Ep39: Is The Low Carb High Fat Diet Safe in Pregnancy? (+ Top Tips) • Lily Nichols

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Lily Nichols
Lily Nichols: Registered Dietitian/Nutritionist & Certified Diabetes Educator

In today’s interview I get to speak with US registered dietitian/nutritionist and certified diabetes educator, Lily Nichols, about the benefits of eating the real food diet during pregnancy.

Lily is very passionate about evidence-based nutrition and helping pregnant women make sense of all the diet advice out there so they know how to achieve optimum health for themselves and their baby.

In today’s interview we get a chance to talk about how adopting a low carb high fat (LCHF) diet can not only be safe during pregnancy, but can help alleviate some common issues pregnant women experience.

If you know someone who has problems with gestational diabetes, hypertension or preeclampsia or just any woman who is pregnant &  interested in making sure she’s getting optimal nutrition, this interview is for them.

I enjoyed this interview immensely and after speaking with Lily, I have a much better understanding of the different factors that affect women’s health during and after pregnancy. Lily helped clarify some of the misinformation that’s based on outdated concepts and government/association guidelines and provided lots of great fact-based tips for pregnant ladies.

Buy Lily Nichols Book on Amazon
Real Food for Gestational Diabetes Book Real Food for Pregnancy Book
Click here to buy Click here to buy


Special thanks to Lily for joining me on the show. Enjoy the episode!

Find Lily Nichols on Twitter, Facebook, Instagram or one of her websites: pilatesnutritionist.comrealfoodforpregnancy.com, or realfoodforgd.com.

Show Notes with Timestamp Links

Highlights of what we talk about during the interview:

Click on one of the timestamp links in the brackets to jump to that point in the interview audio.

[00:20] – Introducing Lily Nichols, a registered dietitian, nutritionist, certified diabetes educator and a qualified Pilates instructor. Lily’s first book is called “Real Food for Gestational Diabetes: An Effective Alternative to the Conventional Nutrition Approach” and she has recently released her second book called “Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition”.

[00:45] – There is great debate amongst dietitians regarding the advisability of adopting the low carb diet. Lily explains how in their training dietitians are taught the government guidelines, which recommend having 45-65% of the calories coming from carbohydrates. What’s more, they are still taught the old misinformation about saturated fat, which is holding a lot of dieticians back from adopting the low carb diet. (Biohackers Lab Tip: Listen to Nutritionist Emily Maguire Keto Diet Tips for Women)

[03:37] – We can meet all our nutritional requirements if we eat real food. In a previous podcast, Dr Gary Fettke also talked about the concept of real food. Lily defines it as unprocessed, simple ingredients from a variety of sources and mainly from a paleo/primal diet template. This can include meats, fish, eggs, dairy, legumes, nuts, seeds, vegetables as well as some fruit.

[05:33] – Lily shares what she believes to be the biggest issues with the current pregnancy guidelines. The Academy of Nutritional and Dietetics guide for optimal pregnancy includes a sample meal plan which is way too high in carbohydrates, too low in protein and too low in fat. In a nutshell, there is an imbalance in the ratio of macronutrients.

[09:36] – We discuss the avoidance issue. Guidelines are often there for food safety reasons i.e. food poisoning because the immune system is slightly depressed during pregnancy. However, there is a huge discrepancy between the prevalence of infection and how common the bacteria causing the foodborne illnesses are in the food women are told to avoid during pregnancy. Sticking too closely to the restriction women are more likely to end up with a diet that’s nutrient deficient. Lily shares the most likely cause of food poisoning, shares some interesting stats with us and explains why she focuses on common food safety and doing things to improve immunity and gut health so we aren’t as susceptible to infections in the first place.

[16:52] – The ‘hangry’ factor occurs with the huge blood sugar swing that happens when we eat too many refined carbs. Women feel less hungry when adopting the real food way of eating. By starting the day off right, with a good breakfast that includes a good serving of protein and fat, means you stabilise the blood sugar levels and the huge blood sugar swings are less likely to happen.

[18:04] – While intermittent fasting is becoming more popular Lily believes you should eat more consistently during pregnancy as your nutrient needs are higher. Also, depending on the stage of pregnancy a woman is at, eating a huge quantity that is required to meet the nutrient needs is not going to be realistic if you’re eating only a couple of times a day.

[20:51] – We discuss weight gain that can happen during pregnancy and how much of it is food related. Whether weight gain happens or not and whether it’s good for the body or not depends on the woman. Food aversions and nausea are common in pregnancy and often we have to surrender to what our body is telling us. Lily explains how the body changes and adapts through different stages of pregnancy.

[26:47] – A lot of the gestational diabetes (GD) is related to pre-existing, undiagnosed pre-diabetes. Eating a healthy diet and maintaining healthy weight helps reduce the likelihood of developing GD. But because insulin changes as we get older and we are more likely to enter pregnancy with pre-existing conditions, there’s a greater risk of developing GD.

[28:40] – If we do develop GD diabetes it does not necessarily mean we will have diabetes for life. Blood sugar levels tend to go down post-partum; however, GD can serve as a great warning. Type 2 diabetes is more likely to develop in women who have had GD previously and in fact, it is the best predictive factor we have for type 2 diabetes in women. Lily’s first book (Real Food for Gestational Diabetes) is an invaluable resource on GD for anyone wanting to know more. Did You Know: This book’s evidence was used to change country food guidelines in the Czech Republic!

[30:41] – It can be tricky to pick up on warning signs as there aren’t necessarily any symptoms of high blood sugar with GD. Lily explains more about blood sugar in pregnancy and how it doesn’t have to be as high as we’d think to be in the GD range. There are some significant risks factors for the baby associated even with small elevations in blood sugar.

[32:42] – The concept of eating for two (or in some cases three or four)! During pregnancy the nutrient needs – especially the micro-nutrients – go up and from this perspective, yes, we are eating for two. Quantity wise, the calorie needs do not double and can increase as little as 70 calories a day, and while its more for twins/triplets it’s still not double. The focus should be on eating high quality, nutrient dense foods!

[36:44] – Hypertension is another issue Lily talks about in her book. She explained how one of the observed commonalities she noticed in pregnant women suffering from high blood pressure/preeclampsia is a high intake of refined carbohydrates. While she is careful to clarify that diet doesn’t necessarily cause these conditions and they can’t always be prevented, eating the right diet, rich in nutrients such as vitamin D, electrolytes, choline and glycine can help manage, improve, or in some cases even completely resolve these problems.

[38:58] – Everyone seems to be afraid of salt and people are often told to avoid it. But salt is an essential nutrient in our diets and helps with so many issues. More salt actually lowers blood pressure and improves preeclampsia. Dr James DiNicolantonio talked about the salt issue in a previous episode and Lily shares some more reasons to eat more salt.

[43:20] – Vegetarian or vegan diets tend to be naturally higher in carbohydrates, but the bigger issue is the imbalance of amino-acids. Glycine is needed in high amounts in the body during pregnancy for connective tissues and it is also involved in methylation reactions, and because it is only found in animal foods, women who don’t eat meat can end up deficient causing numerous issues. There are a variety of other nutrients that could be missing in a vegetarian diet that are covered in Lily’s book. She explains why she could not ethically endorse vegan diet for pregnant women, even with supplementation and shares some unfortunate case studies with us.

[51:02] – We talk about how the real food diet affects the quality of the breast milk. There are certain nutrients in the breast milk that remain unchanged by the diet the mother eats. For other nutrients such as B12, B6, B1, B2, B3, A, D, K, choline, fatty acids and certain trace minerals, diet quality impact their levels in breast milk. Lily wants to encourage mothers to breastfeed and reinforces that they should not be put off breastfeeding; your milk is good enough and you can produce even higher quality milk by eating a better diet.

[54:04] – Finally, we also discuss the importance of taking the time to recover and considering other stresses in life (which are all related!) going beyond food.

[56:34] – For more information on Lily visit her main website pilatesnutritionist.com For anything related to her new book, Real Food for Pregnancy visit realfoodforpregnancy.com For anything related to gestational diabetes and to find out more about her new program for women diagnosed visit realfoodforgd.com You can also find her on Facebook @PilatesNutritionist, Instagram @lilynicholsrdn or Twitter @LilyNicholsRDN

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