top of page

Review of Lily Nichols’ Real Food for Pregnancy

Real Food for Pregnancy by Lily Nichols, RDN, CDE

Reviewed by Maria Boyuk

Pregnancy is a beautiful and miraculous season as new life grows within the mother’s womb. A little person develops tissue, lungs, a heart, tiny fingers and toes, eyelashes, and so much more.

Vital to the development of this baby is the diet and specific nutrients mom provides. In addition, it is so important to support mom’s health with the proper foods as she experiences a demand on her body and navigates challenges such as nausea, heartburn, cravings, blood sugar swings, or gestational diabetes.

Read Food for Pregnancy by Lily Nichols is a beautiful guide for supporting women in this nutritional journey. She inspires and equips women with research-based education and practical resources in order to have a healthy pregnancy and nourish a thriving baby in utero.

Pregnancy is a critical window for epigenetics

As a new mom and a Nutritional Therapy Practitioner supporting women in pregnancy, I value Nichols’ book because of the uniqueness of the prenatal season. Nichols refers to it as a “critical window,” during which the baby’s genes will form a blueprint.

She shares that “researchers have found that genes can be turned on or off by certain exposures in utero, such as levels of nutrients, a mom’s blood sugar and insulin levels, exercise habits, stress hormones, toxins and more” [1]. This concept is known as “epigenetics,” and it explains how our environment impacts the expression of our genes, even before our birth!

What is the best pregnancy diet?

There has been some contradicting education on the proper pregnancy diet for women. This is why I love how this book provides solid research-based recommendations.

Nichols, a Registered Dietician Nutritionist and Certified Diabetes Educator, is a master researcher. She does not simply accept conventional medicine’s advice, based on the government’s nutrition policies. Such policies give outdated guidelines that tell us to “eat less meat, limit saturated fats, and eat more grains” [2].

Sadly, this advice can lead to depleted micronutrients and blood sugar dysregulation. Instead, she draws wisdom from ancestral diets that preceded industrialized foods combined with current research that provides data on the nutrition and lifestyle needs for the prenatal season.

So, what should a woman eat?

Nichols emphasizes the necessity of proper macronutrient ratios. Getting the right balance of fat, proteins, and carbs will optimize a woman’s digestion (a plus for symptoms like heartburn) and blood sugar handling (aiding in hormone balance, sleep, energy, mood, and preventing gestational diabetes). Notably, “research shows that even mild elevations in blood sugar during pregnancy can affect your baby. For example, researchers at Stanford University have shown that elevated blood sugar (far below the diagnostic threshold for gestational diabetes) is linked to a significantly higher risk of congenital heart defects” [3].

A template for balanced meals

Nichols’ meal breakdown guide gives women a great place to start:

  • 2 cups + of vegetables (with some fat, like butter or olive oil)

  • 3-4 oz. of protein (with naturally occurring fat, like the skin on chicken)

  • 1/2 to 1 cup of starchy or carbohydrate-rich whole foods [4]

I appreciate how Nichols emphasizes that these are general guidelines and should be adjusted based on bio-individual needs. Portion sizes will vary per woman and depend on “if you’re gaining weight more rapidly than expected, if your blood sugar is high, or if you’re concerned you’re undereating” [5].

Personally, I found that I did not need to eat a lot more carbs during my pregnancy, and this helped my blood sugar stay stable and have healthy weight gain. I love equipping women to understand their bodies in this way. Once we fine-tune our bio-individual needs, we can adjust macro and micronutrients accordingly.

Some forgotten micronutrients for a healthy pregnancy

Micronutrients are the vitamins and minerals that we get from our macronutrients. Many women think they are all set if they take a prenatal vitamin, but this should supplement our micronutrient-rich diet.

I found it so helpful how Nichols broke down several micronutrients and highlighted specific foods rich in those nutrients. For example, choline is necessary for the development of a baby’s brain. It can “permanently change, in a good way, the genetic expression of your growing baby” [6].

“Unfortunately,” Nichols reveals, “most women consume only a fraction of the choline they need… In fact, it’s estimated that a full 94% of women do not meet the recommended intake of 450 mg of choline per day” [7].

This is primarily because many don’t eat enough of, or in some cases, any of choline’s top sources—egg yolks from pasture-raised chickens and grass-fed liver. If a woman were to eat according to conventional guidelines, her dietary egg intake would be limited, and liver would never be on the radar. If these are new foods for a mom, including them in the diet can feel daunting. For this reason, it is so valuable that Nichols has included recipes and sample meal plans for all her recommendations. I love to equip clients with these resources as it helps them more readily integrate new foods into their diet.

A holistic outlook

There was so much more packed into this book, from environmental toxins to exercise, stress and mental health, to the fourth trimester (first three months of postpartum). Each subject showed Nichols’ appreciation for holistic health—our health is not only determined by the food we eat but our lifestyle, activity, and mental health.

Nichols also dove into the topic of pregnancy expectations and common complications—what causes them and how to use food as a tool to navigate through them. As a new mom, these were extremely helpful as I experienced nausea, food aversions, and heartburn. I loved understanding common causes and how to navigate them with food and lifestyle choices.

I’m so thankful for the wealth of knowledge Nichols has provided in this book. I will continue to use it as a resource for my prenatal clients, and I highly recommend it to any parents or practitioners supporting women during the prenatal season.


[1] Nichols, Lily. Real Food for Pregnancy, 2018, p. 2.

[2] Nichols, Lily. Real Food for Pregnancy, 2018, p. xv.

[3] Priest, James R et al. in Nichols, p. 8-9.

[4] Nichols, Lily. Real Food for Pregnancy, 2018, p. 25.

[5] Nichols, Lily. Real Food for Pregnancy, 2018, p. 25.

[6] Jiang, Xinyin et al. in Nichols, p. 30.

[7] Wallace, Taylor C., and Victor L. Fulgoni III. in Nichols, p. 30

113 views0 comments

Recent Posts

See All


bottom of page