How to choose a good Prenatal Vitamin

One of the most common questions I get from readers and clients is, "What prenatal vitamin should I choose"?  I've avoided answering this question for a while because it's hard to give specific brand name recommendations when there is so much to choose from and product availability varies tremendously depending on where you live. That being said, this week I'm going to offer a launching point for women. You'll find a much more in depth answer to this question on Baby Making and Beyond but for now, here's a great place to start. 

Why do I need a Prenatal if I eat a real food or clean Paleo diet?

This is a great question. Some women do decide not to take a prenatal combination, which is cool, but there are some things that are important to consider:

- Pregnancy (and while breastfeeding) is a time with increased, some might say insane, nutrient demands. We quite simply just need, LOTS of essential micro nutrients to support the body's process of creating a new life. Most diets, even the best, can't provide all you need. The good news is that most of the time your baby will get what he or she needs by depleting you of nutrients. If you aren't replenishing your stores, you can, and will become deficient. This is especially true if you are having multiple babies  2-3 years apart or less.

 If only all farms could look like this :) A view from a home visit a few years back. 

If only all farms could look like this :) A view from a home visit a few years back. 

- Soil and food quality just isn't what it used to be. Even the cleanest of diets won't provide all of the nutrients you need for optimal fertility and pregnancy. The carrots our grandparents ate are not the same as the ones we find in the grocery store today, even the organic heirloom rainbow ones. A Scientific American article looked at several different studies which demonstrated time and time again that from 1975 to 1997 average calcium levels in 12 fresh veggies dropped by 27%, iron levels by 37%, vitamin A by 21% and vitamin C by 30%. 

- The stress of our modern busy lives and athletic pursuits depletes all of us of essential micronutrients. Stress and high cortisol will drain you of several critical fertility and pregnancy nutrients like B- vitamins (including folate), vitamin C, zinc and magnesium. 

- If you've are a recovering vegan/vegetarian, have had a history of food restriction, over exercise or spent much of your life (like most of us) eating a standard american diet, you are nutrient depleted. It takes many years to correct these imbalances.

What to look for in a Prenatal Vitamin

- Steer clear of drugstore or mainstream brands of prenatal (centrum, costco ect). They are made with synthetic vitamins that are not well absorbed or utilized well by our bodies and may even be harmful. For example, synthetic vitamin E can cause congenital heart defects in babies and DNA damage in mamas. 

- Look for a brand that lists Folate (5- methyltetrahydrofolate) not "folic acid" especially if your have or suspect you have MTHFR or other methylation issues as you won't be able to utilize the synthetic form of this B-vitamin. While high dietary FOLATE is associated with a reduced risk of breast cancer,  a high rate of FOLIC ACID consumption or supplementation has been suspected in promoting the progression of breast tumours in some women and can reduce the expression of beneficial tumor suppressor genes while increasing the expression of HER2 (breast cancer promoting genes). High dose folic acid supplementation can also mask B12 deficiency which could put you at risk for preterm labour. Baby Making and Beyond will have lots more on this critical difference. Folate must be sourced from real food so a "raw or whole food" like brand will usually have folate not folic acid in it. 

- Look for the inclusion of both Vitamin K1 and K2

- Look for choline in your prenatal  

- Look for synergistic combinations of vitamins with cofactors to aid in absorption and assimilation. These may include fruit powder extracts, enzymes or herbs.

- Ensure they don't contain soy, gluten or dairy and look for 3rd party testing and verification. 

 

Meg the Midwife's Favourite Prenatal Vitamin

 

Innate Response Baby and Me.  I love the ingredient list and in my mind this company is legit. This is a new formulation as of 2016 and it works great for pre-conception- postpartum. 

Seeking Health Optimal Prenatal - Not cheap but awesome ingredients 

Smarty Pants Prenatal- For women who have lots of nausea and can't stomach a traditional prenatal vitamin OR who are sensitive to iron (this is iron free). If this is all you can get into you, it's a good option.

Runner Up:

Thorne Basic Prenatal. Thorne's Basic Prenatal provides the active forms of folate (5-MTHF) and vitamin B12 (methylcobalamin) for optimal tissue-ready use. Basic Prenatal also contains well-absorbed iron bisglycinate, which meets a pregnant woman's increased need for iron while being easy on the stomach and non-constipating. Several of Basic Prenatal's ingredients (including vitamin C, vitamin B6, and vitamin K) have been demonstrated to benefit "morning sickness." Basic Prenatal is manufactured with the purest possible ingredients and without the additives and coatings usually found in mainstream prenatal supplements. This supplement doesn't contain K2 so it's important that you get your K2 from your diet or from another supplement. 

Vitamin Code Raw Prenatal- This one is significantly more affordable than some of the others and has some decent ingredients. If budget is a concern for you, I'd stick with this one. 

Knowing what supplements to take during pregnancy can feel complicated. Prenatals are a good place to start but in order to optimize your health, you may benefit from taking a few other things (such as calcium, DHA ect), it's best to talk to your functional medicine practitioner about this or become one of my nutrition and wellness clients and book your consult today.  

 

The Real Deal on Vitamin A

Vitamin A is awesome (get it "A"wesome?) that vitamin A is the first one because in my mind, it is one of the most important micronutrients not only to help you boost your fertility and prepare for pregnancy, but also during pregnancy and breastfeeding. So, let's explore the wonders of this over achieving vitamin. 

The Scoop on Vitamin A 

Vitamin A is important for many key functions in the body. These include: 

  • Eyesight
  • Hormone Balance and Fertility  
  • Thyroid function
  • Bone growth and skin health
  • Cell differentiation and multiplication
  • Immune Function (viruses and bacteria seem to retreat in the presence of high vit A)
  • For your growing baby specifically:  Vitamin A is important for the development of the neural pathways between the brain and sensory organs and in the development of the nephrons in the kidney.
  • Vitamin A deficiency is also associated with pregnancy loss...needless to say, it's an important part of a healthy diet. 

Two Types of Vitamin A

 Liver is one of the very best sources of vitamin A

Liver is one of the very best sources of vitamin A

Retinoids (Reteinol Esters): Derived from animal sources. Retinoids are found in the liver of any animal and in smaller quantities in egg yolks,  butter and cream from grass fed cows. 

Carotenoids:  AKA Beta-carotene. Vitamin A derived from plant sources. Think carrots, winter squash, pumpkin, sweet potatoes, cantaloupe. Basically, if it has an orange hue, it's probably rich in carotenoids. Carotenoids must be converted by the body into retinol in order to be used by the body. This is kind of tricky for the body to do and is a pretty inefficient process. This process can be even trickier if you suffer from a hormone imbalance, thyroid condition, it can be effected by food preparation and cooking methods and also if don't have enough fat in your diet or if you have digestive problems. Babies also don't convert well (another reason to feed your infants over 6months liver).  

Vit A in a Nutshell

  • Fat soluble Vitamin. This means it must be consumed with a fat to be properly absorbed.
  • Both Retinol Esters from animals and Beta Carotene from plants must be converted by the body into Retinoids. Once converted they are stored in the liver as Retinol Esters. This  is why liver is such a rad source of Vit A and also why high doses of vitamin A retinol, when taken in a concentrated form, can cause birth defects months after discontinuing them. High potency topical skin serums are known for this. 
  • Traditional cultures around the world seem to instinctively know the the benefits of proper vitamin A consumption. In fact, liver is found in the diets of almost every tribal group around the world, from the Canadian Inuit to the Maori in New Zealand. Many cultures even make special efforts to ensure pregnant women consume liver regularly. They instinctively know that vitamin A is critical for the health and wellbeing of our growing babies and is an KEY part of there development. Weston A Price has a great article that goes into the details about why Vitamin A is so critical for fetal development. Take home message....CONSUME LIVER in reasonable amounts! 

Vitamin A Toxicity in Pregnancy

The fear about Vitamin A toxicity in pregnancy over the past 20 years is something that commonly worries women whenever I suggest regular  dietary liver consumption. Here's the deal.....In 1995, a small study based in Boston found that high does of vitamin A could cause neural tube defects. The issue with this study is that it only looked at higher does (25,000 IU+) Vitamin A consumption from SYNTHETIC sources (retinol & retinol esters).  Follow up studies from several sites in Europe concluded that doses up to 30-50,000 IU in pregnancy from REAL FOOD sources were very safe, in fact, potentially beneficial to pregnant women. Sadly however the FDA did not change it's message and the public was once again misinformed.

Retinol Sources and Levels

  • High-vitamin cod liver oil 230,000IU /100g
  • Regular cod liver oil 100,000IU /100g
  • Duck liver 40,000IU/100g
  • Beef liver 35,000IU/100g
  • Goose liver 31,000IU/100g
  • Liverwurst sausage (pork) 28,000IU/100g
  • Lamb liver 25,000IU/100g
  • Egg Yolk 1,442IU/100g
  • Pasture Raised Butter 2,500IU /100g (this level varies greatly depending on diet of cows)

The US  and Canada currently recommend 5,000 IU per day . From the work of Weston Price, we could guess that the amount of Vitamin A in primitive diets could have as high as 50,000 IU per day. Current  recommendations from a variety of sources hover around the  10,000 IU-15,000IU level when obtained from a modern diet rich in daily grass fed butter, eggs from pastured animals and beef, lamb or poultry liver several times once a week. If you're not eating liver adding a 1 tablespoon of fermented cod liver oil can help. You can also take liver capsules, which are also a great source of b-vitamins. Vital proteins makes a good product. What's a Pregnant Paleo Mama to do?

Lambs liver...one of the milder livers. It makes great meatballs and pate spreads.

  1. Always enjoy your vitamin A sources with a fat. Vitamin A is fat soluble and needs fat to be properly absorbed.

  2. Enjoy liberal amounts of butter from grass fed cows and egg yolks. 

  3. Enjoy liver from grass fed animals once or twice a week to ensure you have a good supply of retinoids. Unless you are consuming Polar Bear or walrus liver, a serving or two of liver per week is not likely to cause any trouble. If you find the flavour of liver to be strong, try chicken liver, duck liver or lambs liver. They are milder. I have a great lambs liver meatball recipe ! It's easy to hide a few ounces of liver in meatballs, burgers or meatloaf. If you're feeling adventurous you could also try one of  Liz's Liver Smoothie Shots I'm going to give this a go this week....keep your eyes out for me on Instagram giving this a shot...literally. Ha ha. 

  4. Consume beta-carotene rich foods to your hearts content. Yumm squash (I am a squash addict) 

    • Always consume vitamin A rich food with a FAT. This helps you absorb to absorb the nutrient. This gives you full permission to slather your yam or kabocha squash liberally with grass fed butter or coconut oil. 

  5. Make sure you are getting enough Vitamin E in your diet

    • Vitamin E is necessary for the absorption of Vitamin A. Vitamin E can be found in: spinach, turnip, chard, sunflower seeds, almonds, bell peppers, asparagus, collard greens, broccoli, kale and brussels sprouts.

  6. Pregnant or planning for pregnancy? I'd give your high dose Retinol skin creams a miss to reduce the chance of toxicity. Try a vitamin C skin serum instead to achieve a beautiful glow!  

 

Postpartum weight loss: How to lose your baby weight effortlessly

Whether you're thinking about becoming pregnant, currently have a bun in the oven or, are already gazing into your new baby's eyes, the topic of postpartum weight loss can instil feelings of anxiety, stress and fear in many (if not all) women.

It's natural and necessary to put on weight during pregnancy. During this magical time, there are a myriad of hormonal changes that happen within your body. You produce human placental lactogen (HPL) which  promotes insulin resistance. This state of insulin resistance does two things, first it helps you increase your blood glucose to feed your growing baby and second, it increases visceral fat stores that will be utilized during breastfeeding. Both totally necessary and vital functions.

I get letters from new mom's frequently who are putting oodles or pressure on themselves to shed the baby pounds within weeks of giving birth. While there is no quick fix, magic pill or underground liposuction network, there are a few things you can do to help the baby weight fall off effortlessly. 

Breastfeed

 As demonstrated by Gisele...breastfeeding, the new celebrity weight loss plan....sorry, cheesy but I couldn't resist.

As demonstrated by Gisele...breastfeeding, the new celebrity weight loss plan....sorry, cheesy but I couldn't resist.

By far, the easiest way to lose your baby weight is to breastfeed. Remember that hormone HPL that helps you hang on to weight during pregnancy? When you breastfeed, HPL is replaced by Prolactin. Prolactin's job is to support lactation, reduce estrogen levels (causing freedom from menstrual periods) and mobilize nutrient stores to feed your growing baby. Prolactin produced during breastfeeding is an easy way to essentially 'reset' your postpartum metabolism. 

It's not just about the hormones either, your body requires an additional 500 calories per day to produce milk to feed your baby. It's kind of like natures built in weight loss system. Most weight loss experts recommend a caloric deficit of about 500 calories/day in order to lose a healthy and sustainable pound per week. In essence, breastfeeding is kind of like natures built in weight loss system. That being said, please DON'T starve yourself. Ensure you are getting adequate calories to support your body's recovery and activity levels. If you drop calories too low your milk supply will suffer. 

Balance your hormones

Ensuring your hormonal levels are balanced and stabilizing post baby is a critical part of weight loss.

Thyroid:

One of the most common and under-diagnosed postpartum conditions is postpartum thyroiditis. This form of hypothyroidism (aka not enough thyroid hormone) is often diagnosed between 4-9 months after baby arrives and can cause symptoms that include weight loss plateaus, weight gain, fatigue, constipation, depression and irritability. Since these symptoms are rather general and may be applicable to ALL postpartum women, it's often missed. You're at greatest risk if you've been diagnosed with a thyroid condition before, have suffered from adrenal fatigue, have an autoimmune disorder or are under-eating. A simple blood test is all you need to check your levels. 

Estrogen:

If you have suffered from PCOS in the past, aren't able to breastfeed or you're baby has weened early you may suffer from a condition called estrogen dominance. In hormonally healthy women, estrogen levels should be balanced by progesterone levels in ratios of roughly 1:5 on day 21 of their cycle. Having too much estrogen or too little progesterone can create this state of estrogen dominance which can cause weight gain, fatigue, cravings for sweets, trouble sleeping and thyroid dysfunction. See your functional medicine specialist if you think this may be happening to you. There are a number of supplements and lifestyle changes that can support a healthy estrogen/progesterone balance. 

Even if you don't have a diagnosed condition like thyroiditis, you still do need to take good care to support your natural hormone function to be able to effortlessly lose the baby weight. Here are some other things you can do to help get things back in check:

 My fav CARB...the purple potato 

My fav CARB...the purple potato 

  • Eat Carbs: Low carb or ketogenic diets are in vogue right now in the weight loss world. For most women, the childbearing years are not the time to experiment with ultra low carb diets. Limiting carbs in your diet (below 100g/day) can cause a host of issues for postpartum women. It can stress your adrenals, tax your thyroid, decrease your milk supply and cause insomnia or other sleep disturbances.  We'll be sure to dive into the carb-conundrum and get into specific levels in the upcoming Baby Making and Beyond program, but for now, just be sure to add healthy paleo friendly carbs like purple potatoes, yams, squashes and even some rice into your diet.

 

 Spend some time enjoying the small things in life.....stress reduction is a key part of a postpartum weight loss plan

Spend some time enjoying the small things in life.....stress reduction is a key part of a postpartum weight loss plan

  • Stress-less: Stress can increase cortisol levels (produced by your adrenal glands) making weight loss very difficult. Support your adrenal glands by following the recommendations in this previous post of mine. Limiting caffeine, practicing regular meditation and SLEEPING will all make the journey so much easier. 


 Spending time exercising outdoors is a BONUS. Outdoor movement increases endorphins and dopamine levels helping you stay happy and balanced.

Spending time exercising outdoors is a BONUS. Outdoor movement increases endorphins and dopamine levels helping you stay happy and balanced.

  • Exercise: A little intelligent movement will support muscle growth and help sustain fat loss. Please, don't go crazy and don't start too soon. Start walking around 2-4 wks. After 6 wks, you can introduce some light weight bearing exercise. The best combination of exercise for postpartum women is lots of walking, a little yoga and some form of weight lifting, trx or body weight movement. 

 

Remember, it takes 9 months to gain the baby weight and it will take 9-18 months to lose it. Practice gentle loving kindness for yourself and don't sweat the small stuff. In the grand scheme of life, 10 extra pounds is a first world problem, focus on the things that really matter like family, friendships and being an active and informed citizen of your community and planet. 

Pregnancy cravings. The why and heck, why not!?

I was recently asked by a reader about why she craves carbs so intensely during her pregnancy. Given that 80% of women experience pregnancy cravings, I thought this would make a spectacular next blog post topic. Please keep your comments and questions coming. Your questions inspire my future posts and direct my otherwise mindless evening research projects, preventing me from online shoe shopping purchases that I will likely regret. Who really needs purple patented leather wedges after all? 

What’s a craving?

By definition, a craving is “a powerful desire for something” (like my frequent shoe purchases). Food cravings can totally hijack your brain and consume your thoughts. This is a common and well documented occurrence among dieters who are restricting a certain type of food or calories in general. Why do cravings happen to so many pregnant women who are not dieting or restricting? Is there any science to help us understand this phenomenon? Well, according to the research, not really….but, here’s my take on the situation.

There seems to be no defined physiological reason for pregnancy food cravings, however, they do seem to have a sort of 'bio-psycho-social' paradigm. What do I mean by that? Research suggests that cravings, particularly in pregnancy, may be influenced by a complicated relationship between sociocultural factors, stress and hormonal fluctuations. Basically, we are complicated creatures and we sometimes turn to food for reasons that aren’t simply nutritionally driven.

To demonstrate this complicated relationship, let’s look at a crowd favourite ...chocolate.

Chocolate contains certain properties that influence our feelings of satiety and contain compounds such as tyramine, tryptophan and magnesium that act as mood altering psychoactive agents. Milk and turkey have these same compounds and yet don't seem to elicit the same intense cravings. 

"I just NEED to eat a turkey breast",  said no one ever. 

 Here my friend Laurie demonstrates the power of a chocolate craving. Nothing like cake in the car. 

Here my friend Laurie demonstrates the power of a chocolate craving. Nothing like cake in the car. 

The answers may lie in our complicated socio/cultural influences. Chocolate cravings, particularly among women, may result from a combination of factors such as, a reaction to stress, hormonal fluctuations and modulations of certain neuropeptide concentrations but also from our relationship with food. For example, studies from countries, like Spain, where chocolate consumption viewed as a part of a healthy diet and is generally higher, report very limited cravings for chocolate. This is contrasted by American women, who’s chocolate consumption is more restricted or considered a "treat". American women report the strongest craving for this rich delicious treat.

In North American culture, chocolate, and carbs in general are often turned to in order to treat and soothe our emotional selves. It is possible that when pregnant, especially in the first trimester, when we might feel nauseous, bloated, tired and crabby (because of hormones), we turn to foods that are easy to digest (make us less nauseous and require less energy to process), increase our comfort levels and boost our feel good serotonin levels. 

Chocolate is also rich in magnesium. Pregnancy, the first trimester in particular, is a time when the body's demand for magnesium is elevated. Perhaps you're body is telling you it needs some magnesium? Satisfy the urge with some high quality 80%+ dark chocolate or mix raw cacao with some psyllium husk (great for constipation) and water or nut milk. When you make this cacao "paste/pudding" and eat it with a spoon (I like some cacao nibs on top), it will eliminate your cravings and give you a solid dose of magnesium, potassium and a shot of iron. Other foods rich in magnesium include: dark leafy greens (spinach in particular), cashews, almonds and sesame seeds (eg tahini). 

Craving Carbs? 

Carb cravings in particular, may also be a result of a more relaxed attitude surrounding food when pregnant. Women who were previously restricting carbs, a common practice in the Paleo community, may see pregnancy as a ‘hall pass’ to enjoy carbs in all forms and as a result may experience intense cravings for these starchy and/or sweet delights.

While we are on the topic of carbs, I think it’s also important to recognize the biological aspects of carb cravings, aside from chocolate, in pregnancy. Your body needs carbs when you’re nourishing your fertile self. Carbs are required for proper hormone function and once you become pregnant, your body becomes increasingly more insulin resistant as a way of increasing fuel availability to your growing baby. This insulin resistant can cause carb cravings particularly in the first trimester. More on Carbs can be found on my previous post, "How Many Carbs Should I Eat When Pregnant?" 

What about fat and salt ? 

 Want really really good and good for you bacon? Don't fart around, pick up some  Pete's Paleo Bacon ...it will change your life forever. 

Want really really good and good for you bacon? Don't fart around, pick up some Pete's Paleo Bacon...it will change your life forever. 


Many women experience strong cravings for the fat and salt. In particular, the combination of the two. This craving seems to be more prominent in the second and third trimesters when our body's increasing its blood volume. During this time we naturally want to hold on to excess water and building new fat stores. Just as carb cravings are 100% biological, the combination of fat and salt have a real psychological component. This combination seems to activate certain pleasure centres in our brains, again, making us feel happy and satiated. I have had several friends who just couldn't get enough Cobb salad (blue cheese plus bacon = fat + salt heaven). Real Food Liz's most intense craving was Caesar salad...much for the same reason.

Citrus and fruit?

The craving for citrus is another very common one. Like salt, it tends to become more prominent in the third trimester. Real Food Liz has been going crazy over pineapple and I have TONS of clients who just can't get enough orange juice and watermelon. What does this mean? Well, it could indicate a deficiency in vitamin C but I think that it could also be your body's way of trying to boost your natural iron levels in preparation for the inevitable loss of blood during birth and the postpartum period. Your body requires high vitamin C levels to absorb iron from your diet...maybe your cravings are trying to help you fill up on nutrients? Just a theory. These cravings also may be a result of your increasing insulin resistance in the third trimester. During this time your body is a sugar monster. It does this to try to create a robust baby who can withstand the stress of the first weeks of life.

 

Salty

Cravings for salty foods, in the first trimester in particular are often associated with the body trying to increase it's blood volume. During pregnancy, by 20-28wks, the body has increased it's blood volume by almost 50%!  If you've been suffering from morning sickness and vomiting, you also may need extra electrolytes. Salt, helps your body draw in more water. Go ahead, satisfy these salty cravings with some healthy treats like sauerkraut, naturally fermented pickles, a well salted potato/sweet potato, salty bone broth or some good organic salty cheese (if tolerated), US Wellness meats Grassfed Franks dipped in mustard are a client favourite. Stay away from excess deli meats if you can. They aren't the best choice in pregnancy and if you must have them choose nitrate free, clean meats (like US wellness meats), being sure to heat them well before consuming to reduce the risk of listeriosis.  

Cravings to pay attention to

While the most cravings are more or less meaningless from a health standpoint, there are a few that are worthy of paying attention to and telling your health care provider about:

  • Ice: If you crave the crunch of ice and find yourself chewing on ice cubes this is a strong sign of anemia. Why ice when you have low iron? Being anemic causes swelling of the tongue and mouth. Ice relieves it. That's why it feels soooo good.  Have your blood levels checked and increase the animal based heme iron rich foods in your diet.
  • Chalk, dirt or other 'non-food' based items (aka Pica): These cravings may seem insane but women DO experience them. They often indicate a mineral or vitamin deficiency. See your doctor and don't eat chalk. It can be harmful to you and your baby.

What should a Real Food or Paleo Mama do about these cravings?

  • Eat carbs, just don’t go crazy. Aim for a diet of between 30-45% carbohydrates from a variety of sources such as non-starchy vegetables, starchy veggies like sweet potato, winter squash, plantains and purple potato (more on that little jewel on my next post). If you need a better list, check out this post all about carbs.

  • Limit your sugary treats. Notice I said limit, not restrict. Don’t deprive yourself. Deprivation only creates stress and will intensify your cravings. Practice portion control, enjoy your treat and then be done with it.

Meg the Midwife Approved Craving Busters

 While it's reasonable to 'cave' into some of your cravings, pregnancy is not time to fill your diet with garbage. Try to find good paleo, primal or real food versions of the things your heart so desires. Here are a few ideas to get you started. 

  • Watch out for refined or concentrated fructose sources of carbohydrates like sodas, sports drinks, agave, honey, juice and dates (in excess). Stick to glucose based sources of sugars such as bananas, berries, potatoes. Eating too much refined fructose can wreak havoc on your liver and increase stress within your body.

  • Consume your carbs with a fat or protein. This will slow the glycemic response in your body making it gentler on your system. Added bonus, your body will LOVE the combination of fat and sugar so hopefully it will satiate you and put a halt to your craving.

 

 My Paleo friendly version of 'Cherry Garcia'

My Paleo friendly version of 'Cherry Garcia'

  • Baked hot Yam/Sweet Potato smothered in Almond, Sunbutter or Coconut butter and sprinkled with cinnamon (cinnamon will also slow down your glycemic response and balance your blood sugar)....feel the need for salt? Pop a pickle on that bad boy. No joke. I've tried it and it's a winner.

  • Full fat dairy or coconut based ice creams. Try my Dairy Free "Cherry Garcia" Recipe...it's sure to satisfy your chocolate, fruit and fat cravings! 

  • Dianne has a great avocado based chocolate mousse

  • Yams, plantains or purple potatoes sliced thin and then either baked or fried in ghee or coconut oil. Once cooked, salt those tasty nuggets (duh!) with mineral rich sea salt or pick up a bag of Jackon's Honest chips. My fav is the purple potato...I'll tell you why next post. 

  • Real Food Liz's Pregnancy Cesar Salad (Recipe to come) 

  • Good Food For Bad Cooks Cinnamon Whipped Parsnips. Not only is this treat easy to digest and made from real food but, the cinnamon will help balance your blood sugar. 

  • Need salty? Jackon's Honest chips, Siete tortillas, plantain chips (fried in coconut oil or palm oil), a few naturally fermented pickles, or a simple half a potato with a touch of sea salt will satisfy most urges. 

I'll have LOTS more real food paleo friendly recipes, and a TON of information to help you optimize your fertility, have a healthy paleo pregnancy and nourish your postpartum body over at Baby Making and Beyond. Sign up for for updates to stay in the know about this exciting project launching in mid-2015. 

Probiotics in your Paleo Pregnancy. Meg the Midwife approved!

If you've been following me on Instagram or listening to the Fertility tips on the Balanced Bites Podcast, you've likely heard some chatter about the benefits of probiotics in pregnancy. 

Liz and I are going to have an ENTIRE section on Baby Making and Beyond dedicated to probiotics, just what to take, when, why and how, but until that program launches late in the spring of 2015 I wanted to share a brief run down of just why you should consider daily supplementation of probiotics during pregnancy. 

While it's great to consume probiotic foods such as raw sauerkraut, fermented veggies (carrots are my faves) and natural yogurts as a part of your daily diet, you may want to consider the addition of a probiotic supplement during pregnancy. Foods are great to support your digestive health but probiotics are even better to support your vaginal flora and the development of your babies bacterial kingdom. 

Not only do certain strains of bacteria found in your vaginal tissues influence the types of bacteria (harmful and beneficial) that will be found in your babies gut, but recent research shows that bacteria can actually cross the placenta and may affect fetal health and wellbeing. This is mind blowing research! Literally, it's blowing my mind over here. Previously, we used to thing that the infant was born 100% sterile. Obviously this isn't the case. 

Probiotics are great and here's why :

  • Reduce the chance of swabbing positive for Group B Strep (GBS) at term
  • Reduce the risk of developing Bacterial Vaginosis, a risk factor for preterm labour
  • Reduce the incidence of yeast infections, which can be common when your pregnant.
  • Reduce the incidence of constipation both prenatally and postpartum
  • Aid in the formation of short chain fatty acids, which are made in the small intestine. These fatty acids are key building blocks for your baby's nervous system and critical for your own mental and physical wellbeing. 
  • Reduces your overall systemic inflammation
  • May reduce your risk of gestational diabeties
  • Increase the number of lactobacillus species in your vaginal tract. These are associated with infant health and wellness and will form the backbone of your babies GI and immune systems. 
  • Reduce your risk of mastitis after the baby's born

What to take? 

I just became aware of this AMAZING new company called Hyperbiotics. They make a product called Pro-Mom's. This proboitic is a combination of 8 strains of high potency proboitics that are clinically proven to support a woman during her childbearing years. 

Pro-Mom's is awesome BECAUSE:

  • It's formulated with Kiwi extract which helps: Act as natural  insoluble fibre to support healthy bacterial growth. It contains an enzyme called actinidin, which aids in digestion AND it contains a polyphenol, which is a natural antioxidant. 
  • It contains the strains clinically proven to be beneficial for pregnancy and is highly potent, having just the right amount! 
  • It has a long shelf life and requires no refrigeration aka you can keep it in your purse.
  • You only need to take it once a day. It's time released.
  • It's Paleo friendly, contains no gluten, dairy, soy, corn, sugars or artificial anything 

Go out and get some! You can order it directly from their website and it's ON SALE right now

As always, check out Baby Making and Beyond and sign up for updates. You can also check me out on Balanced Bites where Liz and I will be sharing weekly fertility tips :) 

Is Kombucha Safe? The great Alcohol Debate

If you're a listener to the most amazing Balanced Bites Podcast, you may have heard Liz Wolfe teasing a new fertility program/site, Baby Making and Beyond, that we are hard at work on. I'm SOOO excited to share this comprehensive information source for everything from fertility, pregnancy, trimester by trimester real food nutrition and popular postpartum topics. We want to have answers to all your questions so if you have something you'd like us to include, please send me a message! This program hopes to launch mid-2015 and will be kicked off with a fantastic 28 day Baby Makin' Bootcamp. Stay tuned for more info on that. 

One of the topics covered on the podcast last week was a question regarding the safety of Kombucha during pregnancy. I wrote about this topic a while back. Here's the link to the Kombucha Saved My Life Post.  Our Baby Makin' and Beyond program will answer questions just like this but until it's launched here's a brief rundown on the safety of Kombucha consumption in pregnancy.

Let's start by breaking down just what's in commercially made Kombucha. As I wrote about in my previous post, I ONLY recommend commercially made Kombucha during pregnancy. 

Kombucha Composition in a Nutshell

Tea (green, black, white): contains caffeine ~ 8-14mg/ 8oz

Sugar:~ 2-6g/8oz

  • This isn't much sugar at all. Kombucha's low sugar content is considered safe for women with blood sugar regulation issues and one serving of Kombucha is even considered acceptable on many Paleo 30 day challenges or while on the 21-day Sugar Detox Program.

Scoby: good bacteria to feed your gut flora

  • Optimizing gut flora is a great idea for both fertility and during your pregnancy. Kombucha was originally used as a digestive aid because the bacteria helps you optimize your gut flora and thus digest your food more efficiently. This can help to maximize the nutrient absorption from your diet. Adding a new probiotic into your regime can sometimes cause a "cleansing effect". If you are newly pregnant and aren't already a long time Kombucha drinker, I would recommend starting with very small doses (2-3oz/day) or just avoid it entirely just to be on the safe side. Once your system has gotten used to the bacteria, it is theoretically safe to continue during pregnancy and many of my pregnant friends happily enjoy 8-16oz/day with no side effects. In fact, a number of friends use GT's Gingerade as a pretty effective remedy for first trimester nausea. 

Alcohol: ~0.5%

  • This is the big concern for most women. While we don't know if there is ANY safe amount of alcohol consumption in pregnancy, we do know that 0.5% is a very small amount. In Canada and the US, non- alcoholic beer and wine are defined as anything 0.5% or less. I know many physicians who have told friends that it's okay to enjoy a non-alcoholic beer (0.5% alcohol content) a day with no evidence of harmful effects. One study even indicated that upwards of 40% of physicians tell their patients that even the occasional glass of wine (11-14%) is safe after the first trimester.  If drinking the occasional glass of 13% wine a week is considered by some to be safe and a bottle of 0.5% O'Dooles beer a day is safe can we say the same for Kombucha?

Some of GT's Classic Synergy products in the United States are labeled a must be "21 or over" with contents at or above 0.5%, while the Enlightened and Classic Kombucha versions have lower amounts of alcohol and do not require special labels. In Canada, there are no such label regulations or warnings on any GT products.

But is it really safe? Well, we don't totally know. Obviously it is unethical to run randomized clinical trials on pregnant women, but, there have been some studies that analyze long term data from pregnant women that we can use to make our assumptions. Once study of over 7600 women measured levels of behavioural problems among 2-year olds. The results were similar between women who reported zero drinking (11%) vs < 1 drink/wk (13.7%) vs light drinking 2-3 drinks/ wk (9%). Multiple studies seem to conclude that very light alcohol consumption may be safe during pregnancy. 

Studies indcate that it isn't the occasional small amounts of alcohol that put our babies at risk for Fetal Alcohol Disorder but it is the BINGE type drinking that is most dangerous. This makes perfect sense when we consider the science behind alcohol metabolism. 

Alcohol is metabolized in the body by a variety of enzymes including alcohol dehydrogenase (ADH), cytochrome P450 (CYP2E1) and catalase. ADH is the powerhouse of the metabolizers and is found in our liver. It's a supply and demand system. The more you drink, the more dehydrogenase you produce. This is why midwives, who live a life on call, are classically cheap dates :) This enzyme is also present in variable amounts depending on your ethnicity. Aboriginal and people of East Asian decent tend to have less and metabolize alcohol at a much slower rate. When you overwhelm this system with LARGE amounts of alcohol in one sitting, like when you binge drink, your body can't keep up with the demand for the ADH enzyme and your blood alcohol content goes up dramatically, crossing the placenta and potentially causing great harm to your developing baby. Bottom line...NEVER binge drink during pregnancy.

So what happens when we consume small amounts of alcohol like what's found in Kombucha or even baking extracts (like vanilla)? While we have no proof that this level of consumption is 100% safe, I feel like it's pretty fair to say that it's likely fine. While I'm not advocating going out and drinking a glass of wine every night, I am suggesting that perhaps the 0.5% we find in our daily 8oz of GT's may be totally safe. What do you think? Send me you're thoughts. 

Essential Fatty Acids: What's the Deal?

It's summer in the Canadian Rockies and the alpine wildflowers are in peak bloom. It's times like these I feel blessed to enjoy where I live and am thankful for the clean air, open spaces and wild country that I call home!

This was a cloudy day last week and a beautiful run through the wild arnica (good for tissue healing) around Buller Pass. This was 30mins from my house. That makes me happy! 

All these beautiful flowers, plus a post by Paleo For Women's Stefani Ruper inspired me to want to write own post about Evening Primrose Oil. I got going on that and then whamo! Up popped a post by Mark Sission that inspired me to write a more general post about Fatty Acid Supplementation.

This wee story may be the starting point for a longer novella about fatty acids in pregnancy but for now, here's my two cents on essential fatty acids. Before we jump right into why I encourage DHA supplementation during pregnancy, let's look at why, in the Paleo community, we talk about balancing our omega-3 and 6 ratios.

Why should I care about Omega3's vs Omega 6's? 

Good question! Why the heck should you care? I'm not a big fan of  'micromanaging' what you eat, but, I think it can be beneficial to take a big picture approach and look at your diet every once in a while. This is especially important if you are suffering from a chronic condition, are trying to optimize fertility or are expecting a little cavebaby! 

To explain it briefly and simply, omega-6 fatty acids (mostly Arachidonic acid ) promote systemic inflammation in the body by stimulating inflammatory prostaglandin's. Omega-3 fatty acids (mostly EPA/DHA)  aren't in themselves anti-inflammatory but rather stimulate a concurrent cascade of chemical activities that basically slows the entire inflammatory cycle down by competing with binding sites and decreasing tissue concentration of inflammatory prostaglandin's. 

Therefore, the amount of omega-3's you need in your diet should correspond to the amount of omega-6's in your diet. Too much omega-6 and you run the risk of developing diseases that are related to inflammation. These include cardiovascular disease, Chrohn's disease, hormone dis-regulation and insulin resistance. Being in a constant state of inflammation can also make conceiving more difficult. This is why we are all so fascinated and obsessed with omega 3:6 ratios. 

Back up here....Prosta-'what'-dins? 

Prostaglandins are autocrine or paracrine regulators rather than hormones. They are produced an act locally within cells and tissues. Prostaglandins have a wide variety of important functions in our body including: being responsible for the cascade of hormones to start labour, smooth muscle regulation, cell growth, hormone regulation, platelet aggregation (formation of blood clots) and localized inflammatory responses. 

This is a great visual that helps point out how much omega:6 is in our diet

 What is the optimal Omega 3:6 Ratio?

Well, good question. I don't think anyone really knows. A standard american diet (SAD)  typically includes ratios of 1:10 or upwards of 1:25. That's totally nuts! Many paleo authors have suggested a ratio of 1:1 -1:3 is a more reasonable ratio for optimal health. These ratios more closely resemble the ratio's that our traditional ancestral diet may have contained.

Should I Supplement?

Well, good question. If you eat a squeaky clean paleo, ancestral or primal diet, with no processed food, no inflammatory seed oils (think canola based margarine) it's easy to think you're doing a smashing job! That being said, even I occasionally cave and eat a bag of organic chips made with canola, and there are tons of Omega-6 fatty acids found in many paleo/primal friendly foods too. These include delicious delights such as avocados, nuts, nut flours (aka paleo treats), poultry and pork products (yup...bacon).  

Most of us aren't perfect in balancing these ratios and we tend to be exposed to many more omega-6 fatty acids in our diets than may be optimal. It's good to look at your intake of these foods and be honest about how much poultry, nuts and avocados you really consume.

To aid in ratio optimization, try to add in more grass-fed beef, game or organ meats, watch your consumption of nuts and seeds (walnuts and macadamias are a good choice), and try to include more cold water fish like herring, mackerel and sardines. You can also get DHA from flax, hemp and chia but it must be converted in the body from ALA to EPA/DHA. Unfortunately, this process isn't very efficient. According to Chris Kresser, less than 5% of ALA getting converted to EPA with less than 0.5% being converted to DHA. Best to stick with the fish and grassfed meats.

If you are trying to treat a specific health condition, trying to conceive or are pregnant or breastfeeding, supplementation may be a good choice and is supported by both mainstream medical doctors and most natural health practitioners alike.

DHA/EPA Supplementation

There are numerous studies touting the benefits of supplementation with DHA, most notably from fish oil. Supplementation of DHA from fish oil has been shown to be beneficial for fertility, pregnancy and breastfeeding.  

DHA supplements may help:

 DHA helps babies brain, eye and overall neurological health

DHA helps babies brain, eye and overall neurological health

  • Enhance male fertility by aiding in sperm quality and motility
  • prevent pre-eclampsia in pregnancy
  • prevent mood changes and postpartum depression
  • Support fetal neurological development (brain/eyes)
  • Reduce of the risk of allergies in infants
  • Supplementation during breastfeeding dramatically increases DHA content of breastmilk...essentially making it "super-milk" 

DHA is one of the few fatty acids that crosses the placenta. Fatty acids are required by the developing fetus as a source of energy, to maintain the fluidity, permeability and conformation of membranes and as precursors of critical bioactive compounds such as prostacyclins, prostaglandins, thromboxanes and leukotrienes. DHA synthesis is limited in the fetus and supplementation or high dietary intake of DHA has been shown to increase overall fetal DHA levels and effect m-RNA expression. Translation: these are all good things! 

DHA absorption by the fetus is shown by studies to really get ramped up in the final 10 weeks of pregnancy. So, if you are nauseated or just can't tolerate fish oil caps in the first half of pregnancy, no biggie. You can make up for it later when you are feeling better. 

What supplements should I buy?

 This is a wee little Krill...he's a good choice if you're going to supplement with DHA.&nbsp;

This is a wee little Krill...he's a good choice if you're going to supplement with DHA. 

Good question! I coach clients to look for DHA from krill or other small marine animals. Krill oil has been show to be more easily absorbed and increase blood DHA levels faster and more efficiently than traditional fish oil capsules. Plus, krill are small little animals and the lower you eat on the food chain, the less risk you have for being exposed to contaminants and toxins. Make sure your supplement has at least 200-300mg of DHA per cap and take between 1g-2g daily.  Chris Kresser wrote a long post all about how to choose a fish oil that is worth a read. 

 For the Fish/seafood allergic there are options!&nbsp;

For the Fish/seafood allergic there are options! 

Don't do fish?  If you're like me and are allergic to fish/seafood/shellfish there is one other option for getting your DHA. Marine algae. Studies have shown that taking a supplement of marine algae based DHA can be just as effective as fish oil. It's more expensive but if you have no other options, it can be a good solution. 

 

 

 

 

Evening Primrose Oil

 Evening Primrose...not just a pretty flower

Evening Primrose...not just a pretty flower

What is Evening Primrose Oil (EPO)? 

Evening primrose oil is a pressed flower oil that contains omega-6 fatty acids, much like safflower or canola oil. I know what you're thinking,

"HOLD THE PHONE, aren't additional omega-6 fatty acids a bad?" Well, , yes, I'd agree, but, EPO is an exception. 

EPO is unique in that it is mostly comprised of (75%) Gamma-Linoeic Acid or GLA. GLA is one of the  few "anti-inflammatory" omega-6's fatty acids. It does this by it mitigating the inflammatory prostaglandin response caused by Arachidonic Acid (aka canola, safflower, sunflower oil) via similar pathways as DHA and EPA.

Evening Primrose Oil's Role in Women's health, Fertility and Pregnancy

There is very little research on the benefits of EPO but here is what we do know...or think we know :)

Manage PMS

  • Inflammatory prostaglandin excess can be responsible for a myriad of PMS symptoms including cramps, breast tenderness, joint pain and bloating. Taking a supplement of EPO may help to reduce these effects and make PMS a bit more manageable. Many PMS sufferers are found to have unusually low levels of GLA in their systems, which is why supplements might help so much. EPO can also help promote the absorption of iodine, a mineral that can be present in abnormally low levels in women with PMS and hypothyroid conditions. 

 Balance your Mood

  • What woman doesn't want help with the delicate balance of mood regulation during their menstrual cycle or pregnancy?  Studies have shown that supplementing with EPO can help reduce some of the mood changes associated with PMS, pregnancy and in the postpartum period. Many studies focused on the use of DHA, not GLA for pregnancy mood related changes so for clients who have struggled with mood in the past, I usually recommend a high dose fish oil or placental encapsulation (that's another post!) for this particular complaint.

Aid in Fertility

  • There are some claims that claim that taking evening primrose oil can help a woman conceive by making her cervical mucus more stretchable and slippery, enabling the sperm to move more quickly through the uterus and into the fallopian tube. Can't hurt!  

Supplementing with EPO during the third trimester of Pregnancy

  • Many midwives recommend supplementation of EPO during the third trimester of pregnancy to help soften and ripen the cervix in preparation for labour. I used to recommend this too until I did some further research. Honestly, it doesn't really seem to work. There have been many midwifery led studies in North America and Europe that show no change in cervical ripeness with EPO supplementation. Bummer. Does it hurt? Nope. Will it help? Probably not, but again, it doesn't hurt!