Happy Healthy Homestead

Book Review: Real Food for Pregnancy

This month I read Real Food for Pregnancy by Lily Nichols

The science and wisdom of optimal prenatal nutrition

Favorite Quotes:

“Outside of a few select nutrients, there’s actually more disagreement than there is consensus on this subject. Digging into the details of conventional prenatal nutrition guidelines – and comparing them to both scientific research and the wisdom from ancestral diets of traditional cultures – uncovers many discrepancies, which is why I have written this book.”

“Though most of us view our genetics as a solid blue print, researchers have found that genes can be turned on or off by certain exposures in utero, such as levels of nutrients, a mom’s blood sugar and insulin levels, exercise habits, stress hormones, toxins, and much more.”

“In terms of weight loss, I encourage you to focus on internal healing for the first 3-6 months before you even entertain the idea of actively trying to lose weight…Remember: restricting your food intake also restricts your nutrient intake.”

Main Takeaways:

I have read many nutrition books and I have also read many books on the topic of pregnancy and preparing for a baby. I have to say, this is one of my favorites that I have found to be the most practical with suggestions rooted in scientific research. She clearly lays out a ton of information on nutrition that is valuable even if you are not pregnant, but especially if you are. She has good information on reducing risk for preeclampsia. She also gives meal templates. My favorite parts of the book are the sections on supplementation, herbs, and natural ways to relieve nausea. I highly recommend this book for anyone thinking about getting pregnant or who is pregnant.

My summary of notes:

Nutrients overview:

  • Macronutrients: gives you energy
  • Micronutrients: vitamins and minerals your body needs for other functions
  • 3 major macronutrients: carbs, fat, and protein


  • Carbs are the only macronutrient that raises blood sugar.
  • Main sources of carbs:
  • Grains
  • Starchy veggies (potatoes, winter squash, green peas, and corn)
  • Legumes (beans, lentils, split peas)
  • Fruit
  • Milk and yogurt
  • Higher levels of obesity among children exposed to higher carb intake.
  • Conventional guidelines (45-65%) are much higher carb % than hunter gatherer populations (3-34%).
  • She recommends pregnant women to have 90-150 grams of carbs per day.
  • She suggests you to prioritize most nutrient dense, low-glycemic sources of carbs such as: non-starchy veggies, Greek yogurt, nuts, seeds, legumes, and berries.
  • Foods such as sweet potatoes, other fruit, and whole grains should be treated as side dish or snack rather than bulk of meal.
  • Check carb intake with a carb tracking app. Check blood sugar after eating with at home glucose monitor.


  • Proteins are the building blocks of human life. Every cell in your body contains protein and you require the amino acids in protein to build new cells.
  • She suggests for you to aim for 80g of protein per day during first half of pregnancy and 100g during second half.
  • Protein foods are very filling and help to stabilize blood sugar. Commons signs your not getting enough protein include: hunger pangs, food cravings (especially sugar), or headaches.
  • Main sources of protein:
    • Beef, lamb, pork, bison, venison, etc (pasture raised)
    • Chicken, turkey, duck, etc (pasture raised)
    • Fish and seafood (wild caught)
    • Sausage and bacon (pasture raised)
    • Organ meats (liver, heart, kidney, tongue, etc)
    • Homemade bone broth or stock, powdered gelatin, or collagen protein
    • Eggs (pasture raised)
    • Cheese (Grassfed and pasture raised)
    • Yogurt (Greek yogurt higher in protein)
    • Nuts and seeds, nut butter
    • Legumes


  • Requirements for choline and vitA, both found in high concentrations in liver and egg yolks rise significantly during pregnancy.
  • Choline directly affects baby’s brain development.
  • Quality of fat matters!
  • Omega 6: vegetables oils/processed seed oils such as: corn, soy, cottonseed, canola and safflower oil
  • Omega 3: animal fat (lard, tallow, etc), dairy fat (butter, heavy cream, sour cream, cheese), plant fat (olives, coconut, avocados, nuts/seeds oils.
  • Always purchase in dark bottles not clear plastic. Don’t cook plant oils at high heat except for coconut oil.


  • Non starchy veggies are so low carb they don’t go with regular carb section. They are nutritional powerhouses and get their own section. They have little affect on blood sugar due to high fiber content. Have a goal to fill up half your plate with veggies.
  • List of non-starchy veggies on pg 21 (includes leafy greens, artichoke, asparagus, Brussel sprouts, green beans, mushrooms, onions, and lots more)
  • Veggies that are moderately starchy (15g net carbs per cup) are: carrots, beets, jicama, parsnip, snap peas, and spaghetti squash.
  • Veggies are an important source of vitamins, minerals, and antioxidants. You should eat them liberally.


  • When your pregnant your fluid needs go up. Aim for 100 oz a day. (Water, broth from soups, teas)
  • Your pea should be clear or very pale yellow.


  • Salt helps to balance electrolytes, supports growth of fetus, and more.
  • Enjoy olives, pickles, sauerkraut, and sea salt.
  • Avoid processed table salt.

How to combine foods:

  • If you eat a “naked” carb (like an apple) dress it up with a little fat and protein (like some almonds) so your blood sugar doesn’t spike as much.
  • Even if your not a snacker it may become helpful for you to eat smaller meals and then add snacks during pregnancy.

Her suggested Meal breakdown:

  • 1/2 plate veggies
  • 1/4 plate protein and fat
  • 1/4 plate carbs (from her list)


  • Eggs
    • 2 eggs meet half of the needed choline daily requirements
    • your are 8x more likely to get food poisoning from produce than from gooey yellow part of eggs
    • excessive dietary carbs are more closely linked to high blood lipids than dietary cholesterol
    • study comparing people eating a bagel breakfast vs egg breakfast found bagel breakfast people had more food cravings throughout day, higher spikes in blood sugar and insulin and more likely to develop diabetes.
  • Liver:
    • Nature’s multi vitamin
    • Richest source of iron, folate, and vitb12
    • 60% of population has MTHFR gene which prevents you from using synthetic folic acid. Eating liver ensures you get the folate you need.
    • Aim to have 2 ounces of liver 1-2 times a week.
    • Chicken liver has milder taste than beef liver.

Meat on the bone, bone-broth, and slow-cooked meat:

  • Provides gelatin and collagen, the 2 richest sources of glycine (important amino acid)
  • Glycine is needed for fetal DNA, collagen and other functions.
  • Pot roast, pulled pork, Chicken wings, thighs


  • Abundant source of folate
  • Contain tons of vitamins and minerals
  • Choose organic, seasonal, and local
  • Salmon, fatty fish and other seafood:
    • Large fish is that contain a lot of Mercury should be limited.
    • 12oz fish consumption a week in pregnant women is linked to babies with higher IQ and higher communication skills as a child.
    • Fatty fish: salmon, herring, sardines and roe (fish eggs) contain most concentrated sources of DHA and low in mercury.
    • Always get wild caught. Farmed fish contain PCBs, dioxins, and other unwanted chemicals. They also use heavy use of antibiotics.
  • Full fat and fermented dairy products
    • You do not need to consume dairy to obtain calcium.
    • Dairy however is a great source of vit K2, which is a vitamin not widely available in our diets.
    • VitK2 is super important for bones and teeth.
    • Iodine is also found in dairy but you can also get from eating enough fish.
    • Choose grass fed organic dairy products
    • Fermented dairy (yogurt, kefir, and aged cheese) has higher k2 levels.
    • Pregnant moms who consume fermented dairy are less likely to have babies with eczema and hay fever.
    • If you are lactose intolerant, you may be able to eat butter, cream, full-fat Greek yogurt and aged cheese without discomfort since they are lower in lactose.

Foods to avoid:

  • Shellfish (such as oysters, clams, etc) are very good for you. But unless you are very certain it’s a clean source avoid because yet account for 75% of seafood associated food illness. So better to stick with cooked shellfish while pregnant.
  • Alcohol
  • Refined carbs (breads, pastas, cereal, white rice)
  • Sugar (except for small occasional treats)
  • Artificial sweeteners
  • Vegetable oils
  • Trans fat
  • Soy
  • No need to avoid eggs, deli meats, soft cheese etc. as your more likely to get illness from produce, but just make sure it’s a clean source.
  • For safety – general rules:
    • -if it smells funny don’t eat it
    • -avoid precut fruit and veggies unless cooking them
    • -cook at home not often
    • -defrost frozen meats in fridge not on counter
    • -raw meats should not be in fridge more than 3 days
    • -wash hands, counters, etc after preparing food
    • -use specific cutting board for meats
    • -put leftovers in fridge within 2 hrs after cooking
    • -consume leftovers within 4 days

Support immune system:

  • 80% of immune system resides in your gut.
  • Eat fermented foods (Kombucha, yogurt, sauerkraut, kimchi, pickled veggies etc)
  • Eat prebiotic rich foods (cruciferous: cabbage, kale, Brussel sprouts. Fruit: berries, slightly under ripe bananas, chia seeds, legumes
  • Include bone broth and slow cooked meats
  • Limit/avoid sugar and refined carbs
  • Don’t have more than 200 mg of caffeine intake a day (16 oz coffee). Always drink organic coffee

Limit whole grains:

  • When it comes to whole grains, they are marginally better than refined grains, however they still raise your blood sugar significantly.
  • Increasing number of people are sensitive to gluten found in certain grains (wheat, rye, and barley).
  • A gluten free diet can absolutely meet your nutrient needs and may actually be more nutrient dense if you choose to replace grains with Whole Foods rather than gluten free processed foods.
  • If you don’t have sensitivity eating grains in small quantities is ok. The Health problems start when people overeat them and/or replace more nutrient dense foods (veggies, meats, good fats) with grains.
  • One slice of sprouted grain bread with your eggs in the morning is far different than: a bowl of oatmeal for breakfast, crackers for snacks, sandwich for lunch and pasta for dinner.


  • Prenatal:
    • Look for a prenatal that contains “activated” B vitamins which are easier for your body to metabolize. Example:
      • Folate (L-methylfolate, 5-methyltetrahydrofolate)
      • VitB6 (pyridoxal-5, phosphate)
      • VitB12
    • Look for correct form of folate and not folate acid
    • Have it also contain activated form of VitA (retinyl palmitate).
    • Take prenatal alongside meal or snack. Better to split up in 2 sections of day for better absorption. So if it’s 3/day then 1 at breakfast, 2 at lunch.
  • Additional supplementing if at risk for preeclampsia
    • She doesn’t think everyone should routinely supplement with magnesium and calcium except for the case when someone has high blood pressure and is at more of a risk for preeclampsia.
    • One study found that a combination supplement with calcium, magnesium, zinc, and vitamin D significantly reduced blood pressure in pregnant moms at risk for preeclampsia.
    • Choline is another nutrient that may protect against preeclampsia
    • Protein intake is especially important when it comes to maintaining normal blood pressure. She suggest eating more foods containing glycine (slow cooked meats).
    • Low salt could be worse for women who have preeclampsia
  • Sun exposure accounts for 90% of vitD for those that don’t supplement
    • Always use vitamin d3. Take it with a meal or snack that has some fat in it for better absorption.
  • Omega 3 and fish oil / DHA:
    • One study pregnant women were supplemented with 2200mg of DHA/day and other group was placebo (olive oil). The moms that had DHA had kids scored significantly higher on hand eye coordination tests at age 2 1/2.
    • Eat 3 servings of fatty fish per week or else supplement.
    • High concentrated sources of DHA: Salmon, herring, sardines, trout, fish eggs, or mussels.
    • Less concentrated sources of DHA: eggs, meat organs, and dairy
  • Probiotic:
    • Probiotic foods/drinks, apple cider vinegar, etc
    • Prebiotic Foods: banana just before it’s ripe
    • Consider taking a probiotic supplement that is beneficial to the v, such as: Lactobacillus rhamnosus, GR-1, and Lactobacillus reuteri, RC-14
  • Calcium:
    • She doesn’t suggest taking a calcium supplement. But if your dairy free try to consume one of these foods every day:
    • -green leafy veggies
    • -bok Choy
    • -broccoli
    • -almonds
    • -sesame seeds
    • -chia seeds
    • -sardines
    • -salmon
  • Magnesium:
    • -seaweed
    • -green leafy
    • -pumpkin seeds, Brazil nuts, sunflower seeds, sesame seeds, almonds, cashews, chia seeds, avocados, cocoa powder, dark chocolate, bone broth, green herbs
    • If you do need to supplement start with low dosage (100mg) and with your way up to 300mg per day. Side effect could be diarrhea.
  • Iron:
    • Is super important for baby development and your need for iron is 1.5 times more when pregnant.
    • But iron supplements are poorly absorbed and often have unwanted side effects
    • Best source of iron is liver, others are:
      • -liver and organ meats
      • -red meat
      • -game meat
      • -oysters
      • -sardines
      • -dark meat poultry (chicken legs and thighs)
    • Cook in cast iron pans
    • You can also take dessicated liver pills or spirulina to get more iron
  • Gelatin and collagen:
    • Important to consume. They are they same except gelatin solidifies once cooled and collagen does not
    • Can get from Bone broth
    • Or You can add a tablespoon to yogurt, soups, smoothies, coffee
  • Chia seeds:
    • -Help regulate bowel movements and form
    • -Serve as prebiotic food, good for gut
    • -start with 1 tsp a day and work your way up to 1-2 tablespoons
    • -mix into yogurt or applesauce
    • -put in smoothie
    • -Jess: energy/power balls
  • Herbs:
    • Lack of evidence of most herbs during pregnancy. Ones that have been studied and she suggests are:
    • Consume:
  1. Red raspberry leaf (tea), good to relax Muscles and cervix, take in 2nd and 3rd trimester
  2. Ginger (tea, crystallized/dried ginger, fresh, or supplements), very good to treat nausea
  3. Chamomile (tea) calming. Also after birth good for increasing milk supply

Things to do to relieve Nausea:

  • -Diffuse lavender and peppermint essential oils (both safe during pregnancy)
  • -eat/drink ginger
  • -magnesium spray
  • -acupuncture or acupressure
  • -seaband
  • -try keeping electrolyte up with coconut water and bone broth
  • -try keeping potassium up with banana and avocado

[She gives meal plans. list of good beverages, a recipe to her special electrolyte drink, glucose testing info, and her suggestions for tests you should ask your doctor for which I did not include in my summary of notes but I highly suggest you order the book so you can view this information.]

If you have MTHFR make sure your not eating folic acid (usually in bread, cereals and supplements). Make sure to get choline, glycine, and B12

Toxins to avoid:

  • -avoid BPA, plathates, and parabens by not using plastic and looking at ingredients on personal care products, even receipts
  • -avoid pesticides
  • -avoid non stick pans and Teflon (use cast iron, stainless steel, glass or ceramic cookware)
  • -avoid stain resistant or water resistant sprays
  • -avoid fluoride in toothpaste, non organic grapes and low quality tea
  • -avoid aluminum foil in direct contact with food and in vaccines, in personal care products, and pans
  • -avoid mercury in fillings and vaccines, bigger fish
  • -reduce time spent in high-pollution areas
  • -do not smoke or second hand exposure
  • -use high quality water filter such as Berkey
  • -buy furniture without flame retardants
  • -clean home with HEPA vacuum filter
  • -avoid exposure to varnishes, paints, solvents, etc
  • -swap out home cleaning products for natural ones or use white vinegar
  • -open windows in home whenever possible
  • -get houseplants that remove common chemicals from air (Boston ferns, peace lily, spider plant, and aloe Vera)
  • -avoid antibacterial wipes and soaps to protect microbiome


  • Full blown detox is not suggested during pregnancy but doing these things to support your liver and other functions is helpful:
  • -drink plenty of filtered water
  • -eat more veggies, especially leafy greens
  • -take supplement of chlorella or spirulina
  • -get plenty of selenium in Brazil nuts, seafood (especially oysters), organ meats, meat, mushrooms, and eggs
  • -get plenty of glycine (bone broth or collagen/gelatin supplements or powder)
  • -plenty fiber foods: chia seeds, flax seeds, non starchy veggies, berries, shredded coconut, legumes, nuts, and seeds
  • -eat more vitC: bell peppers, broccoli, Brussel sprouts, strawberries, kale, etc.
  • -move your body! Exercise and stretching is key!

Stress & mental health:

Self care:

  • Walking outside
  • Practice deep breathing
  • Spending time with friends
  • Meditate
  • Yoga nidra (sleep yoga)
  • Getting enough sleep
  • Tapping / EFT (look up online)
  • Massage
  • Acupuncture
  • Laughing, comedy/games
  • Journal
  • Spiritual practice
  • Movement
  • Listening to music
  • Gratitude

4th trimester:

  • Resting
  • Eating warming soups with bone broth, eggs, seafood, organ meats

Leave a Reply