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. 

How many carbs to eat when you're breastfeeding and following a Paleo diet

To carb or not to carb? That is the question....it seems like I'm asked about carb levels all the time and when I received an email from a client about a suddenly low milk supply after starting a Paleo diet, I knew her story would probably resonate with lots of other gals. So, here you have it. 

My former (most wonderful client) is about 4 months postpartum. She started going to Crossfit mom's as a way of connecting with other women and it was the only program in town that made it easy for her to workout with her baby. Since the start of the new year, her Crossfit group decided to start a one month "Paleo Challenge". Of course, I support this kind of awesome nutritional reset ANYTIME, no challenge required, but I was thrilled to hear she was going to give paleo a good ol' college try.

10 days into the challenge, she had lost 6 lbs. She wasn't sleeping and neither was her baby, who previously slept through the night. She also noticed that her milk supply had significantly decreased. What was going wrong? Should she give in to the bread cravings that were taking over her life?

Typical SAD Macro Levels

Typical SAD Macro Levels

I asked her to punch her nutrition into an online app (I usually recommend My Fitness Pal) which as it turns out, she already did (she's so smart). When she told me her macro's, I instantly knew what the problem was. Carbs were only making up about 20-25% of her diet. Not by choice, just by accident. This would explain the insane weight drop, often caused by rapid water loss when switching from a SAD diet where carb levels are anywhere between 50-60%. The most common mistake folks make when going Paleo is going too low carb by accident. While a Paleo diet is typically lower in carbs than the modern SAD, it isn't designed to be a "low carb diet". Going low carb can happen by accident when we replace the grain laden starches with more filling veggies, fats and meats. 

What was going on?

Her body was STRESSED. While going low carb can result in weight loss, it also can result in systemic stress on your body. Cortisol levels will ramp up disturbing your sleep patterns and your body will begin limiting how much energy it spends on "unnecessary" reproductive functions like ovulation, menstruation and, in this case, breastmilk supply. After all, what body wants to sustain another growing life when it's having a hard time sustaining itself?

If this diet was to continue, it may also cause her thyroid hormones to plummet. Low thyroid in a postpartum woman can cause postpartum depression, stall natural weight loss and cause breastmilk to all but disappear. 

This would explain why both she and her baby were not sleeping through the night.  Her body was holding on to extra calories by dropping her milk supply. Some studies have suggested that when a mom is calorie depleted, her milk may also decrease in fat content. This can cause babies to get hungry faster (aka waking up needing to feed more often) and may also cause them to miss out on critical DHA fatty acids they need for brain and neurological development. 

What To Do if this is happening to you? 

Eat Paleo Friendly Starchy Carbs!  Breastfeeding women NEED carbs. Please ladies, eat the sweet potato, eat the white potato....eat all the potatoes.

These are some good macro's for a breastfeeding mama

These are some good macro's for a breastfeeding mama

While 20-25% may be a good level for an active male or to optimize body composition, it isn't enough to support fertility, pregnancy or lactation. I generally recommend 30-40% depending on activity levels and individual needs. Does she need to eat the bread? Well, no, but, at the end of the day if you eat a slice of gluten free bread, will it really be the end of the world? Probably not. Dianne has a great post about starchy carbs found here with a handy chart, which you can downloadable chart to help you on your way. 

 Eat sufficient calories. When starting a Paleo challenge it's not uncommon for women to drop their calories down too low to support healthy womanly functions. When breastfeeding, this can lead to low milk supply and an unhappy baby. Never drop below around 1800 cals/day when breastfeeding, you'll likely need more if you're active. 

 Lose weight slowly. When women lose weight rapidly they are not only at risk for low milk supply (for the reasons stated above) but, it's also been documented that weight loss of more than 1 lbs or 0.45kg/week can increase the toxic load found in your milk. Say what? True story....

Environmental contaminants such as PCBs and pesticides, are stored in body fat. According to Breastfeeding and Human Lactation (3rd Edition, Riordan, pp 440), when a breastfeeding mother loses weight rapidly (>1lbs/wk), these toxins are released into her bloodstream, and the toxin load of her milk can dramatically increase. These toxins are directly offloaded to a growing baby. Not bueno. 

What about Ketones? When a woman goes very low carb (20-50g/day) she may start producing ketones. Ketones are the waste products of fatty acid metabolism, aka when the body burns some of its own fat for fuel. Ketones will pass into the breastmilk and I wondered if these could be damaging to infants. Apparently not. When I asked famous Breastfeeding Physician Dr. Jack Newman about them, he said that they don't pose any dangers for infants. For more info on ketones during pregnancy, check out this post. Your biggest danger when dieting seems to be is low milk quality and overall supply.

Need more help?

Liz and I will be covering a whole swack more info just like this a little bit more in detail over at Baby Making and Beyond. Sign up for launch specials and updates here. Can't wait for the BMB program and need help now? Fill out this handy form and register for a nutritional assessment. Let me help you on your journey towards being a rad nourished mama! 

Take home message....eat the sweet potatoes and enjoy them! 

I made donuts out of Plantains...true story

I've been shying away from recipe posts as of late. I'm just not very good at being patient enough to measure and time everything I do and man, I'm no expert in the kitchen. This one however was a full stroke of luck. It's delicious. Filled with Paleo friendly healthy carbs and starches and is a great way to satisfy that sweet tooth. These donuts are also a healthy option if you're dealing with carb cravings and food aversion in the first trimester. Feel to switch up the recipe and harness your creative spirit! Add some cacao powder, top the donut with coconut butter, almond butter or chia jam instead of ganache, the sky's the limit here. 

You can see here that Plantains come in a variety of "ripenesses". Green are a great form of resistant starch. As they get more "ripe" and black, they develop there sweetness and develop a much softer texture.

You can see here that Plantains come in a variety of "ripenesses". Green are a great form of resistant starch. As they get more "ripe" and black, they develop there sweetness and develop a much softer texture.

What are Plantains?

Plantains are a starchier, less sweet version of a banana found in tropical regions. They are high in carbohydrates and are a source of antioxidants, B-6 and fiber. All good stuff for a health pregnancy. Green plantains are a source of resistant starch which are beneficial for gut flora proliferation. 

I topped my with gluten free sprinkles. Not quite 100% paleo but hey, I'm no perfectionist! 

Paleo Plantain Donuts (makes 5 mini donuts*) with a Sugar free (option)

1- 7oz (peeled) Plantain**, yellow with no black spots  

2 tbs melted coconut oil

1 egg (at room temp)

1 tsp baking powder

Few drops of stevia to taste or 1 tbs coconut sugar or other sweetener of choice

1 tsp vanilla powder (you can use extract too)

Ganache Topping:

1/3 cup enjoy life chips or 1/3 cup krisda chips (for sugar free)

1 tbs coconut oil

Preheat oven to 375. Chop plantain into a few pieces and place in your blender. Blend until smooth. Add melted coconut oil, egg, baking powder and vanilla powder. Blend until smooth. Spoon into a greased mini donut pan and bake for 10 mins. Remove from oven and cool slightly before removing donuts from pan. Let cool.

Prepare the ganache by melting chips and coconut oil together stirring well. Dip the cooled donuts into the hot ganache and top with coconut, gluten free sprinkles or whatever else tickles your fancy. 

* You could easily double the recipe and use a larger donut pan. I imagine these also would make great mini muffins or cupcakes. 

** Green banana will likely work for this recipe too if I you can't find plantains where you live

Paleo, Pregnant and can't give up cereal? Your not alone!

What is it about that morning, afternoon or bedtime bowl of cereal that is just so special? For western cultures, cereal is  as much of a staple as meat, eggs and dairy. So much so, that entire grocery store isles are dedicated to the sales and marketing of these non-paleo products. 

The problem with cereal: Lectins and Phytic Acid

If your new to the Paleo diet you may be wondering, what the heck is so wrong with my bowl of whole grain organic nutty "0"'s anyway? Well, aside from the obvious suspects (sugar, food colouring and additives), the problem is that cereals are made primarily from grains. Grains are smart...smarter than you may imagine. They contain compounds called lecthins and phytic acid that are designed to protect the plant from predators and aid in their reproductive success. 

Lecthin is a toxic compound that acts somewhat like a natural pesticide, protecting the plant from harmful predators like bugs. Phytic acid is a substance found in seeds that protects the nutrients the plant requires for reproduction. Pretty smart! When we eat foods containing high levels of these compounds (like our morning flakes of goodness), we expose our bodies to toxins, which act as irritants and also bind to minerals like calcium, zinc, iron and magnesium, that our bodies need to stay healthy and grow a sweet little baby. This is why these two compounds are often called 'anti-nutrients'. 

 "BUT ALL I CAN EAT IS CEREAL!"

 I hear you sister! If you've made the transition to a Paleo-friendly diet, you've likely cut out cereal products entirely, but what happens when you become pregnant? For many, the craving for cereal becomes overpowering in the first trimester. In fact, many women find breakfast cereal is all they can tolerate during the first few months of pregancy. So how do you navigate this when you're trying to maintain a paleo friendly grain free diet? Here's how...

Seek out soaked & sprouted grain cereals

Most traditional cultures sprout and soak their grains. Sprouting grains helps break down many of the anti-nutrients. When grains are soaked, they engage an enzyme called phytase. Phytase, helps break down phytic acid (in small amounts) and aid in nutrient absorption. Lethicin is also reduced a small amount during the soaking and sprouting process.

Gluten free cereals such as One Degree Organic's Rice Cereal or Arrowhead Mills Sprouted Corn Flakes are all good options for the pregnant mama who just can't tolerate much other than cereal and needs something fast she can buy from the store. 

You could also try a Paleo Cereal alternative, such as any of these 15 Cereal Recipes. The version of cinnamon toast crunch is my fav and isn't as fiddly to make as it seems. You could also pick up some of Steves Paleokrunch Cereal. They ship across the country and are good alternatives to grain based cereal when eaten in moderation.

Fermentation

The process of fermentation seems to have the greatest effect on reduction of the grains anti-nutrients across the board. The problem is that it's tricky to find pre-packaged cereal! Actually, it's impossible.

In traditional West African cultures, fermented cereals are a staple food. Sometimes called Ogi, it is typically made from maize, sorghum or millet sprouted for 3 days before straining to remove the husk (often then fed to livestock) and prepared as a porridge.  

This recipe from Brittany Angel is genius and may just help fend off your cereal cravings

The process of making traditional sourdough breads includes a substantial fermentation process. If a piece of toast would serve as a good substitute for your cereal craving, I suggest you seek out a traditional bakery in your area and ask if they can make a gluten free sourdough or make your own.

Gluten free Sourdough Recipe

If you feel like toast may be a good cereal substitute, you could try to avoid the grains entirely and enjoy a good slice of Paleo friendly grain free bread. Here are two recipes I've tried that are pretty great and rather easy to make.

Brittany Angel's Grain Free Bread 

Elana's Pantry Paleo Bread

    Stay away from Gluten: Period

    Even though gluten and lethicin levels may be reduced a small amount by soaking, fermenting and sprouting, the effect is minimal (when compared to other grains) and should still be avoided. Foods containing gluten irritate the lining of the gut and affect its permeability. Some believe this can lead to "leaky gut syndrome".  Many people also may experience a full blown inflammatory immune system response when exposed to gluten. During pregnancy, when your body is already in an immuno-compromised state,  best to avoid gluten entirely. For this reason sprouted cereals such as Ezekial 4.9  and wheat based sourdoughs should be avoided. 

    Be gentle on yourself

    Remember, there is no such thing as a 'good' and 'bad' food. You aren't a terrible person if you break the 'paleo' rules and give your body what it is asking for every now and again. "Paleo perfectionism" (thanks Diane for that awesome phrase),  can create unnecessary stress in your life and hold you back from reaching your goals of a happy, stress free pregnancy. Do your best, nourish your body with nutrient dense foods and if you need to live on sprouted brown rice cereal for a few months, so be it. Just try to make the best choices you can. 

    How many carbs should I eat during Pregnancy?

    How many carbs should I eat now that I’m pregnant?

    A healthy Paleo or Primal diet is naturally lower in carbohydrates when compared to the standard American diet (SAD) and commonly ranges from 10-35% depending on individuals’ needs, goals and preferences. Your carbohydrate needs in pregnancy may need to be altered from its non -pregnant levels, both as your activity levels modify and as your body works hard to grow a new life. In this post, I’ll answer the not so simple question to, “How many carbs do I need when I’m pregnant?”

    If you are overweight and/or have a diagnosis of PCOS before becoming pregnant, your risk of pregnancy related complications may be diminished by reducing your weight to ‘normal’ levels and learning to control your insulin levels with Paleo eating and exercise. A common weight reduction strategy among Paleo eaters is to adopt a low carb or very low carb (VLC) approach. Reducing carbs when overweight or struggling with metabolic syndrome can be an incredibly effective tool for fat loss and insulin control, however when pregnant, this approach can cause some issues and it’s important not to attempt weight loss when pregnant in order to properly nourish your growing baby.

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    Pregnancy is a natural anabolic (growing) state; the object of the game here is to grow a new life! The body facilitates growth in pregnancy by creating a natural state of insulin resistance thanks to a variety of hormones including a hormone produced by the placenta called Human Placental Lactogen (HPL). To simplify, your blood sugars are naturally higher when pregnant in order to facilitate adequate glucose transfer to your baby. Remember high school chemistry? Sugars move from high concentration (your bloodstream) to low (baby’s blood stream) through the process of simple diffusion as they cross the placenta. This balance helps your baby grow and also helps you put on stores of fat especially in the first trimester, ensuring adequate calorie stores for breastfeeding.

    If you are eating a low carb or very low carb diet, you may be producing ketone bodies. Ketones are the waste products of fatty acid metabolism, aka when the body burns some of its own fat for fuel. Normally ketones pass from the bloodstream into the urine and are excreted.  Your body also will adapt normally glucose driving functions such as brain activity, utilizing ketones for fuel. Everyone’s body begins to producing ketones when carbohydrates become scarce. While for some, eating less than 50g/day of carbs may create ketones, others don’t produce them unless they are eating 20g/ or less. In essence, everyone is different and a simple at home urine test with a ketostick will help you determine if you are excreting ketones.

    Ketones during pregnancy can cross the placenta and can affect your babies’ development. Some studies have shown that excess ketones in a pregnant woman's urine may affect developing brain cells and lead to babies with a lower IQ and create future learning disabilities. Other studies suggested that ketones and low brain glucose levels in developing fetal brains may also interfere with serotonin receptor development, which may be associated with mood related disorders later in life. If your blood sugars are consistently too low and/or you are in a state of ketosis from a low carbohydrate diet, it puts adequate glucose transfer to your developing baby at risk. Your baby’s genes recognize these ketones as a sign that they are being born into a world where food is scarce and consequently undergo epigenetic changes in their DNA, which have been linked to increased lifelong fat storage in the neonate and older child, suggesting this may increase the risk for obesity later in life. In essence, taking a VLC approach in order to minimize weight gain or optimize body composition during pregnancy isn’t a good idea. Pregnancy is a time to relax, nourish and support your body as it undergoes the miraculous transformations involved in growing a new life.

    On the flip side, there is good evidence to suggest that intake of too many carbs when pregnant may also be harmful. Excessive maternal blood glucose or sudden spikes in blood glucose can also affect the health of you and your growing baby. As mentioned before, blood sugar is shuttled directly to the growing fetus via diffusion. Lots of sugar equals bigger babies. Put simply, big babies are harder to fit out (risk of operative delivery is increased) and larger infants may also have issues stabilizing their own blood glucose levels. This puts them at risk for breathing difficulties and higher rates of admission to the neonatal intensive care unit.

    Elevated blood sugars from high carbohydrate diets may also promote excessive fat storage and inflammation in the pregnant woman putting her at risk for a host of maternal complications such as pre-eclampsia, diabetes and postpartum thyroid problems. High carb diets or more specifically, high levels of fructose consumption have also been linked to an increased risk of gallbladder disease in pregnancy. This is likely due to the fact that blood sugars are naturally higher in pregnancy and the addition of easily metabolized sugars can cause increased bile cholesterol secretion, reduced bile acid synthesis, and increased bile cholesterol saturation, which can result in bile cholesterol “super saturation”. Fructose does not require insulin for uptake into the cells, it stimulates less insulin release than glucose, and it is largely metabolized in the liver and is thus metabolized differently from other carbohydrates, and its high intake leads to insulin resistance that predisposes to gallstone formation in addition to inflammation.

    So what is a pregnant woman to do?

    It seems that the moderate carb Paleo approach may be the most ideal approach for fertility and pregnancy. A recent study was released at the American College of Obstetricians and Gynaecologists' annual clinical meeting a few weeks ago in Louisiana. In this study, researcher, Dr. Jeffrey Russell examined protein and carbohydrate consumption during IVF treatments. His team found that women who consumed greater percentages of calories from protein had higher success rates and most optimal fertility. The study qualified low carb to be 40% of calories or less and high protein to be 25% or more. Indeed this recommendation would jive with the recommendations from most Paleo health and nutrition experts including, Chris Kresser and Stefani Ruper who both recommend moderate carbohydrate consumption during pregnancy. I recommend eating a clean Paleo diet with carb levels between 75-150g/day. You many need more if you’re breastfeeding while pregnant or are participating in vigorous exercise. In the first trimester, don’t stress if your carbohydrate levels are higher than this due to food aversion or nausea, just do your best and make smart carb choices. I recommend trying to get the majority of your carbohydrates from glucose containing sources rather than fructose. Fructose promotes excessive fat storage and can cause wild insulin spikes and crashes, which in the first trimester may exacerbate morning sickness and nausea. 

    banana.jpeg

    Recommended foods include:

    • Starchy foods: Yams, sweet potato, cassava, plantains, starchy tubers

    • Fruits: Bananas, berries, citrus, apricots, peaches and avocados

    • All non starchy veggies are great choices

    Foods to avoid:

    • High fructose corn syrup, Agave (I have a strong dislike of this highly marketed sweetener), sucrose

    • Dried fruits

    • Eat in moderation: Watermelon, apples, grapes, pear, honey, guava and cherries.

    As always, listen to your body; let its inner wisdom guide you as you navigate the fine details of your Paleo pregnancy. Don’t sweat the fine details of your diet and be sure to engage in some form of stress reduction or relaxation. I’m a big fan of the Hypnobirthing method (next post J).  Take an attitude of gratitude. It’s a luxury to be able to optimize our Paleo diets for pregnancy. Remembering that women around the world struggle to feed their families can sometimes help put it all in perspective.