How to eat Paleo during Pregnancy: A guide to every trimester

First Trimester: Coping with Nausea & Food Aversion 

Up to 90% of women experience some form of food aversion, nausea or vomiting during their pregnancy. The good news is that only about 1:5000 will experience nausea and vomiting that requires medical intervention. Most women, find their symptoms are limited to the first trimester and are manageable with some easy adaptations.

Food Aversions

By far the most common food aversion women experience is aversion to protein. From an evolutionary perspective, this makes great sense, in fact, evolutionary biologist, Margie Profet, proposed that nausea during pregnancy evolved as a protection mechanism against toxins and other dangerous substances that could harm the developing embryo. 

In ancestral times, meats had greatest chance of harbouring bacteria and parasites, which posed the greatest risk of harming the developing baby. In addition to protein aversion, my clients also describe food aversions to spicy and smoked foods. An interesting observation, as the flavours in these foods can easily mask the taste and smell of meat turned bad. Women also report an aversion to fresh green veggies. Again, these leafy green powerhouses have the potential for contamination with bacteria like salmonella and e.coli. The body is so SMART!

May women who follow a paleo/real food diet rich in quality protein sources find this new aversion to protein and food in general to be troubling and worry about possible malnutrition during this important period of fetal organogenesis. My first word of advice is DON'T WORRY! Simply focus on food QUALITY rather than stress about calorie levels or macronutrient percentages. You baby will draw upon your stores and get just what he or she needs. You only need 200-300 extra calories during pregnancy, which is a far cry for the common belief that you are ‘eating for two’. It’s more like you're eating for 1.1 or 1.2. Your body is smart and produces certain hormones that actually make it easier to acquire and store nutrients from your foods during pregnancy.  Your baby will get what it needs to grow, and your hunger will return in a few weeks. Just chill and do your best.


Nausea is a normal response to many different hormonal changes (HCG /estrogen/progesterone) that occur during early pregnancy. It's not exactly clear why some women experience nausea and others don't.  In a study of more than 2,400 pregnant women,  nausea and vomiting during the first trimester were associated with a reduced risk of early pregnancy loss, particularly for women age 30 and older. Nausea may be a sign that HCG hormones are increasing and thus the pregnancy is healthy. 

Nausea tends to be made much worse when our blood sugars get low. During pregnancy, your blood sugar naturally runs on the high side in order to ensure a good supply of energy to your growing baby, so, nausea can be seen as a signal that your developing baby is utilizing fuel and growing well.

As I briefly mentioned above, occasionally, when we experience nausea and food aversions, the only foods we can often can 'tolerate' are starchy carbs. These traditionally had very little chance of contamination by toxins...again, our body know's just the right thing for our delicate developing little people.

To help fight nausea:

1. it’s important to not let yourself get too hungry and when you do eat, choose a "safe starch" over a simple starch and enjoy it with lots of healthy fat. 

2. Studies have shown that a 10mg Vitamin B6 supplement along with some ginger root has show to be effective in reducing nausea and is a worthy addition to your vitamin regime. 

What’s a safe starch?

The concept of ‘safe’ starches comes from Perfect Health Diet authors Paul and Shou-Ching Jaminet. They define ‘safe’ starches as “food, which, after normal cooking, lacks toxins, chiefly protein toxins.” These foods are low in phytates, which bind to nutrients like zinc, iron, calcium, and magnesium, which your body needs lots of during pregnancy. Most safe starches are also complex starches and are digested more slowly, limiting any wild blood sugar spikes that could worsen nausea and/or fatigue. 

Meg approved Pregnancy friendly Safe Starches:

jicima...a tasy treat


Winter Squash/Pumpkin

Yams/Sweet Potatoes

White rice (controversial paleo food)

White potatoes* (controversial paleo food)




*A note on white potatoes: These delightful little starch bombs are very high on the glycemic index and may cause spikes in your blood sugar, exacerbating nausea. Potatoes convert into a ‘RS3 resistant starch’ when they are boiled, cooled and then eaten cold (be sure not to re-heat).  Resistant starches act more like a fibre during digestion, rather than a sugar, and thus, don’t cause wild blood sugar spikes in sensitive individuals, like pregnant cavegals. Here's an interesting discussion about safe starches from AHS 2012. If you'd like to include potatoes in your diet this may be a better way to prepare them.

Other Great Eats  for the First Trimester

Avocado puddings. My friends over at Balanced Bites have a great recipe.  

Grassfed full fat yogurt from your local farmer or coconut/almond plant based yogurt. I'm a big fan of kite hill, silk and forager.  

Ginger is a natural anti-nauseant and a great addition to your green smoothies, sweet potato mash and pregnancy tea.

Smoothies with lots of full fat coconut milk, home made almond milk or, berries, greens and a bit of collagen peptides. Megan, the Detoxinista has a great base for healthy green smoothies. Megan  just had a little bundle of her own (congrats!) and drank these frequently during her pregnancy. 

Pasture raised scrambled eggs (bonus, cook them in bone broth)

Homemade Jello: Wellness Mama has a great  recipe base. Experiment with all sorts of flavour combinations.

Bone broth and soups This recipe from Nom Nom Paleo is SOOO easy, just pop the ingredients in the slow cooker and let old man time do all the hard work.

Paleo Chicken "Noodle" Soup I love the addition of eggs and bone broth in this recipe. It's tasty and will give you lots of nutrition in each bowl. 

Cauliflower mash : Neely over at Paleo Plan has a great recipe   Or for something sweet try this Lemon Pudding recipe from Leanne at Healthful Pursuit. 

Paleo Cereal-like creations: For some crazy reason pregnant women LOVE cereal. Perhaps it's easy to digest, perhaps we associate it with comforting emotions associated with our childhoods. Here's a quick roundup of Paleo friendly cereals alternatives. If there is NOTHING else you can stomach, try a gluten free rice based cereal (gasp)'s the most friendly to your gut. 

Cinnamon Toast Crunch - (A paleo version) I  eat I breathe I'm hungry

Paleo Cocoa Puffs - Real Sustenance

Vanilla Puffs - ( use hemp protein + almond flour blend ) Purely Twins

Pumpkin Granola- Paleo OMG






What got you through the first trimester?  What foods helped you overcome nausea and food aversions? What foods do you crave the most?