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The Truth About Carbohydrates and Pregnancy

Today’s interview was prompted after my appearance on Robb Wolf’s podcast, which explored the gestational diabetes controversy (or shall I say controversies), including the topic of ketosis.

Christopher and Julie from Nourish, Balance, Thrive (and hosts of the Paleo Baby Podcast) reached out to me for a more in-depth discussion on the truth about carbohydrates and pregnancy.

In this interview, we discuss the truth about carbohydrates and pregnancy, including:

  • The origins of conventional carbohydrate recommendations during pregnancy
  • How a woman’s diet during pregnancy and ketones can impact her baby’s brain development
  • Why low-carbohydrate diets and ketosis is controversial (I’ve touched upon this before.)
  • The different types of ketosis – which kinds are harmful, which are benign
  • 3 practical ways to find your optimal level of carbohydrates during pregnancy
  • Theories behind why blood sugar levels are so tightly regulated during pregnancy

We cover a whole lot more than that, so listen in for the full scoop, including some extra intel into what to eat preconception for optimal fertility, some useful lab tests, and, per usual, a discussion of gestational diabetes.

I also touch upon the importance of maintaining normal blood sugar – regardless of if you’ve been diagnosed with gestational diabetes or not!

Listen in on Stitcher or Nourish, Balance, Thrive.


Until next week,

UPDATE: Since this interview went live back in 2015, I’ve been back on the show again. Check out our follow up episode on postpartum recovery here.

PS – If you have gestational diabetes and want to learn more about my popular Real Food for Gestational Diabetes Course, go here.

(I’ve been welcoming an increasing number of clinicians to the course, including dietitians and midwives, so it’s not just for moms-to-be!)

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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 Her work is known for being research-focused, thorough, and unapologetically critical of outdated dietary guidelines.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.


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  1. I’ll definitely listen to this podcast soon! I’m incredibly curious as to how ketones and carbohydrates function during pregnancy!

    • Enjoy, Cassie!

  2. Couldn’t agree more with your stance on nutrition during pregnancy, Lily! When I worked as a dietitian with WIC, it drove me nuts how we handed out vouchers for foods that were basically ‘junk food’ in disguise (cereal, juice, etc.), which is definitely not great for pregnancy (and especially those with GD!). Since starting my own practice a few years ago, I really had to almost force myself to ‘unlearn’ much of the conventional stuff that we were taught. So sad. I even dropped my membership with the Academy of Nutrition and Dietetics a couple years ago because their stance/values are just so far removed from my own.

    • Thanks for sharing, Amanda. We’re certainly not alone. In my Real Food for Pregnancy interview with another RD, Frances Arnold, we discussed the pitfalls of WIC. At the very least, women can get eggs and $10 per month towards fresh fruits and vegetables, but I think it’s criminal they provide juice and processed cereals. There’s a lot of work to be done!

  3. Have you ever thought of applying for cdr credit? I’m interested in the course, but it’s hard to commit that much time without cpe’s (which I may do anyhow, it’s just that I’m up for my CDE renewal this year & time is of the essence!) I’m so interested in this approach, and I feel like I almost owe so many women I’ve “helped” an apology!

    • I’m also an RD, CDE. Forgot that part!

    • I have, Jamie! However, when I surveyed other dietitians, it seemed the topic might be a bit too niche for them (pretty rare to specialize in GDM, like me!). That said, there are a number of health professionals who have taken my course. I will continue to look into CDR approval if there’s enough demand.

      In the meantime, you CAN get continuing ed credits for my book via Helm Publishing. 😉

      • Awesome!!!! I have the book, so I will purchase the test for credit. Thank you so much for sharing this!

        • Thanks! I am going to do the same. I would be interested in credits as well if that’s ever a possibility.

          • Thanks for letting me know, Danyel! 😉

            PS – I’ve just received notification that my book is being used as required reading in a major university’s Maternal & Infant Nutrition course. Loving that conventional nutrition programs are open minded enough to accept the newer, evidence-based approach.

  4. I just found your page and already love it! I’ve had two ‘GDM’ pregnancies, both of which i was able to control my blood sugar naturally with a low carb diet (around 75 carbs per day) . I was blessed to have a midwife that was knowledgeable about GDM and low carb, real food nutrition. I have two healthy girls and had to great pregnancies. I am training to be a doula but would love to also offer real food nutritional education and diabetes education to my clients!

    • Great to hear, Kayla. Good luck in your doula training! If any of your future clients have gestational diabetes, check out the (fully online) Real Food for Gestational Diabetes Course for all the info and peer support to get through it healthfully & stress-free. 🙂

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