Women AND Men need the scienced backed information that Lily Nichols puts forth in her books and in this episode, you'll definietly get a snapshot of what a woman needs to focus on to create a healthy baby.
There are so many things to consider, diet of course, supplimentation, but also having a great support staff after the baby comes. You'll hear about that and so much more in this episode that I am so proud to bring to you.
Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based nutrition.
Her work is known for being research-focused, thorough, and sensible. She is the founder of the Institute for Prenatal NutritionTM, co-founder of the Women’s Health Nutrition Academy, and the author of three books: Real Food for Fertility (co-authored with Lisa Hendrickson-Jack), Real Food for Pregnancy, and Real Food for Gestational Diabetes.
Lily’s bestselling books have helped tens of thousands of mamas (and babies!), are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally.
She writes ➡️ https://lilynicholsrdn.com
Lily's IG ➡️https://www.instagram.com/lilynicholsrdn
The Good Foods podcast was created and hosted by Shardan Sandoval in March of 2023 and was active until September of 2024.
There are so many things to consider, diet of course, supplimentation, but also having a great support staff after the baby comes. You'll hear about that and so much more in this episode that I am so proud to bring to you.
Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based nutrition.
Her work is known for being research-focused, thorough, and sensible. She is the founder of the Institute for Prenatal NutritionTM, co-founder of the Women’s Health Nutrition Academy, and the author of three books: Real Food for Fertility (co-authored with Lisa Hendrickson-Jack), Real Food for Pregnancy, and Real Food for Gestational Diabetes.
Lily’s bestselling books have helped tens of thousands of mamas (and babies!), are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally.
She writes ➡️ https://lilynicholsrdn.com
Lily's IG ➡️https://www.instagram.com/lilynicholsrdn
The Good Foods podcast was created and hosted by Shardan Sandoval in March of 2023 and was active until September of 2024.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Hi, I'm Lily Nichols, registered dietician nutritionist, author of three books, Real Food
(00:07):
for Pregnancy, Real Food for Fertility and Real Food for Gestational Diabetes.
I am founder of the Institute for Prenatal Nutrition and Co-Founder of the Women's Health
Nutrition Academy.
And this is The Good Foods Podcast.
All of us are on a journey towards better health, and we're grateful that you've allowed
(00:27):
us to join you on your quest.
In this episode, you can't do it alone, you can't be standing in your kitchen, cooking
full meals when you're early postpartum.
You absolutely require other people to help you on some level.
Can you do it without help?
Yeah, and it is a struggle.
(00:48):
This is The Good Foods Podcast, and now here's your host, Shodan.
As one of your recent grandpa's stated, "I know you're itching to write, but oh my God,
all of these podcasts interview, so I'm very grateful that you're joining me on this podcast,
Lily."
Thank you.
Number five of this week alone, so lots of talking.
(01:08):
Well, I'm very, very grateful.
What got you interested in health and nutrition?
I've been interested in nutrition for a long time.
I mean, as a teenager, even, I made the decision that I would go and study nutrition in
college, so everyone said I'd changed my major and I never did.
I think just growing up in a relatively health conscious family, we always made the connection
(01:31):
with how you feel and what you've eaten.
If we had had more processed food and then we're feeling so good, I'd be like, "Oh, yeah,
I wonder if this has something to do with having whatever the item was."
And so that mindful eating aspect was always built in.
If we got sick, we would temporarily not have any sugar and cut down on the amount of dairy
(01:54):
we would have, so we wouldn't be as congested.
Things like that really kind of stuck with me from a young age.
But what kept me, I think, in the field as I really wanted to work with children eventually,
actually, I wanted to help perform the school lunch policy.
We were seeing rising rates of childhood obesity and diabetes and I thought, "Oh, well,
(02:15):
if we just change the school lunch program, maybe that'll help."
Certainly not to say that that won't help, but I had the opportunity to work with the California
diabetes and pregnancy program fairly early on in my career and that's where I learned
that that children born to mothers who have, you know, not great blood sugar control during
pregnancy, their children actually face a much higher risk of diabetes and obesity later
(02:39):
in life, starting as early as the childhood and adolescent years.
And that was like, "Oh, wow.
Here's an area where we can intervene easily.
We have a motivated group of people.
Pregnant women are usually quite motivated for health change and we can actually change
the development of that child so they have better metabolic health, better blood sugar,
(03:01):
better insulin levels and hopefully set them up real lifetime of health."
So that's what got me started and that's what kept me interested.
At what point did you come up with the idea of riding real food for pregnancy?
The real food for pregnancy is my second book, so real food for gestational diabetes came
first and circling back to kind of what I just mentioned in the intro.
(03:25):
That book was really only written because I was finding in practice the conventional dietary
advice was not helping my clients control their blood sugar levels and in fact they were
often making their blood sugar levels worse, which isn't really that surprising because
the guidelines suggest you consume no less than 175 grams of carbohydrates per day.
(03:47):
So you can imagine somebody who's been diagnosed with a condition that literally translates
to carbohydrate intolerance in pregnancy.
When you give them a high carb diet, their blood sugar levels get worse.
So real food for gestational diabetes is the counter argument against those recommendations
(04:07):
and what I have found in practice to actually work.
Real food for pregnancy came later, a few years later, after lots of people essentially
were asking me for, "Hey, you have this book on gestational diabetes, but what do you recommend
for pregnancy that doesn't have gestational diabetes?"
And of course I was like, "Just read the gestational diabetes book anyways, you don't have to
(04:29):
be as obsessed on the blood sugar aspect, but really the same type of diet applies for
overall health during pregnancy as well."
And after many pushes and shoves and after going through my own first pregnancy and seeing
how just dismal and lacking the advice was and how many myths there were about pregnancy
(04:49):
that I had spent so much time researching and debunking for myself, I was like, "Okay, this
actually is enough for another book."
Like this is a totally different book.
So real food for pregnancy came after that by popular requests.
Speaking of real food for pregnancy, how did you go about gathering the information for
that book and making it easy to understand during this very nutritional sensitive period during
(05:14):
a woman's life?
That's hard to say.
I mean, my writing style has evolved over the years.
I mean, initially the type of writing I was doing was just client handouts.
I mean, I did a lot of face-to-face client education.
I do kind of learn the way in which you explain things makes a difference on whether or
not people want to listen to you, wants to tune you out, if you're too high level, and even
(05:39):
the level of writing in my books has changed over time in response to the feedback that I
get and what people expect from me, right?
So real food for gestational diabetes came right after I was in a clinical job.
I'm working with clients, many of which speak another language than me working with a translator
(06:01):
or have low literacy.
And so that's written in like very simple language, very intentionally, but that came about
from the client work where I have been teaching classes on gestational diabetes.
I know the order in which to introduce things, the way in which to talk about them that makes
sense that people remember.
(06:22):
And so that kind of has carried forward with my other books as well.
I mean, I just, I put in a lot of effort really into making sure that the explanation is
as clear as possible.
I do a fair amount of interviews, but I misspeak in interviews sometimes, right?
Something doesn't come out exactly the way you want to, maybe the order in which you
(06:42):
cover the topic is a little in reverse.
And so I'm kind of obsessive in the editing phase to make sure that things are really
clear as I can possibly make them, especially when you're talking about things that are
kind of higher level content or talking about research studies.
There's a way at a right in which it's just a textbook that's boring that puts you to sleep
(07:05):
and then there's a way to write that's a little more engaging.
Like how much detail do you provide about the study?
Is this a thesis paper?
Am I writing for a medical journal?
Like no, I'm writing for the general public, bless some healthcare practitioners.
So I just do my best to write in a way that resonates with people.
Well, at the time of this recording, just a couple of months ago, real food for fertility
(07:27):
was published.
Did you have to change your approach or your writing in any way or was just a nice organic
transition to that one?
So that book was actually the most challenging one to write of all.
Part of that is because just researching fertility in general, you know, my books are so
heavily cited that I'm not just, I don't sit down and like, I'm going to write exactly
(07:51):
this and this is exactly the way in which you do this and the other thing and let me find
some citations to add to the end of a sentence.
I read the research first and then I write based on that.
And so the process of gathering data was challenging.
Some of the ways in which they write about fertility use words that people don't use in
(08:11):
real life.
Like, foot condibility, like what?
I read, you know, where in pregnancy the terms are much simpler, I find, for the most part.
So that book, I mean, I still took a similar approach to try to make everything as, you know,
readable as possible, but it was a bigger challenge finding the data and writing about it in a way
(08:33):
that wasn't too high level.
And then on top of that, I feel like there were surprisingly even more myths to address
in the fertility area than in pregnancy.
And part of that is because fertility is simply a reflection of your overall health.
(08:54):
And so the range of topics that you need to cover to have a comprehensive resource is
a lot more than pregnancy where there are certain things that you just can do and cannot
do and it's pretty a little more cut and dry.
So the breadth of material is a lot more in this book.
I mean, it's, you know, it's a 500 page book.
(09:15):
It's just a lot of information.
So some were similar approach, but, you know, different challenges.
Per condibility.
What did you just call me one?
What does that mean?
What does it mean?
It means your chances of getting pregnant in any given menstrual cycle, but nobody knows
that.
Well, now maybe a couple of people do.
Yeah.
(09:36):
Do you offer a highlighter with every book purchase because I feel like it's that kind
of a book.
Just a little bit.
Highlight a session.
Greets some more.
Highlight another piece.
Thank you.
Yes.
I appreciate that.
I love seeing highlighted pages, dog ear and pages on bookmarks.
Yeah.
Sticking out.
There's this very famous quote that you may have heard of and it goes like this, "Women
(09:58):
are not small men."
What did you mean by that when you posted that?
Yeah.
So we include that the sentence in the book is, well, I'm not the person who coined that.
I know other people who've used the term "women are not small men."
But essentially, this is pointing to the concept that we're often applying general nutritional
principles to women that may not necessarily be the best match for our physiology.
(10:23):
If you look at how our dietary guidelines are set, most of the data used to set the guidelines
is based on data from men.
And then they extrapolate it for women based on our body size being smaller.
Like, that's it.
You throw a pregnancy into the mix and then they account for maybe the increased energy
demands of pregnancy or if there's any data on like fetal accumulation of nutrients, they
(10:47):
might add that in.
But oftentimes it's just a mathematical estimate, right?
So the same things don't always work for men as do for women.
Men can tolerate a much larger range of like dietary practices without overtly screwing
things up, whereas women's hormones are really sensitive to disruptions and nutrient intake,
(11:09):
even overall caloric intake.
You can disrupt the menstrual cycle within a matter of months with under-eating.
If significant under-eating within a month, you could delay or completely halt the menstrual
cycle.
So men don't have that same feedback that we do from our cycle.
So it's not always as obvious what's happening, but also their physiology is different.
(11:31):
They can handle more dramatic shifts.
You know that post got me to think of when we men women buy supplements, maybe buy the
same supplements and it'll tell you on the package, party to take.
That's like very broad.
How do you approach fine-tuning something for a woman that like this may say to each day,
(11:52):
but what's the checks and balances?
Yeah, it's a good question and supplements are a whole black hole, I guess, of a topic that
it's hard to get clear answers on some of these things.
So I mean, first off is I'm usually looking at the literature to see what is truly needed.
Of course with our nutrients, we have like the RDAs or the dietary reference intakes that
(12:17):
you can look at and there are often separate levels for different nutrients.
There are not those are perfectly evidence based is like a separate conversation because
they're often not, but if I'm looking at a specific supplement say something like alcanateen
or something for a specific purpose, I will try to look up research papers to see if
(12:38):
those have been done in women specifically.
So I'm usually looking at the data.
There's a decent amount of overlap on dosing though between men and women, but certainly
just from the standpoint of body size, we often need less, but when it comes to fertility,
for example, there's, I'll use alcanateen as an example because I already threw it out
(13:01):
there.
We have studies on both firm quality and egg quality with alcanateen.
We have interventions for polycystic ovarian syndrome and the dosage is used in those trials
is usually in a fairly similar range, men or women.
So I just look and see like do we have evidence for it and then is there any just logically
thinking is there any brisket harm with a higher amount or lack of efficacy with a lower
(13:25):
amount and use that as my springboard?
You know when research papers come out and we get to review them and read them, they're
just published, they're put out there.
There's no section and I'm sure if they split up this via huge, you know, or deal to do
it, but there's no like men section, there's no female section, right?
There's no separation.
You have to kind of, maybe there's a header that says xyz done for female, but do you
(13:49):
have to kind of do like a little bit of a deep dive, dick, oh, wait, mate, this is about,
you know, a male or so.
So you have to read the methods of any research paper.
I think a big issue that people run into.
I mean, I'm remembering from college when one of my professors said one day you'll find
the method section is actually where all the gold the paper is found because as a student
(14:11):
you want to just go to the results of conclusion and the summary and just like be done with
that, but you have to see how the study was done.
How did they select the participants?
How did they screen them?
Who did they not allow in their study and why?
So if you look there, you'll see if there's male or female, depending on the research paper
stem, we'll say men or women or male or female in the title of the paper, but that is something
(14:38):
that's definitely worth checking out.
Especially if it's just a general dietary intervention trial.
A lot of times those papers, especially the ones from the 1990s and before, were mostly
men.
A lot of times they specifically want to exclude women because they introduce some challenges
to it.
(14:58):
With the fluctuations and the hormone levels and the menstrual cycle, it just introduces
another variability that has to be accounted for.
Whereas with men you don't have to.
Now of course we're realizing with things like, you know, drug metabolism for example, oh
wait, you know, men and women might metabolize this different and we didn't know because we
(15:19):
never studied it.
We only studied it in men.
So yeah, it's definitely something you need to keep an eye on.
I'm blessed to be talking with Lily Nichols, prenatal and postpartum dietician.
Let's talk about postpartum.
What do we know about postpartum depression?
Well, it is a much more commonly experienced than people realize.
And there's a number of factors that can increase your chances of experiencing any sort of mood
(15:44):
issue, postpartum, whether that's depression or anxiety or something else.
But a really major recurring theme and a lot of these research papers on like prevalence
of it and why it's occurring is lack of support.
So when you don't have support, people with you, you know, at ground level helping bring
you food and hold the baby while you take the rare shower and take the baby.
(16:09):
Early in the morning, so you can sleep in a little bit or whatever it is, you're much more
likely to experience mood challenges postpartum.
So that's huge.
If you look at how other cultures outside of Western culture handle postpartum, oftentimes
you had a family member come and live with you or you lived with them, usually like your
(16:30):
mom, your mother-in-law, your grandma, and auntie.
And they would basically take care of everything that they could for you.
They would cook all the food.
They would clean your house.
They'd take care of the housework.
They'd hold the baby when you need to shower all the things.
They were caring for your needs.
So the only thing that you were doing, which is a lot in and of itself 24/7 job is caring
(16:56):
for the baby and resting and recovering.
And they would bring you food.
They would support you.
They would rub your feet.
We don't have that support.
And I can tell you firsthand from, you know, I have two children, second time around, I
had learned my lesson that you do need more support than you think.
So I invited my mom to come and stay with us for a month postpartum.
(17:19):
Of course, I also had a toddler, so you know, you need somebody to help occupy the big kid,
but it was a night and day difference to have that support.
There are so many other factors that play into it, you know, nutrient intake can play a role
in it.
Just, you know, your general like previous mental health challenges, other health complications
(17:41):
or challenges with your baby feeding difficulties.
There's all sorts of things, but at the center of it, we really do need to have support and
also nourishment happening.
If you don't have those two things met, the chances that you're going to experience some
really happy emotional challenges are pretty high.
And there are now actually have been papers looking at this whole concept of postnatal
(18:04):
depletion and how depleted nutrient levels are low in sake of nutrients can increase the
chances that you might struggle there.
Well, I want to talk about both of those things, but knowing what you know, do you think
that women know to ask for help maybe in month eight, month night, hey, when the baby comes,
(18:25):
you need to have someone come with or I need this, I'm going to need that.
It seems like a simple thing, but it's a monumental thing.
Yeah, I think it's not, since it's not normalized as part of our culture, you know, many of us
now are like third generation from families where the parents are working and, you know,
(18:46):
you move far away from your loved ones where it's kind of normalized that you just do
it yourself.
You know, like it's hard to figure it out.
And at top of that, we're not even myself.
I mean, I had specialized in pregnancy for many years before I had my first baby.
I didn't do much reading on postpartum nutrition.
(19:07):
I knew I'd need more food because of course I knew breastfeeding, mother is need more food,
but there was no discussion about you needing more nutrition just for the recovery aspect
itself.
In fact, we don't even have separate guidelines outside of nutrition for breastfeeding
specifically.
There are not separate guidelines for postpartum recovery and there probably should be,
(19:28):
especially in that first two weeks, first month, you need so much more nourishment, like
so much work food is shocking how much food you can, you can house in early postpartum because
you're not only recovering from pregnancy, but you're recovering from birth as well.
So depending on how that went down, you may need more or less.
And then your body is adapting to lactation.
(19:49):
Now I'm producing milk and of course that in itself is an expenditure of calories.
So there's a lot there and I think since it's not really talked about that much and sort
of normalize that you'll just figure it out on your own, we have, and maybe part of it
is like a pride issue having grown up and post feminist era women can do it all is sort
(20:12):
of the mantra that we're raised in.
You think like, well, I should be able to handle it by myself.
But really never in human history other than maybe the last 50, 100 years did we do that
to women?
And you had, you had this family network or village or community of support.
So I think we need to challenge that notion and I mean a big reason that real food for
(20:34):
pregnancy has a whole chapter on the fourth trimester and postpartum recovery was that
I felt like I was under prepared for postpartum and I started writing that book when I was
10 months postpartum with my first, so I was still in my opinion in the thick of it.
And like I'm putting a chapter in postpartum in the pregnancy book because otherwise you
(20:56):
never get exposure to the information.
If I as like into reading research and being prepared and doing all the things, if I didn't
even pick up a book on postpartum nutrition, who is going to it's going in the pregnancy
book?
I snuck it in there in the last chapter and I can tell you I'm thanked on a daily basis
(21:16):
or that chapter because there's just a lot that you don't know until you go through it
yourself.
Well and it's clearly not a sign of weakness asking for help.
It's knowledge.
We need to have that knowledge.
Absolutely.
Yeah.
You can't do it alone.
You can't be standing in your kitchen, cooking full meals when you're early postpartum.
(21:38):
You absolutely require other people to help you on some level.
And you do it without help.
You will probably not feel very well as a result.
You're not getting a badge of honor for doing it all alone.
We may give those out for many other things but this is really a time to ask for and be
(22:00):
okay with receiving support.
Which again, like I said, I think is uncomfortable for independent self-sufficient women as many
of us are.
Self-included, it's very humbling to be like, wow, I really do need the help right now.
My mom was even like, do you really want me to come up for a month?
Well, yes, do you want to stay longer?
(22:21):
I mean, she came out for like a week with my first born and that was helpful but I didn't
no one asked to know that like, oh, actually I am going to need this.
This is going to be really helpful.
Well, let's talk about food.
Before, during and post pregnancy, what would you like to see women eating and do
in, to build their immune system, maybe build up resiliency?
(22:44):
So there's a lot of overlap between nutrition for fertility, pregnancy, postpartum and just
what's optimal for human health in general at all life stages.
But a big one that I see missing among a lot of women is hitting their protein needs.
So our protein recommendations across the board, population-wide, are too low.
(23:06):
They are particularly too low in pregnancy and postpartum.
We finally now have data on those life stages specifically when they did the studies in
pregnant women.
First ever studies estimate protein requirements and pregnancy were done in 2015, okay?
All the previous estimates were based on these mathematical estimations and they found
(23:30):
especially in late pregnancy, the guidelines under estimated protein requirements by 73%.
But, isn't like, oh, we were 5% off margin of error.
73% is pretty bad, okay?
Not the minimal protein target, but you also need protein for preconception as well.
And then when you take it from the angle of trying to hit microdutriate requirements, like
(23:55):
your vitamins and minerals, looking at where you find those in foods, you find many of those
micro-nutrients most concentrated in our protein rich foods, especially our protein rich animal
foods.
And yet, there's so much talk about going plant-based for a variety of reasons, but I've
found that that often results in much lower nutrient intake, and this is corroborated by
(24:21):
tons of research.
There's a whole chapter in real food for fertility on vegetarian diets outlining some of this data.
This is an area we really need to hit.
Women are the most likely to go on to vegetarian or low meat diets, but they're also the most
sensitive to those nutrient deficiencies, and I see them quite common in practice.
(24:44):
So that's one area, definitely to address, eat enough protein, including animal protein
sources, whatever they are for you.
Be aware of the quality of carbohydrates that you're consuming.
I'm not sure if I mentioned this statistic on this podcast, but I definitely mentioned
it other times.
The average American diet gets 58% of its calories from ultra-processed foods.
(25:10):
These are things made from refined flowers and starches, refined sugars, corn syrup, low
quality oils, vegetable oils, seed oils, and then the slew of artificial coloring, flavoring,
things that make this food-like substance taste good.
Of course, we have a whole food industry built around engineering these foods to be particularly
(25:33):
delicious and addictive.
But these things, of course, have really no nutrient density.
They have a lot of calories, but they have essentially no vitamins and minerals, might
us what might be fortified in a white flower-based product.
So they're not really contributing to the improvement to how's your health or your nutritional
(25:56):
status.
They're just the definition of empty calories, right?
They're giving you calories with no substance there.
So addressing the elephant in the room before I talk about all these foods and why they're
beneficial and all that, this is the area that means the most attention in our diets is
just the quantity of processed foods.
(26:17):
I'm at the point where I almost don't even care about the makeup of a person's diet as
long as they are shifting in more whole foods to squeeze out the ultra-process foods.
We are moving in the right direction.
It doesn't even matter what you're eating as long as it's an unprocessed item.
I'm happy, right?
But take it to the next level and build in that protein and I am significantly happier.
(26:42):
Well, they are creations.
I remember reading and I forget the title of the book in the author's ages ago about processed
food of how they created.
And there was this term that stuck with me that they saw a lot of science as used to
create what he put as the bliss point that when you taste it, it's the most amazing thing
(27:02):
you've tasted.
And then when you eat it, it's gone or even you swallow it, it's gone.
I want another one of that.
And it's, like you said, it's empty calories.
It's not real food.
Yeah, they're engineered like that.
Rob Wolff wrote a whole book called "Wired to Eat" that goes through some of these things.
I mean, the amount of R&D that went into Doritos, for example, it's wild.
(27:24):
Or the "What's the slogan for Pringles once you pop?
You can't stop."
Even the fact that I know that advertisement is nuts, right?
That shows how great their marketing is working on, you know, our subliminal lines, but they
get just the right level of crunch, and salt, and sweet, and fat to keep you coming back for
more and more.
You add in some like glutamate, chemicals, and other things that hit the dopamine reward
(27:49):
center of the brain, and you're hooked, right?
So it starts with interrupting that cycle.
So if I could just go into that for just a little bit, a lot of this has to do with our blood
sugar regulation.
People think it's a well-power thing.
And certainly, I mean, it's been pretty well documented that food addiction can indeed
be a thing that people experience, but the only way to interrupt it is by tackling your
(28:16):
hunger levels and tackling your blood sugar regulation.
And this starts with breakfast.
This starts with a protein and fat-rich breakfast, protein in particular, to set the stage
for stable blood sugar at an inflome level.
So you're not crashing.
Once your blood sugar crashes, which happens when you eat just a carb breakfast?
(28:38):
Even if it's like so-called healthy, like oatmeal for breakfast, you get a huge blood sugar
spike, a huge blood sugar crash, and when you bottom out, your body sends you the physiological
signal to eat more food, and specifically food that's going to raise your blood sugar
back up because it is experiencing what it sees as a metabolic emergency.
It's running out of fuel.
(28:59):
You have to eat.
And you have to get that blood sugar up, so you will be craving carbs and sugars, and it's
really hard to get off that cycle if every morning you either don't eat breakfast whatsoever,
or when you eat breakfast, it's a super high-carb option.
So just swapping out breakfast makes a massive, massive difference in people's satiety, their
(29:22):
energy levels, their cravings, and just honestly everything.
I mean, I think I've recommended a protein-rich breakfast to virtually every client I've
ever worked with because until you address that, you're going to be tackling the mid-morning
snack attack or the 3 p.m. slump forever and ever and ever.
(29:44):
You've got to interact cycle even before it starts.
So real foods, good protein supplementation.
What do you think?
The supplementation come into play?
It has a place, and I mean, there's a whole chapter in supplements in my books for a reason,
but I think we have to look at supplementation from the angle of, I mean, really what they're
(30:04):
designed to be, to supplement, to have in addition to your major source of nutrients is still
your diet.
You still want to get through your diet, quality, as dialed in as humanly possible, and then
you build in the supplements to fill in the gaps on top of that.
So certainly they have a place.
(30:24):
I think we need to kind of choose them carefully, especially choosing the highest quality supplements
that we have access to looking at forms of nutrients, whether or not they have third-party
testing, or they manufactured in a way that's retaining the nutrients and is done in a clean
way, right?
The basics.
We need to make sure that we hit those marks, but for sure, supplementation has a place,
(30:48):
a prenatal vitamin, supplementing additional nutrients as needed, like iron or DHA for individuals
who don't consume much seafood, for fertility, there's a number of, especially antioxidant
style nutrients that can be really helpful for improving egg quality or sperm quality, like
alpha-lipoic acid, for example, or co-Q10.
(31:09):
There's for sure data on a lot of different supplements.
Well, we want the fake food out, but are there any specific foods that a woman should
not take during pregnancy?
Yes.
And the primary ones that I focus on are the ones that are A, something that's overtly
going to be detrimental to the baby at large quantities, like alcohol, something where
(31:32):
there's a threshold at which we get kind of concerned with safety.
So with caffeine, they recommend no more than 200 milligrams per day, for example.
Go easy on the coffee, you could still have a little, with tea, you're pretty unlikely
to overdo it unless you're drinking a lot of tea, and then we have different concerns.
But keeping your caffeine in a reasonable amount, definitely checking if it's coming in
(31:54):
in a protein supplement or an energy supplement, sometimes there's added caffeine to things
that you may not realize.
Then beyond that, most of my recommendations on foods to avoid in pregnancy are the very
ingredients that make up the ultra-process foods.
So the refined starches, white flour, refined sugars, or added sugars in large amounts,
(32:17):
the quality of actual oils, the kind that people use for deep frying, for example.
So cook in different oils, cook in coconut oil, animal fats, butter, ghee, large tallow,
low heat for olive oil, avocado oil, stuff like that, are much a better option than the
canola soy, cotton seed, corn, those kinds of oils.
(32:41):
Trans fats definitely need to be avoided, thankfully now that we have mandatory labeling
of trans fats, they are in such a small quantity in the American food supply now that we almost
don't even need to worry about it all that much, but you may see them in other countries
still.
Those definitely should be avoided.
And then in high quantities and low quality formats, soy is another thing that I think should
(33:06):
be limited or possibly even avoided in pregnancy.
This gets a little bit into controversial land, but unless it's organic soy that's been
traditionally processed in a way that they do in Asia, it's probably best not to have
super large quantities of it.
So your soy protein, bars and shakes, people talk about, well, soy has been traditionally
(33:30):
consumed in Asia for all these years.
You look at the average amount of soy consumption in those countries and it's something like
8 to 11 grams of soy protein per day.
In the U.S., a single protein bar that's a soy protein bar based may have that amount
or more, maybe even double.
We're getting tons more soy than they ever did traditionally.
(33:53):
And it's not in the form necessarily of organic, traditionally processed tempe or tofu or
miso or nato or tamari.
It's in these soy protein isolates made from genetically modified soy.
In huge amounts, we do see this leading to some disruption in hormone levels that can affect
(34:14):
mineral metabolism.
And of course, there's going to be pesticide residues if it's conventional soy, grown and
conventional means where they're, you know, aerial spraying with tons of pesticides.
Well, you said your mother helped you and that was a good learning experience that you had.
When you were pregnant with your own children, did you learn anything by paying attention
(34:36):
to your own body or with the interaction that you have with your medical team that you
might have not known before?
Yeah, for sure.
I mean, I always using myself as a guinea pig.
So, what's some examples? I mean, when you're dealing with the conventional medical system,
sometimes takes a lot to convince them to order the lab tests that you want them to order.
(34:58):
So I was definitely a squeaky wheel, kind of patient asking for my hemoglobin A1C and my vitamin
D levels and stuff like that where, you know, those are not necessarily standard labs.
I certainly used myself as a guinea pig with looking at like glucose metabolism and pregnancy.
I saw first tan that you can get a false positive on the glucose challenge tests if you're
(35:22):
eating low carb prior to the test.
You can follow that up with home blood sugar monitoring and see that everything's actually
perfectly fine, but, you know, these tests are not always infallible.
I've written about that experience on my blog if anyone wants to search on my site,
Glucola, you'll pull up the two-part article series that I did on that.
(35:43):
With, again, I'm going into lab tests because I feel like this is a big area for improvement.
You know, I asked for my vitamin D levels to be checked each trimester and they had been
checked properly the first two times and the third time I get this call that I have toxic
levels of vitamin D. And I was like, huh?
Like, let me see the lab tests results.
(36:05):
I go and look at the lab tests results.
They had ordered the wrong lab and then they had applied non-pregnancy reference ranges
for vitamin D. And vitamin D is a very interesting nutrients, technically a hormone in the way
our body manages it.
And there's different versions that you can test in the bloodstream.
(36:27):
And because vitamin D is so vital to fetal development, your body like up regulates how
much it converts into the hormonally active form, which is what they attested for me, but
it's maintained in pregnancy and what they call superphysiologic levels.
So the reference ranges for outside of pregnancy do not apply in pregnancy.
It is intentionally high.
I just so happen to be a vitamin D nerd and I teach like a two hour webinar in vitamin
(36:54):
D in pregnancy that I knew this and was able to catch this and be like, hey, actually
my result is normal because you tested this level and this is high for this reason.
Can we retest with 25-pidroxy D?
And they did and my levels were perfectly normal.
So I mean, if anything I think I learned, you really have to be your own advocate.
(37:16):
It is surprisingly difficult to navigate the pregnancy.
Honestly the healthcare system is very difficult to navigate, but pregnancy in particular,
I found that the approach felt a lot more like they're always looking for problems instead
of working on the preventative care.
(37:36):
Now I worked to the midwife in my second pregnancy and they're a little more working on
the preventative care angle, but I still found that I had to really be an advocate.
I think I'm a probably, particularly, either I'm a particularly easy or particularly
difficult patient because I like know too much, but I'm easy because my pregnancy as a result
(37:59):
are really low risk.
They don't really have to do anything, but you do have to ask for what you want.
You have to be informed.
So I've tried to translate all of that into my books.
So you have to spend hours on PubMed and Google Scholar finding this information, like
it's in there for you so you don't run into the same struggles that I did.
(38:21):
When you were pregnant, do you think the medical staff was like, oh, the only nickels
was coming in this afternoon?
Okay.
Probably, probably.
I'm taking my lunch at 230.
She's here at 230, I'm taking my lunch there.
Yeah, probably.
First pregnancy for sure, I was probably a little annoying, but I also, I know how to interact
with the medical system, right?
I mean, I went through conventional dietetic internship at the largest hospital in Los
(38:42):
Angeles.
Like, I know how to stay in my lane, smile and nod.
I really am not.
I'm not in the same energy that I am on a podcast where I'm actively here being asked questions
and teaching.
If they're not asking me a question, I'm not trying to like school anybody on anything, but
if they do ask for an explanation, I'm going to have to hit them with a little science.
(39:06):
So yeah, you got the foot notes right there on call.
Right.
The prenatal nutrition guidelines.
What does the lily nickels think we're getting right?
And what are we possibly getting wrong?
Okay.
Well, that's can of worms.
I've already talked about the protein guidelines where we're off on those.
Really all the macronutrient guidelines are off.
(39:27):
They need to be shifted.
The guidelines suggest two low protein, two low of fat and two high in carbohydrates.
And we need to go more protein, more fat, less carbs, the greater emphasis on quality of
carbohydrates.
The guidelines contend that a vegan diet is perfectly safe at any life stage, including
(39:51):
pregnancy, breastfeeding, early-emptancy.
I disagree with that.
If such a diet is followed, you're going to have to be really on your game with your lab
testing and your supplementation and you still may run into some challenges.
So I like to look at it not from what the human body can tolerate, but what's optimal.
So I certainly don't think that is optimal.
(40:14):
I also think a lot of our nutrient values, like our RDAs, are imperfect.
Like I mentioned earlier, a lot of the nutrient allowances, the dietic reference it takes,
are extrapolated from data on men.
And there's a lot of assumptions made for pregnancy, how that changes in pregnancy.
(40:39):
And there is actually a study that looked at how strong is the data used to set the dietary
reference and takes for vitamins and minerals and pregnancy.
So they analyzed the 704 studies that were used in setting those recommendations.
And it was something like only 16 or 17% of studies used even had a single pregnant or
(41:04):
lactating participant.
It was really slim.
So for a lot of our nutrients, we don't even have pregnancy specific data backing those
recommendations.
And in order to move the needle on that, we need to be funding more research, studying
nutrient demands in pregnancy and in lactation specifically, not just relying on these estimates.
(41:28):
We know we've gotten it wrong for vitamin D or coline, probably incorrect for vitamin A,
probably incorrect for iron, incorrect for B12, it's set three times two low at minimum for
B12, it's two low for B6.
There's a number of nutrients even beyond that where there's been some research questioning.
(41:50):
Is this really enough?
Because we have women hitting the marks where there's nutrients and they're still showing
signs of deficiency, which suggests our guidelines are set two low.
For the majority of them, they're just set two low.
I think iron might be the exception where it is set at a level that's so high, it's virtually
impossible to meet from food alone.
(42:10):
Again, that one is based on a lot of assumptions, not necessarily direct estimates, but for
most of them, it's that they're set two low.
Well, I know you'd like to be writing the next book.
Can you share with the next book, it's going to be about or is it too early to?
No, probably too early.
My was real food for fertility.
I co-authored it with the colleague of mine, Lisa Hendrix and Jack, and we have joked that
(42:33):
we have what are we calling it?
Host book, trauma syndrome.
When people ask us about what the next book will be, yeah, I don't know.
I have this very long log of requests for topics, but what people don't understand, I think, is
the way that I go about writing a book is a lot different than most books that you get
(42:58):
on the market.
I'm not just like writing out my opinion and citing a couple studies.
I'm reading a lot of research.
I mean, we have over 2,300 in-text research citations and real food for fertility.
There were so many papers that this would have added 200 pages to the already 500 page book
(43:20):
if we printed it right in the book.
We have it available as a PDF download instead because no one wants to be lugging around
a 700 page brick of a book.
Even within those 2,300 plus citations, many of those are linking out to maybe multiple
studies, so some of them are citing 2, 3, 4, 5, 6, 10 studies.
(43:42):
If it's a really controversial topic, I feel sometimes it's necessary if I'm tackling something
like saturated fat and heart disease, I'm going to give you more than one study because
my conclusions are based on more than one study.
But we don't even know the final citation count.
So all to say, even if sometimes there's overlap in the general principles, like I can
(44:03):
tell you right now, if I was to go deep into the weeds and the research on nutrition for
menopause, I'd probably come to many similar overall conclusions.
The data specifically, of course, would be different data points, different studies I'm
talking about.
But there probably be a decent amount of overlap, but it's not like that's easy or it's
(44:28):
simple to write.
And maybe my assumptions as oftentimes they are would be questions and I'd find data
that would be surprising.
Like, oh wow, I didn't expect that we would need more of swisee nutrient and it turns out
we do for this reason.
Again, it's just time consuming and very cumbersome.
So the last one took us three years.
(44:50):
I have no plans to start on another book any time soon.
So come back and maybe four or five, six years and see if there isn't a book out then it's
possible I'm working on it.
It's possible I've called it quits and I'm not writing anymore books.
What's that process like?
Are you researching and then writing, researching, taking notes?
(45:13):
Walk me through that.
Why does that look like?
It's extremely cumbersome.
So from the beginning, I've always had like an outline, a chapter outline for or books.
Okay, we're going to go through this topic here and this topic there.
Sometimes there's overlap when like, okay, we're going to talk about this here and then
we're also going to talk about this there and which information goes where.
(45:34):
So I try to have as clear of an outline as possible.
So the information is at least going in the right spot.
I get the data points accurate.
I am citing in text as I write so I don't forget the study because I can't actually track
of 2300 citations in my brain.
Once I've written the thing, I can't remember what study it was.
(45:55):
So I'm citing in text as I write and then making sure sometimes information is not flowing
well, right?
So to make a book flow that takes a lot of editing.
I mean, even before I consider a chapter like done, it's probably gone through five
or more edits.
I mean, I'm editing the sections as I write and then I'm going back through making sure
(46:19):
it's logical editing again, writing another section, seeing if it flows.
It's a very time consuming process.
But I'm usually reading the papers and writing about them at that moment and then later kind
of pulling it together in a cohesive paragraph.
Then of course, the research has never done.
(46:40):
So I'm reading something else.
I'm like, "Oh, that's a really good data point."
Then you have to go back and add it in and re-edit all your transitions to make sure it
flows.
And I'm also reading all the papers in full before I cite them.
And so that in itself takes a lot of time.
You're highlighting the papers.
I do it digitally.
I don't pronounce studies usually, but I'm highlighting the studies digitally, pulling out
(47:03):
key points.
The document is like pages and pages of hex in different colors with different comments
and notes.
I mean, you know that mean of that guy who's researching something and he has the bulletin
board with all the thumbtacks and the things attached to the board and they're attached with
string and yarn and he looks like absolutely crazy.
(47:27):
It's a little bit like that.
It's a little bit insane.
You mean like a murder wall?
Yeah, it kind of looks like that except for good purposes.
I mean, all the things connect to all the things that you're like.
You have these light bulb moments where you're like, oh my gosh.
And this explains why this is happening.
Oh, wow.
I have to research this new rabbit hole unlocked.
(47:51):
Another 10 studies to read.
Then you're reading the study and there's a study cited in the study and then you have to
read that study.
I mean, it kind of never ends at a certain point.
You have to just tell yourself, okay, have I like made the point that I wanted to make
because I think it's time to move on.
There's some topics that are there's so much research on like toxins.
(48:13):
There's so much research on toxins and fertility.
I probably could have cited 10 times the amount of studies that they cited in that chapter,
but at a certain point it just gets redundant and repetitive and to the point that it's
too overwhelming for, it's already overwhelming for vibran it's definitely overwhelming for
the reader.
So at a certain point, you have to just cut it.
(48:36):
Choose the best study, throw out the rest and move on to the next topic and that's tricky
too.
Does your husband look at all that layout and go, oh, I didn't know you could do hydrodophics.
That's great.
Yeah, right.
Yeah, well, he's an engineer so he can handle this sort of stuff, but he'd probably have it
organized in a spreadsheet with formula calculated that spit out the data in a beautiful display
(49:00):
and my brain doesn't work in spreadsheets.
It works in messy documents.
So, you know, teach their own.
With respect to the books, what are you most proud of?
I mean, to me, it's the results that people get.
Certainly, I'm proud that we even finished.
I mean, I'm proud that I finished any of these books.
Real food for gestational diabetes.
(49:20):
I'm certainly proud of that one because it changed international policy.
It changed the Czech Republic official guidelines on gestational diabetes nutrition and they
have since reported significant reduction in adverse outcomes like babies being born larger
than average, 50% lower requirements for medication and insulin impregnancy, less comorbidities.
(49:44):
So, that's huge.
I mean, that was a big, that came in about like 2016 that update happened.
And so, that was always quite nice, but I'm certainly happy just to hear from women and
couples and families who have implemented the information and have changed the trajectory
not only of their pregnancies, but of their health for life.
(50:07):
That's like the biggest benefit that I can get is just hearing that it actually helped
somebody.
I mean, these things really are a labor of love.
And so, to see that they're helping people is the ultimate gift.
And finally, what does Lily Nichol's best day look like?
What's happening and who are you surrounded by?
Oh, best day.
(50:28):
Well, I probably wouldn't be at my computer on the best day.
I mean, sometimes if I really get the bug, the research atopic, I will willfully sit down
and do a bunch of that.
But my best day would probably be spent gardening, actually, outside working in the garden
with our chickens, making a meal, nowhere to go, just family.
(50:52):
I mean, I'm kind of a hermit introvert.
So, although I love my friends, I like small groups settings.
And so, if I don't have to go anywhere, I'm very happy.
So, nice warm sunny day in the garden would be where I'd be at.
Lily, thank you for making this happen and for helping not only women, but all of us understand
our health better.
(51:12):
Thank you so much.
The Good Foods podcast is for entertainment purposes only.
The claims, comments, opinions or information heard should never be used in place of your
medical provider's advice or your doctor's direction.
Thank you for listening.
Follow us on social media and wherever you get your podcast.
(51:35):
Good health through Good Food.
Good foods grocery.
[MUSIC PLAYING]
Hi, I'm Lily Nichols, registered dietician nutritionist, author of three books, Real Food
(00:07):
for Pregnancy, Real Food for Fertility and Real Food for Gestational Diabetes.
I am founder of the Institute for Prenatal Nutrition and Co-Founder of the Women's Health
Nutrition Academy.
And this is The Good Foods Podcast.
All of us are on a journey towards better health, and we're grateful that you've allowed
(00:27):
us to join you on your quest.
In this episode, you can't do it alone, you can't be standing in your kitchen, cooking
full meals when you're early postpartum.
You absolutely require other people to help you on some level.
Can you do it without help?
Yeah, and it is a struggle.
(00:48):
This is The Good Foods Podcast, and now here's your host, Shodan.
As one of your recent grandpa's stated, "I know you're itching to write, but oh my God,
all of these podcasts interview, so I'm very grateful that you're joining me on this podcast,
Lily."
Thank you.
Number five of this week alone, so lots of talking.
(01:08):
Well, I'm very, very grateful.
What got you interested in health and nutrition?
I've been interested in nutrition for a long time.
I mean, as a teenager, even, I made the decision that I would go and study nutrition in
college, so everyone said I'd changed my major and I never did.
I think just growing up in a relatively health conscious family, we always made the connection
(01:31):
with how you feel and what you've eaten.
If we had had more processed food and then we're feeling so good, I'd be like, "Oh, yeah,
I wonder if this has something to do with having whatever the item was."
And so that mindful eating aspect was always built in.
If we got sick, we would temporarily not have any sugar and cut down on the amount of dairy
(01:54):
we would have, so we wouldn't be as congested.
Things like that really kind of stuck with me from a young age.
But what kept me, I think, in the field as I really wanted to work with children eventually,
actually, I wanted to help perform the school lunch policy.
We were seeing rising rates of childhood obesity and diabetes and I thought, "Oh, well,
(02:15):
if we just change the school lunch program, maybe that'll help."
Certainly not to say that that won't help, but I had the opportunity to work with the California
diabetes and pregnancy program fairly early on in my career and that's where I learned
that that children born to mothers who have, you know, not great blood sugar control during
pregnancy, their children actually face a much higher risk of diabetes and obesity later
(02:39):
in life, starting as early as the childhood and adolescent years.
And that was like, "Oh, wow.
Here's an area where we can intervene easily.
We have a motivated group of people.
Pregnant women are usually quite motivated for health change and we can actually change
the development of that child so they have better metabolic health, better blood sugar,
(03:01):
better insulin levels and hopefully set them up real lifetime of health."
So that's what got me started and that's what kept me interested.
At what point did you come up with the idea of riding real food for pregnancy?
The real food for pregnancy is my second book, so real food for gestational diabetes came
first and circling back to kind of what I just mentioned in the intro.
(03:25):
That book was really only written because I was finding in practice the conventional dietary
advice was not helping my clients control their blood sugar levels and in fact they were
often making their blood sugar levels worse, which isn't really that surprising because
the guidelines suggest you consume no less than 175 grams of carbohydrates per day.
(03:47):
So you can imagine somebody who's been diagnosed with a condition that literally translates
to carbohydrate intolerance in pregnancy.
When you give them a high carb diet, their blood sugar levels get worse.
So real food for gestational diabetes is the counter argument against those recommendations
(04:07):
and what I have found in practice to actually work.
Real food for pregnancy came later, a few years later, after lots of people essentially
were asking me for, "Hey, you have this book on gestational diabetes, but what do you recommend
for pregnancy that doesn't have gestational diabetes?"
And of course I was like, "Just read the gestational diabetes book anyways, you don't have to
(04:29):
be as obsessed on the blood sugar aspect, but really the same type of diet applies for
overall health during pregnancy as well."
And after many pushes and shoves and after going through my own first pregnancy and seeing
how just dismal and lacking the advice was and how many myths there were about pregnancy
(04:49):
that I had spent so much time researching and debunking for myself, I was like, "Okay, this
actually is enough for another book."
Like this is a totally different book.
So real food for pregnancy came after that by popular requests.
Speaking of real food for pregnancy, how did you go about gathering the information for
that book and making it easy to understand during this very nutritional sensitive period during
(05:14):
a woman's life?
That's hard to say.
I mean, my writing style has evolved over the years.
I mean, initially the type of writing I was doing was just client handouts.
I mean, I did a lot of face-to-face client education.
I do kind of learn the way in which you explain things makes a difference on whether or
not people want to listen to you, wants to tune you out, if you're too high level, and even
(05:39):
the level of writing in my books has changed over time in response to the feedback that I
get and what people expect from me, right?
So real food for gestational diabetes came right after I was in a clinical job.
I'm working with clients, many of which speak another language than me working with a translator
(06:01):
or have low literacy.
And so that's written in like very simple language, very intentionally, but that came about
from the client work where I have been teaching classes on gestational diabetes.
I know the order in which to introduce things, the way in which to talk about them that makes
sense that people remember.
(06:22):
And so that kind of has carried forward with my other books as well.
I mean, I just, I put in a lot of effort really into making sure that the explanation is
as clear as possible.
I do a fair amount of interviews, but I misspeak in interviews sometimes, right?
Something doesn't come out exactly the way you want to, maybe the order in which you
(06:42):
cover the topic is a little in reverse.
And so I'm kind of obsessive in the editing phase to make sure that things are really
clear as I can possibly make them, especially when you're talking about things that are
kind of higher level content or talking about research studies.
There's a way at a right in which it's just a textbook that's boring that puts you to sleep
(07:05):
and then there's a way to write that's a little more engaging.
Like how much detail do you provide about the study?
Is this a thesis paper?
Am I writing for a medical journal?
Like no, I'm writing for the general public, bless some healthcare practitioners.
So I just do my best to write in a way that resonates with people.
Well, at the time of this recording, just a couple of months ago, real food for fertility
(07:27):
was published.
Did you have to change your approach or your writing in any way or was just a nice organic
transition to that one?
So that book was actually the most challenging one to write of all.
Part of that is because just researching fertility in general, you know, my books are so
heavily cited that I'm not just, I don't sit down and like, I'm going to write exactly
(07:51):
this and this is exactly the way in which you do this and the other thing and let me find
some citations to add to the end of a sentence.
I read the research first and then I write based on that.
And so the process of gathering data was challenging.
Some of the ways in which they write about fertility use words that people don't use in
(08:11):
real life.
Like, foot condibility, like what?
I read, you know, where in pregnancy the terms are much simpler, I find, for the most part.
So that book, I mean, I still took a similar approach to try to make everything as, you know,
readable as possible, but it was a bigger challenge finding the data and writing about it in a way
(08:33):
that wasn't too high level.
And then on top of that, I feel like there were surprisingly even more myths to address
in the fertility area than in pregnancy.
And part of that is because fertility is simply a reflection of your overall health.
(08:54):
And so the range of topics that you need to cover to have a comprehensive resource is
a lot more than pregnancy where there are certain things that you just can do and cannot
do and it's pretty a little more cut and dry.
So the breadth of material is a lot more in this book.
I mean, it's, you know, it's a 500 page book.
(09:15):
It's just a lot of information.
So some were similar approach, but, you know, different challenges.
Per condibility.
What did you just call me one?
What does that mean?
What does it mean?
It means your chances of getting pregnant in any given menstrual cycle, but nobody knows
that.
Well, now maybe a couple of people do.
Yeah.
(09:36):
Do you offer a highlighter with every book purchase because I feel like it's that kind
of a book.
Just a little bit.
Highlight a session.
Greets some more.
Highlight another piece.
Thank you.
Yes.
I appreciate that.
I love seeing highlighted pages, dog ear and pages on bookmarks.
Yeah.
Sticking out.
There's this very famous quote that you may have heard of and it goes like this, "Women
(09:58):
are not small men."
What did you mean by that when you posted that?
Yeah.
So we include that the sentence in the book is, well, I'm not the person who coined that.
I know other people who've used the term "women are not small men."
But essentially, this is pointing to the concept that we're often applying general nutritional
principles to women that may not necessarily be the best match for our physiology.
(10:23):
If you look at how our dietary guidelines are set, most of the data used to set the guidelines
is based on data from men.
And then they extrapolate it for women based on our body size being smaller.
Like, that's it.
You throw a pregnancy into the mix and then they account for maybe the increased energy
demands of pregnancy or if there's any data on like fetal accumulation of nutrients, they
(10:47):
might add that in.
But oftentimes it's just a mathematical estimate, right?
So the same things don't always work for men as do for women.
Men can tolerate a much larger range of like dietary practices without overtly screwing
things up, whereas women's hormones are really sensitive to disruptions and nutrient intake,
(11:09):
even overall caloric intake.
You can disrupt the menstrual cycle within a matter of months with under-eating.
If significant under-eating within a month, you could delay or completely halt the menstrual
cycle.
So men don't have that same feedback that we do from our cycle.
So it's not always as obvious what's happening, but also their physiology is different.
(11:31):
They can handle more dramatic shifts.
You know that post got me to think of when we men women buy supplements, maybe buy the
same supplements and it'll tell you on the package, party to take.
That's like very broad.
How do you approach fine-tuning something for a woman that like this may say to each day,
(11:52):
but what's the checks and balances?
Yeah, it's a good question and supplements are a whole black hole, I guess, of a topic that
it's hard to get clear answers on some of these things.
So I mean, first off is I'm usually looking at the literature to see what is truly needed.
Of course with our nutrients, we have like the RDAs or the dietary reference intakes that
(12:17):
you can look at and there are often separate levels for different nutrients.
There are not those are perfectly evidence based is like a separate conversation because
they're often not, but if I'm looking at a specific supplement say something like alcanateen
or something for a specific purpose, I will try to look up research papers to see if
(12:38):
those have been done in women specifically.
So I'm usually looking at the data.
There's a decent amount of overlap on dosing though between men and women, but certainly
just from the standpoint of body size, we often need less, but when it comes to fertility,
for example, there's, I'll use alcanateen as an example because I already threw it out
(13:01):
there.
We have studies on both firm quality and egg quality with alcanateen.
We have interventions for polycystic ovarian syndrome and the dosage is used in those trials
is usually in a fairly similar range, men or women.
So I just look and see like do we have evidence for it and then is there any just logically
thinking is there any brisket harm with a higher amount or lack of efficacy with a lower
(13:25):
amount and use that as my springboard?
You know when research papers come out and we get to review them and read them, they're
just published, they're put out there.
There's no section and I'm sure if they split up this via huge, you know, or deal to do
it, but there's no like men section, there's no female section, right?
There's no separation.
You have to kind of, maybe there's a header that says xyz done for female, but do you
(13:49):
have to kind of do like a little bit of a deep dive, dick, oh, wait, mate, this is about,
you know, a male or so.
So you have to read the methods of any research paper.
I think a big issue that people run into.
I mean, I'm remembering from college when one of my professors said one day you'll find
the method section is actually where all the gold the paper is found because as a student
(14:11):
you want to just go to the results of conclusion and the summary and just like be done with
that, but you have to see how the study was done.
How did they select the participants?
How did they screen them?
Who did they not allow in their study and why?
So if you look there, you'll see if there's male or female, depending on the research paper
stem, we'll say men or women or male or female in the title of the paper, but that is something
(14:38):
that's definitely worth checking out.
Especially if it's just a general dietary intervention trial.
A lot of times those papers, especially the ones from the 1990s and before, were mostly
men.
A lot of times they specifically want to exclude women because they introduce some challenges
to it.
(14:58):
With the fluctuations and the hormone levels and the menstrual cycle, it just introduces
another variability that has to be accounted for.
Whereas with men you don't have to.
Now of course we're realizing with things like, you know, drug metabolism for example, oh
wait, you know, men and women might metabolize this different and we didn't know because we
(15:19):
never studied it.
We only studied it in men.
So yeah, it's definitely something you need to keep an eye on.
I'm blessed to be talking with Lily Nichols, prenatal and postpartum dietician.
Let's talk about postpartum.
What do we know about postpartum depression?
Well, it is a much more commonly experienced than people realize.
And there's a number of factors that can increase your chances of experiencing any sort of mood
(15:44):
issue, postpartum, whether that's depression or anxiety or something else.
But a really major recurring theme and a lot of these research papers on like prevalence
of it and why it's occurring is lack of support.
So when you don't have support, people with you, you know, at ground level helping bring
you food and hold the baby while you take the rare shower and take the baby.
(16:09):
Early in the morning, so you can sleep in a little bit or whatever it is, you're much more
likely to experience mood challenges postpartum.
So that's huge.
If you look at how other cultures outside of Western culture handle postpartum, oftentimes
you had a family member come and live with you or you lived with them, usually like your
(16:30):
mom, your mother-in-law, your grandma, and auntie.
And they would basically take care of everything that they could for you.
They would cook all the food.
They would clean your house.
They'd take care of the housework.
They'd hold the baby when you need to shower all the things.
They were caring for your needs.
So the only thing that you were doing, which is a lot in and of itself 24/7 job is caring
(16:56):
for the baby and resting and recovering.
And they would bring you food.
They would support you.
They would rub your feet.
We don't have that support.
And I can tell you firsthand from, you know, I have two children, second time around, I
had learned my lesson that you do need more support than you think.
So I invited my mom to come and stay with us for a month postpartum.
(17:19):
Of course, I also had a toddler, so you know, you need somebody to help occupy the big kid,
but it was a night and day difference to have that support.
There are so many other factors that play into it, you know, nutrient intake can play a role
in it.
Just, you know, your general like previous mental health challenges, other health complications
(17:41):
or challenges with your baby feeding difficulties.
There's all sorts of things, but at the center of it, we really do need to have support and
also nourishment happening.
If you don't have those two things met, the chances that you're going to experience some
really happy emotional challenges are pretty high.
And there are now actually have been papers looking at this whole concept of postnatal
(18:04):
depletion and how depleted nutrient levels are low in sake of nutrients can increase the
chances that you might struggle there.
Well, I want to talk about both of those things, but knowing what you know, do you think
that women know to ask for help maybe in month eight, month night, hey, when the baby comes,
(18:25):
you need to have someone come with or I need this, I'm going to need that.
It seems like a simple thing, but it's a monumental thing.
Yeah, I think it's not, since it's not normalized as part of our culture, you know, many of us
now are like third generation from families where the parents are working and, you know,
(18:46):
you move far away from your loved ones where it's kind of normalized that you just do
it yourself.
You know, like it's hard to figure it out.
And at top of that, we're not even myself.
I mean, I had specialized in pregnancy for many years before I had my first baby.
I didn't do much reading on postpartum nutrition.
(19:07):
I knew I'd need more food because of course I knew breastfeeding, mother is need more food,
but there was no discussion about you needing more nutrition just for the recovery aspect
itself.
In fact, we don't even have separate guidelines outside of nutrition for breastfeeding
specifically.
There are not separate guidelines for postpartum recovery and there probably should be,
(19:28):
especially in that first two weeks, first month, you need so much more nourishment, like
so much work food is shocking how much food you can, you can house in early postpartum because
you're not only recovering from pregnancy, but you're recovering from birth as well.
So depending on how that went down, you may need more or less.
And then your body is adapting to lactation.
(19:49):
Now I'm producing milk and of course that in itself is an expenditure of calories.
So there's a lot there and I think since it's not really talked about that much and sort
of normalize that you'll just figure it out on your own, we have, and maybe part of it
is like a pride issue having grown up and post feminist era women can do it all is sort
(20:12):
of the mantra that we're raised in.
You think like, well, I should be able to handle it by myself.
But really never in human history other than maybe the last 50, 100 years did we do that
to women?
And you had, you had this family network or village or community of support.
So I think we need to challenge that notion and I mean a big reason that real food for
(20:34):
pregnancy has a whole chapter on the fourth trimester and postpartum recovery was that
I felt like I was under prepared for postpartum and I started writing that book when I was
10 months postpartum with my first, so I was still in my opinion in the thick of it.
And like I'm putting a chapter in postpartum in the pregnancy book because otherwise you
(20:56):
never get exposure to the information.
If I as like into reading research and being prepared and doing all the things, if I didn't
even pick up a book on postpartum nutrition, who is going to it's going in the pregnancy
book?
I snuck it in there in the last chapter and I can tell you I'm thanked on a daily basis
(21:16):
or that chapter because there's just a lot that you don't know until you go through it
yourself.
Well and it's clearly not a sign of weakness asking for help.
It's knowledge.
We need to have that knowledge.
Absolutely.
Yeah.
You can't do it alone.
You can't be standing in your kitchen, cooking full meals when you're early postpartum.
(21:38):
You absolutely require other people to help you on some level.
And you do it without help.
You will probably not feel very well as a result.
You're not getting a badge of honor for doing it all alone.
We may give those out for many other things but this is really a time to ask for and be
(22:00):
okay with receiving support.
Which again, like I said, I think is uncomfortable for independent self-sufficient women as many
of us are.
Self-included, it's very humbling to be like, wow, I really do need the help right now.
My mom was even like, do you really want me to come up for a month?
Well, yes, do you want to stay longer?
(22:21):
I mean, she came out for like a week with my first born and that was helpful but I didn't
no one asked to know that like, oh, actually I am going to need this.
This is going to be really helpful.
Well, let's talk about food.
Before, during and post pregnancy, what would you like to see women eating and do
in, to build their immune system, maybe build up resiliency?
(22:44):
So there's a lot of overlap between nutrition for fertility, pregnancy, postpartum and just
what's optimal for human health in general at all life stages.
But a big one that I see missing among a lot of women is hitting their protein needs.
So our protein recommendations across the board, population-wide, are too low.
(23:06):
They are particularly too low in pregnancy and postpartum.
We finally now have data on those life stages specifically when they did the studies in
pregnant women.
First ever studies estimate protein requirements and pregnancy were done in 2015, okay?
All the previous estimates were based on these mathematical estimations and they found
(23:30):
especially in late pregnancy, the guidelines under estimated protein requirements by 73%.
But, isn't like, oh, we were 5% off margin of error.
73% is pretty bad, okay?
Not the minimal protein target, but you also need protein for preconception as well.
And then when you take it from the angle of trying to hit microdutriate requirements, like
(23:55):
your vitamins and minerals, looking at where you find those in foods, you find many of those
micro-nutrients most concentrated in our protein rich foods, especially our protein rich animal
foods.
And yet, there's so much talk about going plant-based for a variety of reasons, but I've
found that that often results in much lower nutrient intake, and this is corroborated by
(24:21):
tons of research.
There's a whole chapter in real food for fertility on vegetarian diets outlining some of this data.
This is an area we really need to hit.
Women are the most likely to go on to vegetarian or low meat diets, but they're also the most
sensitive to those nutrient deficiencies, and I see them quite common in practice.
(24:44):
So that's one area, definitely to address, eat enough protein, including animal protein
sources, whatever they are for you.
Be aware of the quality of carbohydrates that you're consuming.
I'm not sure if I mentioned this statistic on this podcast, but I definitely mentioned
it other times.
The average American diet gets 58% of its calories from ultra-processed foods.
(25:10):
These are things made from refined flowers and starches, refined sugars, corn syrup, low
quality oils, vegetable oils, seed oils, and then the slew of artificial coloring, flavoring,
things that make this food-like substance taste good.
Of course, we have a whole food industry built around engineering these foods to be particularly
(25:33):
delicious and addictive.
But these things, of course, have really no nutrient density.
They have a lot of calories, but they have essentially no vitamins and minerals, might
us what might be fortified in a white flower-based product.
So they're not really contributing to the improvement to how's your health or your nutritional
(25:56):
status.
They're just the definition of empty calories, right?
They're giving you calories with no substance there.
So addressing the elephant in the room before I talk about all these foods and why they're
beneficial and all that, this is the area that means the most attention in our diets is
just the quantity of processed foods.
(26:17):
I'm at the point where I almost don't even care about the makeup of a person's diet as
long as they are shifting in more whole foods to squeeze out the ultra-process foods.
We are moving in the right direction.
It doesn't even matter what you're eating as long as it's an unprocessed item.
I'm happy, right?
But take it to the next level and build in that protein and I am significantly happier.
(26:42):
Well, they are creations.
I remember reading and I forget the title of the book in the author's ages ago about processed
food of how they created.
And there was this term that stuck with me that they saw a lot of science as used to
create what he put as the bliss point that when you taste it, it's the most amazing thing
(27:02):
you've tasted.
And then when you eat it, it's gone or even you swallow it, it's gone.
I want another one of that.
And it's, like you said, it's empty calories.
It's not real food.
Yeah, they're engineered like that.
Rob Wolff wrote a whole book called "Wired to Eat" that goes through some of these things.
I mean, the amount of R&D that went into Doritos, for example, it's wild.
(27:24):
Or the "What's the slogan for Pringles once you pop?
You can't stop."
Even the fact that I know that advertisement is nuts, right?
That shows how great their marketing is working on, you know, our subliminal lines, but they
get just the right level of crunch, and salt, and sweet, and fat to keep you coming back for
more and more.
You add in some like glutamate, chemicals, and other things that hit the dopamine reward
(27:49):
center of the brain, and you're hooked, right?
So it starts with interrupting that cycle.
So if I could just go into that for just a little bit, a lot of this has to do with our blood
sugar regulation.
People think it's a well-power thing.
And certainly, I mean, it's been pretty well documented that food addiction can indeed
be a thing that people experience, but the only way to interrupt it is by tackling your
(28:16):
hunger levels and tackling your blood sugar regulation.
And this starts with breakfast.
This starts with a protein and fat-rich breakfast, protein in particular, to set the stage
for stable blood sugar at an inflome level.
So you're not crashing.
Once your blood sugar crashes, which happens when you eat just a carb breakfast?
(28:38):
Even if it's like so-called healthy, like oatmeal for breakfast, you get a huge blood sugar
spike, a huge blood sugar crash, and when you bottom out, your body sends you the physiological
signal to eat more food, and specifically food that's going to raise your blood sugar
back up because it is experiencing what it sees as a metabolic emergency.
It's running out of fuel.
(28:59):
You have to eat.
And you have to get that blood sugar up, so you will be craving carbs and sugars, and it's
really hard to get off that cycle if every morning you either don't eat breakfast whatsoever,
or when you eat breakfast, it's a super high-carb option.
So just swapping out breakfast makes a massive, massive difference in people's satiety, their
(29:22):
energy levels, their cravings, and just honestly everything.
I mean, I think I've recommended a protein-rich breakfast to virtually every client I've
ever worked with because until you address that, you're going to be tackling the mid-morning
snack attack or the 3 p.m. slump forever and ever and ever.
(29:44):
You've got to interact cycle even before it starts.
So real foods, good protein supplementation.
What do you think?
The supplementation come into play?
It has a place, and I mean, there's a whole chapter in supplements in my books for a reason,
but I think we have to look at supplementation from the angle of, I mean, really what they're
(30:04):
designed to be, to supplement, to have in addition to your major source of nutrients is still
your diet.
You still want to get through your diet, quality, as dialed in as humanly possible, and then
you build in the supplements to fill in the gaps on top of that.
So certainly they have a place.
(30:24):
I think we need to kind of choose them carefully, especially choosing the highest quality supplements
that we have access to looking at forms of nutrients, whether or not they have third-party
testing, or they manufactured in a way that's retaining the nutrients and is done in a clean
way, right?
The basics.
We need to make sure that we hit those marks, but for sure, supplementation has a place,
(30:48):
a prenatal vitamin, supplementing additional nutrients as needed, like iron or DHA for individuals
who don't consume much seafood, for fertility, there's a number of, especially antioxidant
style nutrients that can be really helpful for improving egg quality or sperm quality, like
alpha-lipoic acid, for example, or co-Q10.
(31:09):
There's for sure data on a lot of different supplements.
Well, we want the fake food out, but are there any specific foods that a woman should
not take during pregnancy?
Yes.
And the primary ones that I focus on are the ones that are A, something that's overtly
going to be detrimental to the baby at large quantities, like alcohol, something where
(31:32):
there's a threshold at which we get kind of concerned with safety.
So with caffeine, they recommend no more than 200 milligrams per day, for example.
Go easy on the coffee, you could still have a little, with tea, you're pretty unlikely
to overdo it unless you're drinking a lot of tea, and then we have different concerns.
But keeping your caffeine in a reasonable amount, definitely checking if it's coming in
(31:54):
in a protein supplement or an energy supplement, sometimes there's added caffeine to things
that you may not realize.
Then beyond that, most of my recommendations on foods to avoid in pregnancy are the very
ingredients that make up the ultra-process foods.
So the refined starches, white flour, refined sugars, or added sugars in large amounts,
(32:17):
the quality of actual oils, the kind that people use for deep frying, for example.
So cook in different oils, cook in coconut oil, animal fats, butter, ghee, large tallow,
low heat for olive oil, avocado oil, stuff like that, are much a better option than the
canola soy, cotton seed, corn, those kinds of oils.
(32:41):
Trans fats definitely need to be avoided, thankfully now that we have mandatory labeling
of trans fats, they are in such a small quantity in the American food supply now that we almost
don't even need to worry about it all that much, but you may see them in other countries
still.
Those definitely should be avoided.
And then in high quantities and low quality formats, soy is another thing that I think should
(33:06):
be limited or possibly even avoided in pregnancy.
This gets a little bit into controversial land, but unless it's organic soy that's been
traditionally processed in a way that they do in Asia, it's probably best not to have
super large quantities of it.
So your soy protein, bars and shakes, people talk about, well, soy has been traditionally
(33:30):
consumed in Asia for all these years.
You look at the average amount of soy consumption in those countries and it's something like
8 to 11 grams of soy protein per day.
In the U.S., a single protein bar that's a soy protein bar based may have that amount
or more, maybe even double.
We're getting tons more soy than they ever did traditionally.
(33:53):
And it's not in the form necessarily of organic, traditionally processed tempe or tofu or
miso or nato or tamari.
It's in these soy protein isolates made from genetically modified soy.
In huge amounts, we do see this leading to some disruption in hormone levels that can affect
(34:14):
mineral metabolism.
And of course, there's going to be pesticide residues if it's conventional soy, grown and
conventional means where they're, you know, aerial spraying with tons of pesticides.
Well, you said your mother helped you and that was a good learning experience that you had.
When you were pregnant with your own children, did you learn anything by paying attention
(34:36):
to your own body or with the interaction that you have with your medical team that you
might have not known before?
Yeah, for sure.
I mean, I always using myself as a guinea pig.
So, what's some examples? I mean, when you're dealing with the conventional medical system,
sometimes takes a lot to convince them to order the lab tests that you want them to order.
(34:58):
So I was definitely a squeaky wheel, kind of patient asking for my hemoglobin A1C and my vitamin
D levels and stuff like that where, you know, those are not necessarily standard labs.
I certainly used myself as a guinea pig with looking at like glucose metabolism and pregnancy.
I saw first tan that you can get a false positive on the glucose challenge tests if you're
(35:22):
eating low carb prior to the test.
You can follow that up with home blood sugar monitoring and see that everything's actually
perfectly fine, but, you know, these tests are not always infallible.
I've written about that experience on my blog if anyone wants to search on my site,
Glucola, you'll pull up the two-part article series that I did on that.
(35:43):
With, again, I'm going into lab tests because I feel like this is a big area for improvement.
You know, I asked for my vitamin D levels to be checked each trimester and they had been
checked properly the first two times and the third time I get this call that I have toxic
levels of vitamin D. And I was like, huh?
Like, let me see the lab tests results.
(36:05):
I go and look at the lab tests results.
They had ordered the wrong lab and then they had applied non-pregnancy reference ranges
for vitamin D. And vitamin D is a very interesting nutrients, technically a hormone in the way
our body manages it.
And there's different versions that you can test in the bloodstream.
(36:27):
And because vitamin D is so vital to fetal development, your body like up regulates how
much it converts into the hormonally active form, which is what they attested for me, but
it's maintained in pregnancy and what they call superphysiologic levels.
So the reference ranges for outside of pregnancy do not apply in pregnancy.
It is intentionally high.
I just so happen to be a vitamin D nerd and I teach like a two hour webinar in vitamin
(36:54):
D in pregnancy that I knew this and was able to catch this and be like, hey, actually
my result is normal because you tested this level and this is high for this reason.
Can we retest with 25-pidroxy D?
And they did and my levels were perfectly normal.
So I mean, if anything I think I learned, you really have to be your own advocate.
(37:16):
It is surprisingly difficult to navigate the pregnancy.
Honestly the healthcare system is very difficult to navigate, but pregnancy in particular,
I found that the approach felt a lot more like they're always looking for problems instead
of working on the preventative care.
(37:36):
Now I worked to the midwife in my second pregnancy and they're a little more working on
the preventative care angle, but I still found that I had to really be an advocate.
I think I'm a probably, particularly, either I'm a particularly easy or particularly
difficult patient because I like know too much, but I'm easy because my pregnancy as a result
(37:59):
are really low risk.
They don't really have to do anything, but you do have to ask for what you want.
You have to be informed.
So I've tried to translate all of that into my books.
So you have to spend hours on PubMed and Google Scholar finding this information, like
it's in there for you so you don't run into the same struggles that I did.
(38:21):
When you were pregnant, do you think the medical staff was like, oh, the only nickels
was coming in this afternoon?
Okay.
Probably, probably.
I'm taking my lunch at 230.
She's here at 230, I'm taking my lunch there.
Yeah, probably.
First pregnancy for sure, I was probably a little annoying, but I also, I know how to interact
with the medical system, right?
I mean, I went through conventional dietetic internship at the largest hospital in Los
(38:42):
Angeles.
Like, I know how to stay in my lane, smile and nod.
I really am not.
I'm not in the same energy that I am on a podcast where I'm actively here being asked questions
and teaching.
If they're not asking me a question, I'm not trying to like school anybody on anything, but
if they do ask for an explanation, I'm going to have to hit them with a little science.
(39:06):
So yeah, you got the foot notes right there on call.
Right.
The prenatal nutrition guidelines.
What does the lily nickels think we're getting right?
And what are we possibly getting wrong?
Okay.
Well, that's can of worms.
I've already talked about the protein guidelines where we're off on those.
Really all the macronutrient guidelines are off.
(39:27):
They need to be shifted.
The guidelines suggest two low protein, two low of fat and two high in carbohydrates.
And we need to go more protein, more fat, less carbs, the greater emphasis on quality of
carbohydrates.
The guidelines contend that a vegan diet is perfectly safe at any life stage, including
(39:51):
pregnancy, breastfeeding, early-emptancy.
I disagree with that.
If such a diet is followed, you're going to have to be really on your game with your lab
testing and your supplementation and you still may run into some challenges.
So I like to look at it not from what the human body can tolerate, but what's optimal.
So I certainly don't think that is optimal.
(40:14):
I also think a lot of our nutrient values, like our RDAs, are imperfect.
Like I mentioned earlier, a lot of the nutrient allowances, the dietic reference it takes,
are extrapolated from data on men.
And there's a lot of assumptions made for pregnancy, how that changes in pregnancy.
(40:39):
And there is actually a study that looked at how strong is the data used to set the dietary
reference and takes for vitamins and minerals and pregnancy.
So they analyzed the 704 studies that were used in setting those recommendations.
And it was something like only 16 or 17% of studies used even had a single pregnant or
(41:04):
lactating participant.
It was really slim.
So for a lot of our nutrients, we don't even have pregnancy specific data backing those
recommendations.
And in order to move the needle on that, we need to be funding more research, studying
nutrient demands in pregnancy and in lactation specifically, not just relying on these estimates.
(41:28):
We know we've gotten it wrong for vitamin D or coline, probably incorrect for vitamin A,
probably incorrect for iron, incorrect for B12, it's set three times two low at minimum for
B12, it's two low for B6.
There's a number of nutrients even beyond that where there's been some research questioning.
(41:50):
Is this really enough?
Because we have women hitting the marks where there's nutrients and they're still showing
signs of deficiency, which suggests our guidelines are set two low.
For the majority of them, they're just set two low.
I think iron might be the exception where it is set at a level that's so high, it's virtually
impossible to meet from food alone.
(42:10):
Again, that one is based on a lot of assumptions, not necessarily direct estimates, but for
most of them, it's that they're set two low.
Well, I know you'd like to be writing the next book.
Can you share with the next book, it's going to be about or is it too early to?
No, probably too early.
My was real food for fertility.
I co-authored it with the colleague of mine, Lisa Hendrix and Jack, and we have joked that
(42:33):
we have what are we calling it?
Host book, trauma syndrome.
When people ask us about what the next book will be, yeah, I don't know.
I have this very long log of requests for topics, but what people don't understand, I think, is
the way that I go about writing a book is a lot different than most books that you get
(42:58):
on the market.
I'm not just like writing out my opinion and citing a couple studies.
I'm reading a lot of research.
I mean, we have over 2,300 in-text research citations and real food for fertility.
There were so many papers that this would have added 200 pages to the already 500 page book
(43:20):
if we printed it right in the book.
We have it available as a PDF download instead because no one wants to be lugging around
a 700 page brick of a book.
Even within those 2,300 plus citations, many of those are linking out to maybe multiple
studies, so some of them are citing 2, 3, 4, 5, 6, 10 studies.
(43:42):
If it's a really controversial topic, I feel sometimes it's necessary if I'm tackling something
like saturated fat and heart disease, I'm going to give you more than one study because
my conclusions are based on more than one study.
But we don't even know the final citation count.
So all to say, even if sometimes there's overlap in the general principles, like I can
(44:03):
tell you right now, if I was to go deep into the weeds and the research on nutrition for
menopause, I'd probably come to many similar overall conclusions.
The data specifically, of course, would be different data points, different studies I'm
talking about.
But there probably be a decent amount of overlap, but it's not like that's easy or it's
(44:28):
simple to write.
And maybe my assumptions as oftentimes they are would be questions and I'd find data
that would be surprising.
Like, oh wow, I didn't expect that we would need more of swisee nutrient and it turns out
we do for this reason.
Again, it's just time consuming and very cumbersome.
So the last one took us three years.
(44:50):
I have no plans to start on another book any time soon.
So come back and maybe four or five, six years and see if there isn't a book out then it's
possible I'm working on it.
It's possible I've called it quits and I'm not writing anymore books.
What's that process like?
Are you researching and then writing, researching, taking notes?
(45:13):
Walk me through that.
Why does that look like?
It's extremely cumbersome.
So from the beginning, I've always had like an outline, a chapter outline for or books.
Okay, we're going to go through this topic here and this topic there.
Sometimes there's overlap when like, okay, we're going to talk about this here and then
we're also going to talk about this there and which information goes where.
(45:34):
So I try to have as clear of an outline as possible.
So the information is at least going in the right spot.
I get the data points accurate.
I am citing in text as I write so I don't forget the study because I can't actually track
of 2300 citations in my brain.
Once I've written the thing, I can't remember what study it was.
(45:55):
So I'm citing in text as I write and then making sure sometimes information is not flowing
well, right?
So to make a book flow that takes a lot of editing.
I mean, even before I consider a chapter like done, it's probably gone through five
or more edits.
I mean, I'm editing the sections as I write and then I'm going back through making sure
(46:19):
it's logical editing again, writing another section, seeing if it flows.
It's a very time consuming process.
But I'm usually reading the papers and writing about them at that moment and then later kind
of pulling it together in a cohesive paragraph.
Then of course, the research has never done.
(46:40):
So I'm reading something else.
I'm like, "Oh, that's a really good data point."
Then you have to go back and add it in and re-edit all your transitions to make sure it
flows.
And I'm also reading all the papers in full before I cite them.
And so that in itself takes a lot of time.
You're highlighting the papers.
I do it digitally.
I don't pronounce studies usually, but I'm highlighting the studies digitally, pulling out
(47:03):
key points.
The document is like pages and pages of hex in different colors with different comments
and notes.
I mean, you know that mean of that guy who's researching something and he has the bulletin
board with all the thumbtacks and the things attached to the board and they're attached with
string and yarn and he looks like absolutely crazy.
(47:27):
It's a little bit like that.
It's a little bit insane.
You mean like a murder wall?
Yeah, it kind of looks like that except for good purposes.
I mean, all the things connect to all the things that you're like.
You have these light bulb moments where you're like, oh my gosh.
And this explains why this is happening.
Oh, wow.
I have to research this new rabbit hole unlocked.
(47:51):
Another 10 studies to read.
Then you're reading the study and there's a study cited in the study and then you have to
read that study.
I mean, it kind of never ends at a certain point.
You have to just tell yourself, okay, have I like made the point that I wanted to make
because I think it's time to move on.
There's some topics that are there's so much research on like toxins.
(48:13):
There's so much research on toxins and fertility.
I probably could have cited 10 times the amount of studies that they cited in that chapter,
but at a certain point it just gets redundant and repetitive and to the point that it's
too overwhelming for, it's already overwhelming for vibran it's definitely overwhelming for
the reader.
So at a certain point, you have to just cut it.
(48:36):
Choose the best study, throw out the rest and move on to the next topic and that's tricky
too.
Does your husband look at all that layout and go, oh, I didn't know you could do hydrodophics.
That's great.
Yeah, right.
Yeah, well, he's an engineer so he can handle this sort of stuff, but he'd probably have it
organized in a spreadsheet with formula calculated that spit out the data in a beautiful display
(49:00):
and my brain doesn't work in spreadsheets.
It works in messy documents.
So, you know, teach their own.
With respect to the books, what are you most proud of?
I mean, to me, it's the results that people get.
Certainly, I'm proud that we even finished.
I mean, I'm proud that I finished any of these books.
Real food for gestational diabetes.
(49:20):
I'm certainly proud of that one because it changed international policy.
It changed the Czech Republic official guidelines on gestational diabetes nutrition and they
have since reported significant reduction in adverse outcomes like babies being born larger
than average, 50% lower requirements for medication and insulin impregnancy, less comorbidities.
(49:44):
So, that's huge.
I mean, that was a big, that came in about like 2016 that update happened.
And so, that was always quite nice, but I'm certainly happy just to hear from women and
couples and families who have implemented the information and have changed the trajectory
not only of their pregnancies, but of their health for life.
(50:07):
That's like the biggest benefit that I can get is just hearing that it actually helped
somebody.
I mean, these things really are a labor of love.
And so, to see that they're helping people is the ultimate gift.
And finally, what does Lily Nichol's best day look like?
What's happening and who are you surrounded by?
Oh, best day.
(50:28):
Well, I probably wouldn't be at my computer on the best day.
I mean, sometimes if I really get the bug, the research atopic, I will willfully sit down
and do a bunch of that.
But my best day would probably be spent gardening, actually, outside working in the garden
with our chickens, making a meal, nowhere to go, just family.
(50:52):
I mean, I'm kind of a hermit introvert.
So, although I love my friends, I like small groups settings.
And so, if I don't have to go anywhere, I'm very happy.
So, nice warm sunny day in the garden would be where I'd be at.
Lily, thank you for making this happen and for helping not only women, but all of us understand
our health better.
(51:12):
Thank you so much.
The Good Foods podcast is for entertainment purposes only.
The claims, comments, opinions or information heard should never be used in place of your
medical provider's advice or your doctor's direction.
Thank you for listening.
Follow us on social media and wherever you get your podcast.
(51:35):
Good health through Good Food.
Good foods grocery.
[MUSIC PLAYING]
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.