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Correcting Outdated Prenatal Nutrition Advice

There are a ton of “strongly-held incorrect beliefs” (as my father likes to call them) in my field.

The conventional prenatal nutrition guidelines inadvertently – or sometimes – purposefully advocate for a diet that leaves out some of nature’s most nutrient-dense, life-giving foods!

My books, Real Food for Gestational Diabetes and Real Food for Pregnancy, tackle many of these myths head-on (with oodles of research to back up my case), but for those of you who have not yet read them, here’s your chance to learn more about my stance.

Myself, and many other real food dietitians/nutritionists, agree that correcting outdated prenatal nutrition advice is long overdue.

In this post, you’ll learn:

  • 6 Prenatal Nutrition Misconceptions That Need to Stop
  • The answer to this question: Is it Safe to Go Low Carb During Pregnancy?
  • My thoughts on: preconception nutrition, prenatal supplements, and vegan diets during pregnancy

Let’s start this three-course “prenatal nutrition myth buffet,” shall we?

First Up

For starters, it’s time to reevaluate some commonly parroted prenatal nutrition-isms. Things like “Always take folic acid” and “You must eat plenty of whole grains.”

I debunk those (and more) in this post: 6 Prenatal Nutrition Misconceptions That Need to Stop (for Aglaee Jacob, The Paleo Dietitian and creator of Radicata Nutrition)

Second Course

Let’s talk carbs.

Most pregnant women are told they need to consume extra carbohydrates during pregnancy. Some clinicians go as far as to warn pregnant women that a low carbohydrate diet is dangerous during pregnancy.

Yet, there is very little evidence to support this.

As far as I’m aware, I’m the first medical professional to break down, point-by-point, why the conventional carbohydrate recommendations for pregnancy are wrong (and why pervasive fears about low carb diets and ketosis in pregnancy are unwarranted).

(In fact, I devote an entire chapter to that topic in my book, because there is so much controversy and research to explain. For those of you reading, turn to Chapter 11.)

To get a taste of this research, check out my post: Is it Safe to Go Low Carb During Pregnancy? (for Franziska Spritzler, The Low Carb Dietitian)

Time for Dessert

And the cherry on the sundae is an interview I did with two awesome (and hilarious) real food dietitians, “Sassy” + “Pearl,” who host the Team Nutrition Genius podcast.

I get pretty passionate about this stuff, so much so that I compare myself to a political pundit at one point.

Alas, I don’t take myself too seriously, and neither to they, thankfully. Tune in and be prepared to laugh.

(Bonus points if you can count the number of times we say “fetus,” which happens to be Pearl’s favorite word.)

Listen to our Prenatal Nutrition Interview here.

Here’s small sampling of topics we discuss in our interview:

  • How long before a woman gets pregnant should she think about prenatal nutrition?
  • If a woman is taking hormonal birth control, does she need additional supplements or time to focus on preconception nutrition?
  • Is it worth it to take a prenatal vitamin? (what to look for and what to avoid)
  • How vitamin company reps are a lot like pharmaceutical reps.
  • Why you don’t want to take folic acid and what you want instead.
  • What supplements do I recommend during pregnancy? (beyond a prenatal vitamin)
  • Little known facts about vitamin D, folate, and choline.
  • Surprising fertility-boosting foods.
  • Why I do not recommend a vegan diet during pregnancy.
  • What all pregnant women should know about glycine.
  • The mercury in fish debate (and why it matters way less than you’ve been told).
  • Which foods should be avoided during pregnancy and why.
  • Why buying meat, eggs, and dairy from pasture-raised animals matters (Read these for more on pastured eggs + grass-fed beef).
  • How a woman’s immune system changes during pregnancy


That’s Not All

The deeper I dig into conventional prenatal nutrition guidelines and compare it to current research, the more potential issues I find. This post covers a few more areas that show us why prenatal nutrition guidelines need to be updated.

Whew, I feel like this post is like an encyclopedia on prenatal nutrition. No wonder I had to write a book (actually, 2 books).

If you like what I have to say, get yourself a copy of my book: Real Food for Gestational Diabetes: An Effective Alternative to the Conventional Nutrition Approach.

Real Food for Gestational Diabetes

Even if you don’t have gestational diabetes (or aren’t even pregnant yet), the book gives you sane, easy-to-implement nutrition and exercise advice to ensure you have the healthiest baby possible – when the time comes.

So, now that you’re up-to-date, I’d love to hear if you have other questions about prenatal nutrition.

Share ‘em in the comments section and I’ll address them in future blog posts and interviews. 

Until next week,

PS – If you like the myth debunking in this post, be sure to check out my latest book, Real Food for Pregnancy, which lays out the evidence—930 citations and counting—on the benefits of real food, why certain foods are essential (and others are detrimental), and countless lifestyle tweaks you can make to have a smooth, healthy pregnancy.

There has never been a more comprehensive and well-referenced resource on prenatal nutrition (believe me; I’ve looked long and hard).

Want to take a sneak peek? You can read the first chapter for free over at,

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Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition and exercise. Her work is known for being research-focused, thorough, and unapologetically critical of outdated dietary guidelines. She is the author of two bestselling books, Real Food for Pregnancy and Real Food for Gestational Diabetes.


Leave a comment
  1. Such great information Lily! People will look back and be surprised that you knew the truth all along. You’re a pioneer. Keep sharing this important and life affirming information, it will change the health of generations to come, but also individuals right now.

    • Thanks so much, Kara! I’ll keep forging ahead and paving the way for healthier moms and babies. 🙂

  2. Lily, for those of us who don’t want to listen to the interview via livestream, is it available for download?

    • Yes TT. Just search iTunes for “Nutrition Genius Radio” podcast, episode 29.

      • Got it. Thanx, Lily!

  3. What a relief, Lily! Finally somebody that talks sense… And I will be sending anybody who is trying to conceive or already pregnant across to you.

    When I was pregnant, my bump was pretty small and at week 30, the midwife was seriously concerned that I had placental insufficiency. Fair enough- she also sent me for a scan as precaution. BUT she gave me a lecture on nutrition, asked me what I was eating and when I told her she warned me that I needed to eat “substantial” sandwiches and the likes for snacks if I wanted a healthy baby…

    Needless to say, everything was perfectly okay and my baby was 3.6kg at birth although I had only put on about 8kg in total… Pregnancy doesn’t mean we can binge eat and do the baby a favour.

    Great to have someone cleaning up myths in the preconception/pregnancy world, thanks!

    • Thanks so much, Patricia! So far, quite a few docs, dietitians, and nurses have picked up my book, so hopefully these misconceptions will become less prevalent. I didn’t even go into the “eating for two” myth in the above posts, but that’s another one worth debunking. 🙂

  4. Lily, I wish I had this article when I was pregnant 11 years ago. I was told never to eat fish. My Asian friends thought I was crazy because they ate sushi and sashimi. However, when your doctor tells you NOT to do something, one tends to listen. I like all the research here and all your advice makes sense.

    • Brenda, The fish controversy is one of the worst. I regularly hear all sorts of bizarre suggestions when it comes to fish/seafood. Of course raw fish can be risky due to potential for food poisoning. Nonetheless, eating raw fish remains a normal practice in many cultures.

      In the US, fully 42% of food-borne illness is from fresh fruits + vegetables (primarily leafy greens), but there are never warnings to avoid fresh produce in pregnancy. 🙂

  5. Fantastic article and feedback – I have a friend who just announced she is pregnant and is a vegetarian… I am sending this article to her now!

  6. What a great reference! There are so many myths when it comes to diet in general and even more so for pregnancy that it is nice to see someone addressing them. I will be sure to pass along to any friends that are or thinking of becoming pregnant. Great job!

    • Thanks Christina!

  7. Wow there is a ton of great info here! Thanks Lily! I’m 14 weeks into my first pregnancy so this is all very relevant- I can’t wait to dig in! I have a question about prenatal nutrition: I was taking a few supplements for a while before getting pregnant. My doctor told me recently that I don’t need to take them. Do you recommend weaning myself off? I also wonder if I really need to stop taking them at all? I’m taking/was taking a B complex, Spirulina, fish oil and calc+mag+zinc, and vitamin D…and a prenatal. I’m confused by the info out there and I know most doctors don’t see the benefits of supplements at all. If you have any pointers or opinions, I’d be so grateful. Thank you!!

    • Hi Anne,
      While I can’t offer personal medical advice in this format, none of those supplements are unsafe, per se. You might be getting enough B vitamins from a prenatal vitamin. You can have your vitamin D levels measured to guide how much to supplement, but generally, most pregnant women need more than what’s provided in a prenatal to avoid deficiency. (More on vitamin D here.) As long as fish oil is good quality, it’s an excellent addition.

      More specifics on supplements I recommend (and don’t recommend) are covered in my book.

  8. Hi Lily, I really enjoyed your interview on the livin la vida low carb show!! And can’t wait to read your book!
    I was lucky to meet a doctor that introduced me to a low carb diet (rosedale diet) while I was pregnant with my first. Healthy pregnancy, no gestational diabetes, even though I started of overweight.
    Now I am pregnant with my second, sticking to a mostly low carb diet checking my BG with a glucometer every other day. My question is, should I take the glucose tolerance test? I am 28weeks, my fasting BG is 85 the highest, 95-100 after 1 -2 hour a meal and I don’t really feel the need to get tested for gestational diabetes. What do you think?
    Thanks! 🙂

    • Hi Stella, Glad you enjoyed that one. While I can’t offer personal medical advice in this format, I did touch upon the GTT in my recent interview with Robb Wolf on the Paleo Solution Podcast. Best of luck! 🙂

  9. Do not have GD but am newly pregnant and worry about since I’m over weight this time around. Will your book help me learn things to do to try to avoid GD as much as possible?

    Searching for a nutritionist who specializes in pregnancy, not easy to find!

  10. Hi Lily,
    Your book has been a big help to me this pregnancy! I was diagnosed with GD early on (I actually passed the OGTT, but had brought in some blood sugars to show them and they diagnosed me based on those, at 12 weeks). I am almost 39 weeks now and my blood sugars went way down in the past several days, so much so that they cut my nighttime insulin (to control fasting BG – I am diet-controlled otherwise, thanks to your book!) and I’ve increased my carbs as well. I am worried because I hear on Facebook groups about placental insufficiency/deterioration. Do you know anything about this at the end of GD pregnancies? Thank you!

  11. Hi Lily,

    I just found out that I am pregnant 2 days ago 🙂 This is the first time i’m going through this process.

    I listened to your book ‘Real Food for Pregnancy’ months ago. I absolutely love it.

    I just wanted to ask, when I went to the doctors for my blood test she was horrified to hear that I’m not taking a folic acid tablet. To which my response was “can’t I just get the same thing from food?”. She didn’t believe this to be a thing (typical) and stressed very strongly that I need to start taking the tablets NOW.

    To be honest I don’t want to put that in my body (and I know how you feel about it). So my question is… how much of whole foods do I need to be eating to get the recommended daily amount? Is there a meal plan or something you could create?

    I’m already eating liver (I hide it in my pasta sauce), I make bone broth with chicken feet – I eat both of these a few times a week. I’m eating kale chips with nutritional yeast every day as a snack, and 2 eggs as a snack each day.

    I know about the power of food through doing the GAPS diet. So lay it on me 🙂 Whatever you recommend

  12. Hi Lily,

    What chlorella or spirulina supplement do you recommend?

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