Lily Nichols isn’t your average dietitian; she has a passion for evidence-based prenatal nutrition (this is why we love her!) and is one of the leading nutritionists questioning the pregnancy dietary guidelines against current scientific research.
Guess what she has found…that most prenatal nutrition is outdated!
After following standard practice for mothers with gestational diabetes, Lily noticed her clients blood sugars were either not improving or getting worse. She deep dived into the research to find out where these guidelines come from. And no one could tell her, not even dietitians working in the field their entire careers. “Following outdated advice is harmful for health, but how often do we question what we are told by medical professionals?” asks Lily. This is what ultimately influenced the writing of her first book, Real Food for Gestational Diabetes.
Her work focuses on picking apart current Food Guidelines with questions such as:
- Where did they come from?
- Do they make sense?
- Does the research support them?
She is constantly questioning everything because there is still so much we don’t know. “Our current dietary guidelines are definitely built from a top-down approach and looking at the macronutrients and micronutrients are a bit of an afterthought” states Lily. Macronutrients are the nutrients you need in large amounts, fat, protein and carbohydrates and they provide you with energy. Whereas micronutrients are your vitamins and minerals that are important for your body’s function, important for optimal health and assist in the production of energy in your body.
“Carbohydrate recommendations are essentially pulled out of thin air because all of the assumptions we make about nutrient requirements for adults as a whole” Lily Nichols
Through understanding the required nutrients for prenatal health and fetal development, she decided a better approach was needed. Lily ran some analyses on a more nutrient sufficient wholefoods-based diet and it proved to meet all the recommended daily allowances for all the micronutrients, but the macronutrient ratios were very different compared to the conventional standards. “We have underestimated the protein requirements in pregnant women by about 73% - with the first ever study done to look at protein requirements directly in pregnant women in 2015”
“There is a lag time of often 17 years until research makes it into clinical practice. Can we cut down on that lag time?” Lily Nichols
Another outdated area of Dietary Guidelines is the topic of foods to avoid during pregnancy, in particular fish. Lily states that “the advice on fish and mercury is usually not given with the specifics around there’s only a handful of types of fish you need to avoid, instead it just given as no fish, which is really unfortunate”.
“In the [United] States the majority of foodborne illness outbreaks (46%) are from raw fruits and vegetables with no warnings to avoid salads and cut fruit. Whereas eggs with runny yolks, the chances you get sick from an egg with a runny yolk is very slim. The chances that an egg contains Salmonella is 1:12,000-30,000 with sickness from eggs only accounting for 2% of foodborne illness outbreaks in the states” states Lily. Hence why Lily is frustrated with the advice to completely avoid runny yolk eggs. She prefers more of a risk versus benefit discussion around foods in pregnancy. But sadly, this is not the norm.
Questions she believes need to be asked are:
- How likely are you going to get sick from this food?
- How likely is it that is contaminated?
- Is there anything you could do to mitigate that risk that would still allow you to enjoy that food?
- What nutrients does it contain?
For many women the prospect of not being about to eat eggs with runny yolks, often leaves them avoiding eggs completely. Lily raises concerns that this “creates a different problem, where this person will not consume enough of the essential nutrient choline, which is critical for placental health and for the development of the baby’s vision and brain. Eggs account for more than half of the choline intake in our diets, it’s really, really important. I think sometimes these guidelines can do more harm by lowering nutrient intakes” states Lily.
You can listen to the full podcast interview on 'The Science of Motherhood' with Dr Renee White and Lily Nichols here.
To find out more information about Lily Nichols, click here.