Today, we talk with Lily Nichols, a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition (https://lilynicholsrdn.com). She is the author of two bestselling books, Real Food for Pregnancy and Real Food for Gestational Diabetes (https://lilynicholsrdn.com/books/). We begin by defining gestational diabetes as elevated blood pressure during pregnancy, either first recognized or first developed during pregnancy. We explain why high blood sugar is so dangerous, particularly for the development of the child. As we discuss the risks of high blood sugar, we point out that most can be prevented by screening early, awareness, and caution. We then talk about the best approaches to prenatal nutrition. We discuss how the recommended guidelines and diets for pregnant women are often too high in carbohydrates, which is what led Lily to write her book and develop her program. We talk about ketones, and the common misconceptions that surround them in nutritional recommendations and guidelines. Lily urges everyone to consider the physiological reality in the development of babies instead of making assumptions based on data on diabetic ketoacidosis. Lily talks about the importance of consuming whole foods and getting all of the nutrients they provide in their most natural, unprocessed forms. She focuses on choosing foods based on which nutrient deficiencies are most common during pregnancy, as paying close attention to blood sugar levels. She explains how grains, which are less nutrient rich, would be closer to the top of her “food pyramid” for pregnant women. We talk about the importance of taking ancestral, traditionally based diets into consideration when selecting your foods. We then discuss how nutrition can affect postpartum recovery. 

• 2:55 What is Gestational Diabetes? 

“This is the physiological reality. We don’t have to try to stuff people full of carbs to try to avoid ketosis. This physiologically happens in all mammals…we just get super freaked out over data on diabetic ketoacidosis, and then people try to extrapolate that for nutritional ketosis in pregnancy, and it’s not the same thing.” 23:11

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