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Nourishing Yourself & Baby for an Optimal Pregnancy

Pregnant woman sitting in bed with her hands on her abdomen

How does one stay fit, lean, and healthy during pregnancy while ensuring that baby’s getting what they need 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 20 years ago. But in all honesty, when another human came into the picture (and I’m not referring to my hubby), it gave me pause to question whether or not there were any extra nutrients I’d need to add into the mix during this incredible time of life.

Since my naturopath whose been my go-to doc for years is not an OB/GYN, I continued with my physician 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 But once I began her office’s prenatal care, I soon started hearing advice that felt conservative, outdated, and 100% Western. Kind of like reading the WeightWatchers Pamphlet my mom shared with me—the one she used to lose her baby weight after I was born!

Some of the general recommendations included:

  • You can exercise and do light walking
  • Definitely get a flu shot
  • Take a baby aspirin daily—I later learned this can increase chance of pregnancy loss, congenital defects, and premature closure of a vessel in the fetus’s heart. (1)

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
  • Don’t eat wild tuna, but 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 would be, at the very least, a solid foundation for optimal pregnancy health.

But was there anything extra I needed 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.

How to Stay Healthy During Pregnancy

I reached out to The Paleo Diet® founder and my mentor of the past 15 years, Dr. Loren Cordain, and asked him if we could hop on a quick call to cover some basic questions. Read on for what he had to say regarding the topic of eating properly for a healthy pregnancy, for mom and baby alike!

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. I suggest that you listen to your body first and foremost and follow your instincts and proclivities for foods. Many pregnant women have reported different 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.

What about the 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, turnip, parsnip, carrot, rutabaga, potato, blackberries, raspberries, strawberries, casaba melon, cantaloupe, watermelon, banana, papaya, or kiwi.

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.

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

Fat-rich foods such as eggs, fatty cuts of pork (Saint Louis spareribs, 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.

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 and recipes including sea salt (all processed foods basically: French fries, pickles, salsa, chips, olives, pizza, hamburgers, hot dogs, processed meats like deli meats, bread, pretzels, tacos, sandwiches, beans, cheese, canned food, pancakes, hot sauce, etc.). Replace with potassium-rich fresh fruit, vegetables, meats, and fish.

Pregnancy Symptoms While on The Paleo Diet

I was relieved after our conversation, to say the least. All of the foods I loved could continue to be center stage in my daily regime. Knowing with certainty I wouldn’t need to add anything questionable to my diet provided me that extra boost of confidence I needed. But what are pregnancy symptoms like when the mother follows The Paleo Diet? These will more than likely vary from person to person, but this was my experience.

Dietary Changes

I began 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, I moved on the more moderate side, hovering around 100g/day, while still loving all the fats I always ate.

I also increased my meals, eating about 3-4 times per day rather than the 1-3 times that I’d been doing for the past four years.


I had an inclination to eat more bitter and sour foods like lemon, kimchi, and kombucha when I felt nauseated for four months straight. Gratefully, though, I never actually got sick. I also had an intense desire to eat organ meat more often than I typically do (my favorite was liverwurst).


I found myself particularly more sensitive to smell. The odor of beer on one’s breath was even more off-putting than normal (I’ve never been a beer fan). Ironically, I developed an aversion to the smell of chicken, which proved a bit tricky during my long Mondays in the kitchen when I was cooking broth!

Originally published on


1. Aspirin during pregnancy: Is it safe? [Internet]. Mayo Clinic. 2018. Available from:

2. Low-Carb Diet During Pregnancy – Is There a Risk? [Internet]. Chris Kresser. 2018. Available from:

Nell Stephenson, B.S.

Nell Stephenson has been an advocate for The Paleo Diet since 2011, and is the co-author of The Paleo Diet Cookbook.

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