birth defects from vitamin A supplementation. On the contrary, most studies showed that mothers who supplemented with relatively high doses (10,000 IU) of vitamin A (even synthetic forms) had a lower risk of birth defects than mothers who didn’t.

    Chris Kresser wrote on May 2nd, 2012
    • Chris,

      Do you recommend a particular brand of Cod Liver Oil? What about fermented CLO? Is that preferred to unfermented? If so, why?

      Thanks for your help! And thanks for what you do. This article is much-needed in today’s world!

      Kristi wrote on May 2nd, 2012
      • Kristi,

        Yes, I recommend the Green Pasture fermented cod liver oil. Fermentation is preferable because it’s a cold-processing method. Omega-3 fats are fragile and vulnerable to heat-processing.

        The fermentation may also increase the amounts of K2.

        Chris Kresser wrote on May 2nd, 2012
        • Chris,
          What condition are the omega-3 fats in from canned fish like salmon?

          Johannah wrote on May 2nd, 2012
        • Derek, do you think it is worth it to get the Green Pastures Butter Oil/Fermented Cod Liver Oil Blend? Or would the Cod Liver Oil provide most of the benefits?

          Adam wrote on May 2nd, 2012
        • Oops! I actually meant to address Chris on that question.

          Adam wrote on May 3rd, 2012
    • Chris,

      I agree with your comments and position, that’s why I used the word “possibly” in my statement.

      But I think any time you speak of peri/prenatal nutrition, and mention liver/cod liver oil, it’s worth discussing toxicity.

      This audience is astute, but some people like to think if a little is good, more must be better.

      There’s a reason the practice of obstetrics has ridiculous rates for malpractice insurance. It’s a touchy subject, and anytime advice is given, it should certainly be done with caution.

      Anyway, I like your articles, just mentioning that it seemed this article was too brief and not inclusive enough, given the subject.

      Derek wrote on May 2nd, 2012
      • It’s also worth pointing out that the article says milk is a good source of vitamin D. This is true in the US, where milk is supplemented with vitamin D (by law). In the UK – and lots of other places, I would imagine – milk is not fortified with vitamin D, so milk is not a good source of this nutrient. Also, I would guess that raw milk is not fortified, even in the US.

        Violet wrote on May 3rd, 2012
    • I’m sure you must be aware of the view by some promoters of high Vitamin D blood levels that almost any amount of retinol will prevent the Vitamin D from being benificial. They say you should let your body regulate how much retinol to produce from beta caretene. I guess I should rethink this because it caused me to stay away from CLO for the last 2 or 3 years. I even avoided a salmon oil supplement because it has a small amount of retinol in it. It seems reasonable that our paleo ancesters ate liver from every kill while walking that 99.5 yards, but wouldn’t have been able to concentrate it by extracting the oil. It leads me to seek more knowledge on the subject, like I currently am doing concerning dairy, try to make sense out of all the opposing views.

      vacexempt wrote on May 2nd, 2012
      • The problem with most knowledge about vitamin A and D is that most of the research has been done in isolation- looking at vitamin A without D, and vice versa. The truth is, A, D and K2 all work together, and protect against toxicity of each other. Vitamin A toxicity only seems to appear if D is deficient, and Vitimin D Toxicity only seems to appear if A is deficient.

        There’s also the idea that findings have been misinterpreted. For example, and increase of Vitamin A may increase calcium in the urine, and this was thought to be bad for bones. But what could be happening is that K2 is removing that calcium from arteries (which is bad for cardiovascular health), and then A is escorting it out of the body. In this case, elevated calcium in the urine is a good thing.

        And of course, Vitamin K2 has been largely overlooked.

        John wrote on May 3rd, 2012
        • Very good points – I totally agree.

          David wrote on May 3rd, 2012
      • Not everyone efficiently converts beta carotene to retinol (esp. people with thyroid disease). If I take D3 without taking any retinol, I develop mild keratosis pilaris on the back of my arms (usually a sign of retinol deficiency) and it clears up quickly after adding retinol.
        I get plenty of beta carotene from green and orange veggies, but I don’t convert it well.

        Erin wrote on September 7th, 2013
    • I think I know the study you’re referring to – this one, yes? Even that doesn’t suggest that pregnant women shouldn’t ever have liver: I calculate that it should be safe to have 20–30g of liver now and again at least, based on those numbers.

      Could you supply links to the other papers, the ones that show a lowered risk with Vitamin A? I’ve found studies in non-pregnant women, and studies in monkeys, but nothing else that actually deals with pregnant humans taking Vitamin A.

      Orielwen wrote on May 4th, 2012
    • Chris, I’m not trying to get pregnant, but would like to start the FCLO/butter oil blend from Green Pastures (they are currently out of stock). I plan to discontinue my fish oil and vitamin D3 supplements after starting the FCLO/BO. Is that wise? I plan to still take my high quality multivitamin daily. Do you think that could be harmful?

      Mary wrote on October 16th, 2012
  6. whether or not to have children is everyone’s personal decision. it worries me though,that fewer intelligent, educated, financially stable people are having children. maybe i’m a bigot, but why should we leave the future generations to the ignorant, SAD eating masses? i guess i want to believe that there is hope for the world by living and eating better. passing along that health and knowledge is part of improving the world, imho.

    HopelessDreamer wrote on May 2nd, 2012
  7. Mark, I love reading your blog every day! I am planning on getting pregnant for the 2nd time in about a year. I am thinking about taking Cod Liver Oil as a supplement soon. Is all the vitamin A in Cod Liver Oil is okay for the developing baby? I’ve heard scary stuff about too much vitamin A. BTW, our first baby is 2-1/2 and is very healthy besides having an intolerance to dairy. We are getting ready to try raw dairy with him. He’s also doing amazingly on an 80% primal diet!

    Jess wrote on May 2nd, 2012
    • Jess: see my response to Derek’s comment about vitamin A above.

      Chris Kresser wrote on May 2nd, 2012
    • Jess…I would absolutely try organic whole raw dairy for your child…then get yourself some kefir grains and make him some kefir. I drink a pint a day. You want to make your gut happy with tons of beneficial bacteria? Drink kefir…as well as lacto-fermented veggies (see the perfectpickler.com) I know it’s not 100% primal/paleo, but I would NOT give it up for the sake of the health of my gut…which ultimately boosts my immune system. I know a father of 6 who got his 12 year old on organic raw dairy and his asthma was cured in 2 weeks…no more meds, etc. I also ate sardines during my whole pregnancy 22 years ago. I didn’t care about weight gain as long as I was eating healthy. Our son was just shy of 9 lbs. And I think all that good fat helped as well as I don’t have one stretch mark on my tummy…and I got huge…all out front. Regarding CLO…go for it. I even have my dog on it. IMHO it’s the best natural anti-inflammatory hands down. Green Pastures carries the best form…Blue Ice High Vitamin Butter Fermented Cod Liver Oil Blend. The cinnamon tingle is outstanding. Good luck with your upcoming pregnancy. Regards, Penny

      Penny wrote on May 2nd, 2012
      • Penny, THANK YOU so much for the website for perfect pickler. It is affordable and I have been looking for ways to ferment veggies that didnt cost upwards of $50. I will be ordering from them soon. Thank you!

        Sara wrote on December 23rd, 2012
  8. So glad this was posted. The woman who sits next to me at work is 7 months pregnant and is constantly eating fast food and microwavable meals. It hurts me to watch and I wish there was better education about the foods you should be eating while creating a human being.

    Katie wrote on May 2nd, 2012
    • Yes, it’s physically painful, isn’t it? And it just becomes even more painful when we fully understand how important nutrition during pregnancy is for the *lifelong* health of our children.

      Chris Kresser wrote on May 2nd, 2012
      • It’s ridiculous! During my pregnancy I told my midwife I was waking up hungry in the middle of the night and she actually told me to eat something sweet right before bed “to keep my blood sugar up over night”. As a lifelong hypoglycemic, I had no problem telling her that advice was absolutely wrong and I would not be following it. Too bad I didn’t know about Primal/paleo eating back then… I could have avoided alot of problems.

        Danielle wrote on May 2nd, 2012
        • Yikes! They always told me to eat something like yogurt or cottage cheese.

          Marcia wrote on May 2nd, 2012
  9. just finished making liver meatballs for the week! I’ve also been using raw egg yolks as dressing lately… hopefully setting myself up for a healthy pregnancy someday.

    katie wrote on May 2nd, 2012
    • hi Katie,

      would you mind posting a recipe for the liver meatballs? I hate liver, but I know I should eat it…any tasty ways to take it in are greatly appreciated :)

      randi wrote on May 2nd, 2012
      • i second that request for the recipe! i’ve been meaning to eat liver for a long time, and as i’m pregnant now, i REALLY should eat it…

        theresa wrote on May 2nd, 2012
      • I made Paleo Liver Chili: http://www.wildnessandwonder.com/2011/07/offally-fantastic-paleo-liver-chili/

        I used chicken livers, and there’s the *barest* coppery tinge as you swallow some bites. Delicious!!!!!

        Jeanie Witcraft wrote on May 2nd, 2012
      • First post on this site, so don’t get harsh on me :) I like chicken livers (from before knowing this is healthy eating) made this easy way: heat 1-2 tablespoons of cooking fat in skillet (I use olive oil but here it seems not good so use what you want) on medium. Fry the chicken livers, covered, for a few minutes, turning once, just until, when poked with a fork, the juice is no longer red, not more. Salt AFTER turning off the heat. Pepper if you wish. Use the cooking liquid as sauce on whatever you eat it with. That’s it – awesome, melt-in-your-mouth, real flavour chicken livers. I’d eat them everyday, but it’s hard to find organic ones…

        As for chicken liver pate (spread, dip etc) take the said livers after they get cool, pulse in food processor with a dollop of butter, some onion slowly pan-fried in butter, salt and pepper. Delish!

        Izzy wrote on October 29th, 2012
    • I second randi’s request… I’m not a huge fan of liver, but meatballs should be tasty. Could you share your recipe?

      jonas wrote on May 2nd, 2012
    • This recipe was recently posted at Primal Palate: http://www.primal-palate.com/2012/02/beef-liver-and-onion-meatballs.html

      Might not be the exact one Katie used, but it’s probably a good baseline. :)

      Christine M. wrote on May 2nd, 2012
      • I started making a similar meatball (using thai flavors like ginger & lemongrass) and my liver-hating husband and 3yr old eat them up, having no clue about the liver :)

        misterworms wrote on May 3rd, 2012
  10. Well, my son certainly got a nutritional boost in being such a smarty-pants. I CRAVED whole eggs while I was pregnant, and ate about half a dozen a day. Yay, choline!

    Danielle wrote on May 2nd, 2012
  11. Chris, do you have any advice for the men? My husband has hemochromatosis which was diagnosed in his early 20’s, and due to that, has a very low sperm count. Because of this, we were told our only hope of getting pregnant was in vitro fertilization which we did in January 2008 and we had a beautiful baby girl that fall. We would absolutely love to have another baby, but in vitro is very expensive! My husband is very interested in finding a way to naturally raise his testosterone levels – he has not transitioned fully to primal eating – other than making that change, is there anything else he can do?

    Amy wrote on May 2nd, 2012
    • What is good for the goose is good for the gander.

      liberty1776 wrote on May 2nd, 2012
    • Yes, in general men should follow the same approach I outline for women. However, since your husband has hemochromatosis, he has to avoid iron-rich foods like organ meat, oysters and too much red meat (beef, lamb). He should also be following fairly aggressive iron reduction strategies to keep his ferritin <100 and iron saturation <45. The reason his testosterone is low is because iron damages the pituitary gland, which secretes LH and FSH. LH acts on the leydig cells, which produce testosterone. FSH acts on the sertoli cells, which produce sperm. Reducing iron levels to the targets mentioned above should improve his testosterone production and sperm count.

      Chris Kresser wrote on May 2nd, 2012
      • Thanks for the info Chris – when my husband was initially diagnosed, he did a very aggressive phlebotomy treatment to get his levels within the normal range, and again, that was probably 15 years ago. No one ever told us that him having hemochromatosis would affect his fertility. Is it possible that his extremely high ferritin and iron levels (1600-1800) when he was first diagnosed have permanently damaged his pituitary glands? We have never really been able to get a straight answer from anyone! He now does quarterly phlebotomies to keep his levels normal. Thanks!!

        Amy wrote on May 2nd, 2012
        • Unfortunately, it is possible. But the reason no one has answered you definitively is that it’s difficult to know for sure. He may simply need additional support to regulate hormone production after the initial damage elevated iron did.

          Chris Kresser wrote on May 2nd, 2012
    • There’s a lot he can do, including bioidentical testosterone supplementation. Also you don’t say where his weight is at, fat is estrogenic & suppresses testosterone production as does a high carb diet, & toxic adulterated liquid vegetable oils & trans fats in take out, fast & junk “foods” completely disrupt & shut down the entire hormone system & block uptake of essential O-6&3 fats & probably all fat soluble vitamins too.

      “…a quarter of all men have low sperm counts, and obese men are 42 percent more likely to be among them than normal-weight men.

      Even more frightening, the obese are 81 percent more likely to make no sperm at all.

      …extra body fat has the unique ability to turn testosterone into estrogen, and once that excess estrogen starts flowing through a man’s body he may as well start knitting.” douglassreport . com

      cancerclasses wrote on May 2nd, 2012
      • He is actually at a pretty healthy weight – he fluctuates between 165 and 175 and is about 5’10.” Like most men, he carries his fat around his belly and sides. He did try to go primal a while back, but had some serious low-carb flu and couldn’t handle it. Although he usually eats primal for dinner with me, breakfast and lunch are typically a SAD and lunch is often fast food b/c he’s on the road a lot during the day. I am doing my best to get him and my 3 year old on board by slowly weaning them from the carbs!

        Amy wrote on May 3rd, 2012
  12. My wife and I teach a natural childbirth class that has an emphasis on nutrition. I find the advice of the course matches pretty well with primal eating, advocating healthy fats, protein such as liver, eggs, leafy vegetables, colored vegetables, calcium/dairy, all daily.
    It does recommend whole grains as well. I figure if they are eating all the nutrient rich foods we emphasize they won’t have time to over-indulge in too much grains and will be much better off than on a SAD diet.

    Randy M wrote on May 2nd, 2012
  13. If one were to follow these eating habits, would that make prenatal vitamins unnecessary?

    Stevi wrote on May 2nd, 2012
    • Even in the context of a Primal diet with superfoods like I’ve recommended here, it can be difficult to get adequate folate and vitamin D. So I do recommend supplementing with folate (NOT folic acid), and checking D levels periodically before and during pregnancy to ensure they’re in the 35-60 range.

      Chris Kresser wrote on May 2nd, 2012
      • Can you explain what is wrong with folic acid? My husband and I are trying to conceive and my ob put me on 4 mg’s of folic acid because I have very minor spina bifida they found on an x-ray. Not knowing anything about folic acid, it seemed like a really high dose.

        laura wrote on May 2nd, 2012
        • I recently wrote an entire article on the subject. I’d post the link here, but they’re getting stuck in the moderation queue. Do a Google search for “Chris Kresser folic acid” and it will be the first article that comes up.

          Chris Kresser wrote on May 2nd, 2012
      • Is it bad to take New Chapter prenatal a (5000 iu of beta carotene) daily AND fclo/Bo from Green Pastures? I am convinced that fclo is ok, but what I haven’t seen is whether or not it is ok to mix the two supplements. Thanks!

        Sara@AJoyfulMother wrote on December 23rd, 2012
    • Definatly stick with the prenatals! Looking back at my own pregnancies I would not have been able to stomach CLO, liver and fish especially during those first few months! I did maintain a low carb diet and ended up with two healthy and pretty darn cute babies.

      Liz wrote on May 2nd, 2012
      • I would agree with Chris’s reply, since this exactly how we ate for my wife’s first pregnancy. The only supplements were Vit D drops 4-6K unit to stay in the 70+ range(recommended by her OB) and folate. Her OB always commented how she was one of his easisest patients and always looked forward to our visits. We were one of the few, if only, who had no issues from start to finish. One way I found to include liver and CLO into my wife’s diet was to mix CLO into shakes/smoothies and mix liver into our ground beef dishes using a cheese grater. You wont even know its in there and I know, since people who gag from eating liver have ate it this way at our house with no issues.

        Joseph wrote on May 2nd, 2012
  14. Given that even grass-fed raw dairy is highly insulinogenic, is it a wise choice for pregnancy? The corrollary question – what is the effect of repeated high insulin spikes on fetal development?

    Andy Williams wrote on May 2nd, 2012
    • Insulin is not a problem. We eat carbohydrate, we secrete insulin, insulin moves the glucose into cells, cells use the glucose. This is normal physiology. It only becomes a problem when someone is insulin and leptin resistant.

      Chris Kresser wrote on May 2nd, 2012
  15. Love the info Chris, thank you. I wish we’d known about it back when my two sons were born (the oldest turns 12 today actually). I often wonder if we might have escaped the onset of his type 1 diabetes with a primal diet.

    That said, my friend’s wife had been unable to conceive for years and years and they heard about the primal/paleo diet from us, tried it, and their beautiful baby girl is now almost a year old. Keep up the good work.

    @dystopicthinker

    Tim wrote on May 2nd, 2012
    • I read Dr. Atkins vita-therapy (or some title like that) book some years ago and he thought that the onset of type 1 had some relation to I believe it was Vit-A deficiency and appeared to have success in preventing it with therapeutic doses. I had a coworker with type 1 who was on a low-fat/low-sugar diet because that was supposed to save her from heart disease and cancer…unfortunately her adolescent developed type 1 too.

      Olivia wrote on May 2nd, 2012
      • Actually, that is a pretty typical diet for those with type 1. They should watch their carb (not just sugar) intake and eat low fat. The low fat is not 100% UNLESS she has problems with blood sugar. If that’s out of control you should 100% eat low fat.

        The high blood glucose makes fat stick to your vessels easier. So, unless you’re controlled you should keep it low fat.

        Justher wrote on May 5th, 2012
    • Our now 19y.o.daughter got diabetes 1 when she was 10y.o.We also wonder this as the three of us are now eating basically Primal/Paleo.It came as a huge shock as we have no other diabetics in the family.At the time we were eating very healthily but of course not primal.At age 7 she was trekking in the Himalayas with us and at 10 in hospital very sick.She is now very independent and going great and at uni but what a journey it’s been!

      Jill Skyvington wrote on May 2nd, 2012
  16. I ate primal before and during my first pregnancy, continued to do so while breastfeeding, and am doing it once again for baby #2. Not only is it the healthiest way to eat for a developing baby (and his/her mama!), but it is also completely doable and sustainable during pregnancy. The popular idea that pregnancy is a time to eat whatever you want and give in to every craving you have is ludicrous to me. I have tried to improve my diet beyond “baseline primal” as much as possible during both pregnancies, going out of my way to eat things I normally don’t (ie liver and sardines). I get morning sickness, fatigue, and cravings just like every other mom, but a healthy baby is more important to me than satisfying a yen! If only popular opinion seemed to feel the same way…

    Kelly wrote on May 2nd, 2012
    • Kelly-

      I am now on my 3rd week of Primal and couldn’t feel better! My husband and I are thinking about starting to try in October. All I want is for a healthy pregnancy and baby! Naturally, I’m nervous of staying on Primal because of its bad wrap, but after seeing your post it provides some confidence that I’m making the right decision. Did you do prenatals and mult-vitamins before and during?

      Magan wrote on September 10th, 2012
  17. Blargh. I’ve been supplementing folate (800 mcg), D3 (4000 IU), and Omega-3s (1500mg/900 EPA/600 DHA), and now this article has totally confused me.

    I’ve looked at CLO, but frankly it just doesn’t seem to provide as much D3 as my supplement, but now I’m worried I’m not getting enough Vitamin A.

    If I supplemented CLO, would I need the D3 and Omega-3s still? I eat liver about once a week, I eat plenty of grassfed dairy, and I even try to work in egg yolks even though I don’t enjoy them. I’m not a fish fan. Any ideas? So confused; what values should I be aiming for?

    Steph wrote on May 2nd, 2012
    • I’d think if you are eating 3oz of pastured liver a week then you would be set.

      Be creative: Do you like hollandaise sauce? That is mainly egg yolk. I for one love mustard hollandaise but use a spice you like.

      Fish. Try braising fish with other flavors/spices you like to create a taste that is less “fish” and the texture will be moist and flaky/shredded when you put your fork through.

      Saute more veggies in bacon fat, lard, tallow, etc to better absorb all the fat soluble vitamins (A,D,E,K).

      liberty1776 wrote on May 2nd, 2012
    • Krill oil is more expensive than cod liver oil but it’s excellent for Omega 3s and it comes in tiny little red caplets. So if you’re looking for another source of Omega 3, that’s one.

      Tim wrote on May 2nd, 2012
    • The only way to know if you’re getting enough D (through CLO and fatty fish) is to test your levels. I recommend testing before pregnancy, during the first trimester and at the beginning of the 3rd trimester – when the fetal skeleton is rapidly developing and mom’s need for vitamin D is the highest. You should be in the range of 40-60 (roughly).

      Unfortunately, testing is the only way to know what dose of vitamin D is necessary. There is a wide range of absorption from food and production from sunlight of D from individual to individual.

      Chris Kresser wrote on May 2nd, 2012
      • Thanks everyone. :) I had my Vit-D checked last year, but will get checked again. We’re trying to conceive as of last month, and I’m just trying to up my odds!

        Steph wrote on May 2nd, 2012
  18. Chris – how do you feel about krill oil vs. cod liver oil (for both pregnancy or not pregnant)?

    Rebecca wrote on May 2nd, 2012
    • CLO is superior because it contains the fat-soluble vitamins A, D & K2 (in the case of fermented cod liver oil). In fact, I think of CLO as primarily a fat-soluble vitamin supplement, and secondarily as a source of omega-3s.

      Chris Kresser wrote on May 2nd, 2012
  19. Thank you for this wonderful post today!

    I read TPB in April 2010 during spring break at the beach with my husband and our to kids, aged 11 and 13 at the time. It caused a revolution in my thinking, and we adopted the lifestyle upon returning home.

    By the end of May 2010 I was pregnant. No kidding. We weren’t trying – in fact we were actively NOT trying. To me, that’s how successful primal/paleo eating and lifestyle is!

    During the pregnancy I was mostly primal but still managed to become diabetic as I had in at least one of my previous pregnancies. This required a trip to the hospital dietician, whose sample menu for a day’s eating included 8oz skim milk, three slices of whole wheat bread, two “low-fat” chocolate chip cookies, an apple and 2T full-sugar peanut butter. When I pointed out the effect that these foods would have on my BG and subsequent insulin response, she became rude and combative. I thanked her for her time and pamphlet and assured her that in no way would I follow her suggestions.

    In February 2011 I delivered an 8 lb 14 oz baby at 39 weeks gestation – a far cry from the 9 lb 3 oz baby I had at 37 weeks for my prior pregnancy! He was still a little large, but considering that he was probably retaining fluids due to a c-section, I was happy with how things went.

    I am documenting some of how we are raising our little CaveBaby on my blog when I have time. He is such a strong and healthy little dude! At 15 months old he has had ONE teeny, tiny little cold and little else in the way of illness or discomfort.

    The primal/paleo lifestyle is the BEST for getting pregnant, maintaining a healthy pregnancy, and raising a healthy child!

    Jenn wrote on May 2nd, 2012
    • Funny, I just wrote about my own experience below. 3 weeks on the Primal Blueprint diet and I was pregnant (at 41), after 15 months of actively trying and another 5 months of not really trying (but doing nothing to prevent it either).

      Marcia wrote on May 2nd, 2012
    • Be careful what you tell hospital dieticians especially going forward. They could use it as a reason to deny insurance coverage. Smile, say thank you, and dump the pamphlet in the nearest garbage. It is shocking though how many dieticians give precisely backward advice.

      Joshua wrote on May 2nd, 2012
      • Good advice. Fortunately I have government health care (military husband) and my doctor supported my choices, which I was able to substantiate via glucometer readings.

        Jenn wrote on May 2nd, 2012
    • Fantastic! It still makes me shudder that the people who are authorized to pass out nutritional advice and particularly to women who are building our next generation still get it so wrong! Congrats on the little addition to your family!

      Candice wrote on May 2nd, 2012
  20. Mark Sisson got me pregnant.

    Just kidding (sort of). It took me 1.5 years to get pregnant with my 6 year old. When he was 3.5, we started trying again. After about 15 months, we gave up. At that point, we were getting “long in the tooth” anyway.

    Later that summer, I needed to lose a few pounds. I started eating fewer carbs, that helped a bit. Then I decided to try an experiment. Since the paleo folks and the vegans are both so…adamant about their diets and how great they are, I decided to try both.

    Just then, the primal 21-day challenge was starting, so I decided to do that, record how I felt and how my weight changed, then switch to vegan for 21 days and do the same.

    Except very shortly after (1 week, 2 weeks?) the end of the primal challenge (where I still allowed myself one slice of bread at breakfast, I admit it), I found out I was pregnant. At 41. Coincidence? I don’t think so. Up until then, I was trying the low-fat thing, which I’ve been doing for years.

    I admit that I have fallen off the primal wagon while pregnant…there are certain months where I just needed the carbohydrate. But now that I have only 9 weeks to go, I have to say that I am shifting more and more towards it to stem my weight gain. The problem with carbs is that they are addictive.

    I never did make it to that vegan diet experiment. I was happy to read about the liver. I bought some grass fed local liver at the farmer’s market last fall, but then read that I should be eating it while pregnant due to the Vit A, so there it sits in my freezer…waiting for me to not be pregnant.

    Marcia wrote on May 2nd, 2012
    • I LOVE your line about Mark Sisson getting you pregnant. We should start a club and use that as the name. I wasn’t 100% during and immediately after the pregnancy, more like 75% but I was able to recover from a difficult c-section and some serious anemia with the help of liver and steak dinners my husband would bring me from the lovely market near our home.

      Good luck with the last 9 weeks!

      Jenn wrote on May 2nd, 2012
    • Low fat anything suppresses fertility. Something in the processing really impacts you. Also, soy is a major culprit of infertility. Eat the liver while pregnant, it’s safe and the natural vitamins in it are much healthier than what you find in a bottle. I’m nine months pregnant with my second child so I understand your concerns. I found grains were giving me severe congestion, especially in pregnancy, and don’t eat them now. I have normal blood preasure this pregnancy, I had pre-eclampsia last time, and zero swelling or bloating. Carbs are addictive but only if you eat the processed stuff like bread. Fruit might be sweet but can you eat five at one sitting? Bet not.

      Jana wrote on May 2nd, 2012
    • I got pregnant at the beginning of the primal challenge (I have three weeks to go). And, we were most definitely not trying to get pregnant. I wonder how many other primal challenge babies are out there? :-)

      Tricia wrote on May 2nd, 2012
    • Marcia thanks for your post! I laughed so hard about Mark getting you pregnant. My husband and I were practicing the paleo/primal for awhile until I got pregnant. Fell into the thinking that I didn’t want my baby to lack a nutrient so started the carbs again, even potatoes and carrots. One of the most difficult things with pregnancy is that the blood sugar drops so fast and I’m instantly hungry, not just a rumble but a feed me now hungry. And if you’re not prepared you grab the slowest moving thing and shove it in the gaping hole.
      Anyways, a few months ago my husband prints out the primal cookbook and says I’m eating off this only (I think he was tired of the pregnancy weight creeping on him as well).
      But my point is this, as soon as I introduced those starches back into my diet I ballooned 40 pounds. Now that I only have 10 weeks left I’m back to eating more closely to the primal diet and am feeling so much better again. You’re so correct about the addiction with carbs!
      Loved your post! Good luck with the baby!

      Angela wrote on May 2nd, 2012
    • I too have conceived two babies on PB. I was told that I would never have children due to endometriosis when I was 18. I Got pregnant with my oldest at 19 while eating SAD and I am talking NOTHING that did not come out of a box. I didn’t really try or try not to get pregnant after him. I dabbled with paleo in 2008 and went full on out paleo in 2010 and found myself pregnant in 3 months. My little girl is 10 months and we have been blessed with another (unplanned) pregnancy! There is also a HUGE difference in the disposition of my two children. My son was colicky and suffers from some emotional imbalance, my daughter is the happiest little thing ever! She has hit all of her milestones early where he barley reached them on time.

      Sharee wrote on May 2nd, 2012
    • Your story is really inspiring to me. I just turned 40 at the end of November and am hoping to get pregnant this year. I am transitioning to Paleo diet, and hopefully this will boost my chances of getting pregnant, which I know at my age are slim. All the best for you and your family.

      Amanda wrote on January 23rd, 2013
  21. I highly recommend purchasing Chris Kresser’s Healthy Baby Code program. My husband and I find it invaluable. We’ve been following the nutrition recommendations for a little less than 1 year now and are 6 months along with our first pregnancy.

    Kaitlyn wrote on May 2nd, 2012
    • I don ‘t recommend it, Chris is a bit quackish.

      Tom wrote on May 2nd, 2012
      • Care to elaborate?

        Shebeeste wrote on May 6th, 2012
  22. What does the graph mean i.e. “Deaths from CHD before age 65″ of 1.5? 1.5 per 100,000? Is the difference per birth weight really significant or am I more likely to be struck by lightening?

    mikeinmadrid wrote on May 2nd, 2012
  23. While I agree with this for the most part. I was told by my doctor even liver is dangerous because of the vitamin A content regardless of whether it’s balanced with other naturally occurring nutrients.

    I also want to forward some advice to pregnant women: if you’re as sick as I was during your pregnancy, eat what you can regardless of whether it’s a grain or not.

    The only thing I COULD eat during the first three months was plain pasta with butter and buttered white bread. Even after the first three months, I had to eat a fair amount of carbs in order to keep enough food down for me and my baby,

    Don’t feel bad because you aren’t eating right for your baby, eat what you can if that’s all you can eat!

    Christine wrote on May 2nd, 2012
    • Christine,

      The vitamin A concern is unwarranted. I’ve addressed this further up in the comments section. Your doctor is misinformed, unfortunately. The research does not support his conclusion.

      Here’s a good summary: http://www.westonaprice.org/fat-soluble-activators/vitamin-a-on-trial#dprotects

      Chris Kresser wrote on May 2nd, 2012
    • It’s also a question of natural vs synthetic vit A; that one (now discredited) study that showed vit A caused birth defects used synthetic stuff.

      Certainly we need to eat. I discovered that being hungry made my nausea worse and gave in to the lure of grains and dairy as quick fixes. But here’s the thing: if you don’t tolerate these foods, you’re exposing your child to your body’s reaction to them, and possibly predisposing their body to expect heightened immune activity etc. It’s not just about the calories.

      There is a strong case for the suggestion that we crave carbs to replace cholesterol and/or hormones carried by it. Eating meat and fat would solve that better but those with low stomach acid or magnesium deficiency may have aversions to exactly those foods. Try ACV and small servings of palatable proteins (liverwurst on toast with a little currant jam?) and work your way up, and regular Epsom salt baths.

      I do entirely agree with you that – provided a woman is not indulging in the pregnancy as get out of jail free fallacy – a side-serving of guilt is just as damaging as crappy nutrition. Do what you can to avoid both!

      Lauren wrote on May 2nd, 2012
    • That’s bullshit, unless you’re subsisting almost entirely on a diet of Arctic animals.

      From Wikipedia re Hypervitaminosis A: “The liver of certain animals — including the polar bear, seal,[12] walrus,[13] and husky — is unsafe to eat because it is extraordinarily high in vitamin A. This danger has long been known to the Inuit and has been recognized by Europeans since at least 1597 when Gerrit de Veer wrote in his diary that, while taking refuge in the winter in Nova Zemlya, he and his men became severely ill after eating polar bear liver.[14] In 1913, Antarctic explorers Douglas Mawson and Xavier Mertz were both poisoned (and Mertz died) from eating the liver of their sled dogs during the Far Eastern Party.[15]”

      And “Although hypervitaminosis A can occur when large amounts of liver (including cod liver oil and other fish oils) are regularly consumed, most cases of vitamin A toxicity result from an excess intake of vitamin A in the form of vitamin supplements. Toxic symptoms can also arise after consuming very large amounts of preformed vitamin A over a short period of time. The U.S. Institute of Medicine says that the Lowest Observed Adverse Effect Level (LOAEL) for vitamin A, when taken over an extended period of time is 21,600 IU.[7] Most multivitamins contain vitamin A doses below 10,000 IU, therefore multi-vitamins are unlikely to cause vitamin A toxicity when taken at their recommended dosages.”

      Remember, your doctor is not a nutritionist, most only get 1 week of nutrition in med school, so if you’ve read the Primal Blueprint & understand the basic biochemistry of LCHF & paleo diets you likely know more about nutrition than your doctor.

      cancerclasses wrote on May 2nd, 2012
  24. Hi Chris

    I want to get pregnant I have already use FCLO I eat salmon 4 times a week but do have problem with liver(the taste of it). It is really needful?
    Also I would like to ask you about veggies what kind of veggies is good. I have heard that some of them are not good for thyroid other have oxalic acid, then nighshades etc. So it is ok to eat raw spinach or no? eat tomato? Brolccoli everyday? Thanks a lot

    Michaela wrote on May 2nd, 2012
    • Too many goitrogenic vegetables (primarily the cruciferous veggies) isn’t a good idea because they inhibit iodine absorption. But this can be mitigated by taking 800 mcg of iodine per day, or by cooking the vegetables. Steaming decreases goitrogen content by 30%, boiling and keeping the water by 65%, and boiling and discarding the water by 90%.

      Chris Kresser wrote on May 2nd, 2012
      • Hi Chris,
        I make sauerkraut with red cabbage. Does fermentation mitigate the effect on iodine absorption?

        Cristen wrote on May 4th, 2012
  25. I’m assuming beef liver is what is being refered to?

    Albert G wrote on May 2nd, 2012
    • All types of liver, but beef liver is probably the best choice in general. Chicken liver is especially high in folate, which is a crucial nutrient during pregnancy.

      Chris Kresser wrote on May 2nd, 2012
      • If anyone is looking for a great liver drink, Nourishing Traditions has the Pottenger (Dr. Francis Pottenger who did the cat studies) Liver Cocktail…I drink it daily.

        1 small chunk pasture-fed beef or lamb liver frozen for at least 14 days
        4-6 oz tomato juice (I use organic Very Veggie
        dash of tabasco sauce or to taste
        squeeze of lime juice
        1 tablespoon whey

        Since I make my own organic whole raw milk Greek yogurt weekly I have plenty of fresh whey. I’m guessing this may be hard for some people to come by.

        I put all in a tall glass and blend with a hand blender. Yum Yum!!

        Note: to make things quick and easy I thaw my liver and cut into chunks (about a tablespoon) and put into icecube trays. Take out when frozen, pop out and put in a freezer bag and take out a chunk when you are ready to make the cocktail.

        If I’m in a really big hurry, I always have some desiccated liver on hand and pop 3 tabs.

        “Invest in your food…invest in your health” Penny

        Penny wrote on May 2nd, 2012
  26. Absolutely love and agree with everything here. There is a paucity of good pregnancy info and it’s helpful to find things like this. I just want to include a bit of encouragement to mothers who may not have eaten ideally during pregnancy. I work in early childhood healthcare and I see many babies born into less than ideal situations (far more severe than being the product of microwaved meals) and they live happy, healthy lives. Sure we can argue if they are or are not ideally healthy, but sometimes mothers don’t have this info and sometimes things happen that cannot be mitigated. Your baby can still be ok. For example, I am a soy-formula baby, which is not a great idea we now know, and maybe I’m not as ok as a breast fed baby, but I’m happy and healthy and that’s all I can ask for.

    Karen wrote on May 2nd, 2012
    • Good on you Karen, lovely comment!

      Heather wrote on May 2nd, 2012
  27. Question – the weight at birth (chart) and at one year (PDF link) refer to males correct? There are gender differences in weight?

    Also, I think what you feed kids in their first year of life is just as important. Kids who eat fatty fish (salmon) before their 1st birthday have lower incidences of ezema and asthma (so I’ve read), for example. I hope diet has SOME influence because I’d hate for my daughter who was born 7 weeks premature with congential heart defect (birth weight 3.4lbs, weight at 1st birthday 16lbs) to be doomed. She’s thriving now, at age 7, eats nutritious food, but will always be a peanut (40lbs now, not tall, very slight build {inherited}, but eats like a horse, very endearing).

    BootstrapsOnMyFivefingers wrote on May 2nd, 2012
    • Yes, you’re correct – that study was conducted on men.

      I agree that nutrition during early childhood is also crucial. I discuss how to introduce “first foods” and which are most important in the Healthy Baby Code.

      Good nutrition during the early childhood period can make up for a lot.

      Chris Kresser wrote on May 2nd, 2012
      • I was hoping that eating well as an adult could help. I was premature, w/ asthma & now (I think) autoimmune thyroid disorder, obesity, and likely some insulin resistance.

        *sadpanda about the future.

        Jeanie Witcraft wrote on May 2nd, 2012
    • This is exactly the kind of thing I was talking about. Major kudos to you for hanging in there and what a blessing to have your daughter seven years later and healthy!

      Karen wrote on May 2nd, 2012
  28. As a farmer who raises livestock, I can confirm that animals (all species) who don’t get a good start in life often end up in the ‘failure-to-thrive’ category and most often, the stew pot. As we humans get further away from our food supply, we lose sight of the big picture of what it means to be healthy.

    Sandra Kay Miller wrote on May 2nd, 2012
  29. Great info! I always suspected there was a connection between early health in the womb and health later on. I weighed under 4lbs. at birth and had depressed lung function. 35 years later I struggled with nearly all the issues listed but have since over come most of them with diet and exercise. Now that I’m planning my own pregnancy, I plan to continue on the Paleo path.

    Maren wrote on May 2nd, 2012
  30. The diet certainly doesn’t hurt, I started the diet 3 months before our IUI and got pregnant that cycle. The biggest push back i hear from doctors about primal is low carb ketosis, that is apparently to be avoided during pregnancy. Otherwise they were fine w/ my diet, just wanted me to get more calories since i wasn’t gaining much. I tried eating eggs and liver and just gagged on it, major egg aversion during pregnancy. The things i really craved were grapefruits and apples. And then my baby was born rather tiny for gest age, 6lbs at 38 1/2 wks, and still couldn’t put on much weight until we started supplementing formula at 3 months, much to my chagrin. Now she’s a happy chubster at 4 months.

    Hilary wrote on May 2nd, 2012
  31. Chris can you address the issue of rancid fish oil. I stopped taking it because of studies I found that said it did more harm due to the fish oil not being able to be preserved properly.

    Ashley wrote on May 2nd, 2012
    • Yes, best to stick with reputable brands that proper processing technology (like fermentation).

      Chris Kresser wrote on May 2nd, 2012
  32. What about for dudes? Do the same foods boost male fertility?

    Sarah HI wrote on May 2nd, 2012
  33. Ergh. I so wanted to be primal during pregnancy. Unfortunately any meat or fish or eggs made me violently sick by week 7 and any vegetables (fruit was strangely OK) by week 6. Seriously,even the sight of squash would make me unable to eat. Conversely the only thing that eased the nausea and made me able to function, was rice, or bread. I think primal is a great approach (I would watch the liver… research is conflicting) but sometimes it is just not possible.

    Lekki wrote on May 2nd, 2012
    • I couldn’t stand the sight of eggs for my most recent first trimester either. Everything else was fine, and I’ve eaten them like crazy the rest of my life. It seems like a common aversion for many first trimester women… does anybody know why?

      Danielle wrote on May 3rd, 2012
  34. Oh, how I wish I could have followed this advice during my pregnancy! As a woman with PCOS, I “accidentally” became pregnant (I was eating a healthy, mostly primal diet), but during pregnancy, I dealt with hyperemesis gravidarum. That means that I vomited for 9 months and was on prescription anti-emetics, near hospitalization the whole time. Yogurt with frozen berries were a good option, but eggs would get stuck in my nose when I’d vomit. Ice cream was the only thing I found to help with my third trimester migraines. Now that my baby is born and I’m breastfeeding, I’m back to a nutrient-dense, grain-free diet. I just hope that I didn’t stray too far off course during pregnancy!

    Megan wrote on May 2nd, 2012
  35. Which animals’ livers? “Liver” is pretty vague.

    Katie H wrote on May 2nd, 2012
    • Any type of liver, but beef and chicken liver are probably the best choices.

      Chris Kresser wrote on May 2nd, 2012
      • Almost all, from Wikipedia re Liver (food):
        “There have been several anecdotal reports and a few scientific studies of vitamin A poisoning due to the consumption of the livers of polar bears, seals and huskies. The livers of these animals can contain very high levels of vitamin A.[2] The Inuit will not eat the liver of polar bears or seals.[2]

        Vitamin A poisoning is less likely from consuming oil-based vitamin A products and liver than from consuming water-based and solid preparations.[5]“

        cancerclasses wrote on May 2nd, 2012
  36. Yay! I ate all five of these foods during my pregnancy! And I’m now cuddling my two-week-old infant girl who was born weighing 8 lbs 12 oz!!

    gilliebean wrote on May 2nd, 2012
  37. I am about 7 mos pregnant and for most of the pregnancy I adhered to a paleo diet and had a sugar aversion and still got diagnosed with gestational diabetes, I could not tolerate the 50g of glucose or the 100g they make you drink for that test! So I am now required to take a nutrition class and monitor my glucose. All my meal numbers are lower than their standard range however my fasting glucose maybe a few points elevated. Their diet suggests I eat whole grains to avoid ketosis. Any suggestions as to what other carbs to eat besides sweet potatoes? I do eat some fruit. Is that enough to avoid ketones? Also how to lower my fasting glucose? I am trying to avoid being on insulin. Thanks.

    wildwoman wrote on May 2nd, 2012
    • Plantains (both ripe and unripe), taro root (slice & brush with duck fat or lard to make the best chips ever!), yuca (make fries with duck fat/lard; see my recent recipe for this on my website) and more exotic choices like lotus root.

      You don’t need much carbohydrate to avoid ketosis. Usually 50 grams will prevent it.

      Chris Kresser wrote on May 2nd, 2012
  38. I once considered FCLO, but because I ate so much liver (5 or 6 big portions a week – it’s now down to about 4 big portions at lunches) I thought I’d get too much Vit A.

    When I eat liver, while I eat sardines and 1 to 3eggs everyday, I’ve been having a couple of drops of Vit D drops (very good value) at 4000IU each. If I remember right from the WPF, a good ratio is 5:1, A:D.

    Phil wrote on May 2nd, 2012
  39. 14 years ago I gave birth to a girl over 10 lbs. Trying to give her a good start I became a vegan during my pregnancy. I went from 120lbs to 215lbs during this pregnancy. She is now wheat & dairy intolerant and ADD. I wish I would have known.

    momupthecreek wrote on May 2nd, 2012
  40. What about folic acid? Doctors stress the importance of getting enough especially in the first trimester. Do paleo food supply enough? If so, which ones?

    Adriane wrote on May 2nd, 2012
    • Folate is a crucial nutrient during pregnancy, and is difficult to get enough of in the context of a Primal diet. This is one thing I recommend most women supplement with for fertility and pregnancy.

      Folic acid is a synthetic form of folate, and should not be supplemented with.

      Chris Kresser wrote on May 2nd, 2012

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