Dear Mark: First Trimester Frustration, Liver Dosage, and NY Times Barefoot Piece

Being pregnant is tough – or so I hear. You’re tasked with creating a child, with actually building an entire human being bit by bit from scratch. You have to carry that child, even as it grows to seven, eight, or even nine pounds or more inside your body. And all the while, your body seems to be rebelling against “what is best.” You want to eat the best food and get the right exercise and do all the right things, but what happens when your body fights you? What are you supposed to do when all you can stomach are mac and cheese and tortilla chips? For the first section, I try to help a woman in her first trimester with these issues. Next, I discuss the question of retinol overload from dietary liver, along with whether or not we need to worry about nutrient density in other organs, too. And finally, I give my take on a recent NY Times piece on barefoot running that seemed to call its usefulness and relevance into question.

Let’s go:


I am in my first trimester and have read several of your posts on pregnancy. However, I am seriously struggling to maintain my primal/paleo lifestyle. I can barely stand the sight or smell of meat. I have been able to eat some vegetables and fruit. I have been primal/paleo for a year and love it! It seems though that my pregnant self does not love it. I am so concerned that I am not feeding my body and baby the best food as I have been giving into eating whatever I can manage to keep down. Many foods that sound appealing are foods from my childhood…mac and cheese for instance and tortilla chips. I worry that going away from primal/paleo will make this pregnancy more difficult and is not healthy for my baby. I continue to CrossFit 3-5 times per week, but not having enough good fuel has made that more difficult also. Being so putt off from meat, nuts and many vegetables is making this extremely difficult and I am at a loss as to how to handle this.  I guess I am just concerned and would appreciate any words of advice you may have.


First of all, don’t stress out about this! While nutrition is important during pregnancy, so is stress management. And not just for the health of the future baby, but also for your health, including your ability to cope with postpartum depression. So, you know, take walks, get massages, try out meditation or yoga, get your partner to give you foot and back rubs – that sort of thing. Besides, the first trimester is notoriously hard on a woman’s appetite. Things should improve as time goes on.

Make super smoothies. Invest in a good blender. Toss in some frozen fruit, ice, some milk (if you do dairy), juice, or coconut milk, some protein powder, a few egg yolks, an ounce or two of nuts, and a handful or two of leafy greens. The egg yolks will provide choline, folate, vitamin A, and healthy fat. The fruit will give you phytochemicals and vitamins. The milk will provide protein, fat, and minerals. The coconut milk will provide medium chain triglycerides. The protein powder will give you protein. The greens will provide folate and minerals. The fruit flavor should predominate, making it easier to get down. You can even toss in some fish oil without it really affecting the taste much.

Get a good prenatal. Prenatals are there to give you what you need in the (likely) event that eating healthy food is impossible or repulsive. Chris Kresser recommends Pure Encapsulations Nutrient 950 with vitamin K2. Whatever you get, make sure it contains folate, rather than folic acid.

Primalize your non-Primal foods. Let’s take your two examples – mac and cheese and tortilla chips. If mac and cheese are all you can eat, dress it up. Buy gluten free mac and cheese (usually made from rice). When you make the cheese sauce, add a few egg yolks (from a farm you trust) to the mix; you won’t even know the difference. See if you can’t handle adding some ground beef or a few ounces of baked salmon to the mac and cheese, or maybe even some chopped, steamed spinach. Get tortilla chips cooked in lard or a high-oleic seed oil. Check the nutrition label for a high monounsaturated fat content and a low polyunsaturated fat content. Instead of just eating salsa, make a nutritious dip for the chips, like guacamole. Add an egg yolk to your guacamole (trust me, it tastes good, especially if you make it from scratch).

Reduce the CrossFitting. Five times a week is too much, in my opinion, especially if you’re doing full-fledged 20-30 minute WODs. Reduce the intensity, the duration, and the volume. Stick to 2-3 workouts a week, focus on strength versus metcons, and do a lot of walking.

Eat high quality cheese as a snack. Since you’re loving mac and cheese, real cheese shouldn’t be too much of a stretch. Cheese is high in protein, fat, calcium (important for the baby’s growth), conjugated linoleic acid (if it’s grass fed, especially), and even vitamin K2 (if it’s grass-fed and aged). Pecorino romano is a nice aged choice that’s almost always made from grass-fed sheep’s milk.

Check out Chris Kresser’s guest post from a while back and focus on the foods he outlined. You may not be able to get all the “sacred fertility foods” down, but at least you’ll have something to work toward.

Dear Mark,

Liver is awesome. But how much is too much of a good thing?

Do other organs (kidneys/hearts/lungs/brains) present the same problems with regards to retinol or other vitamins?


We’ve all heard the stories about the hungry Arctic explorers who died from retinoid overdose after eating polar bear (or sled dog) liver, and almost every pregnant woman has been admonished by her doctor to avoid liver because the vitamin A can increase the risk of severe birth defects. And yes, it’s true: you shouldn’t eat polar bear liver because of the extreme retinol content and vitamin A supplementation has been linked to birth defects.

That said, polar bear liver is special; just a gram of it contains between 24,000 and 35,000 IUs of retinol. A gram of beef liver contains just 165 IUs. Lesson? Don’t eat polar bear liver.

As to the risk of birth defects from liver, that’s been overblown. Retinol from food does not have the same effect on the fetus as supplemental retinol, and even though a 1995 study proved this, “avoid liver” is still standard advice given to pregnant women. In the study, women received retinol in the form of fried calf liver, oral supplements, or intramuscular injections. Both types of supplemental retinol caused huge spikes in all-trans-retinoic acid, the primary teratogenic (causing malformations to the fetus) metabolite of retinol, while liver caused no such spikes. Levels of the birth defect metabolite were 20-times higher than baseline after supplementation.

We’ve also heard that “vitamin A causes osteoporosis.” But that’s an oversimplification that ignores the very real phenomenon of nutrient interactions. Our bodies didn’t evolve eating isolated supplements. They evolved eating whole foods, and, as Chris Masterjohn has shown, it appears that vitamin A only really becomes a problem for our skeletal health in a vitamin D-deficient state. Of course, most experts won’t ever speak with that kind of nuance, instead preferring the easy way out of making declarative statements about isolated compounds.

None of the other organs you listed contain comparable levels of retinol, but they, along with liver, are rich sources of copper and iron – two essential minerals that we need but can also overdo. Folks with iron overload disease should limit their organ intake, or at least keep an eye on their levels.

I’d stick to around a half pound to a pound of liver per week, max. A bit more if you’re eating non-ruminant liver, which is lower in retinol. Less if you’re also eating other organs (not because of the retinol, but because of the copper and potentially the iron).

Good on you for eating organs!

Thought I’d show this to you. Thoughts? I’m a barefoot runner of 3 years. I can run 30km easy. I can’t run 1 km in shoes without pain. Obviously I’m on team barefoot.

Myths of Running: Forefoot, Barefoot and Otherwise


Ultimately, by defining the “best way to run” as that which allows the runner to “use the least energy and run the fastest,” I think they miss the main point of barefoot running: to reduce injury and prolong one’s ability to run and be active. Going barefoot isn’t really about being the fastest runner around. It’s about removing a barrier between the ground and your foot to heighten proprioceptive awareness and allow your body to make subconscious adjustments on the fly. Instead of having to consciously decide to adjust your gait to avoid injury, an experienced barefoot runner will do so more quickly and with less hesitation – since that barrier to awareness has been removed or reduced. And besides, there is evidence that running barefoot or minimalist improves running economy. Anyone who’s seen Barefoot Ted trotting along a trail can attest to this. And I’d assert that you when running barefoot you don’t have to run as far (or as fast) to get the intended strength and muscle development.

Although it’d be tough to put together a study that tested for this, I also think a big advantage to barefoot running is that it’s simply more enjoyable to experience the world that way. Our feet are remarkably attuned sensory organs, with nerve endings blanketing the bottoms of our feet, just begging to be used. Ram Dass once said “If you wear shoes, the whole world is covered in leather,” and I believe it. Feeling the grass between your toes, the sand beneath your feet, and yes, even the occasional sharp rock digging into your heel is an essential (but now missing) part of the human running (or walking) experience. You won’t find that aspect detailed in PubMed, but I think it’s pretty darn important all the same.

For some people, heel striking might be the fastest way to run and win races. I don’t care about that anymore, and I’ve never claimed that. All I know is that the heel strike is the improper way to land for the bare, natural human foot. So the fastest runners in the nation land on the heel, with the foot splayed out, with pigeon toes, and so on? Great. They’re fast in spite of their form. And the millions of people who read that article aren’t the fastest runners in the nation, nor are they getting paid to go out and run. They’re running to be healthier, and I worry that looking at what the professionals get away with is only going to open up the amateurs to injury and disappointment.

Thanks for reading, folks. Take care and Grok on!

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About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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129 thoughts on “Dear Mark: First Trimester Frustration, Liver Dosage, and NY Times Barefoot Piece”

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  1. Regarding the running article–Mark, you hit it on the head; any article that ignores the amount of injury as well as subjective measures, such as reports of comfort with running, miss the point.

    I know numbers don’t lie, but I have a difficult time understanding how forefoot stride can’t be more efficient than heel-strike strides. The heel is meant for stopping. It is a way of “putting on the brakes.” I understand that padded shoes take away some of this effect, but isn’t this just another example of what Mark would label as “Digging a hole to put the ladder in to wash the basement windows?”

    All one really needs to do is look at the normal physiology of the foot. The metatarsals are obvious, efficient shock absorbers. There is nothing about the calcaneus or subtalar joint that indicates an ability to absorb repeated impact of this force and volume. It does, however, appear to be the perfect formula for shin-splints.

    1. Are heal strikes the largest contributor to impact? I have a herniated disk in my back. My doctor recommends not running except on an elliptical runner. I wonder if I run barefoot (well, in vibrams, I live in a dirty city) if the impact will be less and I can actually run outside. Anybody familiar with barefoot running and herniated disks?

      1. Definitely try barefoot running. Herniated disks are relatively common as people age, most go undiagnosed, but doctors love telling people not to run or to wear massively padded shoes. You’ll have 65% less impact running barefoot than in shoes. anecdotes abound online about people with bad backs who have zero back pain after starting barefoot running. Give it a few weeks (start slowly, remember) and see how it goes.

        1. Great, thanks for the reply. I will give it a try. It sucks being cooped up inside the gym.

      2. I have a herniated disk and i switched to barefoot running. It taught me the proper form. Much less stress on the joints. I have now run three years and haven’t had any real problems. Make sure to build your core muscles. Learn to run barefoot or with minimal shoes. You don’t have to give up your regular running shoes, but you do need to change your form.

      3. I have at least one herniated disk (as of 6 years ago revealed by mri). I ran a bunch last year on vibrams and dabbled going barefoot. It was fantastic. I had some of my best runs. It took a few months to adapt my feet,achilles,calves by doing short runs (10-30 minutes)but the time spent was worth it. After 5 months i could run 60-90 minutes and cruise even while fasted…it was sweet. It felt like almost zero joint pounding.

        As far as the hernitated disc, don’t worry about it(even though it may be hard to). Most doctors are clueless about what you can and can’t do. I never limit myself and I am pain free. So go for it. Also, check out Dr. John Sarno if you want an alternative approach to herniated discs.

  2. Mark, thank you so much for addressing early pregnancy problems! I was sick as a dog through my first pregnancy, and could barely be in the house while my husband cooked meat. I could get it down, but it came straight back up again! And I couldn’t eat anything with eggs in for the whole 9 months – couldn’t even look at eggs. I wasn’t paleo then, but existing on white bread and mashed potato didn’t make me feel great. I could eat (and craved) fruit though…silver linings!

    My husband and I are thinking about baby number two, and now that we are eating primally (with dairy because I’ve never quite got back to normal with meat – can manage it hot but can’t stomach it cold so been replacing meat in salads with full-fat good quality dairy) I’m worried about what I’ll do if I can’t manage meat or eggs again next time.

    I guess giving it my best effort to remain as primal as possible and not stressing out too much is the answer!

    1. Do you think you might be able to stomach chicken stock made from the bones only? If you remove all the meaty bits and roast the bones in the oven until they’re brown, the stock won’t smell like meat. Then while the bones are still hot from the oven, place them in a soup pot and pour very cold water. Then bring to a boil and simmer overnight with some bay leaves, chopped onions, celery and carrot. If it still bothers you, maybe you can dilute it?

      Then you can cook all your vegetables with the chicken stock instead of water.

      Can you eat fish? How about smoked trout? I think the smoked/dried fish wouldn’t have as much as a meaty texture.

      You know, if none of this works I’m tempted to suggest fried worms and snails!

    2. Luckily you eat dairy, so that can make the bulk of calories if you can’t eat meat or eggs.

      Look into making cultured/fermented dairy products if you get bored.

    3. I’m recently pregnant with number 2 and went totally off meat, eggs and dairy. I can eat a little meat now, but it has to have very little fat.

      I can second the chicken stock suggestion. I made some with the leftovers of a roast chicken the family had the night before. I cooked up some pumpkin and pureed it with the stock, adding a can of creamed corn. I also used the chicken meat that fell off the bone and put that into the soup, because I like a bit of chunky in my soup.

      I’m presently hanging out for week 12 (10 weeks now) so the baby can feed via the placenta. The theory is your hormones wind down and you have less morning sickness. Fingers crossed!

  3. I run in Vibram because of the injury stuff- I used to hurt when i ran in normal running shoes – now i dont hurt all the time – my running partner has told me i actually run faster in 5fingers and normal shoes so go figure

      1. I ran for 15+ years in standard running shoes and assumed aches & pains were normal and just something to accept as a runner. Once I turned 40 the aches & pains were worse and took longer to heal..then I switched to vivobarefoot shoes and the annoying little pains went away….I will never go back to standard running shoes!

  4. Pregnancy- I’m 7 months and it is much more difficult to ignore everything your body is telling you with cravings. No, I don’t need chocolate cake everyday, but damn does it sound really good. Occasionally you just have to give in, and your mention of stress is correct!

    Running- I thought the Tarahumara of Mexico were some of the fastest in the world, and they have always been barefoot. I wish people would understand that it’s not always about being faster and winning, its about doing whats best for our body.

  5. I wanted to suggest Gouda cheese as a pregnancy snack. It’s high in vitamin K and tastes yummy! Costco has an imported Dutch variety that I’ve seriously become addicted to (though at their price – it’s very affordable). Great suggestions for the first trimester.

    1. This is a great suggestion! Gouda was my go-to snack food first thing in the morning. It still wasn’t all that appetizing, but not repulsive – and it was easy to keep down.

  6. Thanks Mark for addressing the pregnancy issue 🙂
    I was very happy with my paleo diet until I got pregnant. I originally thought I would stay primal easily as it was a pleasure not a sacrifice, and in particular during a time when I would want to do my best for my baby..well..Impossible!!
    The first trimester I just couldn’t stomach (or even smell) some of the things I use to eat: no more dark meat, eggs, kale or any types of cooked greens..What seemed to be the best for me nutritionnaly speaking was rejected by my body (I am not talking stupid ice cream cravings here, but “you are trying to make me eat soap” type of feelings..).

    Anyways, the only things I was attracted too were bland food, and in majority carbs: white rice, sweet potatoes, mashed potatoes, bread and butter, swiss cheese and milk, galleons of milk..And of course all possible types of fruits (don’t think I have ever eaten so many in a day).

    I caved in and ate the best carbs I could, trying to hide some proteins in the middle. And I am happy to report that second trimester cured it: I am back to a primal diet and to a good exercise regimen.

    My conclusion for my next pregnancy? I will do mybest for first trimester but I won’t worry as much about eating carbs and not exercising, after 3 months it can go back to normal, and there must be a good reason for this carb load and lazy time..

    1. I had twins, & had all-day nausea for the first four months. I could only deal with rice, cheerios & chewing gum. (This was pre-GF.) I actually LOST weight & was so scared for the babies. But then the nausea passed & my appetite returned & I gained almost 50% of my weight! The kids were full term & healthy. And my taste for coffee which had been completely shut off all 9 months, clicked on like a switch the day after they were born! Pregnancy is weird & not much fun but the results are sure worth it. 🙂

    2. Pregnant women are craving starches and fruit, it would seem. Could it be a biological directive telling them to put some fat on their bodies for the baby in case of famine?

      1. Yes, actually it’s very common for a pregnant woman to be averse to high protein foods. You see a lot of similarities in the comments here – they couldn’t stomach meat, but yet they want fruit and grains. The body wants lots of carbs and some (or lots, depending on the woman) fat. Too much protein early on in the pregnancy can cause problems, so it’s a fail safe. Smart bodies we have, eh?

      2. Yes. Also, too much protein causes birth defects. Pregnant ladies want to throw up meat on purpose.
        Load up on the carbs and the fat. Any deficiencies that might be coming up can be mitigated by a good quality fat instead.

        Anyone who has the money should really really really get Chris’s healthy baby code. It’ll make you feel way better about it.
        Pregnancy isn’t an illness, but it is a special physical state, and normal rules don’t apply.

    3. Nice to know I’m not alone!

      After a year of Primal (42lbs lost and motivated by a desire to be a healthy Mum) I’m nearly 7 weeks pregnant and I can’t face my morning eggs (bleurgh) or much meat. (although beef jerky seems OK at the moment).

      The only foods that I can stomach right now are carbs and fruit, I’m grateful to hear others’ experiences here as I was worrying about the stuff I’ve been eating.

      Does make me wonder what Mrs Grok ate when she was pregnant though…

  7. Barefoot running is the only way I can do it now. After suffering through plantar fasciitis and enduring two surgeries, neither of which fixed my feet, I gave up running for years until I discovered Vibrams. Now I can run, and faster than I did before. Conventional shoes feel heavy and burdensome. Never going back!

    1. I can’t run (bad knees), but I switched to 5 Fingers for hiking – best hiking “boot” I’ve ever had! After getting a bone spur at the base of my big toe removed last year (pre-primal lifestyle, unfortunately), 5 Fingers are almost the only comfortable foot protection I have.

      Funny, the foot doc said to stick to very stiff soled shoes, but my foot and knee hates those, but loves the 5 fingers. I guess doc’s don’t know everything, do they?

  8. Thanks for addressing the liver issue. I sometimes eat no liver and then sometimes I eat a couple pounds in a week. Nothing bad has ever happened from it. Every day I typically eat a can of fish with the bones and skin and go outside in the sun in my flat, sandaled feet (too wimpy to burn my feet on hot pavement) to run and soak in the Vitamin D. Perhaps that is why I can eat so much liver and love it.

  9. I was horribly sick for both of my pregnancies, and the only meat I could eat was super-fatty bacon, breakfast sausage, and hot dogs. Anything else smelled like a dead carcass rotting in the woods to me. Try a whole pan of bacon. That always worked for me 🙂

    Also, Mark, my family takes cod liver oil. Should we not also eat liver?


  10. I’m usually someone who doesn’t allow excuses when it comes to lifestyle, however when it comes to pregnant women, I sit down and shut up 🙂

  11. I wonder why these barefoot running articles often fail to address the surface the runner is on. Running on hard sidewalks and roads has to be different than running on the ground itself. I absolutely notice a huge difference even walking when I stay on the sidewalk. I prefer the ground instead of the side walk because I feel like my impact is absorbed better by the ground rather than by hard concrete or asphalt.

    1. I agree! If you read that article, they found that “10mm of cushioning is best” and say that is the amount in lightweight shoes. It sounds to me like they really proved that the human foot evolved to run best on naturally softer surfaces! For hard surfaces like roads, the shoes’ cushioning isn’t so much improving the foot as they are making up for a deficiency in the running surface (too firm).

  12. I ate about two pounds of liver in the last two days.. and have three more to eat in the next three days, when I’ll be living outside and cooking will be impractical or inconvenient. Then I planned to make canned cod liver in cod liver oil a staple. I hope that’s not overdoing it.

    1. But maybe after 1000 or so dextromethorphan highs that amount might be useful? Happy to see that going primal has greatly improved my digestion in the last year and a half though..
      I’ve read that alcoholics are supposed to benefit from mass amounts of nutritional supplements because they have a harder time absorbing nutrition from food.

  13. I hate to say it, but I think that one should not use pregnancy as an excuse to not eat healthy. Lots of people are “put off by” or “don’t like/can’t stomach” certain foods when going paleo/primal innitially, but they get through it. I think women need to think of their growing child’s health and nutrition and just get over not wanting to eat healthy primal foods, and take a pass on the junky comfort foods of past SAD days. I don’t think that being pregnant is a good excuse to give in to bad for you cravings, in fact you should be steadfast to get past them even moreso. Tough love from this corner!

    1. I agree that one shouldn’t binge on unhealthy foods, but until you’ve experienced severe nausea 24 hours a day for months, I wouldn’t be so dismissive about the “can’t stomach” part. Trust me, this is not a matter of will. Not all women have nausea, but for those who do it is very very real, & nobody would choose to feel that way!

      1. +1 I couldn’t go near any kind of meat for either of my pregnancies. Eating something just to throw it up is not all that helpful to a developing fetus. While pregnant and breastfeeding I wanted carbs, carbs, carbs.

        1. On Sunday I went to Taranaki Farm (Victoria, Australia) to see how they’re ‘Polyfacing’ their place. Twas rad. Got too much sun. Anyhoo, they were talking about the differences between the egg-breeder chooks and the for-meat-bred chickens. Only the egg-breeders got grain because it went straight into producing the necessary fat for the egg.
          They meat birds ate bugs and grass and whathaveyou, moved every day or two for fresh forage material. Sort of likening it to hunter-gatherer men? Whereas (as I interpreted it at the time) the ‘women’ were fed/ate the grain because they had to produce a potential being. Till Joel Salatin pointed this out I thought feeding grain to chooks was a lightweight option, but it seems they actually need it to produce the eggs- or at very least benefit enormously.
          This all said, I don’t want to eat grain of any type, pregnant or otherwise. But all I could stomach with my first pregnancy was Italian organic rice crackers with butter and marmite. It stressed me out because extruded grains make people psychotic according to a study I read via WAPF once. But passing out from starvation with a bun in the oven probably has a worse effect. This coming pregnancy, I’ll eat what my body asks for and I’ll jolly well thank it for producing another strong healthy baby without allergies or illnesses.

    2. I have to disagree. Researchers will one day discover a reason why white carbs in the first trimester are beneficial. Our bodies have wisdom, and we should listen. Maybe with berries & cream instead of Ben & Jerry. But we. should. Listen.

      When we’re pregnant, our senses are so heightened its impossible to ignore. Maybe the time to stock up on our stores of vitamin & mineral rich foods is pre-conception. Maybe the body prefers in the first trimester to use its own energy stores to help the fetus develop. There’s a lot we don’t know. But if we accept that the body has wisdom, we can learn.

      1. I agree! I’m in my 2nd trimester & back to eating primally (although in larger quantities and WAY more grass-fed butter and cheese than ever). The carb cravings in the 1st trimester are very interesting. Yes, there are healthy carbs and non-healthy ones, but every pregnant person I know has had serious carb cravings and serious aversions to meat. I still cannot stomach the thought of lamb after forcing it down and then throwing it up in the 1st trimester.

      2. I have to ask, because there is this 800lb Gorilla staring at me from across the room.

        In paleolithic times, which is where our newfound food crush here at MDA comes from, where would a pregnant cave woman have found carbs carbs carbs to feast on had it not been the right time of year?

        What if it was late fall or winter or early spring? <– 800lb Gorilla staring at you.

        Could there be something else confounding us thats causing these cravings and/or lack of ability to stomach certain foods?

        Im certainly not insinuating that women here dont care about their growing babies, but there really is a missing link here.

        1. No 800lb gorilla here at all.

          Yes, there were periods of time that peleolithic women would not have access to a carb rich diet. However, there is nothing to suggest that these same peleolithic women were not *craving* those carbs. It is entirely possible that the cravings are driven by some nutritional need that we dont yet understand.

          It could be that this lack of access to the craved carbs at the right time during pregnancy was one of *many* factors that contrubuted to the the low birth survival rate at that time.

        2. There are some theories on this. One is that woman fasted during the early parts of pregnancy, but could do so considering they had eaten nutritious foods their entire lives. That’s one theory I’ve heard.
          I think it’s more a problem of food aversions than food cravings. I wonder if the food cravings we have aren’t really being read correctly, or only happen because of the society we live in and don’t happen to hunter/gatherers. It would be interested for someone to study pregnancies in hunter/gatherer cultures to see how the morning sickness is handled.

        3. I think you also have to factor in that women did not ovulate 13 times per year back in the day, as we do now. I think that ovulatory cycles were probably much more linked to available nutrients back in paleo times. This could have conceivably allowed the first trimester to perhaps coincide with a time of plenty.

    3. You’ve obviously never been pregnant. This isn’t about preference or choice, it’s about being literally nauseated and gagging at the sight, smell or even the THOUGHT of certain foods. How dare you assume the woman who wrote the question isn’t “thinking of her growing child’s health and nutrition”? She wants to eat her normal Paleo diet but is physically ill because during pregnancy hormones run wild and a woman’s sense of taste/smell can also become much more acute. Ridiculous assertation on your part.

      1. I absolutely have been pregnant, I have a 9 year old. Thankyouverymuch.

        1. But you should understand that *all* pregnancies are different. I know a couple of very lucky ladies that made it through without any morning sickness. (Those women were very much SAD-eaters – so it wasn’t because they were ultra-healthy that they didn’t get sick).
          Myself, I’m in the 12th week of my second pregnancy, and it is WAY WORSE this time around, even though I’m eating a primal diet now (since before pregnancy).

          It’s just cruel to say that I don’t care about my growing baby because I can’t force down a primal diet right now. Do you really think I LIKE going to the hospital for rehydration because I can’t even get a sip of water to stay down? Do you think it wasn’t a heart-wrenching decision to take medication to try to stop the vomiting enough to just get in some water or SOME kind of fluid?

          I have had NO cravings. At all. It’s really just a matter of what doesn’t sound totally, horribly awful to me. What doesn’t make me gag just thinking about it or looking at it. I’ve lost a lot of weight and it has not been easy.

          So don’t you DARE tell me I don’t care and am just being selfish. Even with your horrible attitude, I pray that you NEVER experience hyperemesis gravidarum with any future pregnancies. Because it is HORRIBLE. And scary. Shame on you.

    4. Have you ever been prego? When you are put off by something while pregnant, it is impossible to eat it without throwing up. Its a strange phenomenon but it is really harder than you would expect.

      1. yes, the vomiting of all that nutritious food just isnt worth eating it! bland carbs are better than nothing!

    5. I was pregnant once more than half a lifetime ago and the memory of my queasy stomach is still so fresh that even thinking about Mark’s ideas to put egg yolks in guacamole has my 20-year-old self running for the porcelain.

    6. I agree with the other commenters…perhaps you are one of these amazingly lucky (and pretty rare!) people who sailed through pregnancy with no nausea, or perhaps you have never been pregnant as suggested…I tried to eat balanced, healthy meals but literally lost them all on the second last bite most days for the first 20 weeks – very frustrating as I enjoyed the taste at the time! Surely it’s better to eat SOMETHING than exist with an empty stomach for the first 5 months?!

      As for the cravings, these are not ‘i fancy some chocolate’ cravings, these are ‘I must eat something because there is nothing left to puke up and the only thing I can manage is carbs’ cravings! They are NOTHING like when going primal initially, I don’t think there’s any comparison!

    7. I wish I could have just sucked it up and ate what I wanted, but it is hard to eat chicken when the smell of just cooking it makes you throw up. It is not a matter of taste my dear, it is a matter of not vomiting. I had “baby flu” for 7 months with each of my 2 pregnancies and actually lost weight until the last trimester because my body rejected almost all forms of food. I thought morning sickness and cravings sounded like flip remarks women made to pig out, until I had babies. I am afraid your tough love cannot help but raise the hackles of some of us gals who had hard pregnancies. I know you didn’t mean to offend anyone, its just that primal mama bear thing 😉

    8. You’ve never been pregnant otherwise you would understand this isn’t an issue of laziness.

    9. If you’ve ever been pregnant you would know that it is not possible to be “steadfast” as you say. When hormones are raging through your body causing intense cravings for some types of foods and the total disgust for others, this is far beyond your control. I could smell an open jar of Cheez Whiz (someone insisted on eating it at work) from about 20 feet away and it would make me want to vomit. If I my lunch hour coincided with this Cheez Whiz fan, I had to leave the lunch room and find somewhere else to eat.

      I found that once I got past the first trimester the intense cravings/disgust became more manageable.

      1. Draw what conclusions you will from this: A girl I knew for a while was pregnant and she always wanted grilled cheese. Before that she was living off lots of grainy, carby foods (same boat as me – shelter life, and shelters generally provide lots of cheap fillers). She got drunk early in her pregnancy because she didn’t know she was pregnant. She continued smoking weed and cigarettes. (With the excuse they all use – “Quitting smoking is too stressful on the baby!”). She had an early miscarriage.

        1. She blamed the father for cheating on her and causing her stress. That may have been a factor. I blame the lifestyle.

    10. I must agree with the others in saying that you must have never been pregnant before Sarah or you never would’ve made such a comment.
      When pregnant, there is no getting through your aversions.
      When you can’t stomach something when pregnant, it makes you gag or throw up. There’s no pushing through that.
      I had such an aversion to meat that even the thought of it made me gag and completely lose my appetite.

      Pregnancy shouldn’t be an excuse to eat junk, but don’t think you know what it’s like to have an aversion until you’ve been through it yourself.

      1. I think it’s funny that you all assert that I “must not have ever been pregnant” Yes, I have been, and have a 9 year old. I know what it was like.

        1. I know what it’s like to be pregnant too, having had 2 children. That being said, I have absolutely zero understanding of what it is like to have the level of “morning sickness” and food aversions that some women have. My worst “morning sickness” was a vague all day queasiness, which did not last more than a month. My worst food aversion was with my first pregnancy (and a year beyond), yogurt smelled and tasted like sour milk, so I didn’t eat it. I could have if I had too, so it wasn’t to the point that it made me vomit at the mere smell of it. That is the level of “food aversion” some women have. I suspect that you too, were one of the lucky women with a relatively easy pregnancy. Because if you suffered from debilitating “morning sickness,” where you were lucky to keep anything down, or food aversions to the point that the smallest bite or even just the smell of the offending food made you vomit, I just cannot imagine you would be so callous in suggest that a woman “be steadfast to get past them” (the food aversions). Eating healthy food that do not stay in one’s stomach long enough to be digested provides no nutritional benefit. Of course, with some women, it might not even make it to the stomach as the mere act of smelling it or putting it in their mouths is enough to make them empty their stomachs (which would provide a negative nutritional benefit, as it has removed the ability to get any nutrition from the food they just relieved themselves of).

    11. Sarah, have you ever been pregnant? And if you have been, did you experience debilitating morning (<==misnomer) sickness. I actually did not, felt fine, ate well throughout. But if you've ever seen someone who is throwing up constantly from it, you would know it isn't willpower that is hindering their diet. Excuses here aren't necessary. If I've learned anything from the Primal lifestyle, it's to listen to my body. Some women's bodies scream loudly during pregnancy.

    12. Sarah, that is an extremely rude and ignorant comment and makes me pretty damn angry that you imply that not staying primal is a selfish and weak-willed act. Sometimes getting ANYTHING at all down is the best you can do for your baby! My first pregnancy I lost 13kgs (about 30lbs) in body weight because I was so sick with ‘morning’ sickness – I almost ended up hospitalised with a drip on a number of occasions – so for me to even be able to eat white bread was a feat. Thankfully my second pregnancy was no where near as bad but I still couldn’t stand meat or eggs for the whole 9.5 months so I just ate whatever I could stomach (usually bland starchy foods). It was either that, or starve myself and my child which I am sure even the most idiotic person in the world would agree is NOT in the baby’s best interests.

      1. Maybe your body was trying to protect itself by terminating the pregnancy with lack of food.
        I believe we should aspire to ideals but biology is a selfish beast.

        1. Here’s an example. A mother raccoon took residence in a shed with her three babies where I used to live. After I was informed I opened the shed door because I was curious and wanted to see the babies. The mother saw me then started tearing apart the woodpulp wall of the shed where there was a hole to escape. She didn’t try to protect the babies. Instinct had her looking out for herself.
          Maybe free will and conscience serves the purpose of evolving our instincts..

        2. Another raccoon story I just posted on Signs of the Times yesterday:
          I lived outside in the summer and cooked liver one night. I left some in the package to cook in the morning but when I woke up there was no sign of the liver or package. A couple days later the empty package was back near where I left it, then shortly after that I saw a family of raccoons living nearby.

        3. Interesting perspective, but I wouldn’t think so. Our bodies are able to terminate pregnancies easily without having to resort to starvation of the mother(I can’t think what it is right now, but the rate of natural miscarriages, especially early on (first couple of weeks) is extremely high) plus the rest of the pregnancy went perfectly, as did my second one only 18 months later. (Part of my constant throwing up was due to working in Aged Care with incontinent adults and having that crazy pregnancy sense of smell!!!) It does make sense though that if the mother was already undernourished, the body would terminate a pregnancy because otherwise you would just end up with an unhealthy mother AND child! Which leads me to muse, I wonder if there is a statistically significant difference in rates of spontaneous miscarriage between people eating real food vs SAD? I have read many times before that there is a link between PCOS, miscarriage and diet…

        4. I don’t do extensive research. My ideas are half-baked speculation.

    13. I have to say I also disagree with this. I’ve never been pregnant, but there has been a time in my life when I experienced similar food aversions, when recovering from appendix surgery (and being pumped full of nausea inducing antibiotics). My body was clearly telling me to eat, but at the same time told me very clearly it only wanted carbs. I could only eat mashed potatoes for several days (I managed to sneak in some butter and salmon on good days) Anything else made me sick (including fasting!). So I totally sympathise with the plight of pregnant ladies who feel like this for 3 months or more!

    14. Oh dear. I’m sorry, but for this one I’m in the corner of “don’t judge until you’ve been through it”. I’ve been decently Paleo for the better part of a year now and never take excuses at face value when people tell me they “just need bread” and all that bs. I’m 11 weeks pregnant and am just starting to give myself a little compassion for how unable I am to make myself eat my normal foods. I’d rather skip dinner than eat what I cook these days and often take 2 bites, want to barf, and then give in for a bowl of cereal. I promise you it’s not ‘all in my head’, so all the tough love in the world won’t change that. Baby is better served by a bowl of cereal than by a fish fillet that ends up the toilet.

    15. I’ve never been pregnant but it’s common sense not to keep eating foods that make you vomit from morning to night and from morning to night again and again. My idea of a perfect dinner is fat and juicy beef roast with roasted parsnips and carrots drizzled with lots of gravy and butter, with a dessert of whipped heavy cream and strawberry sauce, but you better believe it that if I were pregnant and this food made me vomit all day long, I wouldn’t eat it!

  14. Great post mark; however, I would add as a cautionary note to your smoothie recipe that the whites of the egg should not be used raw. Raw egg white contain avidin and excessive consumption can lead to biotin deficiency, a condition that already commonly occurs to a mild degree during pregnancy.

    1. The recipe says to use egg yolks and protein powder, not egg whites. (maybe he changed it already based on your comment?)

      1. Nope, it was always like that. I just figured some users might decide to just throw in the full egg (more protein right) and avoid the hassel of separating it.

  15. I lived on deviled eggs and whole milk for much of my pregnancy. I was making my own mayo and eating around 6-10 eggs every day. I couldn’t handle much else. It was of some comfort to look at the profile of eggs on the WAPF website. They have an amino acid profile second only to breastmilk! Always pick organic and try for free range. The milk I drank was organic but I really wanted raw for the additional nutrition. Oh well. My little boy is super healthy, strong, and mellow. He eats like a champ and quickly at that (his brother took forever and was tiny).

    1. It was helpful for me to look at the WAPF recs for pregnancy. The 1st trimester was so hard! It really helped to focus on what TO eat versus all of the things NOT to eat.

      1. Right on. WAPF were the folks that stared me on the road to Primal. Love them.

  16. Ironically, the Ram Dass quote is about the value of meditation, and is based on an old Buddhist teaching:

    Rather than trying to smooth out the world to protect yourself from injury, wear shoes and the whole world is protected (that is, you can’t control the world to prevent suffering, but you can — in theory — control the mind so that the world isn’t an imposition).

    And even though I’m obviously a barefoot convert — as the developer of Xero Shoes — I’m the first to admit that the studies about barefoot/shod running are far from comprehensive and have some conflicting results (mostly because of the study design).

      1. Dissociation and ignorance are bliss but too much and the temple will end up in disarray.

  17. I’ve been paleo for the bulk of this year, and I’m amazed at how pregnancy has just dropped me to my knees. My “morning” sickness is worse the second time around – it is 24/7 with literally no relief (and I’ve tried all the home remedies/acupuncture/prescription drugs). I’m just trying to survive at this point.
    I’m allergic to dairy and clearly wheat, I’ve discovered. I suspect an intolerance to soy as well. With pregnancy, I’m having aversions to fat (all kinds of fat), so that leaves fatty meats out, and aversions to almost all fruits and vegetables. Basically, all I can keep down are some lean meats, lettuce, tomato, white potato and homemade applesauce. Some days I can’t even stomach this stuff. I broke down and started eating corn tortillas after an incredibly desperate weekend. They are bland and seem to help soak up the stomach acid, I think. I’m just keeping my fingers crossed this ends once the first trimester is up, like last time. I’m going on week 4 of being sick, and predict about 5-7 more weeks, if the timeline is the same as it was with my first. I’m pretty sure I’ll completely hate lettuce, white potato and applesauce by then!

    1. Oh Casey, hang in there. My last pregnancy was 18 years ago, but all these stories make me remember them like yesterday. I feel now that the stress side is really important, and so is what you have been doing prior to getting pregnant in the first place. If your diet and lifestyle has been fairly clean, then your baby has such a good foundation, remember the fetus is only tiny in the first trimester, and I am sure our amazing bodies can provide for it really well, despite the hell it is putting you through. Eat what you can, when you can, trying for unprocessed as much as possible. For me the best months of my pregnancies (I had 3), were the fourth and fifth months, where I felt fantastic. The first trimester of my second child was the worst. Each one is different.

      1. Thanks! I’m floored by how much harder this pregnancy has been compared to my first, so far. They’re not kidding when they say each pregnancy is different. Wow!
        Last time around, my second trimester was great, so here’s hoping I get lucky again. I’ll be so glad when I can take down a plate of fatty meat, vegetables and fruit again!

  18. The pregnancy thing – I think Mark has the right attitude – do what you can and don’t beat yourself up over your choices.
    When I was pregnant, I used to take a minute and ask myself what do I really want to eat? Surprisingly to me, it was usually cottage cheese and fruit. So I ate it. The baby, who is now 20 years old, is just fine!
    Don’t sweat the small stuff!
    Good luck!

  19. To the pregnant primal…. I used to crave meat pre-pregnancy. Once pregnant though, I could not stand meat, the smell, sight even the thought of it made me gag.
    I didn’t worry about it too much. Def didn’t stress myself out because that’s bad for you and your baby.
    I had a wonderful pregnancy. Gagging was the worst of my morning sickness and other than a constant stuffy nose… my pregnancy was uneventful.
    Mark S. def gave some wonderful advice on making those not so primal foods better. Just do what you can and when you finally can stomach meat again (it came back for me close to 3rd tri), then get back to being primal 🙂

  20. “Lesson? Don’t eat polar bear liver.” I truly would never have known. Ya learn something new everyday! Thanks for saving my life, Mark.

  21. I never had anything more than mild queasiness when pregnant (and I wasn’t primal at the time), but these things helped me:

    Eating often (every 2-3 hours) – going longer always led to queasiness,

    Eating some form of protein with every meal/snack (nutbutter, or even yogurt with a bit of protein powder),

    Eating dinner late (around 8pm, closer to bedtime, helped prevent morning sickness),

    Eating soup (nourishing, but not overwhelming),

    Eating freshly pickled beets (so many things smelled disgusting, like cheese, but anything with vinegar was fine.) I read an article once that said a pregnant body is trying to prevent ingestion of poisions or dangerous bacteria, so moldy cheeses and raw meat smell awful, but clean smells (like my preference for lemon or vinegar) are okay.

    If meat was heavily spiced (like Tex-Mex), it didn’t smell like meat, so that worked too (my husband would cook because I couldn’t even be in the same room as raw meat). Hope that helps!

    1. Some interesting suggestions with the pickled foods and heavily seasoned meat. I’ve been dumping hot sauce on chicken and am suddenly really into mustard and vinegar, so this makes a lot of sense. I think I’ll try to experiment more with this concept to maybe expand what I’m able to keep down. Thanks!

      1. My Grandma’s maiden name is Mustard, I think that means I ought to eat tons of turmeric. I’ve also liked curry and vinegar.
        “metonymic occupational name for a dealer in spices, or a nickname for someone with a hot temper or a vicious tongue” .. hmm sounds about right. I’ve read google directs you to sites that reaffirm your beliefs though. That’s sketchy.
        Then there’s the Swedish one from my Dad’s side, Helburg (not sure of spelling), which as far as I could figure out seems to translate to Lighthouse.
        In my tunnel vision, I’ll take that as a pot loving luminescent hermit.

    2. Intersting. When I was pregnant with my oldest, I talked with a man whose wife had severe morning sickness her entire pregnancy (which is why they only have one child, he couldn’t bear putting her through that again). It turned out that the foods she could actually eat, were the ones she’d been told to avoid – anything with a strong smell and taste. The examples he gave were liver and broccoli. So that’s what she ate and it helped quite a bit. However that advice does NOT work for most women, but certainly worth a try. Though I would not recommend cooking those foods in the house, while the pregnant woman is home, or will be home soon, as they may have the complete oposite effect. Either cook them elsewhere or run the exhaust fan and open a window. That should limit the smell spreading throughout the house, and clear it out quicklly. No sense in adding to the misery.

      1. I have to agree. I had terrible all-day sickness and could barely even keep water down. The heartburn was awful. Oddly enough, the baby only craved healthy foods (very primal, now that I think about it, and this was long before I was primal), but was very particular. If I didn’t meet her fetal demands, I was running to the bathroom. My only salvation though was when I realized that I could avoid some of the vomiting if I thought about a food first. The sheer thought would make me queasy. Nope, baby doesn’t want that. I’d go through a mental menu until my stomach didn’t turn and that’s what I was allowed to eat at that moment. It was never the same twice (to my hubby’s chagrin). The 2nd half of the pregnancy was awful heartburn. The only thing that helped was eating everything I wasn’t supposed to — tomatoes, coffee, spicy food, greasy fried chicken, etc.

        Pregnancy is weird. My DH’s mother never once suffered with any of the 5 kids (probably why there’s 5). My mom and sister were both sick from the day they were pregnant until the baby was born. I got lucky(?) and landed in the middle, but boy was that 1st half miserable.

        Therefore, just because you’ve had a child, please don’t assume it’s the same for everyone. Not only is each person different, but each pregnancy. Sometime you have no choice (I mean really… I couldn’t drink water of all things? Come on!)

  22. I’m five months with my second pregnancy and have been very lucky with only extremely mild nausea in the first few weeks. I actually craved liver and was eating about a kilo a week from roughly week 7 to week 13… I didn’t realise there was a caution to go with it and the organic butcher only sold it in kilo lots! Foodwise I’ve kept primal really well, but I was only early on my primal path, and the exercise is the part where I really haven’t stepped up yet. I’ve been trying to take a good walk (bush and local urban)once a week but now my hips have started playing up (pubic symphisis pain) and all the (CW) recommendations are to sit down a lot and not walk or cycle – my main exercises apart from some push ups and squats.
    I have found that Katy Bowman recommends continued light exercises but I’m finding her site hard to navigate. Any one have any suggestions for dealing with the pelvic pain?

    1. Last pregnancy, my chiropractor was my miracle cure for hip pain and heartburn. IMO, a good chiro is worth a try.

  23. Mark,

    I just had my first baby August 1st…she is a dream.

    Reading this inquiry I could TOTALLY relate to her! I always prided myself in eating healthfully and right before I got pregnant, felt I was at my healthiest/fittest! Then, about 6-7 weeks into my pregnancy, it was like my body rejected any healthy foods! It was nuts. Veggies repulsed me, I could stomach SOME fruit (clementines became more morning sickness “cracker”), I tried smoothies (as you suggested) and puked them up (every time). I lived on English muffins and nut butter, grilled cheese, pizza (without sauce…couldn’t take it), clementines and not much else. I gained 10 pounds in the first trimester!!! Honestly I believe that because I had a low body fat % my body was craving fat and carbs for me to gain weight. As soon as I got out of the first trimester it was like I couldn’t get enough veggies and fruit. In fact, it was all I Wanted! My weight gain slowed down and I ended up gaining about 33 pounds. Perhaps it is the same for this woman? Either way, next time around I am going to try and be more prepared. At the time, I had no energy to care. I was so sick. Ug, just thinking about it makes me nauseous.

  24. I could have written the first question when I was pregnant. I felt like something had taken over my body when all I could stomach were carb-y foods from my childhood. My husband teased me that I was just using the pregnancy as an excuse to eat junk, but it was all I felt like I could eat – tortilla chips, mac n cheese, etc. After the 1st trimester my nausea subsided & I was able to eat a little better, but I still had strong aversions to things like cooked veggies throughout my whole pregnancy. I did the best I could & ate primally as much as I was able to. I gained a healthy amount of weight, and lost it all quickly after my son was born. He is a healthy 6 month old now, and I am back to eating primally and I feel great! I have no cravings for junk food at all. I wish I could have eaten differently during pregnancy, but again, it felt beyond my control. Don’t stress about it & rest assured the normal you will come back!

  25. Hi Callie,
    Congratulations on your pregnancy. Strong abs will help you push the baby out someday. I can’t remember the name of the book, but I had a pregnancy fitness book by a yoga instructor/ob nurse — she had lots of kegel exercises and “elevator” routines to teach and prepare for giving birth. I utilized it and had my kiddo pushed out in under 30 minutes and it could have been faster. So iow, maybe one of your fitness days can be a chance to sit and connect with your baby and practice how to relax with some yoga and kegels…being able to relax and submit to the birth journey makes labor manageable. I also wished I knew about the spinningbabies website and orgasmic birth book when I was prego with my first.
    You can make ultra-pasteurized organic milk more nutritious by culturing it. Piima cultures at room temperature and is mild flavored with a drinkable-yogurt consistency. Spring for the best eggs you can get.
    I was able to stomach carlson labs lemon flavored cod liver oil — both the oil and the gelcaps. Actually I had a strong aversion to vitamins in general and gel cap anything was easier to take.

  26. For the pregnancy question: some things that have helped me stay primal during pregnancy was ginger. One little piece always made a big difference. And I could usually do almonds as my “crackers”.

    There are some great recipes for quinoa “Mac n cheese”, “tortilla chips” made from almond flour, and others. Our bodies definitely crave more carbs especially during the first trimester. Sweet potatoes in the crock pot for breakfast or anytime is another one. It’s true, these aren’t necessarily the BEST choices for a primal diet, but they also don’t cause as much inflammation as the wheat, corn, and white potato counterparts.

  27. I have neuropathy up to my knees, evidently from an autoimmune bout that also left me with a mild case of Type 2 diabetes. The doctor insisted I had to encase my feet in prescription shoes and keep them there to prevent damage to my feet. I did this for 3 years and had the worst problems with my feet. Ended up losing a toe. Finally I just got disgusted and started either wearing sandals or going barefoot. My feet quickly toughened up, my legs got stronger. I have to watch where I’m walking and I check my feet often, but barefoot has been great for them. Just don’t tell the doctor.

  28. Halfway through my second pregnancy I gave up grains. What a difference! All my allergies went away, I could breathe at night through my nose, my appitite changed to more primal foods, my blood pressure improved, and I didn’t get pre-eclampsia like I did with my first child. If you can do something to help your pregnancy try dumping the grains.

  29. When I was pregnant with my first meat was a total turn off during the 1st tri as well. With my second my husband cooked all meat and I stayed far away from the kitchen, then I could actually eat it. Hopefully once you hit the second trimester, you’ll feel a bit more normal.

  30. Before my paleo days, I didn’t eat much meat. But, when I became pregnant, I CRAVED meat.

    Garlic was my nemesis. Normally, I love everything about it, but during my first trimester, just the smell of it would make me nauseous. Some days, it seemed like every home in the neighborhood was cooking with it. Man, I’m glad that eventually passed.

    1. Overall my sense of smell isn’t that acute but my nose is quite sensitive to the smell of girls. It’s like walking through a garden, just about everywhere. I find that strange, it’s only been that way for a few years or so.
      And occasionally I get sensitive to certain plant and meat smells as well.
      I ate a bunch of liver this week – stuffed myself – and I got gassy, exuding the stench of Cheerios, though the only grains I’ve had lately are through beer.

  31. Dangit, Mark. Wish you’d written this post back when I was still in my first trimester. 😉

    Also, where’d that poor lady’s belly button go???

  32. During my 3 pregnancies, meat tasted to me like dog poop smells. Can you force yourself to eat dog poop? I sure can’t! But, I did need to eat, and often, in the first trimester, or I would throw up. Carbs from bread were ok, but what my body really craved was mashed potatoes and blue cheese. Bananas were okay, as long as there was not a single brown spot, then they smelled so bad I couldn’t eat them.

    When pregnant, my sense of smell was much better the whole pregnancy – things that effected me not at all before could make me throw up. I was dehydrated for the first one, until I figured out how to keep liquids in. I did my absolute best to eat good foods (we had lots of elk and venison then) but it just couldn’t make it into my mouth. Fried or grilled zukes, though, now those were great!

  33. WOW! Avoid liver? My mum (Aussie) was told by her doctor to eat liver once a week during pregnancy, and this was passed onto me in the 80s and 90s. I don’t know of any anti liver advice given to Australian mums to be? I could be wrong tho.

  34. I spent the first six months of my three pregnancies in hospital for around 5 days out of each 14 days. I was so sick I could not stand it. I used to drug myself with antihistamines in order to sleep. Even sipping water to take those tiny pills would make me vomit. I used to vomit into a ice cream container to make sure the pill didn’t come up.. and if it did I’d take another. My doctor said if I was born in a different century I would have died. I lost weight with each pregnancy. My hair fell out, my skin was ruined, I looked like death warmed up. I ate literally nothing for months. I threw up bile til my throat bled. Morning sickness is quite possible the most disgusting nausea ever. I’ve suffered from sea sickness and air sickness and assorted other tummy things but NOTHING compares to pregnancy. As soon as I got to 7 months pregnant I ate anything and everything I could get my hands on. If carbs are all you can stomach I say eat them. It’s temporary. Be thankful we live in a society where you can get a dry cracker. The other option, starvation isn’t fun. My babies were all born full term and of healthy weight.

  35. For the preggo mama, I always blend liver to a paste and then sneak it into my foods (like marinades, soups, etc). You can barely taste it, and it’s one of the most nutritious foods on earth.

  36. Boy, can I ever sympathize with the first letter. I’m in my first trimester too (8 1/2 weeks) and I’m struggling to eat well. Something healthy will sound appealing, so I’ll buy it or make it, and I can eat two bites before it’s so awful I can’t bear the sight of it anymore. Thanks to Mark and all the commenters for the tips and sympathy. Smoothies and full-fat dairy definitely sound appealing (though gosh knows how long that’ll last).

    1. I was doing all she suggested from even before I got pregnant with the exception of very little bone broth and less CLO. It didn’t help here.

  37. The best thing you can do while pregnant is get your sleep and even that’s not always possible.

  38. When I was pregnant, my midwife told me that when you are craving sugar/carbs, your body neeeeeds more protein – get it however you can. If meat is gross, there are lots of other protein options! She also told me if you are craving chocolate, then your body is crying out for more calcium. For what it’s worth! I’ve been through 6 pregnancies (4 full, 2 miscarriages partway through), so I’ve run the gamut of morning/noon/night sickness. The smell of chicken made me want to vomit my first pregnancy, but didn’t bother me during any of the others. Most of the time, nut butters and eggs were my proteins of choice. 🙂

  39. I wanted to say a very special THANK YOU for writing this article Mark.

    I had spent several months getting rid of processed foods, then several months going low carb, until I went more primal. I had great success too, until something changed. I went two months before realising I was pregnant.

    That was two months I had turned off my successful primal eating habits, and wanted only carbs and sugar, without realising the cause.

    Reading in the comments, about how other women feel nauseous in regards to primal foods too (craving carbs instead) made me feel “normal”. I gave myself a hard time, believing I had caved back into the lifestyle which had previously made me sick.

    Now I realise, my body had it’s own programing it had to stick to after millions of years of evolution. So thanks for airing the subject!

  40. Ugh, huge sympathies. I got pregnant in June having been primal (and feeling amazing)for just 4 months. Did great for the first couple of weeks then the food aversions kicked in and I totally went off meat, eggs and veg. Could manage some fruit but basically existed for 4 months on rice krispies, toast and ginger ale. So not primal. I’m 3rd tri now and things are improving but I can still take or leave meat and can’t face veggies. Did manage a scrambled egg the other day. I need to get back off the gluten for the sake of my digestive system but still really struggling at the moment, once pregnancy is over and breastfeeding established I’ll be back onto primal living for sure!

  41. Ugh… Pregnancy aversions…. I had them really badly with my first pregnancy pre-primal, and was hoping to avoid this this time around due to a better diet, but so far, it’s not going great. I was really glad to have Mark’s “blessing” to just do the best you can. I’ve been experimenting with healthy carb-like baking and wonder if Callie might find some recipes she could tolerate in the same vein: think almond flour “focaccia”, coconut flour muffins and breads, etc. This morning, I ate some leftover pumpkin bars (a recent recipe on Elana’s Pantry) and I think that was not too bad a breakfast for my queasy tummy: with pumpkin, eggs, coconut oil, etc., it was filling and full of good nutrition, too, but felt like I was eating cake!!

    Good luck, Callie, I know how hard it is!!

  42. I just have to put it down here that raw egg yolks are a big no no for pregnant women! I’m all about the green smoothies but if protein intake is your issue look into protein powder or maybe silken tofu but no raw egg! (I’m in my 1rst tri for baby #2)

  43. You are telling the pregnant woman to eat A LOT of egg yolks in her food. I was alarmed to read this because pregnant women are NOT supposed to eat uncooked egg yolks, it can be very harmful to the baby if something is wrong with those yolks. This was the first post I read from you and was very disappointed. Get your facts straight before telling a pregnant woman what to eat. You could do a lot of damage.

    1. Doesn’t say uncooked. It says add them to the hot food, which will cook them.

      1. Don’t know how you make your smoothies, but most of mine don’t involve anything hot. I agree that adding them to the cheese sauce for mac-n-cheese would be fine since they’d get cooked, but wouldn’t dream of putting them into a smoothie and consuming raw while pregnant.

        I can definitely sympathize with the others who had to forgo their primal diets while pregnant. I’m currently 9 1/2 weeks and am having a hard time with meat, as well, so if a particular meat sounds good for a meal, I’m happy and go with it. Usually, the thought, smell, and especially taste of meat causes me to gag (or worse). The things that have consistently sounded good to me the last few weeks are apples, carrots, citrus, and potato salad. I figure none of those are that terrible (even with the white potatoes in the salad) and is better than wanting sweets, so I’ve been rolling with what the stomach is happiest accepting.

        I’m fortunate and usually manage to hold the small amounts of what I eat down. The couple of things that really seem to work for me are:
        1. take the prenatal at bedtime (any other time of day caused major nausea – apparently, it’s the iron in it)
        2. drink lots of water (or juice if it sounds better)
        3. become a grazer – instead of eating full meals, I eat in snack portions throughout the day, so a fruit/spinach smoothie for the drive to work, then a serving of yogurt about 90 minutes later, then an apple after a few hours, etc. Keeps the stomach from getting too empty, which tends to increase nausea.

  44. I realize this is an old post, but I’ve been struggling with the first trimester (this is my second pregnancy, and the morning sickness is worse this time around) and have had a very hard time sticking to the Primal diet. I’m not stressing about it, though, and remain gluten-free.

    I’ve noticed that when I do have carbs with a meal (gluten free bread or rice) that I have more energy and generally feel more like myself, so I will continue eating these things as necessary.