Nell’s Corner: Nourishing Yourself + Baby for an Optimal Pregnancy

And, no, eating “three daily servings of dairy for calcium” needn’t be part of the picture.

How does one stay fit, lean and healthy during this incredible time of life while ensuring that baby’s getting what he or she needs for optimal development?

When I first got the great news, I immediately began to wonder if I would need to change anything in my eating regime.

I felt completely confident that the way I eat is what allowed my own leaky gut to heal almost twenty years ago. But in all honesty, when another human came into the picture (and I’m not referring to my hubby,) it did give me pause to question whether or not there were any extras I’d need to add into the mix now that I have a little baby to nurture, growing inside my very belly!

Since my naturopath whose been my go-to doc for years is not an OB/GYN, I continued with my physician, whom I’ve been seeing for year,s for my regular women’s health exams. She had been completely fine for the annual routine.

But once I began her office’s prenatal care and regime of office visits, I soon learned that the advice I was given was exactly of the nature I’d expected it would be:

One hundred percent western, conservative, and quite frankly, outdated.  Kind of like reading the Weight Watchers Pamphlet my mom shared with me – the one which she used to lose her baby weight after I was born!

Some of the general recommendations included:

  • You can exercise; you can do light walking
  • Definitely get a flu shot
  • Take a baby aspirin daily – I later researched this out of curiosity, only to find that this can increase chance of pregnancy loss, congenital defects, and premature closure of a vessel in the fetus’s heart (1).  Thank goodness I don’t ever take that stuff!

However, my favorite pearls focused on those having to do with food:

  • Be sure to drink 2-3 cups of low fat or skim milk each day as great calcium sources to help with baby’s bone development
  • Definitely don’t eat wild tuna, but (this was fair enough; obviously eating anything with a high Mercury content is a bad idea, but it was followed up with) canned tuna is fine
  • Stay away from saturated fat, organ meats, skin, dark meat, and stick with lighter options such as chicken breast

I knew enough to know that these recommendations made no sense and that my back to basic, nutrient dense, approach that I’ve followed for years – which has kept me in tip top health and shape – would be at the very least, a solid foundation.

But was there anything extra I’d need to add?

I looked for a book, some research, a study but came up empty.  There just didn’t seem to be any more reasonable sources of information.

When in doubt… go right to the source!

I reached out to Dr Loren Cordain (2), my mentor of the past 15 years and asked him if we could hop on a quick call to cover some of the basics.

Read on for what he had to say regarding the topic of eating properly for a healthy pregnancy, for mom and baby alike!

Q: Is there anything lacking in an authentic, modern day Paleo Diet in terms of promoting optimal fetal development while simultaneously supporting the health of the mother?

I don’t think that we have definitive answers to your question because “optimal fetal development” depends upon the interaction of genetic and environmental factors. As a pregnant mother, I suggest that you listen to your body first and foremost and follow your instincts and proclivities for foods. Many pregnant women have reported otherwise food preferences during this special time of life. My wife, Lorrie, had a special interest in high fat hamburger meat when she was pregnant with all three of our boys. This preference makes sense because higher protein diets can have adverse effects upon pregnancy and childbirth.

Q: What about the same old question about getting enough calcium; do we really need to alter the consumption of dairy, for example?

Part of the equation about pregnancy is that the placenta preferentially “steals” from the mother for the requirements of the developing fetus. Accordingly, mother’s calcium stores likely contribute to the developing fetus’s calcium requirements, regardless of mother’s calcium intake. For pregnant mothers, a good rule of thumb from an evolutionary perspective is to ingest a calcium to magnesium ratio of about 2:1. The calcium part of the 2:1 equation is not as difficult as the magnesium part. In the western world, we are awash in high calcium foods (milk, cheese, skim milk, yogurt, ice cream, ice milk, dried milk products, etc.). Typically, we tend to eat less high magnesium rich foods such as Swiss chard, spinach, parsley, kale, broccoli, acorn squash, daikon radish, turnips, parsnip, carrot, rutabaga, potato, blackberries, raspberries, strawberries, casaba melon, cantaloupe, watermelon, banana, papaya, kiwi fruit.

Q: How about folic acid or folate? Do all women really need to supplement and what’s the difference between the two? Who should take which?

If you eat or juice leafy green vegetables daily or consume liver regularly, you will not have to worry about folate requirements for your developing fetus. Folate deficiencies result in birth defects called neural tube defects. The natural form of folate is present in leafy green vegetables and also in organ meats such as liver. Folic acid is an artificial compound which can be converted to folate in the liver. Excessive folic acid ingestion increases the blood pool of folic acid and may have deleterious effects to adults over years and decades of consumption. The bottom line — eat folate rich leafy greens on a regular basis and don’t depend upon folic acid fortified wheat flour for you and your fetus’s folate intake.

Q: Are there any foods that are viewed as particularly beneficial that we should focus upon? Anything to avoid during pregnancy that may be a real, Paleo food, but not necessarily conducive for optimal health during this critical time?

Fat rich foods such as eggs, fatty cuts of pork (Saint Louis Spare Ribs, Pork bellies, pork roasts, etc.), fatty lamb cuts (leg of lamb, lamb chops, lamb racks), grass produced butter and fatty fermented foods such as high cacao dark chocolate all contain fat soluble antioxidants and other nutrients which are healthful to mother and fetus. Combine these high fat foods with plenty of fresh leafy green vegetables and fresh fruit, and you will enhance your odds for a healthy baby.

Q: Any other words of wisdom you’d like to share as a general message to women who a) understand what a real Paleo Diet is and b) would like to continue this optimal way of eating throughout pregnancy?

Avoid salt laden foods (all processed foods basically — French fries, pickles, salsa, chips, olives, pizza, hamburgers, hot dogs, salami, bologna, recipes which include sea salt, bread, pretzels, taco’s, sandwiches, chili beans, cheese, processed meats, canned food, pancakes, hot sauce, canned tuna, canned sardines etc.). Replace with potassium rich fresh fruit, vegetables, fresh meats, and fresh fish.

I was relieved to say the least.

All of the foods I loved could continue to be center stage in my daily regime and to know with certainty I wouldn’t need to add anything questionable provided that extra boost of confidence I needed.

And what about cravings?

  • An inclination to eat more bitter and sour when I felt nauseated for four months straight, though, gratefully, I never actually got sick (I was loving lemon, kim chi and kombucha)
  • As well as an intense desire to eat organ meat more often than I typically do (loving the US Wellness Meats Liverwurst )


I find myself particularly more sensitive to smell:

  • The odor of beer on one’s breath is even more off putting than normal (never been a beer fan)
  • Ironically, the smell of chicken, the latter of which proved a bit tricky during my long Mondays in the kitchen when I was cooking broth!

Overall the only real things that have changed are:

  • Including a bit more carbohydrate in the form of a couple of pieces of in-season fruit per day.  Whereas my pre-pregnancy daily carbohydrate intake was on the low side, in favor of fat, now I’m on the more moderate side, hovering around 100g/day, while still loving all the fats I always ate.
  • Eating about 3-4 times per day rather than 2-3 (or sometimes 1) that I’ve been doing for the past four years.

For more posts about Nell’s “Baby Journey” check out her blog!





About Nell Stephenson, B.S.

Nell Stephenson, B.S.Nell Stephenson is a competitive Ironman athlete, personal trainer, and a health and nutrition consultant. She has an exercise science degree from the University of Southern California, a health/fitness instructor certification from the American College of Sports Medicine, and over a decade in the health, fitness and nutrition industry. To support her training for the Ironman Triathlon, Nell has tried many different nutritional plans and has found that the Paleo Diet is superior to all other ways of eating. She’s found that she’s leaner, faster, and fitter than ever before and uses her own experience to teach clients how to achieve optimal nutrition and health. Visit her website at Download meal plans tailored to you here.

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  1. Iodine should also be mentioned. The requirement for iodine increases from 150 mcg to 220 mcg during pregnancy and up to a whopping 290 mcg during lactation (a higher % increase than any other nutrient). A paleo diet can easily result in iodine deficiency due to the lack of (iodized) salt and milk (see: ( ). A quart of milk can supply 150-200 mcg iodine. On a paleo diet, marine seafoods or seaweeds would therefore be important to include (for example cod or crab). Also eggs in all its forms in nature – including from birds, snails, fish, frogs, shrimps and so on – could supply a decent amount of iodine, this is especially the case from marine types like roe/fish eggs. The problem is that many modern paleo dieters have a diet very different from what is consumed by present living hunter gatherers or during the stone age. For example among the primitive population groups it is common to eat all the organs of the animals and these are often praised higher than muscle meat, and that would include the thyroid gland which is very rich in iodine. But the modern paleo dieter may eat only chicken breast and ground beef. Similarly, the eggs/roe of fish or shrimp is typically thrown away. These eggs – just like insects – can actually supply a good amount of calcium carbonate found in the shell. (Egg foods are also very rich in choline, see more below). Instead, the modern paleo dieter may rely on foods like broccoli to meet calcium requirement. However broccoli contains goitrogens which may depress thyroid function and thus increase the need for iodine. It is interesting that the population groups Weston A. Price studied a hundred years ago, put special emphasis on foods like seaweeds and fish eggs for proper reproduction (see : The inuits even dried the salmon eggs to preserve them for later use; for small children after they had been weaned, or to increase fertility in women.

    Another nutrient which requirement increases much during lactation is choline. The average choline intake among adult American women was found to be just 280 mg, whereas the requirement during lactation is 550 mg. It is not so hard to obtain this amount by including some organ meats or roe/caviar/eggs (100 grams of cooked beef brain/kidney/intestines, 100 gram caviar, 150 gram roe, or 4 egg yolks could each supply about this amount). Betaine can reduce choline requirement, so one option on the paleo diet low in eggs and organs could be to include some spinach and beets. Wheat and in particular quinoa are significant source of betaine and so avoiding such non-paleo foods can result in a lower betaine intake on a paleo diet than the standard American diet. It may be that the increased requirement for folate/folic acid during pregancy to prevent birth defects, is a result of a too low intake of choline. It is interesting that for dogs or cats the choline requirement can be quite high – about 850 mg per 2500 kcal metabolizable energy according to one recommendation, but for folic acid/folate only 135 mcg for the same 2500 kcal energy (of course they can reproduce just fine with this low amount of folate, and a carnivorous diet is generally low in folate too). In other words 6 times more choline vs folate than what is recommended for lactating women. Even human milk supplies just around 175 mcg folate per 2500 kcal, but 550 mg choline.

    Re calcium/magnesium ratio, I think this is questionable for a variety of reasons. One is the huge difference in bioavailability of calcium and magnesium in different foods. Some examples of calcium bioavailability: Spinach 5%, almonds 21%, milk 32%, broccoli 60%. Commonly 30-70% of dietary magnesium is absorbed, but one study found that the addition of phytic acid added to white wheat bread reduced absorption from 33% to 12% ( The official recommendation of 320-420 mg magnesium is based on a diet that includes plenty of phytic acid rich foods like whole grains, nuts and legumes, and maybe not so much of this magnesium is actually absorbed. Another reason the calcium/magnesium ratio is questionable is that it would depend on the sheer amount of magnesium and other nutrients in the diet (for example vitamin D, phosphorus and potassium). It is possible that the common short stature of hunter gatherers has to do with a lower calcium intake. It is just not mathematically possible to build the skeleton of large men today without substantial amounts of dietary calcium, even if absorption is very high. Staffan Lindeberg found the adult male Kitavans he studied was only around 160 cm tall, which could perhaps be explained with lower caloric intake, low calcium and low protein intake. However the Hadza hunter gatherers aren’t much taller and they consume fairly large amounts of meat and honey, both though to increase growth hormones (cf for example Valter Longo’s research). BMI among the Hadza’s is also only about 20, meaning that the weight of their skeleton is fairly low compared to young or adult males in the western world today. Conversely, the Masaii males can be over 190 cm tall on a diet very high in milk. It may be advantageous to have a shorter stature for longevity however (, Indeed if homo sapiens is designed to have a certain stature it may function best and have lower rate of disease on that particular stature. However, for a large adult there may also be a higher need for calcium than what the paleo diet typically supplies to sustain calcium content in their large skeleton, especially in old age.

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