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. Just had a awesome pregnancy. I am 37 and went primal half way through the pregnancy. Best , easiest and fith pregnancy! Beautiful 8 pound 2 ounce boy and I am thinner than when I got pregnant at 7 weeks post partum. The only time I felt yucky or had heart burn was when I had any grains or sugar. I had several pounds of elk liver in the freezer and got organic chicken livers from the farmers market but I slowed down because of the vitamin A worries and did lots of fish oils and organic food . Now I am breast feeding and still going strong on the primal blueprint, the baby is a happy mellow thing that has gained 4 pounds in 7 weeks.. The only hard part is trying to master the pull up!

    Queenbolete wrote on May 2nd, 2012
  2. Mark u left out COCONUTS, I would add coconut oil and coconut milk and coconut products to the list, its very healthy and beneficial for fertility and in pregnancy and post pregnancy.

    Irene wrote on May 2nd, 2012
  3. Thank you for posting this! Now- to figure out how to pass it along to resistant pregnant friends!

    Stefanie wrote on May 2nd, 2012
  4. Question: I am 7mos pregnant, third kiddo. Eating mostly primal when not dealing with nausea.
    I currently take a vit D3 supplement. 3-4 drops (1000 IU’s per drop) daily. If I start taking the cod liver oil, should I stop or reduce the D3 drops?
    (I had my vitamin d level tested at the beginning of my pregnancy and it was low. Doc recommended 1000 IUs/day. I have not had it retested since then. Guess I should.)
    Thanks!

    gina wrote on May 2nd, 2012
    • Yes, you really have to test to answer that question.

      Chris Kresser wrote on May 2nd, 2012
  5. Chris,

    I just started eating a primal diet and I expect I will begin losing weight as Im currently overweight, but Im also trying to conceive. Will I have to stop eating primal when I get pregnant if I keep losing weight? If you are losing weight, you are in ketosis, right? I know it would be ideal to lose the weight before trying but due to our age and some fertility issues we feel it’s best to not wait any longer. What can I do to ensure that our future baby will have the best chance of living a healthy life if Im overweight while pregnant?

    jenny wrote on May 2nd, 2012
    • Ketosis and weight loss are NOT the same thing.
      Your metabolism will change in pregnancy (the switch flips to “hoard”), so as long as you have a nutritional balance and caloric intake that covers your collective needs, ignore the scale.
      The biggest concern are any underlying health issues that led to your overweight situation – are they dealt with? If your guts are healthy and hormones in order, your weight will sort itself out. And as many people here have said, so will your reproductive status!

      Lauren wrote on May 2nd, 2012
    • As Lauren said, losing weight will not put you into ketosis. Ketosis is caused by a very low carbohydrate intake. I don’t recommend a ketogenic diet during pregnancy, because glucose needs are higher during pregnancy. It is absolutely not a good idea to follow a caloric restricted diet during pregnancy.

      Chris Kresser wrote on May 2nd, 2012
  6. I love all of your articles. But i’d seriously love to see some info on a PCOS diagnosed woman trying to conceive and what would be recommended? Going Low-carb has brought back regular periods, but not sure that means fertility. Would it be dangerous to continue this during pregnancy? I fear miscarriage as it’s common for PCOS women…just curious, great article all the same :)

    Brandi Goff wrote on May 2nd, 2012
  7. Thank you so much for an article like this! My third baby is two months old and while I was pregnant I could find very little information on following a low-carb diet during pregnancy. We have followed the PB for about two years now, and really believe in the truth of this lifestyle, but it sure was hard to find information to support it while pregnant or breastfeeding. So, it’s very nice to see this information out there!

    Sarah wrote on May 2nd, 2012
  8. Thank you for this article! Can you do a similar one for nursing moms? Or would your recommendations be the same?

    Bethany wrote on May 2nd, 2012
  9. Nice article. I am gonna recommend this on my site.

    Kris Reddy wrote on May 2nd, 2012
  10. Thanks everyone. Mark, do you think foie gras is a safe way to get liver into the diet during pregnancy?

    MBT wrote on May 2nd, 2012
  11. We have 2 boys, and both were feed semi palio, my wife was still not onboard then and we didnt have the foods down pat as we have it now, grass feed, good eggs and so on. But since I do most of the cooking she luckly didnt have a choice for the main meals. My wife was told specificaly NOT to eat liver and so many other things incase of food poisoning. Actually it makes sence! If you are going to eat these things, purchasing them from the supermarket is probably not such a good idea, a sick cow/chicken on SAD diet can only donate sick livers upon the sweet release of death. Still, both pregnancies, went fine, and doctors comented about the health of the placenta. So we did something right.

    Michal wrote on May 2nd, 2012
  12. Hi Chris, My husband and I have been Paleo/primal for a few years now. I’m currently 5 months pregnant and finally able to eat full PB again. I was so sick with extreme food aversions for the first 4 months, that even the smell of meat cooking sent me to the bathroom. I unfortunately had to stomach down, gf bread w/almond butter, bananas, fruit I was fine with, quinoa and I supplemented protein with a vegan protein shake I could stomach. I feel bad about the choices I had to make, any ideas for those with extreme sickness? I hope to have another someday down the road and would love any ideas, as I still am struggling with a tiny bit of nasuea still. Thanks!!

    Bridget wrote on May 2nd, 2012
    • Maybe try to drink raw pasteurized eggs? The pasteurization will kill any harmful pathogens and when eggs are raw they don’t really have a smell or taste. You can get some protein that way and many other vitamins like choline and iron.

      Jana wrote on May 2nd, 2012
    • Sometimes extra vitamin b-6 can help with nausea in early pregnancy. Also, second pregnancies are often different than the first, so I wouldn’t necessarily expect you’ll have the same issue.

      Chris Kresser wrote on May 2nd, 2012
  13. interesting. because ive found from midwives that you can lessen morning sickness by eating 80-100 grams of protein a day. it worked for me for my second pregnancy. and with this pregnancy im also drinking kangen water and it has eliminated the morning sickness and pregnancy exhaustion. i need and crave fat! i feel so much better and less starving and less bloated.

    i did have a question.. but due to pregnancy brain i cant remember it ;)

    julia wrote on May 2nd, 2012
  14. My husband and I are planning to start trying to get pregnant. I am concerned because I am considered pre-diabetic. My sugar levels were fine but my insulin levels were high. What can I do to make sure I don’t have to deal with crap the doctors put you through when you have sugar issues? Is there anythign special I can do to make sure I am on the right track. I have been 80% ish primal for about 3-4 weeks. I am starting to notice some changes but my hormones seem to be going crazy right now. I just want a healthy pregnancy with minimal medical interventions, which means I need to lose this pre-diabetic crap and lower my insulin levels.

    Karen wrote on May 2nd, 2012
    • Sounds like you’re on the right track. Just keep at it. The changes are cumulative.

      Chris Kresser wrote on May 2nd, 2012
  15. I know that being partially primal helped with my weightloss which then helped me finally get and stay pregnant.
    BUT once pregnant, primal went out the window unfortunatly. Not by my choice, but by my aversions and cravings. Sigh…
    Aversions are letting up finally (almost 3rd tri), so I’m hoping to at least finish this pregnancy as Primal again. Specially hope that it helps my milk supply when my LO arrives :)

    LisaL wrote on May 2nd, 2012
  16. In Indian culture, it has long been believed and established that the mothers Womb is the most critical part of any person. The mothers thoughts, mental state and nutrition affect the baby for the whole life. Here is the intersting part though, most of them follow high carb, vegetarian diets, with lots of legumes,cultured butter, yogurt etc. Yet, they don’t seem to have a problem with fertility,case in point the population!
    So while I try to live the primal life, I am constantly reminded, that what if all 7 billion of us decided to turn primal. would we convert all our forest into pastures to feed livestock so we can eat our “pound of liver”?
    Primal with doubts

    Ariana wrote on May 2nd, 2012
    • Keep in mind that your ethnic heritage has a lot to do with what you can tolerate and what your genes are able do. Asians are usually unable to handle dairy while Europeans do fine. A high carb diet on an Inuit would be a disaster because their ethnic heritage is based almost entirely on protein and fat. Look more to your heritage than someone elses to determine what your genes can handle. Primal is a great way to go and it incorporates this very concept.

      Jana wrote on May 2nd, 2012
  17. When I was pregnant I seriously ate SO MUCH fatty foods. Like omelette’s, bacon, cheese, pizza, cheeseburgers, mac and cheese, and some more CHEESE. I wasn’t primal but I would say I craved salty/fatty things rather than sweet stuff. I always lied to my nutritionist when I saw her during my pregnancy.
    My baby is completely healthy and LEAN. I was always worried about the way I was eating would make him fat, but it never did. He is really good looking too (which some experts say is determined by mother’s diet). But maybe I am a little biased about that. :-)

    Melissa wrote on May 2nd, 2012
  18. 2 questions:

    1. What brand of CLO do you recommend. i take Carlson, which notes that it’s “naturally low in Vitamin A”. 1 soft gel contains 150 IUs of Vitamin A and 80 IU of Vitamin D.

    2. I am a thin Type 2 Diabetic and have controlled my blood sugars very effectively following a Primal diet. I’m finishing up my 3rd month of pregnancy. My endocrinologist has insisted that I need to raise my carb consumption to 150-200 g per day – and eventually go on insulin – b/c I am not gaining weight. He insists that if I remain low carb, ketosis may prompt me to go into preterm labor.

    Do you think this is valid? So far I am ignoring the advice to eat 150 g of carbs a day. I’m probably closer to 60 – 80g/day…

    Shema wrote on May 2nd, 2012
    • 1. Green Pasture fermented cod liver oil or fermented cod liver oil/butter oil blend if you’re not eating any dairy.

      2. I agree it’s not a good idea to be in ketosis. Unfortunately I can’t offer specific medical advice online.

      Chris Kresser wrote on May 2nd, 2012
    • If you’re already at 60 to 80 I’d imagine you’re not in ketosis…maybe add a protein shake with a banana if you are. You could add a serving of soaked raw quinoa or even soaked raw steel cut oats. Both those things don’t send me to bed the way the cooked versions do and they’d be the oh-so-healthy whole grains to get the doc off your back.

      Olivia wrote on May 2nd, 2012
      • Thanks! Last time I saw the doc he insisted that I start a very detailed food journal tracking my carbs and post prandial blood sugar levels so he could monitor my response and determine if/how much insulin I might need.

        I’m really not interested in going on insulin. So we’ll see. I had been making myself small quantities of smoothies at a time consisting of 1/4 cup of greek yogurt, 1/4 cup of blueberries, and 1/8th of a frozen banana (I keep cut up pieces in the freezer). Oddly enough when I described this concoction the endo’s jaw dropped and he wondered if I was consuming something along the lines of 50 g of carbs in one sitting b/c “smoothies are dense in carbs”. I disagree. In fact I calculated it after and it came out to being more along the lines of 15 g…

        Either way, I’m interested in knowing what the optimal number of carbs is for a pregnant woman to be consuming at each meal so I can plan accordingly…

        Shema wrote on May 2nd, 2012
        • Are you in ketosis? If you are in ketosis how are your blood sugar levels? If your blood sugars are not controlled you ‘must’ got on insulin for the health of the baby (Yeah I said must).

          High blood sugars can cause all kinds of problems with the baby including birth defects and miscarriage.

          I understand that all of us want to eat healthy and do primal but when you’re pregnant you need to make the best choice for the baby. Sometimes that means taking medicine.

          Justher wrote on May 5th, 2012
  19. Thanks Mark and Chris! I just found out I’m pregnant and came to MDA today to search the archives about pregnancy! I am 41, have been following Weston A. Price since the birth of my first four years ago, and just started eating Primal about 2 months ago. Another surprise Primal pregnancy! I have had more than a few miscarriages and am doing all I can to help is one stick! Can anyone tell me how long Green Pastures FCLO lasts after opening? I’ve had some in my fridge for a while….

    Cristen wrote on May 2nd, 2012
    • It lasts for quite a while, but you should ask them to be sure.

      If you’ve had frequent miscarriages, I’d definitely get screened for MTHFR deficiency. It’s a common genetic mutation that causes problems with folate metabolism, and in turn increases the risk of miscarriage significantly.

      Chris Kresser wrote on May 2nd, 2012
      • Thanks Chris, I have heard of this. How does one find MTHFR screening? What would be the course of action if diagnosed as deficient?

        Cristen wrote on May 2nd, 2012
        • Spectracell Labs has a good MTHFR test. If you’re positive for one of the mutations, best to get some professional help. In general, you’ll need to supplement with high doses of folate (5-MTHF) as well as some other co-factors like TMG (betaine), B6, etc.

          Chris Kresser wrote on May 2nd, 2012
  20. wow, sounds like some mom-blaming going on here. poor moms can’t do anything right.

    drea wrote on May 2nd, 2012
  21. Thank you for this post, Chris! I am 6 months pregnant. I’ve been paleo for about a year now but came across WAPF nutritional guidelines early on in my pregnancy and have been loosely adding liver. I take my fermented cod liver oil daily and make a kefir smoothie with egg yolks in it a couple times a week. My one concern is their recommendation to drink raw milk. I have been drinking Strauss milk which seems the closest thing to raw grass-fed milk I can find (it is also non-homogenized). Is is worth the risk for me to drink raw milk? Do you recommend raw milk in your Healthy Baby Code? I am just worried because of the risks associated with drinking raw milk in pregnancy.

    Chrissy wrote on May 2nd, 2012
    • Hi Chrissy,

      Your timing is serendipitous. Next Friday I’ll be publishing the first article in a series on raw milk, with a particular focus on raw milk safety.

      There is a small risk associated with raw milk (when I say small, I mean *really* small – about a 1 in 94,000 chance of becoming ill). My goal is to give the facts without bias or hype so everyone can make their own informed decision.

      Strauss milk is probably the best pasteurized milk you can get, since it’s non-homogenized as you pointed out and the cows are pasture-raised at least some of the time.

      Chris Kresser wrote on May 2nd, 2012
    • If you live in the Bay Area, which I’m guessing you do because you’re buying Strauss, you might want to check out St. Benoit milk and yogurt. It’s grass-fed and vat pasteurized at 145 (a lower temp than typical, but still effective).

      Chris Kresser wrote on May 2nd, 2012
    • Of course, you should make your own informed decision, just wanted to share that raw milk is absolutely my favorite pregnancy food. And it is the very best cure for occasional pregnancy heartburn!

      Danielle wrote on May 3rd, 2012
  22. Any studies on a primal diet preventing pre-term labor? I was on bed rest for the last seven weeks of my pregnancy with an incompetent cervix and my daughter was born 4 weeks early weighing 5 lbs. I certainly did not eat primal during my pregnancy.

    Sarah wrote on May 2nd, 2012
    • Maintaining sufficient levels of vitamin A (many people don’t get enough), folate and iron helps promote full-term pregnancy, so this is one way that a Primal diet along with the superfoods I mentioned can help.

      Chris Kresser wrote on May 2nd, 2012
  23. Hi Chris, I was just wondering what your view is on taking Kelp during pregnancy? I am 20 weeks along with number two and have been taking various supplements, one of those being Kelp, however I stopped taking it a few weeks ago because I can’t find any conclusive information about its safety during pregnancy. I am also taking a pregnancy multi-v, fish oil, multi-b (which I think has really helped with the morning sickness) and flax seed oil. Due to bad food aversions I am eating a bit of bread, pasta and potatoes and really struggling to eat much in the way of meat and eggs. Thankfully I am maintaining my weight, not gaining, or losing a tonne like I did last time from constant vomiting!

    Emily wrote on May 2nd, 2012
    • Kelp is safe as long as you don’t have autoimmune thyroid disease, in which case you’d want to be careful. It’s also important to take selenium while supplementing with iodine (which kelp has in it). 200 mcg per day is a good dose.

      Chris Kresser wrote on May 2nd, 2012
  24. I went fully primal before I got pregnant and we got pregnant the first month I was off the pill. Once I got pregnant though, I couldn’t stomach meat at all and the only thing that I could keep down for the longest time was grains. I’m six and a half months pregnant and still extremely sick. What would you recommend if I want to try to get back to being Primal?

    Cassandra wrote on May 2nd, 2012
    • I couldn’t eat beef but could eat fish when pregnant- though you do have to watch for mercury. Can you stomach eggs and nuts? Maybe just getting plenty of good fats like coconut/olive oil and avocado would be beneficial.

      sqt wrote on May 2nd, 2012
      • I can’t do fish at all. Even the fish oil my doctor has me taking makes me sick more often than not. I made fish and the smell of that made me sick and my husband ended up having to finish cooking it and eat it. I have been eating a lot of avacados though.

        Cassandra wrote on May 3rd, 2012
        • You poor thing. I’ve seen some recommendations here that grass-fed dairy can be good for women who can’t stomach meat. Good luck!

          sqt wrote on May 3rd, 2012
  25. The pressure placed on pregnant women. :S Especially when they have such weird food issues anyway.

    All I know is that fish oil was absolutely a life saver in my second pregnancy. I was stupid during my first pregnancy. I had a really hard time at work (as a computer programmer) because I couldn’t figure out solutions to problems. That had never happened to me before.

    Second pregnancy my midwife told me to take fish oil. I felt myself slipping into stupidity and when I started taking it I went back to normal. I could tell if I forgot to take it. It was amazing. :)

    Laura wrote on May 2nd, 2012
  26. Hi
    Chris

    I do have friedn who is vegan is there any option to have safe pregnancy and then to keep child heathy on vegan diet? What do you think about infant toddler eating only vegan food plus supplement. Thank you so much I appreciate your answer

    Michaela wrote on May 2nd, 2012
    • I strongly advise against a vegan diet during pregnancy and early childhood. There are just too many vital nutrients that are missing. The fact that you have to supplement with so many of these when following a vegan diet is a clear indication that it’s not an optimal approach.

      Chris Kresser wrote on May 3rd, 2012
      • Thanks a lot

        Michaela wrote on May 3rd, 2012
  27. I wish I had had this info when I was pregnant. I ate the CW diet and had a heck of a time getting the weight off after having the kids. I was lucky in that they were both in that sweet spot where their weight was concerned and if I did anything right it was by taking the right vitamins– they are both really healthy kids.

    But what really gets my attention here is the risks for low weight babies- I was only a 3lb baby. My health was okay until my pregnancies and then I believe I started a downhill slide into the dreaded metabolic syndrome. Fortunately I went primal before my blood sugar went off the rails, but my cholesterol was off and my thyroid was turning into a nightmare. Thank God for sites like this one.

    sqt wrote on May 2nd, 2012
  28. Hi Chris,
    Do you know if Green Pasture’s cod liver oil has D2 or D3? I think that the D3 is much better isn’t it?
    Thank you.

    Alina wrote on May 3rd, 2012
  29. I was seriously going to write Mark an email today asking about primal nutrition during pregnancy- and when I logged on- here it was! He must be psychic! I was primal for 2 years and lost 70 lbs. For the past 10 weeks or so, I have had some pretty severe morning sickness, and I felt like the only thing I could tolerate was bland starchy grains (lots of baked potatoes and plain rice). As a result, I feel like crap and I’ve gained some weight. I’m trying to get back on track now that the nausea has passed for the most part, but everything I read about pregnancy nutrition indicates that eating this way is dangerous. Particularly, the circulation of keytones in the blood can cause kidney damage in the fetus. I’m a labor and delivery nurse and have seen first hand the effects of poor nutrition on pregnancy. I’m praying I can get this figured out and feel healthy again!

    Sonia wrote on May 3rd, 2012
    • duh *ketones*… pregnancy brain

      Sonia wrote on May 3rd, 2012
      • My comment ended up down below :)

        Molly wrote on May 4th, 2012
    • I know I am in exactly the same boat! primal for 2 years got pregnant and now just cannot stomach meat at all! first 10 weeks I also felt terrible but now though I still can’t stomach meat I eat as primal as I can by eating veggies and nuts and eggs. I am hoping the aversions subside completely too but all we can do right now it just eat the best we can in the circumstance. I also ate alot of plain rice in the middle but stopped that as it made me feel ever worse. I think it’s just best to try not to worry and eat the best we can because posts like this can be un nerving when you’re trying so hard to eat well and you just can’t!

      Aloka wrote on May 3rd, 2012
  30. Thanks for this post Chris and Mark.

    I got pregnant at first attempt after eating primal for the last 2 years. I’m nearly 4 months pregnant now but still have really bad food aversions to raw veggies and all kinds of meat. I am eating alot of eggs, cooked veggies, coconut products and alot of fruits as I’m always hungry between meals. I have also decided not to stress too much and disect everything I eat because eating real food for the last two years have taught me not to stress and micromanage nutrients.

    so while I’m not eating the best paleo foods out there, I’m doing my best to eat nutrient rich food and I really hope the aversions subside so that I can eat all the good stuff. Initially I had to eat white rice and other non paleo stuff as I could not keep anything down but now since the nausea is subsiding I am eating as clean as I possibly can.

    One question. is weight gain in paleo/ primal pregnancies the same as they recommend other wise? the 3 pounds a month recommended weight gain by conventional wisdom standards? If I’m not gaining weight is that something I should be really worried about?

    Aloka wrote on May 3rd, 2012
    • Yes, you should be gaining some weight during pregnancy. If you tolerate it, try adding some grass-fed dairy into your regime. It has a lot of the nutrients that are necessary during pregnancy, and is very nourishing overall.

      Chris Kresser wrote on May 3rd, 2012
      • thanks! will try that ..

        Aloka wrote on May 4th, 2012
  31. Hello, I am new to Primal Blueprint. After I read this article, I thought that it was important that I comment. I was born with PKU (Phenylketonuria). It is a somewhat rare condition that is caused by a recessive gene. People who have PKU cannot metabolize proteins in the same way that others can. If a baby has PKU, and it is not known, the child will become mentally retarded. However, if it is known, the child is put on a low protein diet until the brain reaches normal adult size. If I were to try to have a child now, and I did not go back on the diet, the child would have an extremely high risk of being born mentally retarded. Most of the foods on this list are high in protein. It is only as an adult that I have started the Primal Blueprint plan. I don’t want to discourage anyone, I just wanted to inform everyone about this, so, that if they have any concerns, they could consult a pediatrician and/or geneticist. I would be interested to hear Mark Sisson’s comments on this subject.

    D.R. wrote on May 3rd, 2012
  32. Is there a limit on eggs for when you’re pregnant? I’ve discovered I crave deviled eggs and I make my own mayonnaise to keep the soy out. I also use only free range organic eggs. I find that given the choice between chocolate Bryer’s ice cream or a deviled egg, I want the egg. I find it rediculously easy to eat five whole eggs that way over the course of the day. Should I be concerned with over consumption?

    Jana wrote on May 3rd, 2012
    • I’m no expert here, but I’ve read about traditional cultures where women eat up to a dozen eggs a day when TTC, pregnant, and nursing. So it sounds like 5 is pretty reasonable. :)

      Danielle wrote on May 3rd, 2012
  33. While I see the value and agree wholeheartedly with the information provided here, I fail to see where this information is applicable to those wishing to conceive. It’s great information for those already pregnant.
    The only sentence in this entire article that applies to fertility is “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.”
    Ok, so out of this entire article, which claims to have info on several superfoods that promote FERTILITY and pregnancy, we get ‘drink milk in the wet season’?
    I don’t mean to be rude, but to me this is false advertising. You’re grouping together fertility and pregnancy (which are completely different)…yet every superfood mentioned is supported with examples pertaining to how that food helps with the development of the baby, etc.
    Those struggling with infertility will see this article and have a flare of hope…which ends up being empty.
    If I’m missing something and this is not the case, please follow up by giving us what your title advertises – what are the superfoods that increase fertility in those wishing TO BECOME pregnant, and how do those superfoods work to increase said fertility…

    Kay wrote on May 3rd, 2012
    • One fertility factor I discovered recently is Vitamin D. It increases sperm quantity and quality in men, and stimulates progesterone production in women. But experiments measuring the vitamin D levels in the follicles of women undergoing IVF have come to contradictory conclusions: more is better, more is worse, it doesn’t make much difference.

      I am also aware that it’s been known for a long time that vitamin A is necessary for reproduction (if you don’t have enough, you won’t conceive at all; if you have just a little more than that, you’ll conceive but miscarry after a couple of weeks) as well as development – in fact Fetal Alcohol Syndrome has been found to be a disease of vitamin A deficiency. (Retinol needs to be converted to retinoic acid to be of use in fetal development, and if the enzyme is too busy converting ethanol to ethanoic acid, the baby won’t get enough.) I do wonder whether the different outcomes seen in the vitamin D experiments reflect different levels of vitamin A in the sample populations.

      Orielwen wrote on May 4th, 2012
    • There’s copious evidence that the nutrients these foods contain promote fertility. There’s only so much that can be covered in a single article. I have written about this elsewhere and it’s covered in detail in the Healthy Baby Code.

      It’s also common sense that foods and nutrients that support fertility would support a healthy pregnancy, and vice versa. We’re talking about the same reproductive system, hormones, etc.

      Chris Kresser wrote on May 4th, 2012
  34. Can you advice some kind of workout for woman who wants to get pregnant. I was running doing hit, some very light lifting weight, but unfortunatelly I have lost my period( for 8months, never happened before) so I have to slow down actually stop workout. I only walk and do some yoga. Why my body could not do it? Thanks a lot

    Sam wrote on May 3rd, 2012
  35. I’m not currently trying to get pregnant, though I hope to start trying in a year or two. But I think I’ve screwed up my cycles and hormones from 15 years of being vegetarian leaning towards vegan. I’m eating all these super foods except for raw milk (I do eat grass fed butter) but I’m still having weird cycle issues. How long do you think it would take eating these foods regularly to make up for those years of bad eating?

    Stephanie wrote on May 3rd, 2012
  36. I love this article. I see so many people with metabolic syndrome, PCOS and obesity. They cannot loose weight and they get frustrated because they are eating almost nothing!! Nutritionist seem to think the only source of fiber on this planet is grains!! Great info!!

    Joe Tittle wrote on May 3rd, 2012
  37. What are your thoughts on Calamari Oil?

    Katrine wrote on May 3rd, 2012
  38. Sorry but the study on higher birth weight making a positive difference in health seems strange to me.

    My husband’s boss just had a 9.5 pound baby boy, she has gestational diabetes, she was overweight, she SMOKED throughout her pregnancy, had junk food daily and both her and her husband are tall. So it’s NOT surprising that she had a big baby.

    Now compare that to my sister-in-law, she has always been thin, she DIDN’T have gestational diabetes, she didn’t smoke during pregnancy, she ate a healthy diet, her husband is also thin, and she had a 6.4 pound baby boy.

    So you’re telling me that despite ALL those factors, the 9.5 pound baby from a diabetic, overweight smoking mother will grow up healthier than the 6.5 pound baby from a non-smoking, non-diabetic, healthy weight, healthy eating mother??

    It’s starting to sound ridiculous to me. The take away message seems more like eat till you’re diabetic so your baby will be big too and it’ll be healthy.

    Sarah wrote on May 3rd, 2012
    • Weight at birth is a proxy for maternal nutrition, but of course there are exceptions where that isn’t true – like the example you mention.

      Remember, our health is determined by multiple influences. A single factor will never tell the whole story.

      Chris Kresser wrote on May 4th, 2012
  39. Hi Chris!
    Love the post… Thank you for the great info!

    Do you have any opinions on the Twinlab Emulsified CLO? It was recommended to me because it is cost effective and palatable. However, it is emulsified and contains sorbitol, pectin, and other added ingredients. I know Green Pastures is a better choice but am I still getting some benefits with the Twinlab or am I wasting my time and money?

    Thank you, in advance, for your time!!!!!

    Heidi

    Heidi wrote on May 4th, 2012
    • You’re certainly getting some benefits, but I think the Green Pasture product is superior. I should have mentioned this before, but I have no relationship with that company and nothing to gain from recommending their products – other than the satisfaction of helping people!

      Chris Kresser wrote on May 4th, 2012
  40. I had Hyperemesis Gravida for my first two – threw up constantly for 5 months – lost 13 kilos with the first and 11 with the second. They’re both FINE.

    Do what you can do. Don’t worry about what you can’t do.

    My little fellas must have been living off ketones for those months I couldn’t eat – and don’t forget that *chronic* poor maternal nutrition is often associated with other factors as well – poverty, lack of access to medical assistance, smoking, stressful lifestyle etc These studies never seem to tease out the full demographics behind the numbers. Those babies you saw may have had a whole lot more going on in their gestation than just poor maternal nutrition…

    Eat as well as you can now. Don’t worry about the time you couldn’t eat due to nausea. Eat lots of green leafy veggies when you can and have a sweet potato if you’re worried about ketones. As long as you keep up your carbs with veggies you can still be Paleo and be getting loads of nutrients. Personally I have to get under 20g carbs a day to go into ketosis, so three cups of salad veggies and I wouldn’t be producing ketones.

    Lastly – with the studies on ketones in the maternal diet – were these studies of diabetics ? Or of women specifically on a low carb diet ? Just because what diabetics get – ketoacidosis – is completely different to ketosis and is very dangerous both for Mother and child, whereas I haven’t come across anything indicating that ketosis is dangerous. It certainly doesn’t make sense from an evolutionary point of view for ketosis to be dangerous for a gestating woman….

    Could you ping me some of those studies – I’d be interested in having a look at them myself !!

    Good Luck !
    Molly

    Molly wrote on May 4th, 2012

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