Pregnancy, Protein,and The Paleo Diet

Dr. Loren Cordain:
I’m Loren Cordain, founder of the Paleo movement.
Shelley Schlender:
I’m Shelley Schlender.  This is the Paleo Diet Podcast for April 2013.
Dr. Loren Cordain:
Coming up we’ll discuss how eating Paleo can help woman with a great pregnancy and delivery.  With one caveat, during pregnancy women should avoid eating too much protein.
Shelley Schlender:
Loren will also explain why too much protein increases the likelihood of a low birth-weight baby, even death for the mom and the baby.
Dr. Loren Cordain:
I fully explain how to eat Paleo during pregnancy in my latest book, The Paleo Answer, along with the scientific references.  Today we’ll talk about it.
Shelley Schlender:
Loren Cordain, you’ve heard many stories that women have an easier time getting pregnant if they’re eating a Paleo Diet.
Dr. Loren Cordain:
Yeah, absolutely.  I think that some women and actually couples can benefit by eating Paleo to help them get pregnant.  Paleo is high in zinc, high in fresh foods and vegetables and meats and long-chain fatty acids.  We know all of these nutrients tend to support reproductive function.
Shelley Schlender:
On the other hand I know a friend who had to have her baby induced early because she started having protein in her urine.  Is that the kind of side effects someone can have if they go too overboard on eating Paleo?
Dr. Loren Cordain:
This is a problem only for women when they become pregnant.  We’ve known this for about a decade, or maybe two decades, that during pregnancy the ability of the liver to turn protein to excrete it as nitrogen is reduced.  Those pathways are somehow reduced.  Many women actually have an aversion to meat and high protein, low fat animal foods during pregnancy, and I think that’s a good thing.  They should follow what they’re feeling, what their body is telling them.
[00:02:00]
 
Shelley Schlender:
In fact, you write about this in your book The Paleo Answer, that women who are eating somewhat higher protein really need to think hard about cutting back when they’re pregnant, because it’s better for their babies if they don’t eat as much protein.
Dr. Loren Cordain:
That’s the basic concept.  What we need to let our readers become aware of is how much protein in the normal US diet, how much do we get in a Paleo-type diet.  If we look at the average protein intake in the United States, it comes out to be 98.6 grams per day for men, and that translates into 15.5% of their total calories.  For women, it translates into 67.5 grams per day, or 15.1% of their total calories.  That’s what the average person in the United States is consuming.  When people go on a Paleo diet, they are eating meat and eggs and fish virtually at every meal, so their protein intake is going to increase.  We can categorize high-protein diets, any diet that contains between 20-30% of the energy or calories from protein can be considered a high-protein diet.  A very high protein diet would be 30% or above total calories for both men and women.

If we look at those numbers, the average protein intake for a male would be 125-186 grams of protein per day for a high-protein diet.  For the average woman that would amount to 89-133 grams of protein per day.  There’s a limit to how much protein that you can actually ingest, and that’s known as the physiologic protein ceiling.  That translates into about 35-40% of energy for most people. What happens is that they get nauseous and sick, and eventually if you try to continue eating that much protein it’ll kill you.

[00:04:00]
 
 
The symptoms are exactly what your friend experienced, not so much protein but amino acids spill out into the bloodstream, and that’s called hyperaminoacidemia.  A byproduct of protein metabolism we mentioned is nitrogen, and nitrogen is turned into ammonia.  Two things happen you get hyperaminoacidemia, excessive amino acid spilling in the bloodstream, and you get excess of ammonia spilling into the bloodstream.  Those are the two major events that cause lots of trouble, and why protein can be toxic.
Shelley Schlender:
For women who are pregnant, sometimes there is no symptom except that there is protein in their urine.
Dr. Loren Cordain:
That’s right.  It’s probably going to be amino acids, and I’d have to look at the essay, because most people don’t know what amino acids are.  That would be what a physician’s diagnosis would be to a person that is non-medically oriented.  It would actually be amino acids that spill out into the bloodstream, and that’s not a good thing.

Going back to our total amount of protein, we’d mentioned that protein can be toxic when it’s between 35-40% of total calories.  You simply can’t do that day in, and day out.  You can do it for a couple days, but then you get sick.  There’s an interesting, kind of historical aspect to this in the early literature, before medically we knew about this.  This condition was described by explorers such as Lewis and Clark, and other frontiersmen that were out on the frontier, didn’t have access to carbohydrates or any other foods.  They had to hunt for foods in the wild.  They noticed this condition, their men started to get sick, and they would eat more and more and more and more fat-depleted animals.

Shelley Schlender:
This would be in the early spring, before the animals that were wild had fattened up on their grasses again.
[00:06:00]
 
Dr. Loren Cordain:
That’s right.  These early explorers described this condition.  It later came to be known as rabbit starvation.  The reason for it is that small animals can have a lot less body fat than do large animals.  If you all you had to eat were rabbits and no source of carbohydrate or fat source, you would rapidly develop this protein toxicity, or rabbit starvation as the early explorers and trappers called it.

It’s a very real effect.  What we found in human clinical trials is that women, when they become pregnant, they lose the ability to excrete or to detoxify as much protein.  What those numbers then come down to are about 25% of total calories should be the absolute limit for women once they become pregnant.

Shelley Schlender:
No more than 25% of their calories should be protein, and they can have it be a good deal less and they will be fine?
Dr. Loren Cordain:
Yeah.  I think that actually helps to insure a healthy, normal weight fetus is by reducing the protein, but still maintaining a Paleo-type diet.  Still eat all your fruits and veggies.  There’s a couple of strategies I think that women can take when they’re pregnant, is to consume fattier cuts of meat.  Hamburger, ribs, lamb, all of those fattier cuts of meat.
Shelley Schlender:
Egg yolks?  Eat lots of egg yolks?
Dr. Loren Cordain:
Egg yolks, yeah. Egg yolks are a good thing. Even eggs per se don’t contain that much protein compared to let’s say a lean steak, or game meat, or chicken breast or whatever.  Women should be encouraged during pregnancy to not even give it a second thought about eating fattier cuts of meat.  Other strategies, if people like avocados, what a great treat.  Eat as much of those as you want.  Bananas, yams, sweet potatoes.
Shelley Schlender:
In addition to eating fat you could eat more root-based carbohydrate, and fruit.
[00:08:00]
 
Dr. Loren Cordain:
That’s right.  Carbohydrates are a good thing.  Women shouldn’t be so uptight about how much weight they gain during pregnancy.  It’s a time to build a healthy baby, and a new person is entering the world.  Better to be a little bit overweight, or gain a little bit extra weight during pregnancy, as opposed to trying to maintain total Paleo, and being lean and mean throughout.
Shelley Schlender:
High protein, you really discourage women who are pregnant to eat a high-protein diet.
Dr. Loren Cordain:
Absolutely.  That information isn’t well known, either.  Even within the medical community, it’s kind of an obscure fact.  It’s clearly an obscure fact in the Paleo community.  I read an article in one of the popular Paleo magazines, and the person who wrote in said that she had an aversion to meat during her pregnancy.  The answer that was offered in the magazine was completely unaware of the notion of the reduced ability of women to break down protein.
Shelley Schlender:
What was the woman told to do if she didn’t like meat during pregnancy?
Dr. Loren Cordain:
I don’t remember precisely, but I think that they didn’t say stop eating meat.  Listen to your body, if your body says you have an aversion to meat during pregnancy, then that’s probably something that you need to know.  I know my wife Lorrie, she and I have been doing Paleo for longer than most people on the planet except for hunter/gatherers.  She told me that during all three of her pregnancies with our boys is that she had the same thing, and that she would actually crave fattier meats.
Shelley Schlender:
Loren Cordain, once in your office you showed me this huge stone that was a Paleolithic stone and you grabbed it, and you waved it in front of me, and you said you think that they used this to hunt rabbits?
Dr. Loren Cordain:
(Laughs) That’s what’s called a stone-age hand ax, and they first started being built by people, or hominids, about 1.5 million years ago.  It was kind of the Swiss army knife of the day and age.  It was used to butcher animals.  It was also used to cut down sapling and to shave the saplings into spears and whatever.  It was an all-around tool.
[00:10:00]
 
Shelley Schlender:
One thing that you mentioned about it was that this was the kind of tool that you’d use to hunt a woolly mammoth, and woolly mammoths have a lot of fat.  They’re harder to hunt than it is to hunt a whole bunch of rabbits.  They have a lot more fat, which kind of hints that Paleo people looked for fat.
Dr. Loren Cordain:
Shelley, you’re absolutely right.  They preferred larger animals, because larger animals contain more fat.  Fat has tremendous survival value, because you can’t just eat lean protein.  Our stone-age ancestors, they used hand axes to butcher large animals.  They actually hunted them with spears.  Most of the current thinking is the way that successful hunters, once we started hunting wild animals, is that we hunted them with spears.  Primarily not throwing spears, but rather thrusting spears.  You’ve got to get up close and down and dirty and take that spear and thrust it.
Shelley Schlender:
Do you think that there’s a good chance that it was important.  Among other things, women who were pregnant could eat more fat and less protein.  One thing I’m wondering, is just how much protein is this?  Are we talking about, it sounds to me like a 60 gram portion for a full day is roughly three meals with about 2 ounces, maybe 3 ounces of protein per meal.  It’s not all that much protein.
Dr. Loren Cordain:
The value that women should shoot for is no more than 25% of their calories.  That would range for the average women, if she wanted to get between 15-20%, that would be about 70 to 90 grams of protein per day.  That’s not a whole lot of protein.  There is a strategy required to eat fattier meats, so you get a lot more fat in your diet, and to eat more carbohydrate and fattier fish.  Those are the elements that women should consider once they’re pregnant.
Shelley Schlender:
Loren Cordain, in your book The Paleo Answer, you also talk about a woman who wrote in and said by following this kind of Paleo Diet her delivery was the easiest one she ever had.
Dr. Loren Cordain:
Yeah, you know when I get people that respond and write in, it’s just really wonderful.  People can read about that particular case.  It was actually a physician in Texas Lane Sebring, MD who was in on that delivery.  Those were his exact words when this woman delivered.  Eating Paleo is very, very helpful in getting pregnant for women that have difficulty in getting pregnant.  Also maintaining a pregnancy and producing a healthy fetus.  The only caveat, as I mentioned Shelley, is that we need to reduce protein so that it is no more than 25% of energy.
Shelley Schlender:
In all of those babies that have been born thanks to your recommendations, has anybody ever named their baby Loren?
Dr. Loren Cordain:
(Laughs) I don’t want to go down that road, but you know I’m just very grateful of all the readers worldwide, and listeners that have embraced Paleo.  It’s phenomenal to be in the middle of this.  I was lucky that I got in early on, and you’ve been interviewing me way before Paleo became famous.  Thank you so much, Shelley.
Shelley Schlender:
Thank you, and let’s see what we have to talk about next time, too.
Dr. Loren Cordain:
That’s all for this edition of The Paleo Diet Podcast.  Visit my website, thepaleodiet.com for past episodes and for hot links to the experts in studies that we talked about today.
Shelley Schlender:
Our theme music is by Chatman Stick Soloist Bob Culbertson.
Dr. Loren Cordain:
Want to send me questions or comments, the place to go is thepaleodiet.com
Shelley Schlender:
For the Paleo Diet Podcast I’m Shelly Schlender.
Dr. Loren Cordain:
I’m Loren Cordain.

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