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Gestational Diabetes and Hyperemesis Gravidarum Interview

Six months ago, I started a project that had been bouncing around in my head for over 2 years.

It was big, it was going to take a lot of energy, and there was a chance I wouldn’t finish it.

Even though I had mapped out my steps, planned a schedule, and worked at it day by day, I almost gave up a few times. I’m sure you know the feeling.

We all have projects that seem to drag on forever.

One of my secret weapons to staying the course was talking about it with other people. (Oh, and taking lots of breaks to hike and binge-watch Netflix…)

There’s something about having an actual conversation and sharing what’s on your mind that helps remind you of your big WHY.

And maybe it’s just circumstance, but I was interviewed over a dozen times on this topic in the last quarter of 2014 (and most of these opportunities came to me completely out of the blue).

Today I’m sharing (another) one of those interviews. This one is with the lovely Rachel Dewell, a registered nurse and mother of five, who, like me, is a free-thinker and voracious reader of medical research.

Rachel has a website (and podcast) called Preventing HG Before Pregnancy, devoted to uncovering the possible causes and natural solutions for hyperemesis gravidarum.

During our combined gestational diabetes and hyperemesis gravidarum interview, we discuss:

  • A little history from me – like at what age I knew I wanted to become a nutritionist + how I feel about working in hospitals (you can probably guess)
  • Why there is controversy around the best way to diagnose gestational diabetes (first trimester screening, A1c, glucose tolerance test, etc)
  • How blood sugar levels can trigger nausea (reactive hypoglycemia/rebound hypoglycemia) and the type of diet that helps
  • How a woman’s metabolism changes during pregnancy (and what that means for her blood sugar levels and risk for experiencing nausea)
  • How insulin levels (and blood sugar levels) change during pregnancy and how that may affect nausea (insulin levels increase 3 to 3.5-fold by the 10th week of pregnancy)
  • Why simple carbohydrates aren’t the best option when you’re nauseous (think saltine crackers, bread, rice, fruit, popsicles, etc.)
  • What to do if the only foods you can tolerate are simple carbohydrates
  • How my nutrition recommendations for gestational diabetes differ from the conventional standards (and why 45g of carbohydrates per meal is usually too much)
  • Why fears around ketosis during pregnancy are unfounded (with the exception of diabetic ketoacidosis)
  • Why ketosis and diabetic ketoacidosis are not the same, and why clinicians continue to mix them up
  • How virtually all women go into ketosis during pregnancy
  • Why starvation studies or diabetic ketoacidosis studies during pregnancy cannot be used to describe nutritional ketosis (aka the type of ketosis that may occur on a low-carb diet)
  • Why I don’t recommend a ZERO carbohydrate diet (but DO suggest a lower carb diet)
  • How the Institute of Medicine sets the carbohydrate recommendations for pregnant women and why they are not set in stone
  • How good blood sugar control can reduce other pregnancy complications including: less preeclampsia, less weight gain, less swelling, faster recovery after delivery, and more
  • How woman can either prevent or control gestational diabetes in subsequent pregnancies
  • Overview of what I cover in my book, Real Food for Gestational Diabetes

Listen to the full interview here!


I’m also thrilled to announce that my book, Real Food for Gestational Diabetes, is available for purchase!

Real Food for Gestational Diabetes

I’ve never put so much blood, sweat, and tears into a project and since its (quiet) launch on Saturday, I’ve already received dozens of emails thanking me for writing it. (Seriously, some of these ladies read all 190 pages in one sitting! Who knew my book would be a page-turner?!)

Until next week,


P.S. If you want to learn more about using real food to manage gestational diabetes (and get a special freebie from me), visit

Manage gestational diabetes without fear.

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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. Congratulations on the book, Lily! I’d love to listen to the interview, too, but it’s in streaming format, and the room where I have my computer is different than the room where I listen to my MP3s. Is there any way to get a downloadable copy of it?

      • Thanx, Lily. In the link you gave, I clicked on “View in iTunes,” and it opened iTunes, but then I don’t see where to download it. And it’s also not listed in the 18 other talks that show up on that page. How do I download it? Sorry — I’m usually not technically challenged, but I just don’t see how/where to do that with this one.

        • It’s the episode published Nov 19th titled “How to control gestational diabetes with your diet”

          • It worked! Thank you!

  2. Congrats on your book, Lily! That is so very exciting 🙂 I can’t keep up with all of your interviews – you are certainly making the rounds…you are such an expert on this topic, and your passion shines through each and every one of the interviews that I’ve listened to thus far 🙂 Best of luck in 2015 with all of these exciting opportunities!

    • Thanks Stacey! And I have more interviews coming up. 🙂

  3. I’m so glad you wrote this book! I had GD with my son and it can be very frightening and confusing to navigate. I managed it all with diet, but I wish I had know some of this information then.

    • I’m hoping to make this diagnosis less scary and I believe it’s all about having the right information! I have a growing Real Food for GD community here if you know any moms currently struggling with this diagnosis.

  4. Great interview Lily … can’t wait to read your book. I too recommend lower carb intake than the current recommendations and it makes me feel good that you recommend the same. In my first pregnancy, I ate a lot of carbs (crackers, breads, popsicles, etc) due to nausea. now in my third pregnancy, I’m not eating as much of these and trying to eat more eggs, chicken soup, and meat and I feel much better… although must admit… craving citrus fruit often as well!

  5. I am 27 weeks with 2nd HG pregnancy. Still vomiting almost daily. Received news today from midwife office that I failed glucose test (mine came back 186). Between HG that isn’t well controlled and being a vegetarian, I’m concerned about switching out my safe foods for my GD friendly foods without creating an entire new list of food aversions. Thank you for the info and for posting the podcast. Very informative and helpful.

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