48. [WISE WOMAN] WITH AUTHOR LILY NICHOLS - REAL FOOD FOR CONCEPTION PREGNANCY & POSTPARTUM - MYTH BUSTING AND PRACTICAL EVIDENCE BASED TIPS
Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based nutrition.
Her work is known for being research-focused, thorough, and sensible. She is the founder of the Institute for Prenatal Nutrition®, co-founder of the Women’s Health Nutrition Academy, and the author of three books: Real Food for Fertility (co-authored with Lisa Hendrickson-Jack), Real Food for Pregnancy, and Real Food for Gestational Diabetes.
Lily’s bestselling books have helped tens of thousands of mamas (and babies!), are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally.
She writes at https://lilynicholsrdn.com. When she steps away from writing, you can find her spending time with her husband and two children — most likely outside or in the kitchen.
In this episode we dive deeply into nutrition requirements for preconception, pregnancy, and postpartum.
Lily debunks common myths with practical evidence based research on topics like vegetarian diets, pre-eclampsia, and gestational diabetes.
This is a powerhouse episode every woman needs to hear!
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Music The Ancients (feat. Loga Ramin Torkian) by Azam Ali
Disclaimer:
The information and resources provided by me are not intended to constitute or replace medical or midwifery advice or a Mother’s intuition. Instead, all information provided is intended for education purposes only. My advice is not to be seen as medical diagnosis or to treat any medical illness or condition of Mother or baby/fetus.
The follow transcript is AI generated so there will be mistakes
Emily: Welcome to Soul Evolution.
My name is Emily, also known as the Birth Advocate. I am a retired nurse, health coach, women's circle and ceremony facilitator and and the host of this podcast. Here we dive deep to reclaim our rites of passage with a big dose of birth story medicine, intentionally curious conversations with embodied wisdom keepers, and a sprinkle of polarity as we will hold space for our men from time to time too.
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I walk you through, step by step, exactly how to prepare yourself, your partner and your home for the most incredible experience you get to have in this lifetime. Birth is a sacred rite of passage worthy of honoring.
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Emily: Welcome Lily to the podcast. I am so excited and honored to have you on. You do incredible work, absolutely incredible work, and I think you're aware of that because of how successful your books have been.
You know, my best friend, she's going to be conceiving Care soon and she read your book Fertility, the one about fertility. I said, do you have any questions for Lily that I could ask her?
She goes, you know what that book was so comprehensive. I don't have any questions.
Lily: Music to my ears. Yeah.
Emily: Yeah, it's amazing.
Emily: I recommend your books to all of my clients and I wanted to let you know that my audience is really women that want to take birth and labor and pregnancy and conception into their own hands.
They're women seeking a sovereign birth free birth, home birth. They're not women that are handing over their self responsibility to the medical industrial complex. So what you do is foundational and so appreciated.
So welcome.
Lily: Awesome. As a home birth mom times two, I'm, I'm happy to hear that. We, we love it when you take matters into your own hands.
Emily: Absolutely. And you know, I am, I'm super passionate about women reclaiming childbirth as a rite of passage and, you know, the spiritual aspects of it all. And also birth imprints. Right.
And I think that what you have brought into the equation is it's not just how a baby is brought into the world, but preconception and how important it is for just that basic foundational, like anchored, rooted.
What do women need to be doing in preconception to help support their babies and the future generations? Like, that's why I'm so obsessed with birth imprints is because we're talking about supporting the future of humanity.
So. Yeah, yeah. Do you want to start by just talking a little bit about preconception, nutrition and why that's so crucial?
Lily: Yeah, sure. I think, you know, a lot of people can easily understand that what you consume during pregnancy, what you're exposed to, has an effect on your baby. But we can arguably rewind the clock and go back to what you were consuming, what you were exposed to, what your partner was exposed to in the months and even years leading up to conception.
Because that leaves an imprint on sperm quality and egg quality, you know, the health of your menstrual cycle and the sufficiency of your hormone production and balance of your hormones lays the foundation for the very start for conception.
Right. So we have to think not just about how can we have a healthier pregnancy, but how can we set ourselves up for a healthier time to conception, a healthier pregnancy from looking away in advance.
In my opinion, you're really in an ideal world in a pregnancy that's planned, you have kind of taken some time to be intentional about your choices leading up to that.
And you know, it's, it's more than just healthy egg and sperm combining to, you know, fertilize an egg and all that. You have to think about where is that then going to implants in the uterine wall.
Like is your endometrium sufficiently thick and nutrient rich to support the growth of that embryo?
That's like a whole highly complex process. Like really the sufficiency of your menstrual bleed is a reflection of whether or not you have a nice cushy home for that or implantation to take place, or the placenta to inform, to form and properly embed itself into the uterine wall.
Like you need your endometrium to be thick enough. This is why when you look into, you know, assisted reproductive technology, oftentimes they're actually measuring the thickness of the endometrium to see whether or not it's even worth trying in a particular cycle to go through with know, IVF or something.
So we need to be think like all of these little things, a lot of which is reflected in the health of your menstrual cycle. And really your overall health lays the foundation for easier conception, easier pregnancy.
You look at, you know, pregnancy complications, the vast majority of pregnancy complications stem back to either an issue with placenta or an issue with the metabolic health of the mom.
And when you look at an issue with the placenta, that's not only like how well did all of it embed in the uterine wall, but the placenta highly expresses paternal DNA.
So we need a healthy partner in order to have a healthy enough placenta to fuel that baby's growth. Right. Like it's all intertwined.
So, you know, I think especially for individuals who have some menstrual cycle issues, hormonal issues, the list of which can be quite long, you might want to give yourself a longer time planning for conception.
For somebody who's in pretty vibrant health already, you might not actually have to make all that many changes to your food and lifestyle choices to set yourself up for an easeful conception and an easeful pregnancy.
Emily: Right, yeah, of course. I mean there's the phrase we birth how we live and we also conceive how we live. You know, our lifestyle is everything.
So when you're saying a longer period of time, are you talking like eight months to a year?
And then also I'd love for you to give the specifics on like when the, the follicle is forming, isn't it like about 3 months and then the sperm is like 70 days or so?
Lily: Yeah. So when you're looking at the sort of run up minimum time for preparation, I'd look at the amount of time it takes for the sperm to fully develop, be fully developed, and then for an egg to be fully developed and released at ovulation.
So for sperm it's a little over 70 days. For an egg, it depends, like how far back you want to go. If you want to go all the way back to when it was recruited as an underdeveloped follicle, that process starts 220 days prior to ovulation.
So you're going back seven or eight months.
So, you know, for somebody again who's in pretty decent health, you might not need to do much more than three to six months of intensive, more intensive prep work or really any difference at all.
Because what's supportive of fertility is also supportive of optimal health. So if you're already eating a pretty nutrient dense diet and prioritizing your sleep and managing your stress and getting, you know, proper light exposure at the right times of day and sleeping well, you know, it might not be that much.
But as a population, you know, we see fertility issues on the rise in both men and women. And, you know, especially with the widespread use of hormonal contraceptives, which by design shut down ovarian function and ovarian hormone production, you're, there's going to be a period of recovery after you come off the pill for your, for your ovaries to resume functioning again and for hormone production to be in a good place for your endometrial lining to build up sufficiently thick for egg quality to improve.
And so for somebody who has either been on the pill for a long time or any hormonal contraceptives, or if there's longstanding health issues, whether reproductive, hormonal, you know, cycle related or not, you're going to probably need a longer period of time.
And especially for those who have had recurrent pregnancy losses, there's all sorts of different ways to define it, whether two or more or three or more. It depends on which guidelines you want to go by.
But I would say if you've had two or more, you may need an even longer time to kind of like dig into what's actually the root of the dysfunction going on here.
Like, why is this happening?
And take, take the time to address it. Like, the better, if you're in better health prior to conception, you're just going to have a much easier journey through all the different transitions from getting pregnant to the complications to the delivery, to the postpartum recovery, the nursing journey, like all of that is going to be easier.
So if we can start from a place of more robust health, then you have sort of like a built up reserve of nutrients to pull from during that time. Which is just so highly nutritionally expensive.
You know, pregnancy and breastfeeding are very depleting time periods in your life, and it requires really, really deep nourishment. So we want to, in an ideal world, start from a place where you're already deeply nourished, and then you can kind of, you know, ride those waves a little easier.
You know, pregnancy can throw all sorts of symptoms our way that. It's like I've always said, my. My motto during pregnancy and then birth and then motherhood is surrender, because you can't control all the pieces.
Right. So in this preconception time, even though it might feel overwhelming, you have more control now than you ever have in any of the rest of the phases. So build your foundation up as strong as you can.
Now, I really cannot emphasize that enough, and I think anybody who's listening who already is a parent gets that.
Emily: I'm sitting here just, like, nodding yes.
Lily: Yeah, yeah.
Emily: Especially, like, for my. And many of my friends and many mothers around the world, I think, or maybe more so in the developed nations. But we're having children later in life.
Lily: Yeah. Right.
Emily: So I'm. I was 37 when I gave birth, and I can tell. I mean, and I would consider myself, like, a food nerd. You know, like, I'm. I'm all about all the real whole foods, but, like, my eyesight and my hair turning a little more gray.
Like, there are things that I've noticed after giving birth and breastfeeding for two years, like, my body absolutely has been pulling nutrients from places where I maybe didn't have the stores that I thought I had.
Lily: Yeah. It just puts. Pregnancy is like a stress test on your body. I would say breastfeeding is as well. I mean.
Yeah. And when we're, you know, it's not that age necessarily dictates our health, but, like, I know as I'm getting older, too, like, you almost have to put in more work towards your health as you get older.
When you're younger, you can kind of coast off of the naturally higher muscle mass, the naturally more robust mitochondrial health. I mean, we're. We're coasting off of what our mothers and grandmothers and great grandmothers did.
If. If you hopefully have, like, a strong, you know, you know, health history from your family, but, like, that gets depleted. Like, as years go by, it just gets harder and harder, and it feels like you have to put in even more work.
So, yeah, I'm with you. After two kids and, you know, nursing both of them for a couple years at a time. And they're, they're out of the toddler phase and stuff now.
They're a bit older, but it's still, I'm still more depleted than I was before I had kids, that's for sure.
Emily: I really want to just like, honor you for doing the work that you have done while child re rearing. I think that that is just one of the most incredible accomplishments.
How did you deal with that? Like, what, what was that like for you?
Lily: Well, I will say that I, I, I didn't do all the thing, all the things that I have done. I didn't do them all at once.
And so I think people look, it's always easy to look at somebody who's accomplished something and been like, oh my gosh, how do you do it? Well, you do it like one day at a time, one step at a time.
So, you know, my first book I wrote before I had my first child. I'd been working in the perinatal space for many years, working in gestational diabetes.
And I could not handle hearing another terrible story of the awful advice that's given that does not work for gestational diabetes whatsoever.
And I had to just put it in a book. So that one was the quickest book to write. It is the shortest book. It is written in the most simple, accessible language possible.
And that was written when I didn't have any kids.
Not too long after I wrote that book, I got pregnant with my first child. And I did not even, I did not even know if I was going to return to work, honestly.
And then that experience of that pregnancy and postpartum journey, not that it was particularly difficult, I had a fairly easeful pregnancy and postpartum recovery wasn't too rough.
But there's just, there's so much that you don't know, right, until you go through it and embody it yourself.
And so, yeah, so at around, I don't know, four months postpartum, I was like, you know, I, there's the amount of research that I had to do to know for myself that the choices I was making were the right choices.
Like, most people don't have the ability to do that. And I need to, like, put this into writing. People had been asking me, they're like, can you write a book just on general pregnancy?
I'm like, just read the gestational diabetes one, because it's essentially the same thing, which is true. If you're just looking at like, the nutrition things, you could apply the meal plans from that book and you'll be in A good, good spot for pregnancy as a whole.
But there's all the questions, right, well, what about the foods to avoid? Well, I don't know. I'm not really convinced, like, it's safe to do to eat liver. Okay, I need to go into more detail on that.
Well, what about this? And then there's just research that I uncovered as I started really picking through all of. Just like, how did we get to the guidelines we have for pregnancy as a whole?
It's one thing to pick apart the gestational diabetes ones, but like, you start looking at the rest of the recommendations and I'm like, oh my God, like, this actually does have to be another book of its own.
So the way that that book came about, I mean, I, I had been thinking about it for a long time. I'd been ruminating on it since I was pregnant, actually.
And I, at about 10 months postpartum, I finally was like, you know what? I think this needs to. This needs to be written. It was actually my co author for Real Food for Fertility, Lisa Hendrickson Jack, who was like, I think you should write another book.
And I'm thinking of writing a book. I was like, great, let's be book accountability buddies. And well, so while I was writing Real Food for Pregnancy, she was writing the Fifth Vital Sign.
And we'd meet almost every week.
It was a big challenge because I had super limited childcare. So I had maybe nine hours of childcare a week. Like a homeschooled teenager would come and carry my baby for three hours or something.
As long an amount of time that I didn't have to pump because I absolutely hate pumping. So I'd like nurse before, she'd hold the baby for a nap or something and then I'd, you know, work.
And then I did a lot of, you know, baby wearing naps on walks, dancing or bouncing on a yoga ball, researching stuff on my phone or at my desk and just took it one chapter at a time.
I had no timeline. I had no. I don't know how long this is going to take. I'm just going to try. I tried to do about a chapter a month.
The editing process was a lot more challenging. The editing process of a book is just always a nightmare. And by that point, my son was a toddler and he could, my husband could take him out for a couple hours while I'd get some, some chunks of work time in.
So that book came out right around the time my son turned 2.
And then the most recent book, Real Food for Fertility, which I Co authored with Lisa. As I already mentioned, that was a longer process. That was a full, you know, three year process.
And you know, co authoring has its own challenge. And I had more childcare during that time frame, but we had all sorts of delays because you had all the pandemic stuff going on and you know, all the, all the changes with child care and all the things, all the things disrupted it.
But we, we pulled through eventually. But I would just say I just do one thing at a time. My best, my best advice for moms who are trying to work and get things done, like set realistic and flexible goals and focus on one thing at a time.
You do need to lean into having somebody help with the kids to some capacity, whether that's your husband or partner or family or someone in your community, babysitter, whatever kind of child care to help you have brain space for it.
But I do a lot, I tend to do a lot of like, ruminating about ideas even when I'm not actively like at my desk working. So a lot of things I'm like, thinking about and then it comes into form when I'm, you know, at my computer.
And I think the thing about motherhood that's kind of interesting is even though your time is all disjointed and constantly interrupted and not within your control, I'm so much more efficient.
And like, I don't. The perfectionist tendencies have to go by the wayside because you only have such a limited amount of time. So it's like, okay, I wrote a paragraph or read three research studies or something and that's all I was able to accomplish.
I'm probably not going to go back and be like, should I say it this way? Should I say it that way? Maybe I should say it this way because you know what, it's done.
And I'm like, I have to move on to the next thing. So it like motherhood has built my efficiency.
Maybe it has decreased my output if I was just like workaholic mode. But I find I don't question myself quite as much. I'm just like kind of just run with it instead of.
Yeah. Trying to, trying to nitpick every single detail.
Emily: I love that. That's sort of medicine to my ears as the work that I'm doing now and building a course. So it's really, it's intense.
Lily: It is, yeah, it's definitely intense. Any sort of project just, you know, one thing at a time. Rome wasn't built in a day, as they say, and, and any project just takes it takes time.
It's also okay for it to take longer than you think it should take.
You know, there's all sorts of ways, different ways of working the whole mother, balancing the motherhood with the work. And for me, it was most aligned for me to not have super long work hours in those first.
Especially like the first year and first two years. My babies were both just like very much wanted to be with mom, and, and I wanted to be with my babies too.
And so I, I didn't like having super long stretches away from them. So, you know, I, I made it work for me in the way that it did. But, you know, if somebody is feeling really, really good with and they have like a good.
I don't know, like, if I had family close by that could be helping, that would feel a little more aligned for me. Or if my husband had had a more flexible work schedule at the time, maybe that would have been easier to get like longer work hours in.
But for me, it was just, it was honestly very piecemeal.
Yeah, very piecemeal. And probably slower than most people would like.
Emily: Yeah. Well, I appreciate you sharing all of that. I think that's good medicine for women to hear out there. I would love to talk a little bit about how I'm sure it was pretty easy, honestly, for you, to see how the guidelines are so off when it comes to our actual, you know, individual makeup and what actually works.
And just, you know, how you put this into simple terms, I think is really beautiful and wonderful people to hear, especially those that are rebels like me and a lot of my audience out there that, you know, don't necessarily do things just because they're told.
Lily: Yeah. So, I mean, my work has bridged kind of an interesting gap because, you know, I was, I was introduced to ancestral nutrition practices and sort of the. Just this, it's overused cliche, but the concept of food as medicine from a very young age.
So even before I went through my, like, conventional training. So sometimes I feel like I have to over explain myself because my background is as a dietitian and people assume that dietitians all follow the government guidelines, food pyramid, whatever.
And I, while I was going through my program, was not looking at those guidelines as law or like etched in stone. It was like, okay, I know there's all sorts of industry things at play here.
And I had already personally experienced vast improvement in my health from adopting a more ancestral type diet.
And so I was already like, well, definitely the, you know, fat guidelines are totally wrong. Like, we don't need to be restricting fat or restricting saturated fat. But it was like, as the years went on, the more you dig, the more you learn.
So it started with looking into the gestational diabetes guidelines, specifically on carbohydrates, because there's just these very intense warnings about not going lower in, in carbohydrates than the guidelines, which they set a mandatory minimum in pregnancy of 175 grams a day.
And nobody could ever explain to me where that number came from.
And so that kind of set me off digging into the Institute of Medicine documents. There's like a thousand page plus document on the guidelines and the evidence used to set them.
And just seeing what shaky ground was used to set those guidelines. And like, okay, these are really just somebody's opinion more than solid science. Then you just start digging into all the other ones.
So by the time I was writing Real Food for Pregnancy, for example, the first ever study came out that directly assessed protein requirements in pregnant women. The guidelines were not based on solid data in pregnant women themselves.
A lot of our data or a lot of our guidelines rely on what they call factorial methods, where they do a mathematical calculation based on the difference in body weight from an average man or an average woman.
And then you try to estimate in the effects of pregnancy. You have the effects of changes in weight, but also how much of certain things does the fetus accrue.
Some of that is based on really bizarre data. Like the vitamin A requirements, which they're already higher than outside of pregnancy, but they're arguably set too low, is based on data from some stillborn babies from Asia.
Like, how do we know that those babies didn't die because their vitamin A stores were not adequate like that. That's what we're basing it on. Like, it's actually crazy. As you start to dig into, you know, nutrient by nutrient, it's like, whoa, it's shockingly inadequate.
Emily: I think that this is just a huge point. I want people to really understand that, like, the evidence out there on nutrition is like novice at best, honestly.
Lily: Yeah.
Emily: Wouldn't you agree? And then also, like, we haven't studied women a lot of the times we're studying men and just then adding in pregnancy. This literally has not been studied.
Lily: Yeah. For a lot of, for a lot of nutrients. It's very understudied. So they made, they made their, like, best guesses on some things.
And most of that data originates from data we have on adult men. Again, that's been adjusted to women and then adjusted again for pregnancy. There are a Handful of nutrients, where we actually have some pretty good data that, okay, we need to revise these to make it higher.
Protein is a perfect one. Our protein requirements in pregnancy were set 73% too low. Okay, yeah, we need to adjust that population wide across the board. Protein requirements are set way too low.
It was the way in which they did the studies, the way in which we measured protein requirements. We have much more advanced ways of looking at that now. But we're still relying on the, on the guidelines that were set really in like the 80s and 90s based on this old way of looking at things, basically nitrogen balance studies for choline.
We have much better data on choline nowadays. So choline was the most recent nutrient that we determined was actually essential. They thought it was not essential because our bodies have the capability to produce choline.
However, in the late 90s, they did a study on adult men where they, they restricted their choline intake and that created all sorts of issues for them, including liver issues, muscle issues that you, you basically developed fatty liver when your choline intake is too low.
So our endogenous production, not enough. So they set a requirement for men and then they just adjusted that down based on body weight for women. Okay, well, now we have studies, randomized controlled trials, where they have given women, pregnant women, okay, this is like pretty close to what the requirements are, slightly higher than what they have set adequate intake at.
And then they give another group of women double that amount.
And then they've followed these children, these babies of these mothers who had that higher choline intake only for a portion of their pregnancy, by the way. And regardless of what those children ate once they were out of the womb, regardless of their choline intake, their brain development, their cognitive function, their reactive reaction time, their visual acuity, their problem solving skills, all of those things were better, not only in toddlerhood, but they've published data now following these children until age seven.
So are the choline requirements truly adequate for women or do we actually need to aim for double? Now that opens a whole nother can of worms. Because if you follow the overall pregnancy guidelines, you are told to limit foods high in saturated fat, many of which are high in choline.
If you don't consume egg yolks, for example, you're not going to have a choline adequate diet. It's virtually impossible. Unless you're eating a really, really high intake of all your other animal foods.
You're definitely not going to get to the 930 milligrams that the study used. Right. So it requires like it requires some mental gymnastics for people who are really locked into the conventional guidelines.
Because if you believe that our protein intake should only be a certain amount, our fat intake should only be a certain amount, our cholesterol intake should only be a certain amount.
And yet in order to meet the choline requirements from food, you're going to have to eat more of all those other nutrients because that's what they're found, that's what they're found in the same foods.
Then we've got a problem. Right?
So that's just one example. But there's, there's a lot of nutrients that are just significantly understudied for the ones where we do have more data, generally speaking, it's showing we need more of these particular micronutrients.
From the macronutrient perspective, we definitely need more protein. I'm of the opinion that you need more fat. Cause you're not going to hit those micronutrient requirements unless you're eating more protein.
And protein foods have fat in them for good reason. And we need that fat to, to fuel our higher hormone production in pregnancy as well. And by default that means we need to be decreasing the quantity of carbohydrates that we're consuming and consuming better quality carbohydrates of the ones we are eating.
So we're not only meeting the higher energy demands for pregnancy, but also all those vitamins and minerals. That's, that's my take in a nutshell.
Emily: I, I love it. That's beautiful. I, I completely agree. And I really, right here and now would love to talk about animal products because I know like people like dance around this and it's a sensitive topic and this and that.
Honestly, I am, I am biased and that's okay because the evidence supports it, my own embodied experience supports it.
And it's just, you know, the protein that you get from plants is not absorbed the same, it's not the same quality. And I just, I'm very biased and I really, I am very concerned for women that in preconception or pregnancy do not consume animal products.
And I'd love to hear your opinion.
Lily: Yeah, that's a, that's a topic I've kind of changed the way I've approached over the years.
In short, I used to dance around it as well. I used to be vegetarian. I have loved ones who are vegetarian and vegan. I understand all the reasons people choose to eat that way.
So you can see it if you have all three of my books. I don't even address vegetarianism at all in Real Food for Gestational Diabetes? Because I'm like, why would I recommend something that is awful for your blood sugar control?
By far the most challenging and most complicated cases I had were in vegetarian women. It makes the blood sugar control really difficult, makes nutritional adequacy really difficult. Um, with Real Food for Pregnancy at.
At the push of some of my colleagues, I included a section on vegetarian diets and pregnancy and nutrients of concern. And it sort of snuck in at the end of chapter three.
And that, that little section of the book, it's not that little, it's pretty meaty. But still, that changed so many people's lives and so many people's opinion on animal foods that by the time we got to Real Food for Fertility, it was like, this is just going to be a chapter of its own.
So that is the place where I have the most expanded discussion of the considerations for a vegetarian diet and Real Food for Pregnancy. I'm mostly taking it from the angle of micronutrient sufficiency.
So going through individual vitamins and minerals and not going into a whole lot of detail on the. Whether or not you can combine proteins to get a complete protein, all that sort of stuff.
There's actually data that's been published since Real Food for Pregnancy that I was able to incorporate into Real Food for Fertility that tackles some of these. These things in more detail.
So, in short, the way that I approach it is purely from like a, A data perspective. Of course. Like, I have my own personal bias and clinical bias from what I've seen with clients where I am of the opinion that some animal foods of some kind need to be in the diet for it to be nutritionally adequate, for it to support optimal hormone production, and I would argue also optimal pregnancy outcomes.
Are there a small handful of individuals who can make it work, who can get by? Yes, certainly people get pregnant on a vegetarian or a vegan diet.
Some of them seem to recover.
Okay, maybe if it's like one pregnancy. I think as it gets to subsequent pregnancies, we start to see greater challenges with conception, greater challenges with recovery, and greater challenges to the children.
Because, again, you're relying, you're. You're still coasting on your mother, grandmother, great grandmother's nutrient intake. Right. You have generations of family who's consumed animal foods probably in significantly higher quantities than is the norm nowadays, and you have a strong foundation.
But does that mean you're going to pass on that strong foundation to your kids?
So we've had some more prominent vegetarian and former Vegan moms speak out about the issues their children have faced as a result of their dietary choices. And many of them are no longer vegetarian or vegan anymore.
Some of the health effects you don't see right away at birth. You know, baby looks okay, 10 fingers, 10 toes, you know, but maybe later on you start seeing issues with their teeth.
Right? You start seeing dental enamel defects, or maybe you see issues with their growth, or maybe you see issues with their brain development. There's a lot of nutrients required for a functional, strong body from brain development, skeletal development, and so on and so forth.
So you can take it from the micronutrient angle. There's a lot of vitamins and minerals that may not be found in foods or found in sufficient quantities. They might not be found in a form that's very bioavailable.
They might be found in some plant foods, but not a wide variety of plant foods. So although it's possible, for example, to meet the iodine, your iodine requirements on a vegan diet, that's really only gonna be possible if seaweed is in regular rotation in your diet.
Or vitamin K2, you could get that from plants. If you're eating natto on a regular basis, a super.
Emily: I don't know what that is.
Lily: Natto is a highly fermented soybean product that's popular in Japan and some parts of Asia. It is. Look up videos of natto. It's very interesting. It's like this slimy, super fermented soybean thing where when you pick it up with chopsticks, like hundreds of little spider webs of like, goo come out of it.
It's a very interesting thing. I think for people who grew up eating it, it is, it is enjoyable and is a delicacy. And for those of us who did not grow up eating it, it is totally repulsive.
Like, kind of how some people look at French cheeses, like really strong French cheese, and they're like, whoa, that's awful. And then. But it's a delicacy. It's one in the same.
But that vitamin K2 is really, you know, natto is the only plant source that's a significant contributor to our vitamin K2 intake. The rest are fatty animal foods. Right, Right.
So there's so many examples of this. I go through all of them in my book with the protein quality aspect. We have to be more honest about how much protein is actually utilized from these foods.
And we have to be have a more honest conversation about the amino acid makeup so people don't know this, and I didn't know this actually until I wrote Real Food for Fertility and was researching it.
Are protein requirements population wide?
They don't have a separate RDA for vegetarians.
And that is because an assumption was being made when they set those that at least half of the protein intake from vegetarians would be coming from high quality sources, meaning eggs and dairy products.
Think back to the 90s. We had a lot of vegetarian friends and family members in the 90s. You'd go over to somebody's house who was vegetarian and they'd serve like quiche for dinner.
Like everything had eggs and cheese. There was all these egg and cheese casseroles and things.
If you were making chili, which had of course, beans in it, you would have lots of cheese on top and sour cream and like eggs and dairy were a pretty prominent part of the diet.
Well, it turns out if you're not getting that amount of protein, more than half of it coming from animal foods, we actually need to be setting the protein requirements a lot higher for vegetarians and vegans to account for that, because most of the protein they're eating has low bioavailability.
Now in order to accomplish that in real life, that would mean a pretty significant dietary adjustment for most vegetarians and vegans, where you're then very intentionally eating a lot more beans, legumes, nuts and seeds, or adding in isolated plant proteins to supplement to make up for the poor bioavailability.
Um, even that it doesn't fully match the animal protein because it doesn't have the same amino acid makeup. And so now we have data, now that we have this, this way of looking at protein where we can actually measure the oxidation of individual amino acids.
We used to assume a lot of amino acids are not essential. Not essential, meaning our body can create them for other amino acids. So don't worry about getting them from your diet.
Well, now that we have a way to watch the oxidation of individual amino acids, which we never did before, they're finding that this whole concept of non essential amino acids is not, not based in solid science at all.
And it's arguable that a lot of these so called non essential amino acids we actually require for optimal health. And those are only found in animal foods. So creatine, carnitine, animal foods.
Correct. So creatine, carnitine, taurine are some examples. You also have some amino acids that are found in plant foods, but in such low concentrations that you can't get enough for your body's needs.
Glycine is one of them. Found in really high amounts in collagen. And you only get collagen from animal foods. So it's like your body has to expend an excessive amount of other resources to try to create these amino acids from other things, and that's a big stressor on your system.
I could go on and on, but those are some of, like, the primary points of contention.
And then, you know, just one other thing I would say is a point we really try to drive home in, in real Food for fertility, is that your menstrual cycle doesn't lie.
So people can go on and on about how, well, I'm vegetarian, I'm vegan, and I'm fine, and I was able to do. I was able to get pregnant and my baby's fine, and this is all fine.
And that some of that may be true if they had pretty intensive supplementation regimen. But how is their menstrual cycle okay? Like, how are their hormone levels? Are you actually looking at those things?
A lot of women I speak to who have told me in the past, oh, yeah, everything's fine, my health is great. You start looking deeper and it's like, okay, they have a short luteal phase, they have scant menstrual bleeding, or ridiculously heavy menstrual bleeding.
They have fibroids. Fibroids are actually much more common in vegetarian women because of the soy intake. There's like a two and a half times higher risk of fibroids in women who are high consumers of soy.
And that often is the primary source of protein for most vegetarians. There's, there's some, of course, where that's not the case, but you look at almost any of the meat replacement products, the vast majority of them are relying on some form of soy.
You start to look at, you know, did they have delays in conception? Oh, maybe it took them like two years to conceive their child, or maybe they had a really, really rough postpartum recovery.
I hear a lot of these stories where it's like, the pregnancy was okay, although they might have had some complications. We do see higher rates of preeclampsia and preterm birth and babies being born smaller than average among vegetarian and vegan women.
But maybe their recovery was a challenge. So maybe their pelvic floor didn't fully heal. You need like a ton of collagen for your connective tissues and for wounds to heal well.
And when that's not being consumed in the diet and again, your body's trying to expend extra Resources to make collagen then from whatever protein you are taking in. Plus you're, you have the demands of nursing, which is a huge drain on our nutritional resources.
What does our body biologically prioritize?
It always prioritizes the offspring. You are always going to give whatever available resources you have, however depleted, to that baby. So then you see the recovery more difficult, you see more challenges with healing those perineal tears, you see more challenges with pelvic floor recovery, you see more challenges with mental health.
I mean, you have just drained like as much of your DHA stores as possible to supply your baby's brain.
And we know that the plant based omega threes are not the same as the animal based ones. I have an article now on my website on this how, how the Omega 3 quality is different.
And yeah, you have a very small capacity to make some DHA from that flaxseed oil or chia seeds or walnuts or whatever. But it's not enough.
It's not enough for your body and it's also not enough for baby because they've actually done studies where they give breastfeeding women flaxseed oil supplements and then look at the DHA content of their breast milk and it does not increase the DHA content of their breast milk, whereas if you give them a DHA supplement, it does.
Right, so is every vegetarian woman or anyone who's not eating fish really, are they all taking supplemental dha? There is a vegan source. You could do an algae based dha, but are they doing that?
A lot of times the only nutrients they're told about are like B12 and iron. You know, so it's like, who's filling, who's making sure that these women are filling in all these gaps?
It would take a really quite extensive supplement protocol to make sure that it's adequate. And even with that you're kind of guessing as to whether or not it's adequate. Yeah, based on the guidelines being so out of date.
Right. So is targeting an RDA level, is that really enough? Like I can't say for sure that it is because the guidelines are set on such shaky science.
Emily: Yeah, yeah, yeah. You know, when I was pregnant I tried to do mostly, you know, whole food, but I supplemented with DHA D2 or D3K2 and I took desiccated liver. And I think I also did an organ complex.
Desiccated organ complex. And I mean that was my quote unquote prenatal. Like that's what I did. What, what are your thoughts on that?
Lily: I get this question quite a lot, like can a organ supplement be a replacement for a prenatal vitamin? And I'm the first to be like a proponent of organ meat consumption.
I write about it in all of my books and I even refer to them as nature's multivitamin because you're hard pressed to find a more nutrient dense food.
Comprehensively nutrient dense. Probably the closest thing is maybe bivalve shellfish like oysters or clams, but it really is highly nutrient dense.
I think depending on the person, somebody who's very nutritionally replete, which it sounds like you yourself are, that could probably like your diet is so high in nutrients already that having an extra, you know, organ supplement and the other ones you mentioned might fill in the majority of the gaps.
I caution people to look at them as a one to one replacement to a prenatal vitamin though, because the prenatal vitamin, it depends on which one you're looking at, right?
But a comprehensive one will have higher levels of certain nutrients than are found in organ meats. Like organ meats are high in a lot of nutrients, but they're not high in all of them.
So if you have a comprehensive prenatal vitamin, it'll probably have more vitamin C, vitamin E, certain minerals like iodine, calcium, magnesium. Like there will be certain things that are higher in a comprehensive prenatal than an organ meat supplement.
So whether or not it's truly a replacement I think depends on what is the nutritional adequacy of the person's diet as a whole. And that will give you a better idea of whether or not that would make sense for somebody to take that route.
I do, I do kind of like take issue with, with the concept though that it is a one to one replacement. That's really my point of contention. Like they're not like, look at the micronutrient makeup and like concentrations.
And it, it's not a one to one, even though it's highly nutrient dense. And I encourage you to have organ meats or an organ meat supplement.
Sometimes people will do kind of a bit of a combo where they'll maybe on the days when they're not consuming organ meats, take an organ meat complex or maybe they even skip their prenatal vitamin on the days that they're doing like a, you know, three or four ounces of liver or something because you're getting so many nutrients that day already, but still having it as a bit of a backup, like I do, I don't know.
Nutrition is complicated. You get into all Sorts of little, like, niggly possibilities of nutrient deficits, like iodine, for example, and someone who's not consuming seafood on a regular basis or seaweed, and especially somebody who's also not eating eggs and dairy products, then that opens up a possibility of an iodine deficiency, which can have a pretty profound effect on a baby's neurodevelopment and, and on maternal and fetal thyroid function.
And that's something where you wouldn't get enough iodine from an organ meat supplement, but a comprehensive prenatal would have enough to cover your needs. Like, that's just to give you another example.
Emily: Yeah, yeah. Thank you for that.
I would really love to turn and talk about preventing some complications, because my whole goal is to have healthy mothers so that they can have their physiological birth at home.
Right. So the two things that risk women out, a lot of times we won't go into bmi, because that's a whole thing, but we have diabetes and we have preeclampsia.
I'd like to start talking about pre preeclampsia.
Lily: Yeah. So it's a tricky one because. And people won't. Sometimes people don't like when I say this. But not all cases can be prevented, and not all cases have a clear, like, origin.
Right. It's, there's, there's still active, active, active debate in the literature, in the research world on how can we prevent this complication because it can have such severe consequences if not well managed.
And if we had, like, a crystal ball to prevent every case, we would be implementing all of those things. Now, it doesn't mean that what you do has no effect.
I do like to focus on what are the things you can do to mitigate. But there are a substantial proportion of preeclampsia cases have their origin all the way back to placental development.
How well did that placenta form and how well did the vasculature of it invade the uterine wall?
And that comes. That goes all the way back even to your partner's sperm health. Okay. There's some studies saying 13% of preeclampsia cases are essentially dad's fault. Okay. And we have some really interesting data where you have women who have had babies with different partners.
And it's like if multiple women could have a baby with the same man. And like, each time in those pregnancies, there's preeclampsia, even if the women have had babies with other partners and did not have preeclampsia, even if they had a baby after the fact Right.
You think previous preeclampsia, higher risk and next pregnancy, well, you have it with a different man, no preeclampsia. So like, it wasn't necessarily anything the woman did, it was his sperm.
Okay, so that's what I mean when it's like people are looking for interventions during pregnancy itself. And I think, yes, we always want to stack the deck, but I also want to just like broaden people's horizons that there, there could be something that's not entirely within your control that could be at play here.
So shifting gears back to what is within your control, what steps could you take?
A big thing is to make sure you're eating a nutrient sufficient diet.
So protein, absolutely crucial. Lots of people in the birth world like calling out Dr. Brewer's, Brewer's work. Brewer was way ahead of his time.
And yet I feel like his, his research wasn't as well documented as we would hope. But nonetheless, a big part of his approach was optimizing protein intake. He also, by default, when you optimize protein intake, you're optimizing micronutrient intake.
He also optimized calcium intake, really pushed dairy quite heavily. He optimized choline intake, really heavy on the eggs.
And he optimized sodium intake. He encouraged them to consume more salt and calorie intake. He pushed a really high calorie diet. And in some types of preeclampsia that are more towards the under a woman who's kind of on the undernourished side, that sort of approach works really well.
Not all women need to be eating a ridiculously high calorie diet though. And so I do see there's some cases of preeclampsia that more overlap with like a gestational diabetic kind of profile where the extra protein and salt for sure, but they don't need like 3,000, 4,000 calories a day.
Like they, they need their proportional like calories more matched to what their body actually requires. So I think we can kind of embrace some of the things with, with the Brewer diet, but not take it to such a degree.
Like I've heard from women who are like, I just couldn't eat the quantity of eggs that he, that he suggested or the quantity of dairy. And I'm like, yes, because for your body that was just too much, you know.
Emily: So yeah, let me also right here, just because with the, the amount of protein that is actually required, especially also what he's recommending, I. The biggest complaint that I get from my clients is constipation and they feel that it's really related to eating this much protein.
So do you have any specific tips or ideas about, like, how to solve this constipation issue in pregnancy when eating that much protein?
Lily: So I would say make sure that you're still also consuming enough of your minerals, specifically your sodium, potassium, magnesium, like enough of your electrolytes.
My experience with a lot of, a lot of people who kind of switch to more whole foods, especially those who are kind of used to processed foods. When people cook at home, they don't season their food enough.
A lot of times food is kind of tasteless. Your food should be really well seasoned. If it's really well seasoned, it has enough salt. If you don't have enough salt, you're going to have issues with transit time.
You could also add in extra, like an extra magnesium supplement that keeps things moving. Generally, I would make sure you're still consuming fiber, particularly from like whole. Whole foods, whole fruits, whole vegetables, legumes.
That can help keep things moving. I would think about gallbladder health. A lot of people have issues with gallbladder health. And if your gallbladder is not actively pumping out enough bile, you're going to see decreases in transit time.
So that can look like having more bitter foods like grapefruit, dandelion greens, lemon juice and water, things like that of that nature.
Also, just getting enough protein often helps with the gallbladder function because you're using some of those amino acids to make the bile. Some people can even benefit from specific other digestive supplements that would help them, like something very acidic, or even taking a betaine hydrochloric acid supplement, taking digestive enzymes.
Some people even supplementing with like ox bile to help, like, if they're not producing enough, we need to help them out a little bit.
And then choline intake, which hopefully, if you're doing a brewer's diet, you're getting a decent amount of choline in the egg yolks. That helps with emulsifying the fats and creating and secreting enough bile.
All of those things generally tend to help, but it can be tricky.
And again, not everybody has that response to a high protein intake. So you might want to like, look at where are they getting their protein. Sometimes some people don't do super well with having a super high amount of dairy in their diet.
So maybe you want to pull back a little bit on the dairy. Calcium can be a bit constipating and, and focus on some of your other protein sources a little more heavily for a while and See if that can help.
Or switching out the type of dairy to, like, goat or. Or sheep or only fermented dairy instead of, you know, fluid milk.
Those would be some of the things I would try.
Emily: Yeah, those are excellent suggestions. Thank you very much.
Lily: Yeah, so, yeah, with preeclampsia, I mean, a lot of the nutrients I just mentioned, those would help play a role. Calcium, magnesium, sodium, potassium, like all of our minerals often play a role.
Keeping our blood sugar in check is huge.
So people don't realize there's a relationship between blood sugar and blood pressure. This is why oftentimes gestational diabetes can put you at higher risk for preeclampsia.
So for some people, I would say, I mean, first of all, prioritizing protein is my first recommendation because that naturally will keep your blood sugar in check and your appetite better regulated, so you have less propensity to want to over consume carbs.
But second to that, I would say maybe pay attention to your blood sugar for a week or two and see what your response is to different foods. If you're consuming a decent amount of, like, processed or refined carbohydrates, you know, bread, crackers, cereal, stuff like that, it'll be pretty obvious whether or not that's playing a role.
But there's even some individuals who have to be sort of more careful or cognizant of their portion sizes, even of whole food carbohydrates. We're all different. Like, everybody's body is a different response to different foods.
For me, like rice and oatmeal are, they spike my blood sugar unreasonably high, but as somebody else, they might have the opposite effect. But they find that, like, bananas and sweet potatoes spike their blood sugar more than they'd expect.
So with some blood sugar tracking, you might be able to pinpoint some of the foods or maybe portion sizes of those foods that aren't working for your individual system.
And sometimes that can help quite a bit. So those would be some of the. Some of the top things. I mean, there's others, you know, exercise, vitamin D. Are your vitamin D levels in a good range?
Because that can play a really substantial role in the risk for preeclampsia and also preterm birth, which is a risk factor when you have a preeclampsia diagnosis. Yeah. Yeah.
Emily: Thank you.
So I want to make sure that we have enough time to talk just a little bit about recovery and postpartum. But let's just briefly touch on this whole glucose tolerance test and maybe alternate methods and just.
Lily: Yeah.
Emily: Kind of blowing the lid off the myth of this whole situation with gestational diabetes.
Lily: Yeah, a big topic. So I don't know if I'll try to keep it brief.
Emily: Just go get her book.
Lily: I will say, you know, there's all sorts of different ways to diagnosis and diagnose it and there are pros and cons to all of them.
So the Real Food for Gestational Diabetes book takes it from the angle of just like you've been diagnosed. This is what to do. I go into the diagnostic tests and steps to try to prevent gestational diabetes from developing in the first place.
In Real Food for Pregnancy, it's like you add the gestational diabetes resource if you need it. Not everybody needs that book.
So in that part of Real Food for Pregnancy, it's in chapter nine, I go through some of the issues. I mean, I'm not completely entirely anti glucose tolerance test, but it, it's in my opinion really only the appropriate type of test for a particular individual.
You know, within the healthcare system, it is the gold standard screening method.
The challenge is that it, it's trying to test your body's response to a specified amount of glucose and seeing if you, you know, fall within range or go outside of the range.
But if you are somebody who eats a relatively lower carbohydrate diet and your pancreas is adapted to such, which is that it doesn't need to release all that much insulin, at least not in a huge bolus, there's a chance that you could get a false positive on it if you've not carb loaded in the week prior to the test.
So that's an issue. Another issue is like all the weird added ingredients in it. I mean the, the glucose is there for a reason because you have to have the glucose bolus to see how your body responds.
But there's other ingredients in some of the formulations that people don't want. There's food dyes, there's brominated vegetable oil, which I believe they're going to be phasing that out finally.
So there's things that people don't like about it and some people just, you know, it's not natural. For me, I don't normally eat 50, 70, 500 grams of pure sugar in a sitting.
So why would I do the test? And for those individuals, I would say do home blood sugar monitoring for a couple weeks and see where your blood sugar comes out and compare it to the ranges.
And I have, have charts of that. In, in Real Food for Pregnancy, the Challenge working within our conventional health care system is a lot of providers don't want to accept home blood sugar monitoring in lieu of a glucose toler best.
And so that's a choice you're going to have to make with what kind of provider or what kind of birth scenario that you want.
And sometimes for some people who want a more sovereign experience, that's their, you know, red flag that this is not going to work for them.
So. But I just want to make that entirely clear that although I'm talking about as an alternative, if you're in the conventional system, you're, you're probably going to have some, you know, conversations, not comfortable conversations about this because your provider might not accept it, so to speak, at the end of the day.
My opinion on gestational diabetes though, is that it, it doesn't matter whether or not you have that diagnosis documented in your chart. What matters to me is that everybody has some idea where their blood sugar is at.
So I think everybody should be doing some home monitoring during their pregnancy. Now that's speaking in an ideal world. I've worked within the conventional system and there's going to be, you know, some pregnant women who are just like not putting their health as a priority.
And for them, just doing a single in office glucose tolerance test is better than nothing. Right. You're at least hopefully catching the issue.
But for people who are really taking their health into their own hands, I would say in an ideal world, you'd be monitoring your blood sugar for at least a couple weeks at a time each trimester and see where you're at.
Because this idea that it only develops at 24 to 28 weeks is actually nonsense.
Vast majority of cases there is a preexisting blood sugar issue pre pregnancy that was going on and we simply have identified it during pregnancy.
And whether or not you have the diagnosis in your chart, the important thing is where or where are your blood sugar levels day to day? And if you can keep those within or pretty close to the normal range, your risk for other complications and risk for adverse outcomes on your baby go way, way, way, way, way down.
So my opinion is everybody should pay some attention to their blood sugar.
Emily: Yeah, absolutely. And I learned something from you was about the baby's pancreas in utero. I did. I actually, I guess I was under the belief that the, our placenta like really did a lot of things for the baby, but the actually producing insulin inside.
Lily: Yeah, maternal insulin does not cross the placenta, so maternal glucose does and therefore the baby's exposure to glucose is equivalent to the mom's blood sugar levels. Once the baby is at the point in, in gestation where it is, has a functional pancreas, it will start producing insulin to the level it needs to keep its blood sugar within range.
And so if you have a mom with persistently high blood sugar, that baby has persistently high insulin levels.
And that affects the baby's growth and development. It also affects the growth of their pancreas. So their pancreas actually grows larger, their bodies become insulin resistant in utero and it predisposes them to developing type 2 diabetes in their life.
It's upwards of a 19 fold higher risk for type 2 diabetes.
So I think a thing that I want to drive home in like the, you know, more sovereign birth world and believe me, I'm fully in that world myself. I was, I was a home birth baby myself.
You know, this is your time to really take your health into your own hands. I think some people go into this with a little bit of denial that everything that happens in pregnancy is just totally natural.
And I'm rolling with the punches and I've, I've even seen some, some birth accounts suggest that gestational diabetes is a made up diagnosis and it doesn't actually happen. And you know, your blood sugar is higher in pregnancy and that's, that's actually not true.
The physiological adaptation, if all systems are working as intended, is your blood Sugar runs about 20% lower even by conventional guidelines. They drop the criteria for hypoglycemia by 10 points in pregnancy compared to outside of pregnancy because maternal blood sugar levels average about 88 milligrams per deciliter in pregnancy.
Like they're well below 100. When you look at 24 hour averages when that's not happening. We have tons of data on this, like tons, like from multiple countries, over 23,000 women where they looked at blood sugar levels and development of the baby and all the things, you see a linear relationship between maternal blood sugar dysfunction and issues with the baby.
So things like the fetal insulin production being high, that's titrated precisely to the changes in maternal blood sugar levels. Even a 5 to 10 milligram per deciliter change in maternal blood sugar levels predicts a stepwise increase in that baby's pancreatic insulin production and then also that baby's growth.
So the role of the hormone insulin, it's an anabolic hormone, it helps us build tissue.
Typically we're storing it as, as extra fat, but it also plays a role in, you know, Muscle building and all the things. So we need a certain amount, of course.
But when you have persistently high insulin levels with high glucose levels, we see a change in that, in the fetal, you know, body proportions, where you have a higher percent fat mass.
So these babies that, you know, the, the idea of the baby, you know, being larger for born to women who have gestational diabetes. And by the way, that doesn't happen just because the diagnosis, it's related to the blood sugar control, but that is because the fetal response to that high glucose is higher insulin production, which is higher fat mass.
And they actually are just, their bodies are less metabolically flexible. They're not as able to go between burning sugar for fuel and fat for fuel. They're kind of stuck in like sugar burning mode.
This is why they're prone to hypoglycemia right at birth, because once they're born and you cut the umbilical cord, that consistent supply of sugar disappears, but their insulin production is still high, so their blood sugar tanks.
That's, you know, we want, the biological design is that babies are actually born in, in fat burning mode. So that has to do with how well your blood sugar was controlled.
If your blood sugar's in a good range, your body will be going in and out of burning glucose for fuel and fat for fuel, as will your baby. And it will have the flexibility to adapt to those early days out of the womb better than a baby who is so biologically programmed just to burn sugar for fuel.
So yeah, you know, this is one of those conversations that I just don't, I, I don't know that it's been at the forefront because the way in which our medical system looks at gestational diabetes is always looking at worst case scenario and over medicalizing the birth.
And I think that has like, brought out sort of like the outrage from the other side where it's like, well, this is just a made up diagnosis and BS and like, I completely disagree with the over medicalization of the diagnosis.
And yet it is indeed a physiological phenomenon that we should manage better to optimize outcomes and that should be done via food and lifestyle. So you can still have the birth that you want and it can be done.
I mean, I have, I run a gestational diabetes course. I've been running it for almost 10 years now. And I have tons of women in that program who have given birth at home or outside of the system.
So it can absolutely be done. But we do need to acknowledge that, yes, like, blood sugar should be something that we pay attention to.
Emily: Yeah, it is crucial. Thank you so much. So I know our time is almost over. I'm. I'm really interested to talk about in postpartum when we are having that insane drop off the cliff with all of our hormones.
We know, like, healing. Okay, obviously we're going to support our protein and our micronutrients, but as far as helping our liver to detox and rid our bodies of these hormones as they're leaving, what do you have to.
Lily: Say as far as nutritional requirements or postpartum specifically? Yeah, so, I mean, in postpartum, we. We first have to acknowledge that your nutrient requirements, not just calories, protein, and a number of micronutrients, are way higher than they were even at the final stages of pregnancy.
And that, that shocks a lot of people there. We just assume, like, most of our job is, like, done when the baby's actually in our body, but we're still growing that baby.
They're just outside of our body now. And now we have to go through this process of repleting our nutrient stores and thinking about liver health specifically. I'm actually glad you brought that up, because there's a lot of women who have cholestasis postpartum.
They get liver and gallbladder issues. And part of that is because your body is doing a lot of work metabolically to heal. You are just. All systems are on overdrive for your healing at that time.
So not only are you excreting excess hormones, you're switching over to the hormones of lactation.
Your thyroid is completely remodeling. I mean, tons of stuff is going on hormonally, but you are also mobilizing stored body fat for fuel to fuel breastfeeding. I mean, you're using all available fuels.
You're pulling dramatically from, you know, liver glycogen stores, the. The food that you're consuming, pulling glucose out of your bloodstream, but you're also breaking down maternal fat stores. And with that, that can place a burden on the liver.
The biggest thing I would say for supporting liver health postpartum would be to eat enough protein. I know I'm like, just basically a broken record on protein.
The first ever study on protein requirements in postpartum was done a couple years ago. They looked at women at three to six months postpartum, so not even in the immediate postpartum recovery phase.
I can only imagine what the protein requirements would have been if they had checked at that phase, and maybe someday they will. It's a challenging time to recruit study participants, but they found the protein requirements are higher than a typical female athlete.
Okay. Essentially, you should be eating pretty close to a gram of protein per pound of body weight when you're postpartum, arguably, maybe even more, depending on how ravenously hungry you are.
But when people think about liver health, they think about juice cleanses and supplements and like, fiber and those. Sure, that stuff can all have its place. I already talked about bitters and bitter herbs and things like that.
That can play a role. Yes.
But when we look at what the liver actually needs to function, I mean, it is a nutritional storehouse because it uses all those micronutrients as co factors for all these enzymatic processes and detoxification, creation of bile and all the things.
So you're gonna rely pretty heavily, particularly on amino acids, for those to be running well. So you need a lot of different amino acids for bile production. And you, you need your bile not only for all the digestive things we already talked about, but it's also a mode for excreting toxins out of your system.
So you need, well, choline's not an amino acid, but you need choline for bile production, then you need other amino acids, you need taurine, you need glycine. There's a few others that I can't recall off the top of my head, but some of these, especially taurine, only found in animal foods.
Highest in seafood, by the way, but it's found in lots of different foods. Glycine, you find in your collagen, rich cuts.
Glycine is the most abundant amino acid in collagen. And you think about how did traditional cultures approach postpartum recovery? Very heavy on the animal foods. And a lot of them were soups and stews made from things like, you know, pig's feet with the pig's feet soup in China, or you have a seaweed soup in Korea that's made with a really rich beef bone broth.
In Mexico, you have a whole chicken head, feet, all the collagen rich parts, all in there. Right. Made into a really rich gelatinous soup. You need that to help with your bile flow, your liver function.
So I would lean as heavily as you can into protein consumption postpartum. Honestly, it fixes probably 99% of your problems. Postpartum, seriously, I would lean into hydration, more fluids, especially if you're nursing.
And I lean into electrolytes pretty heavily. And then other than that, make sure you're eating enough calories as a whole. So fill in the blanks with all the foods. This is Not a time for restriction of any time of any, any type of nutrient.
You, you really want to lean into like all the foods. But I would prioritize the protein as the central thing to, to emphasize it's, it's all too easy to just fall into like undereating and let me just go to the pantry and grab whatever is easy.
And most of our easy accessible things are just carbs, which is fine. You need carbs for nursing too. However, you need the protein. And you're just going to be on a roller coaster of ridiculous hunger and cravings and deep, deep depletion if you're just relying on whatever happens to be in the pantry.
This is why so many cultures had practices of having other women in the community or family make food for you.
That's the central thing, is the food. And if that's not happening, that takes the work on your part to prepare for it or to arrange for it to come to you in other ways.
Stocking the freezer, great idea. Slow cooker meals, great idea. But relying on some sort of community support or potentially even hired help or meal deliveries to meet that need the quickest things for things.
Quickest way for things to fall apart postpartum is to not be eating enough.
Yeah, everything falls apart when you're not nourished.
Emily: Thank you so much for your time. I cannot thank you enough. Honestly. I really appreciate you and I will link everything in the show notes, but do you want to give a shout out to your website, Instagram, et cetera?
Lily: Yeah. Yeah. So Lily nicholsrdn.com has all the resources. It links out to my books, it links out to blog articles. There's hundreds of them. I give away the first chapter of Real Food for pregnancy for free up there.
Click the Freebies tab for that. There's information about my professional training under services.
I will say on the blog area, if you want to spend some time reading. Not quite so sure you want to invest in a book yet.
Search for terms like protein, look for postpartum recovery. You will uncover a lot of different resources that are really helpful. I have like a super detailed article on postpartum recovery meals.
I link out to 50 plus recipes. Kind of run through the things that you can do for preparing or arranging help to come your way. So definitely spend some time on my blog because there's so many articles, there's no paywall, it's all free.
Over in social media land, I'm on all the platforms but I'm most active on Instagram and my handle is the same as my website. So it's Lily Nichols, rdn.
Emily: Thank you so much Lily.
Lily: Thank you.
Emily: Thank you for listening through to the end. I do hope you found good medicine in today's episode and that it encourages your own soul evolution. I have a few new offers, both in person and virtual that I'd like to tell you about.
Beginning in January, I will host a free in person perinatal Women's Circle for anyone trying to conceive, pregnant or postpartum seeking community and support. There will be a focus on preparing for natural birth and healing from birth trauma.
Children are welcome. You can sign up via my website.
I also now offer a monthly online virtual Village circle for families seeking an empowering physiological conception, pregnancy, labor, birth and postpartum. It's just $10 a month or free when you purchase my online course.
So you want a home birth? You can gain access by signing up via my website.
As always, I host host women's circles once a month at my home in Southern Maine. All women are welcome. For details go to my website.
I have 20 years of experience in the medicalized system. I let my nursing license expire in 2023 and now I walk with women seeking a physiological, instinctual and deeply spiritual conception, pregnancy, lady labor, birth and postpartum journey.
I help prepare and repair for the most expansive rite of passage that women get to experience in this lifetime. It is my greatest honor and sole mission to hold sacred space and witness women as they claim their own inner authority and power.
I am a fierce advocate and guardian of natural using the culmination of my life's experiences including my own embodied wisdom when it comes to being a home birthing mother, nearly two decades of experience in our healthcare system and a year long sacred birth worker mentorship with Anna the Spiritual Midwich.
I support births with or without a licensed provider presentation at home birth centers and the hospital.
I offer birth debriefing and integration sessions for women, their families and birth workers.
I offer therapeutic one to one sessions, individually tailored mother blessings, closing of the bones and fear and trauma release ceremonies.
If any or all of this resonates, I offer a free free 30 minute discovery call if you have a birth story to share or if you're a embodied wise woman, witch healer, medicine woman.
I am also interested in sharing your contribution to our soul evolution.
You can book in via the link in the show notes.
Thank you so much for your love and support everyone. Until next time, take really good care.
