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Pregnancy Diet | Interview with Lily Nichols

Pregnancy Diet | Interview with Lily Nichols

Nov 27, 2019

To start things off, tell us a little bit about yourself! 

I’m a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition. I’m the author of two best-selling books, Real Food for Pregnancy and Real Food for Gestational Diabetes. My work is known for being research-focused, thorough, and unapologetically critical of outdated dietary guidelines.

You can find my work at and on Instagram @lilynicholsrdn!


Why do you think prenatal nutrition advice is outdated and where do you see the biggest areas of opportunity? 

Research is constantly evolving, especially in the field of nutrition, and yet, there’s a lag time between new evidence getting incorporated into clinical practice and eventually public policy (often 17 years or more). Prenatal nutrition is no exception, and in fact, it’s often lagging far behind other areas of nutrition science due to ethical constraints around studying pregnant women. For example, numerous micronutrient targets (and even targets for macronutrients, meaning fat, carbohydrates, and protein) are well overdue for an update. This includes choline, protein, carbohydrates, salt, vitamins B12, B6, D, and many more. This post covers several of these in more detail!



Tell us about your book Real Food For Pregnancy. What inspired you to write it?

I wrote Real Food for Pregnancy to provide an evidence-based summary on optimal prenatal nutrition as well as other topics related to pregnancy, like supplements, exposure to toxins, the validity of typical “foods to avoid” lists and more. I believe every pregnant person should have access to the most accurate information available, whether or not they are a researcher or nutritionist herself. Ultimately, I hope Real Food for Pregnancy can serve as a one-stop resource for moms and healthcare providers. We can help the next generation have better health by getting better nutrition information in the hands of expecting moms. 


A common question we get asked is in regards to what should women eat while pregnant. What is your general advice on food that pregnant women should eat?

Put simply, a diet that is comprised of mostly whole, unprocessed food (meaning “real food”) is optimal for pregnancy health. To me, that means an omnivorous diet that includes vegetables, fruit, nuts/seeds, animal foods (including meat, eggs, seafood, and possibly dairy), and legumes. Try to plan your meals around having a solid source of protein, some produce, and healthy fats. Don’t forget to make your food taste good!


A lot of moms worry that if they are very nauseous in the first trimester causing them to barely eat, that they are not providing the right nutrients for the baby. What would you recommend to these moms? 

Nausea during pregnancy, often termed “morning sickness,” is no joke. Some seem to bypass this queasy phase, while others get hit HARD. Those that avoid it entirely are the exception, however, researchers report that 70-80% of women will experience nausea at some point in their pregnancy. There is no cure-all, but the following tips can help you get through this phase.

  1. Eat small, frequent meals or snacks.
  2. Balance your blood sugar—aim to include some protein and fat when you eat, even if the portion is small.
  3. Try salty, sour, or cold foods.
  4. Keep a snack at your bedside and move slowly first thing in the morning.
  5. Consider eating more (and/or supplementing with) ginger, vitamin B6, and magnesium.

For a detailed explanation on why the above can help—as well as other ideas for managing nausea—see chapter 7 of Real Food for Pregnancy. In short, nausea is common, you’ll probably be eating differently during this phase than you usually do, and sometimes it’s just survival mode! You do the best that you can and take it day by day


What particular foods do you recommend pregnant women to stay away from?

There are actually very few foods that need to be strictly avoided during pregnancy. You’ll want to have some common sense about food safety to minimize your risk of food poisoning, however to put foods into categories of what’s safe versus unsafe is actually not evidence-based. For example, the majority of food poisoning cases in the United States come from raw fruits and vegetables, however these foods are nowhere to be found on “do not eat” lists. Chapter 4 of Real Food for Pregnancy details the statistics on food safety and may provide some reassurance and perspective in this area.

In my opinion, it’s more prudent to pay attention to nutrient density when choosing which foods to emphasize or minimize/avoid in your diet. For example, refined grains and sugars, refined vegetable oils, and trans fats offer little in terms of nutrition, are linked to numerous pregnancy problems when consumed in excess, and displace other foods from the diet that would otherwise be providing you and baby with important micronutrients. It’s also wise to avoid/minimize your intake of caffeine and alcohol in pregnancy.



What are the most important vitamins and minerals for pregnant women?

Technically, you can argue for the importance of just about every vitamin and mineral during pregnancy. Some of the most crucial are folate, choline, vitamins A and D, vitamin B12, iron, zinc, iodine, and magnesium.


We noticed you talk about toxins in your book. What are some common toxins pregnant women should try to avoid?

There’s considerable research on the effects of toxins on pregnancy complications and fetal development. Some of the most important ones to be aware of are chemicals found in plastics (such as BPA and phthalates), PFCs or perfluorinated chemicals (such as those found in non-stick cookware), pesticides, and heavy metals. There’s an entire chapter devoted to this topic in Real Food for Pregnancy. It’s also covered in this post.



It’s common for women to focus on eating right once they learn they are pregnant. What is your opinion on the effect that your diet/nutritional intake can have on preconception and fertility?

Nutrition before conception is just as important as during pregnancy. Numerous nutrients play a role in egg health (as well as sperm health), which means you can have an impact on your chances of conception and reduce your risk of miscarriage with proactive lifestyle choices (particularly in the 3-4 months prior to conception). Also, early embryonic development, which includes the formation of the baby's internal organs, happens in the first 8 weeks of pregnancy. This is often before many people even know that they’re pregnant. Lastly, early pregnancy is often a time of nausea or food aversions, which means you may be more reliant on your nutrient reserves during this phase. If you have the luxury of planning ahead for pregnancy, it can be reassuring to know that you’ve been eating well prior to conception. 


If you could give one piece of advice to our moms, what would that be?

Don’t overthink your food choices too much. Celebrate every bite of nutrient-dense foods you eat rather than obsess over doing everything “perfectly.” 


Check out Preparing While Pregnant: Postpartum Nutrition Strategies and Best Foods for Moms to Eat Before and After Labor for more information about best practices during your pregnancy.

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We'd love to hear about your experiences as a pregnant or new mom! Share your stories with us @lovemajka #lovemajka #fuelingmotherhood 


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