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2 May

5 Primal Superfoods for Fertility and Pregnancy

This is a guest post from Chris Kresser of

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.

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. 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
  2. What are your thoughts on Calamari Oil?

    Katrine wrote on May 3rd, 2012
  3. 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
  4. 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 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
  5. 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 wrote on May 4th, 2012
  6. Hi

    I would like to ask your opinion on raw milk actually we have very good source raw sheep milk I make raw kefir every day buy raw goat and sheep cheeses and raw butter. What is better choice raw goat or sheep milk? I like sheep better cause it is more fatty and prefer it over goat and cows one. Thank you so much

    Michaela wrote on May 4th, 2012
  7. I think the best logic, if my doctor were telling me what I should/shouldn’t eat for my baby, would be this:

    If it makes me feel bad to eat it, what is it doing for my baby?

    Is a woman with celiac disease and lactose intolerance supposed to choke down milk and wheat bread for the alleged nutrition for her baby? That doesn’t make any sense at all.

    My uterus is presently uninhabited and babies are a few years away yet, but there’s no way I’m going to tear up my stomach and spend hours with a stomachache and shifty blood sugar because someone else thinks my baby needs black beans and brown rice in utero. I just can’t see how it wouldn’t hurt him/her if it’s hurting me.

    Kristina wrote on May 4th, 2012
  8. Since when has fish and liver been classed as a superfood? Being a raw food vegan, I was expecting goji berry or cacao but not animal products – especially not liver!

    Julie-Anne Michael wrote on May 6th, 2012
    • You are on the wrong message board. Most of us will think you are unethical to force your raw food vegan lifestyle onto your child (in womb or out) who has no choice. Babies and kids need ample fats and protein and nutrients to build their bodies and brains. It’s pretty established in the mainstream that fish oil contains essential fatty acids so you shouldnt be surprised to see fish recommended. Liver used to be considered a superfood…ask your grandparents. It just went out of fashion. But that doesn’t make it any less nutrient dense. I used to be vegan and my cycles got all out of whack and worse and worse. I know you won’t listen to me, but please at least try reading the Vegetarian myth by Lierre Kieth. I’m starting to think the vegan movement is misogynist, since it wrecks women’s bodies so much and the main people who promote it, at least, that I used to read, are male. I think some people do better than others on a intelligently supplemented vegan diet, but that’s not what we evolved to eat. There aren’t any traditional cultures who are vegan. Sorry, I hate to go off, but I feel it is my duty as someone who was hoodwinked by the arguments for vegan ism that caused me health problems to at least try and. Help lead people towards water. Whether you drink is up to you.

      Stephanie wrote on May 6th, 2012
  9. Check out the Brewer diet. There’s more to it, but in essence he was an OB who realized that women who ate enough protein were less likely to develop toxemia and other common pregnancy condition. Going completely primal would be wonderful. But anything that reduces sugar and increases protein seems like a healthy step!

    mntnmom wrote on May 7th, 2012
  10. Thanks for the useful article!

    Mom of a 9-month-old, still breastfeeding. I’m worried about vitamin K2 deficiency; I have a hunch I was already deficient before my pregnancy as I was diagnosed with osteopenia a few years ago.

    I try to get some K2 through eating calf liver and Green Pasture mixed cod liver/butter product.

    After reading “The Calcium’s Paradox” I think I should take MK4 supplement, but I don’t know how much I need. 5mg per day (the recommended amount for healthy people) may be insufficient in my case. Apparently a positive impact on bone health was observed with 45 mg, i.e., 9 times (!!) the ‘default’ dose.

    What do you think?

    Lemurette wrote on May 7th, 2012
    • Given that of the best known dietary sources, hard cheese has only 79µg of MK4 per 100g, and even foie gras (whose creation is terribly cruel to the goose and not something that would have been possible until recently) has only 370µg per 100g (data from The Calcium Paradox), I find it hard to see how we could possibly have evolved a requirement for as much as 5mg per day, let alone 45mg. Was Grok supposed to have been eating 13kg of goose liver every day? Or did he rely on some especially MK4-rich animal that he eventually hunted to extinction?

      Orielwen wrote on May 7th, 2012
  11. Need foods to assist with strong and mobile sperm development

    Victor Mbi wrote on May 7th, 2012
  12. Great article! I had a question: I am unable to have children and my husband and I are in the process of a domestic infant adoption. Since I can’t really control the environment our baby will develop in, are there things I can do once he/she is born to counteract those negative effects, or reset his/her nutritional profile? I am planning on doing a local milkshare for breastfeeding, but I can’t really control that either. Any advice would be so greatly appreciated! Thank you so much!

    Brenda wrote on May 8th, 2012
  13. There’s another superfood you should know about called the Aroniaberry (chokeberry). It is native to North America and contains one of the highest levels of antioxidants – anthocyanins and proanthocyanidins of any fruit. These powerful berries have been utilized for years because of their overall health and wellness benefits. Learn more at

    Emmalynn wrote on May 14th, 2012
  14. In March 2010 I eliminated inflammation foods. In November 2010 I eliminated legumes moving to a primal eating regimen – I also did my first 1/2 marathon. I conceived that month following a 5 year period of supposed ‘infertility’. Through my pregnancy I’ve continued a primal diet and a consistent workout regimen. No morning sickness, no cravings, maintaining most muscle tone, experiencing healthy weight gain. I eat more than I ever did when I consumed grains and legumes and feel a million times better. Beyond meals I snack daily on berries, watermelon, veggies, avocado, hard boiled eggs, coconut milk, seeds and nuts. Before pregnancy I was strong, lean and toned. Throughout pregnancy my blood work has been 100 percent on target. At 29 weeks I’m still lean and strong where it makes sense and confident I’m providing good nutrition to my baby.

    deb wrote on May 18th, 2012
    • Congratulations Deb!
      What are inflammation foods? I have been trying to get pregnant for the past year and half. I am 44 years old though so I do not have too much time left. How old are you?
      My problem is that the follicle does not release the egg. My hormones progress well in the first half of the cycle, there is a follicle growing so everything looks great except that when the time comes to release the egg nothing happens. I think this is called follicular cyst. Very frustrating.
      I would like to learn some more about your regime that let you to get pregnant if you do not mind.
      Thank you.

      Alina wrote on May 18th, 2012
      • Although I replied privately to this post, if other readers are following comments I do want to post my age. I’m 42 and will be 43 before the arrival of our first baby.

        deb wrote on May 18th, 2012
  15. Hi Deb,
    If you want to you can email me at alinan44 at gmail dot com. It might be easier that way.
    Thank you.

    Alina wrote on May 18th, 2012
  16. Great advice.

    On the flip side, are there any known food or herbal contraceptives? I’ve heard papaya seeds are used in traditional cultures, but wondered how effective they were or if there are any others?

    Ann wrote on May 21st, 2012
  17. Thank you so much for this post and for the link to fish safety!

    Katie wrote on June 12th, 2012
  18. When I was a kid I lived across the street from a farmer and his 9 kids. Wow, talk about good looking bunch! The boys were all over 6′ by age 14, the girls looked like curvy models.. he had a brother with kids who lived downtown (factory worker), who has a few kids who were scrawny and sickly.. night and day. Farmer’s family was big on liver, kidneys, heart, raw milk and raw cheeses they made.. and fresh veggies. He had a fish pond too… seeing is believing.

    Jim wrote on September 9th, 2012
  19. Good god, way to keep up the “blame the mother” version of child development theory.

    kiki wrote on October 29th, 2012
  20. Is is ok to take Mark’s primal flora during pregnancy??

    Krista wrote on October 30th, 2012
  21. So for someone that is VERY allergic to shellfish but trying to conceive, what should I do about CLO? Green pastures specifically states that it may contain shellfish. I hope that eventually when my gut is healed my allergy will subside, but in the meantime I’d like to avoid sticking myself with an epipen.

    TulsaGal wrote on November 1st, 2012
  22. I have heard that the juice from amaranth greens is very good for pregnant and lactating mothers, and also to be given to babies about 1 tsp per day. Also might want to consider things like leached acorns, mesquite flour, cacao.

    Locust wrote on November 4th, 2012
  23. I am 5 weeks pregnant and try to eat primal all the time. From the standpoint of calcium, if I were to start eating plain yogurt would you recommend greek yogurt or plain yogurt, or even kefir? I have also considered taking a calcium supplement, but don’t know which one/kind/amount to take. I currently don’t eat any dairy at all and my husband is concerned about my calcium intake.

    Christina wrote on November 6th, 2012
  24. Congrats! i delivered my first baby in July at age 43. I’ve been dairy free for 15 years and on a primal diet for over a year. I think you will find this super informative and it does list non dairy calcium sources further down.

    deb wrote on November 7th, 2012

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