In this episode we’re talking with Ryann Kipling about nutrition during preconception and pregnancy. Ryann is a clinically trained Registered Dietitian Nutritionist, Certified Lactation Educator, and Author of The Feel-Good Pregnancy Cookbook. She is the founder of The Prenatal Nutritionist, a virtual nutrition private practice, which focuses on preparing women for pregnancy and conquering nutrition during and after pregnancy. She helps women feel confident in their ability to properly nourish a growing baby through a real food approach. Aside from one on one nutrition counseling, Ryann is a nutrition writer and content creator on her popular Instagram account @prenatalnutritionist. Click here to check out the Prenatal Nutrition Library and pregnancy grocery shopping guide. This is the article Ryann mentioned about protein intake in the preconception and pregnancy periods.
The following was transcribed by Karly Nuttall:
Ali: Hi and welcome to the Birth Kweens podcast. We’re your Birth Kweens! I’m Ali.
Karly: I’m Karly.
Ali: And today we’re talking about nutrition. This has been an episode that, I mean, we did an early, early nutrition episode but it’s been requested to talk about it more and especially some preconception nutrition and some pregnancy nutrition stuff. And we called in an expert so that you don’t have to just listen to us tell you what to do. So we’re talking with Ryann Kipping via Zoom. Hi Ryann!
Ryann: Hey! Excited to be here!
Ali: We’re so glad to have you. I want to tell everybody a little bit about your background before we jump in. So, Ryann is a clinically trained Registered Dietician Nutritionist, Certified Lactation Educator, and author of the Feel Good Pregnancy Cookbook. She’s the founder of the Prenatal Nutritionist, a virtual nutrition private practice which focuses on preparing women for pregnancy and conquering nutrition during and after pregnancy. She helps women feel confident in their ability to properly nourish a growing baby through a real food approach, and aside from one on one nutrition counseling, Ryann is also a nutrition writer and content creator on her popular Instagram account @prenatalnutritionist. So we have the right lady for the job today! Well, let’s just get started by talking a little bit about, and I feel like maybe this is obvious to some people, but important to mention, why does nutrition matter and why is it so important before, and of during pregnancy?
Ryann: Yeah, so this period, and I think you guys could speak to this as well, the whole prenatal journey from thinking about conception all the way to postpartum, honestly, the full year postpartum is such a critical and sensitive period of life for the mom and also for the baby. So, to me, I know I’m a little bit biased, but to me if there’s any time where you should work on your nutrition and have, honestly, the best nutrition, is during this time. Because it matters, not just for you anymore, right? It matters for your baby too, and, you know, your future family and what you’re eating is now not only affecting you, all those nutrients and things are going to baby as well. So, I just think that there’s any time we should really focus on really dialing in our nutrition and finding what works for you, is how I like to say it.
Karly: Yeah, It’s really important to get something that’s sustainable but when you were talking I was thinking about the time in between pregnancies, too, because a lot of people have more than one baby and you’re definitely thinking about your baby’s nutrition as they’re growing. You want to give them the best foundation you can, but at the same time, your body gets really depleted during pregnancy, so replenishing, hopefully we can talk a bit about that, too.
Ryann: Yeah, for sure, yeah that time in between children is definitely important as well.
Ali: So, how, if somebody isn’t necessarily where they want to be nutritionally, which that is probably a whole conversation in and of itself, figuring out what that means, right? But, most of us can identify when there’s room for improvement, big or small in terms of what we’re eating. So, if someone isn’t where they want to be or where they feel like they should be before they get pregnant, how far in advance of getting pregnant, aside from you know, the beginning of your life do you feel like somebody should start making changes in their diet if there is an amount of time. Does that make sense? I feel like some people are like, “when do I start this process?”
Ryann: Yes, no, this definitely makes sense, and I was just talking about this earlier today, actually. And what I was saying was, ideally your reproductive years…and it was funny to me that you said, “the beginning of your life”, you should always be having good nutrition, right? But ideally your reproductive years should be this continual process of you working toward your best health, because it is a process, right? And it never really stops. I’m a dietician and I can say this: I don’t even have that point in time where I’m like “Yep, I nailed it! I’m doing exactly what I should be all the time, and everything is perfect and wonderful”. No! I still have nutrition goals and food goals for myself. So, it’s definitely a continual process and I think the time period that’s thrown out there a lot is 3 months.
Ali: Yeah, that’s kind of what I was thinking when I wrote question was “wow, I only have to do this for 3 months? Amazing!”
Ryann: Yeah, right? And it’s funny because so many women know way before 3 months, we can’t plan but some women are like, “at age 28, that’s when I want to be pregnant”. Which is funny because it’s so hard to plan something like that, but, if you do have that in your head and you’re 26 and by the time you’re 29 is when you want to start trying, now is a great time! I know you’re 3 years away or whatever, but that’s a great time period to start working on it and checking in with yourself and going to different health care providers. Even things like going to regular dentist visits and all of these random things you don’t think about. We should be towards our best health. I don’t even know if the 3 month thing is scientific. I don’t know if its evidence based.
Ali: I wonder where it came from because I’ve definitely heard it before.
Ryann: I don’t know, but if you’re listening and you are 3 months out and you’re like, “shoot, I’ve done nothing, but I think 3 months is when I’m gonna start trying”, that’s fine! It’s never too early or too late to start making nutrition changes, even if they’re the smallest nutrition changes. People think they have to completely 180 their diet. No! It’s not really about that, it’s really about making those small, small changes that ultimately lead up to big results, a bigger impact. So, if you are a year out or if you are 3 months out, it’s time. You know? If you know that you’re going to have a baby soon, it’s time to really start dialing it in and thinking about, “ok, what are some changes that I maybe need to make and how can I start implementing these?”
Karly: Right, that kind of brings up a question for me. So, when you’re talking about building your health that you start with small changes, what small changes do you recommend that people start with? I know that everyone’s diet is different so, maybe everyone has a slightly different aspect of their nutrition that’s missing, but when you say make small changes and you make them slowly over time, what pace are you thinking and what changes do you think are the most important to start with?
Ryann: Well, I think overall, people are definitely under-consuming fruits and vegetables.
Ali: Yeah, that’s an easy one.
Ryann: So basic, and you hear it, “eat more fruits and veggies” all the time and that’s kind of what we were taught growing up, “you need to eat your fruits and veggies!” But really, people are under-consuming these things. Dark leafy green cruciferous vegetables is a category of vegetables that has nutrients super important like folate for pregnancy and I will tell you guys, like 90% of my clients when they come to me are not eating enough green, cruciferous type vegetables.
Karly: Eat your broccoli!
Ali: Yeah, what is enough for someone who’s wondering “what’s my target?”. For most people
Ryann: So, it’s gonna be different, right? If you’re someone who eats vegetables twice a week, I’m not going to come up with a recommendation of “you need to start eating vegetables 3 times a day” because that’s unrealistic, right? If you’re only eating them twice a week to eating them 3 times a day you’re gonna be like “whoa, whoa, whoa, what?” You know, so I think if you’re someone who is not a frequent vegetable consumer and maybe you’re just trying to barely get one in a day, then I would just try to start being more consistent with that and see how you can up your consistency with one vegetable a day, and then work your way up from there, right? Because it’s going to be harder to just start eating 4 vegetables every single day
Ali: 4 servings, yeah.
Karly: Baby steps, baby steps.
Ali: But 4 servings is the ultimate goal though? Just for people who are like, “no matter where I’m at now, where am I headed?”
Ryann: Well, generally I would say at least getting in one leafy green per day is a good goal, but overall, probably 3-4 servings of vegetables, total.
Ali: Got it. Ok, what are the other things, like when somebody sits down with you for coaching or is just beginning to look at their diet and think about things, aside from fruits and veggies, are there any other major things that are always a topic of conversation?
Ryann: Yeah, I think fish is definitely another one. Omega 3’s overall because people don’t…not many people are super into fish, and if they are…
Karly: Mmmm…talking to one of ‘em right now.
Ali: Yeah, the look on Karly’s face just now was [shudder sound]
Karly: I know, I feel so bad that I don’t like
Ryann: Yeah, and I wasn’t a huge fish person my whole life. I really didn’t’ eat much fish at all so I totally get where people are coming from and when people do like fish, it’s often the white flaky kind that isn’t as…
Ali: Covered in butter you mean? That kind? That’s the kind I like!
Karly: Fish and chips! I’m eating my omega 3’s!
Ryann: Yeah, so that type of fish that people are usually about, not like the herring and sardines, and super oily fish that have the most DHA in them. Those are the kind of fish that people usually DON’T eat. So, that’s definitely a conversation to be had. And then there’s always a conversation about supplements, too, which I know we’ll probably dive into a little bit but my main focus as a dietician, really, is to do our best through food and then use supplements to kind of back it up. An insurance policy type thing. But, I’ll definitely say fish is one, and protein over all.
Karly: Do you have tips for somebody who hates fish. I know that people who promote eating organ meats do this whole hidden-liver thing and they’re like, “dice it up! Chop it up! Throw it in things that actually taste good! And then you won’t even notice it’s there.” Do you have tips for people who don’t like fish.
Ryann: I was going to say doing a crust, like a healthier crust, so kind of mocking a fried fish, but making your own bread crumb or something like that on the fish is good. And if you don’t like fish at all, and I’ll be honest, I was one of these people and I have now started eating fish over the past 5 years, maybe. But that’s really how I started. I started with super bland, white types of fish like I just described are not good sources of DHA and all this stuff. So, I started there and I just sort of worked my way into working it into my taste buds. And I can’t say now that I’m eating sardines by the can by any means. But, when I’m incorporating them into different dishes, it’s not as, “ugh, this is so bad”. It’s a little bit easier to go down, so, again, start small.
Ali: Got it.
Karly: K, hot tip!
Ali: What about, so like, for people who are like, “absolutely not, it’s not gonna happen for me”, is fish oil…are fish oil supplements a good or suitable substitute in this case?
Ryann: Yeah, especially if you are currently pregnant or thinking about being pregnant, you’re definitely going to be looking at some form of supplementation.
Karly: And do you have a favorite fish oil supplement? Because I know people will be dying to know. I like Carlson’s because I feel like it’s really fresh and I can drink it by the tablespoon and not gag, but are there other ones that you think are just as good or better?
Ryann: So that’s a good brand, and when we’re thinking about fish oil supplements, we want it to be either small fish based or algae based because there is some confusion there with you can get DHA from flax seed oil and things like that which is not true. So, picking a fish oil supplement or an omega 3 supplement, you definitely want to read the label and make sure it’s either algae based or actually made from small fish like sardines and things like that. But, yeah, I think that’s a good brand. Nordic Naturals is a brand I like as well. But 3rd party testing is what I’m all about when it comes to supplements, so just making sure you’re finding a brand that is really quality and is being true with their labeling and doing extra additional testing, and all things like that. Because we know there’s about a million, billion options when it comes to supplements, and you know, it’s overwhelming, and everyone’s always trying to push that theirs is the best, so you always want to be cautious.
Ali: And 3rd party testing is, like, the ones who are doing it are generally noting it on the labels or is that I guess just internet?
Ali: I feel like, am I correct that there is no FDA regulation of what goes on those labels or those products at all?
Ryann: Correct, there is very little oversight, so 3rd party testing is basically, this company is paying another company that is not affiliated with them to test their supplements to say, “our supplements have in them what we’re saying they have in them, and they don’t have any of this other bad stuff”.
Ali: Ok, great. Well, speaking of supplements, when do you recommend someone start taking a prenatal vitamin, assuming that they’re not pregnant yet?
Ryann: Same thing, right? Same thing as nutrition changes. If you’re a year out and you’re like “this year is the year I want to start trying” then I would say, start taking a well-rounded prenatal vitamin. Again, if you’re 3 months out, if you’re 2 months out, if you’re 1 month out, now is the time as well.
Ali: Never too early, never too late.
Ryann: Yes, never too early, never too late. If it’s a surprise pregnancy, yes, you should start taking them now as well. But even more so, something that’s targeted for your needs. Working with your provider and your dietician, and other health care professionals that you’re working with to find a supplement regimen that’s gonna be suited for you is, of course, the most ideal.
Karly: Mmhmm, and what goes into that? Is it just assessing someone’s diet and seeing where the nutritional gaps are? OR is it doing blood testing to look at micronutrient panels and all that?
Ryann: Yeah, so a combination for sure. For me it’s definitely doing a nutrient analysis of your food intake, asking lots of questions about their dietary patterns, and then, obviously, looking at their blood work too, whatever they have, and then if I think we do need additional testing, I might recommend more micronutrient testing. It does get expensive if you want to go through all the micronutrients and things like that. So, if you have the means to do that, absolutely. It’s so great to know.
Ali: I feel like if I walked into my GP and asked for that I feel like she’d say, “no, you don’t need that”. So, who do you usually recommend people see that?
Ryann: Yeah, you could definitely go through a naturopath, you can go through dieticians too, that can order them through certain online…Spectracell is one that will do it for you. They have different panels. But yeah, you can honestly, I think just as an individual you can go on and order online through some of these places, but, even if you decide to do that, you would definitely want to have it looked over by a dietician or some sort of clinician that is knowledgeable. Don’t try to just interpret it on your own and be like, “oh yeah, I think I should start taking this, and that, and that”.
Ali: Yeah, totally. Ok, well any other things you want to throw in regarding preconception you think are really important to know or consider?
Yeah, if you’re listening and you’re in that time period, this is such an important time period and you have your full capability to get to your nutrition A game, right? I always say this time is so important for several reasons, but whenever the first trimester hits – and I know we’re going to jump into this too – it’s so hard because your whole routine is totally thrown off. Nothing sounds good, you can’t eat anything you were eating before, but, during that time your body is largely relying on the nutrient stores your body built up prior to being pregnant. So, if you’ve done the work in the preconception period and you’ve really focused on your nutrition and included the most nutrient dense foods and all that good stuff, then you don’t have to be as concerned and as freaking out. People message me almost daily. “I can’t eat anything, how is my baby getting any nutrients, how are they growing?” all of this stuff. And it’s like, well, number one our bodies are pretty amazing, they kind of have the blueprint and they know what to do and all that good stuff. But they are relying on those nutrient stores you built up. So, granted you were adequately nourished before you went into pregnancy, you don’t have to worry as much is what I’m trying to say. You can just eat what you can while you’re going through that nausea and hard time.
Karly: It’s such reassuring information to hear because I get not just my clients, but also their partners that are like, “surely there’s a way that she’s going be able to eat something besides toast and bagels for the next 3 months” and I’m like, “I meannnn, that’s kind of standard”. It just seems so counter intuitive that nature would make you so sick that you can’t eat nutritious foods in the first trimester.
Ali: You guys, what the fuck is that about, though? What a joke!
Karly: I don’t know! Is it trying to weaken the species?
Ali: Is there some biological reason? I gotta know what the deal is. But, yeah, so, for people who are worried about that, it sounds like the punchline is: hopefully you were able to dial in your nutrition before, but either way our babies are relying on our bodies and our nutrient stores to get through that.
Ryann: Yeah, definitely, and also, too, if you’re in your first trimester and you’re like, “I don’t know what you’re talking about. I can eat leafy greens and sardines” then you should do that. Do it.
Ali: This is more advice for people who can’t physically either keep stuff down, or their aversions are so strong they just can’t. It’s like toddler diet, is how I hear a lot of my clients describe it.
Ryann: Yeah, totally
Karly: No pungent flavors, nothing strong.
Ali: White, tan foods.
Ryann: Mac n cheese
Ali: Do you have any tips, speaking of 1st trimester- or for some people it goes on longer – sickness, on what to eat or how to cope? I know there’s a million old wives tales, but, anything you like to offer to people when they ask?
Ryann: Yeah, there’s so many things you can try to kind of manage the nausea, and what I say is, “try them all. Right? Try everything.” Something might hit, something might work, so might as well try all the foods, try the high B6 foods, ginger. Those two in research have shown to be equally effective. Generally, I go with B6 first, let’s try foods first and then of course we can think and talk about supplementation if that’s not working. You can try ginger in anything like fresh ginger in smoothies or cooking, you can try ginger tea and ginger ale. Of course, you’ve gotta watch the sugar there, but that can help too. Protein, I know is the worst and all we want is carbs during this time, but if you’re able to eat protein at breakfast, that has shown to help subside nausea later in the day, or at least not make it worse. You’ve probably heard the crackers at your bedside one.
Ali: Like, get something in as soon as you wake up is kind of the idea behind that?
Ryann: Yeah, exactly, so not having an empty stomach. And that’s kind of where the small frequent meal recommendation comes in too. So, you’re eating 6 times throughout the day, so your stomach is never really super empty. And that can help, and that does help some people so it’s definitely, again, worth a shot to try to do something like that and see what hits. If the crackers at the bedside works for you, that’s great. Some people kind of laugh at that so I’m like, “cool”. But sometimes it works so I’m going to keep recommending these things, you know?
Ali: Totally, I was going to say, I’ve had people where citrus helped a lot, either essential oil, or I had a client who would all day everyday had a fresh cut, whole lemon, and she would just rotate it out for a fresh one, so who knows, you never know what’s going to do it.
Ryann: Yeah, certain smells like and things like lavender and peppermint and lemon. I think if you have candles or an essential oil diffuser, those are definitely things to try.
Ali: Yeah, do your best, especially with nutrition. It sounds like just try to dial it in before and then hold on and survive for those months when you’re sick, right?
Ryann: Yeah, some calories are better than no calories, is what I always say, too. So, if you’re able to eat toast or eat cereal, I was just talking with a client before we got on this call and she was like “well, I can really only eat Cheerios”. And I’m like, “Cheerios, honestly, cereal during this time is not a bad option because cereal is at least fortified with certain nutrients and then if you can eat cereal with whole milk, you can slice a banana in that which is what she was doing. I was like, “honestly, this is not a bad little option for when you’re going through nausea” because you are getting some nutrients in with that type of meal. Of course, ideally, we would probably want some more protein and things like that, but this is definitely not a bad option while you’re struggling through.
Karly: Well, there might be one invisible way to get some protein in there which would just be doing…I don’t know, are you a fan of collagen powder? I know it’s not THE best protein but it’s some protein and it’s pretty invisible when you mix it into something so you could just mix it up with that whole milk.
Ryann: Yep, yep, and that’s actually what I had told her, too, because she was using it with some other things and I was like, “hey, you could throw a scoop of collagen in there and that would add a little bit more”.
Karly: Great minds think alike!
Ryann: That’s so funny!
Ali: You know what? I do it in my coffee every morning now and it’s how I justify just really launching my day with caffeine but like, a little protein.
Karly: As if you needed justification, I mean, survival is justification enough.
Ali: Exactly. And I find, because I’m not a fan of protein powder, I find that most of them are kind of gross, and collagen, I can barely tell.
Ryann: Same. I feel the same. I’m not a big fan of protein powders, and like I said at the beginning, I’m definitely a food first type person. But pregnancy is one of those times in life we’re just trying to do what we can, we’re trying to get in all the nutrients we can, and if it’s something like a protein powder is going to help you up your protein a little bit, then yeah, I’m definitely about it.
Karly: And if they’re doing a grass-fed milk, then they would be getting at least the CLA, which is a healthy fat in the whole milk.
Ryann: Yeah, and DHA, too. There’s a lot of grass-fed, organic type milks that have some DHA, too. So that’s always a good thing.
Karly: So, a lot of it is just about what you’re choosing. Even if you can only eat Cheerios, it’s good to get the best that you’re capable of getting.
Ali: What is the recommendation on how much a pregnant person should aim to eat and calorie recommendations? I feel like in general, we’re very much about, “listen to your body and go by what you need and how you respond to foods vs a number on the scale or the number of calories, but I also know there are people who are like, “give me numbers” you know? Like, “I need guidelines” so maybe you can give us some data on that.
Ryann: Yeah, I’m the same way. I’m definitely about, we want to listen to our bodies as much as we can and definitely, same. No number is on the scale is…we want to kind of steer clear of that and calorie numbers and all that good stuff, but yep. I come in contact with a lot of people who are like, “that’s great and all, but I’m a numbers person.” So, I would say, in general it’s probably, to start this off, of course this is individualized. To know your needs specifically, you’re definitely going to want to work with a dietician or other nutrition professional, but as a general note I would say it’s probably not a good idea to go lower than 1800 calories a day. Some women needing well over 2000, you know, 2500, and as the pregnancy goes on, but that’s another, I guess another myth I will say that’s floating around is that everybody needs to eat 300 extra calories in the 2nd trimester, and then 400 in the 3rd trimester, or even more, and honestly, that’s individualized too. Those are really not hard and fast numbers that you should be like, “oh! Hit my second trimester, I need to add in a pb&j sandwich, you know what I mean?
Ryann: Those are things you need to make sure you’re getting those in because for some people, yes, you will need to gradually increase calories, and protein. Well, pretty much everyone, the protein thing, but as far as calories go, some people might not even need to increase their calories at all when they’re pregnant. Maybe what they were doing before is suitable for their whole pregnancy. But it comes back to what we were just saying at the beginning. Listen to your body. If there are certain days where you feel ravenous and you’ve eaten five full meals that are massive, that’s fine if that’s what your body is telling you need.
Ali: That’s me right now. Non pregnant, let me be clear.
Ryann: With the calorie thing, setting a specific number, the downside to that is that really, every day is probably going to look different so if you are trying to hit a certain calorie mark per day, my fear is that you might not be listening to your body and you might be instead saying when you’re not hungry, “oh, but I haven’t eaten this many calories yet.” Or if you’re already at that mark you might be like, “oh I’m really hungry but I already hit 2000 calories or whatever it is, right?” And I’d much rather prefer you guys, and my clients, and everyone kind of just listen in and be like, “it’s midnight but I am starving and so I am going to eat something”. You know what I mean?
Karly: Going to bed hungry is the worst. I can’t eat if I’m really hungry when I go to bed and sleep is really important.
Ali: Yeah, same
Karly: It seems like calories are such a subjective thing, like the more important things are that people are getting, like, it sounds like you might actually have a real number for protein, but not a real number for calories as far as what people’s needs are. Because so much of that just depends on an individual’s metabolism and what not, and it seem that the nutrients and the protein, those things are actually much more important and we kind of have numbers for those whereas the calories, it’s just kind of like, “eh!” And you could get so much more full from eating lower calories in some instances than higher calories, it just depends on how much fiber, and did it spike your blood sugar, and all that stuff. So even the question of eating when you’re hungry depends so much on how are you eating in the first place, like, what is it that’s leaving you hungry.
Ryann: Right, exactly. More so looking at your plate and seeing how the macronutrients are distributed and all those things. But, yeah, I’m definitely more so about, “are we meeting our nutrient needs, are we feeling full, are we feeling satisfied, those types of things.
Karly: And do you have a solid number for the grams of protein you think pregnant people should be getting everyday?
Well, I do have a little calculator that I use, so it is, again going to be individualized. But, I will say in general, in the first half of pregnancy I usually shoot for around 70-80 grams and then it kind of goes up as you go throughout pregnancy. For most women, the second half you’ll want to be aiming closer to 100 grams per day.
Karly: And will you give a detailed explanation of why? Because I know sometimes I have vegetarians that maybe struggle to get that much protein and they’re trying to find different places to get it in, and question, is it really that important?
Ryann: Yeah, absolutely. There’s definitely research that says protein is the most important macronutrient during pregnancy. So, I don’t know the authors of that study but I would be happy to send, and post, and all of those things.
Ali: Yeah! People will love that.
Ryann: Yeah, I will definitely go find it and send it to you guys after. So yeah, protein is quite literally the building blocks of your baby. So, amino acids is what makes up proteins and there’s certain amino acids that are more important during pregnancy as well. So, you know I don’t wanna…it’s…going down the vegetarian route…there’s definitely ways you can still meet your goals but you do want to be cognizant of these other amino acids you might have trouble fitting in and figure out if it’s a supplement that you need to bring in, or if maybe you do want to start incorporating fish or something like that, then you’re going to have a much easier time meeting your nutrient needs. And I always get a little bit of backlash here, but for me I teach off the science, right? So, I’m kind of putting religion and ethical reasons aside. If it’s that, that’s not what I’m teaching on, I’m just teaching on the science and what the evidence says. So, that’s kind of my standpoint. I know I went off on a tangent a little bit for vegetarian stuff.
Karly: But protein: important.
Ali: Right, however you get it.
Karly: And do we know of any specific problems from not getting enough protein in pregnancy?
Ryann: So, there is data on issues if you get too much and, also if you get too little. So, there can be complications on either side, so aiming for that balance in the middle is super crucial.
Karly: Do you have any examples of what problems you run into if you don’t have enough? I just feel like people might want to know.
Ryann: Just pregnancy complications that we’re kind of familiar with hearing like small for gestational age, or preterm delivery, or increased risk for cesarean, those types of things.
Ali: Um, ok, well I know obviously we talked a little bit about specifics around protein but I do want to address some of the specifics around what the essential vitamins and minerals are that we need during pregnancy, and then just maybe like recommended intake and food that can contain them and all that. So how about folic acid vs. folate and that whole topic? Can you explain what that is?
Ryann: Yeah there’s so much confusion around folic acid and folate and you know part of the reason is because people use them interchangeably and I mean, they are the same.
Ali: They are and they’re not, right?
Ryann: Yeah, exactly, they are the same nutrient but folate is gonna be the natural kind, so the kind that’s found in foods like avocados and leafy greens and citrus fruit, some of the things we were already talking about actually. And often folic acid is actually the synthetic form of folate. So folic acid is often found, more so in supplements, I’ll say, but it’s also the type that is used to fortify foods. So back in the 80’s or 90’s? I’m forgetting my timeline here. I think it was the 80’s, they decided to require folic acid fortification because of neural tube defects. So there was an incline in neural tube defects so they were just like, “well, let’s just fortify food with folic acid and we’ll fix that issue.” And they did, they totally did. They put folic acid in a bunch of stuff and then they started to see a decline in the amount of neural tube defects. So it definitely worked but the foods that they added the folic acid to were things like pasta, cereal, rice, so more of those refined carbs. So…
Karly: So, they saw an uptick in gestational diabetes and a downtick in neural tube defects.
Ryann: Right, so is it the best to be recommending women eat more refined carbs to get folic acid vs. just recommended foods that are high in natural folate? Right? So, my take: I’d much rather focus on the foods that naturally contain folate. And like we were just saying with the nausea and eating cereal that’s fortified: that cereal is fortified with folic acid, which is fine, right? It’s still fine that you’re eating it! For some people. Now if you have the MTHFR gene mutation, that’s a whole other topic, but, you would want to be a little more cognizant about folic acid because those people can’t process it. Just a little side note there. But for the most part, we all want to be focused on folate, and then we also want our supplement to have folate as well.
Ali: Yeah, I was gonna say, that’s a big important thing to make sure you do when you you’re getting your prenatal is ensure that it has folate, not folic acid, right?
Ryann: Yeah, exactly.
Ali: Got it, because folate is what everyone, or, I shouldn’t say everybody, but basically everybody can absorb and the folic acid is…some people don’t know that they can’t [absorb it].
Ryann: Most people don’t know. For sure.
Karly: 40% of the population has the MTHFR gene mutation and you can have a few varieties so some people might only have one mutation and they can actually absorb a lot of it still, but it’s like 20% that they can’t absorb. So, most people are still going to be able to absorb some of it but yeah, 40% of people have some form of the gene mutation, so…
Ali: Might as well get that folate.
Karly: Might as well! Get the good stuff.
Ali: So, you mentioned avocado, are dark leafy greens a source? Besides what you’re going to get in your prenatal hopefully?
Ryann: Yeah, avocados, dark leafy green vegetables or any leafy greens, asparagus is good, citrus fruits are good, too. And then nuts and seeds have some as well.
Karly: I love all those things.
Ali: Yeah, delicious!
Ryann: You’re good then.
Karly: I can have a baby!
Ali: What else as far as minerals and nutrients?
Ryann: Oh, the other one I always love to talk about is choline, which has been compared to folate in its importance during pregnancy. But is a relatively “new nutrient” that was somewhat recently discovered by the institute of medicine so that’s why it’s still, like, we’re doing the best we can to get the word out about it. And the cool news is that the dietary guidelines just this year mentioned choline, so yay!
Karly: Hooray! It’s progress, you know?
Ryann: Yeah, totally.
Karly: This one is often conspicuously missing from prenatal vitamins.
Yes, definitely. It’s not in a lot of prenatal vitamins, so that’s another tip for your prenatal is to look for one that has choline. But even then you’re really not covered, unfortunately because most of them have like 50 mg.
Karly: And you need way more, right? Like 500 per day?
Ryann: Yeah, you need closer to 500 mg per day. So, yes, it’s good that it has some, but you still want to again, focus on food as much as you can.
Ali: And what are some good sources of food?
Ryann: So, choline is found, the best source is in eggs, specifically in the yolk so don’t throw out the yolk. You definitely want to keep that thing because all of the choline is in there. Most all the nutrients are in the yolk.
Karly: So instead of an egg white omelet you can start doing just egg yolk.
Ali: Yum, give it to me. Ok, great, how about, I know we had also previously talked about iron, vitamin D, calcium, can we touch on those real quick?
Ryann: Yeah, so definitely vitamin D is an important one to mention because it’s so hard to get it through food and most people are unable to get enough through food, again, going back to that fish chat we had. Most people don’t eat a lot of fish and fish is one of the only sources of vitmain D. There are definitely some other sources, too. But that’s one of the main ones. I mean, mushrooms if they’re grown in the sun, things like that. Dairy has some too, but most people are not getting enough vitamin D and it’s so important during pregnancy. So, if you’re in the preconception phase, too, this is definitely a time when you want to get your vitamin D tested and kind of see where you’re at as well.
Karly: Yeah, And I should say that in San Diego we live in the sunshine and people are usually spending a lot of time out at the beach and I do test all my client’s vitamin D levels and everyone’s deficient unless they supplement. And some people are shocked because they intentionally go out into the sun every day thinking that they are getting enough Vitamin D and they’re still in just the high 20’s where they should be between 50-80.While we’ve got you on the phone here, Ryann, I’m so excited to ask you about supplementation for vitamin D because I have seen, and I’m sure you’ve seen this too, and I’m just wondering what your take on it is: when people’s vitamin D levels don’t go up with supplementation.
Ryann: Honestly, I have not seen that. Mostly all of my clients, they have gone up at least slightly, right? So maybe it hasn’t been this massive increase over 3 months which is generally what we want to give it, you know? Test, and then supplement, and then retest in 3 months. It could be the type, right? Because we want to go for D3 instead of D2 which some supplements have. Yeah, but that’s interesting. For how long usually?
Karly: I just had one recently and I would guess it was at least 3 months apart because we tested, she was low, we re-tested and it hadn’t changed at all. It may have even decreased, and she was like, “what?” And I was like, “I don’t know what’s happening” and I started doing some reading and it seemed that I was able to find some articles that said that not all people respond to D supplements, to D3 supplements. Maybe it wasn’t specifying D3.
Ryann: You know, that’s true for other supplements as well, too, because going back to the vegetarian thing, a lot of people are like, “well, it’s no big deal, I’ll just supplement with B12” and all these nutrients that you might be missing and what people don’t realize is that not everybody’s body responds well to supplements. So, if you are vegetarian and you’re like, “oh, I’ve been taking this B12, I should be fine”, really you should be testing and seeing if you actually are fine because for some people, only food does the job.
Karly: Ahhh that is tricky.
Ali: Yeah, what is the recommended amount of supplementation or is there a general recommendation?
Ryann: Honestly, it‘s definitely variable. I think people are really surprised when they learn how much supplement they need. Sometimes I start out at 5,000 IU’s for people, but again it definitely depends on what your number is, and how low, or if it is close to 50 already then it’s like, “oh, maybe we only need to do 2,000 IU’s or you know, whatever it might. But some people need up to 10,000 IU’s so I would definitely not guess, and I would, again, work with a clinician that kind of knows what they’re doing as far as dosage goes and all that good stuff.
Ali: And I think that’s one, I just know from my own experience, this could be different for everybody. But, um, when I was trying to get some of this stuff tested, I wanted to get as much done through my GP as I could obviously so I could use this goddamn insurance I’m paying so much for as opposed to going out of pocket with the naturopath I was seeing for the labs. And the doctor, they test for vitamin D all the time, or at least my GP in the regular medical system was like, “yeah, sure” like, you know. So, that I feel is one, and this could be the case for others, too, I don’t know, it’s always worth asking, but that was one that was very easy to get approval for.
Ryann: Yeah, vitamin D is pretty easy to get approval for. I will say I’ve had some push back which blows my mind. Every time I’m like, so aggravated, I’m like, “this is it’s the easiest test to run” and it’s super cheap to fix, like, supplementation is not that expensive, granted it works, right? I guess there’s some people for vitamin D it doesn’t quite work, but, right? For the most part it’s a pretty easy process.
Ali: It’s also like, “Hey doc, all you have to do is write a piece of paper, or like, type a thing”. I don’t know, that’s a whole other rant.
Karly: Someone else is gonna do your dirty work.
Ali: Yeah, I mean, maybe there’s more to it, but yeah, hopefully, I think it’s something that’s worth checking in on regularly especially if you’re pregnant or trying to get pregnant.
Ali: Ok: iron, calcium, I think those are the ones we haven’t addressed yet?
Ryann: Oh yeah yeah, yeah. Iron, super important, of course! Again, best sources are going to be from meat sources. So, heme iron is the type that’s found in meat and that’s the most well absorbed by our bodies. So, if you do include red meat in your diet, that’s great. I generally do recommend including red meat, especially during pregnancy to make sure your iron levels are good. And as you go throughout pregnancy your risk just keeps increasing for iron deficiency so it’s definitely something you want to, just like vitamin D, keep checking up on, making sure that every day, literally every day you are including good sources of iron.
Karly: And this is something I’m curious about too, because when you take iron and calcium supplements together, the iron isn’t really absorbed but I’m assuming that’s probably different in foods because there are a lot of foods that contain both minerals.
Ryann: No, it’s the same. So if…
Karly: How rude!
Ryann: Yeah, it’s actually the same. So, if people have iron deficiency, that’s when I kind of worry about it more. If you’re good on iron I’m not really going to be so nit picky about like, “ok, let’s not make a dish that has milk as a cream sauce with your red meat” if that makes sense. I’m trying to think of a dish.
Karly: Well, I’m even just thinking of something like kale or spinach that are high in both. They’ve got iron and they have calcium.
Ryann: Oh, oh, oh, I see what you’re saying. Yeah, I mean, that, you can’t really escape, right?
Ryann: But, I never really understood the recommendation of having this tall glass of milk with dinner for kids because I’m like…
Ali: That was big dairy, let’s be real.
Ryann: Yeah, no, for sure. But that doesn’t make any sense. If you like milk, I’m all for it, there’s great nutrients in there, but maybe don’t have it with your steak dinner.
Karly: Yeah. Good plan. Sound advice. Love it.
Ali: Are there any other major, I mean, I’m sure this is getting into the weeds, but I’ll just ask it. Are there any other nutrients that cancel each other out or block absorption that are common, kind of off the top of your head that people might not know?
Ryann: Uhhh, not really, I think that’s the biggest one, other than like, competing for absorption there are a lot of nutrients that work together. So, there’s definitely a lot of teammates, I will say, like buds, like nutrients buds. Calcium and vitamin D, all of those, those work together along with K2 and magnesium. Those 4 are all…did I say 4? I can’t count!
Karly: Yeah, you said 4! Good job!
Ryann: Ok, cool! Those 4 work together, so I’d say more so it’s about like food, what’s that word? Synergy. The synergy between different foods and different nutrients, but I think, yeah, you kind of put me on the spot but I think those are the only two that compete, pretty much.
Ali: We won’t hold it against you if there’s another one. I did put you on the spot there.
Karly: Well, and I guess this is kind of related but sometimes I think this is more specific to supplementing and not to just food, which is why you’re a proponent of getting most of our nutrition from food. But things like if you’re supplementing one B vitamin for a long time, then that can cause an imbalance in the other B vitamins. And I know that if you have a copper IUD for example, then all the presence of copper is going to cause a zinc deficiency, so, there are ways to throw your nutrition out of balance, but it’s not usually through food. So…
Ryann: Exactly, that’s what I always tell people too because a lot of people that I work with and that are in my membership are always so concerned about overdoing certain nutrients. And it’s not that that’s not a real concern, like it’s fin, but I think what people don’t get is that whenever you’re going to get a nutrient toxicity, it’s usually gonna be from taking too many supplements. It is sooo hard to overdo any nutrient by just eating food. You would have to eat so much of something. Like, so much.
Ali: So much food, right? Like, an impossible amount.
Karly: Like, it’s a full time job, just downing the oranges from sun up to sun down.
Ryann: Yep, exactly. So, I’m like, you would have to be eating so much, you guys. So, it’s really about supplementing and that’s why us health care professionals are constantly saying, “always run it by your provider. Always run it by your health care providers that you’re working with” because…
Ryann: Right? You never know and then if you are taking medication and things like that, there are possible interactions so that’s why it’s definitely important. And then, the other thing that I was going to mention that you were saying, why I’m so, “let’s try to do this all through food” is that when we…so take vitamin C for example, when we extract vitamin C, and we just supplement with vitamin C, some science shows that it performs differently when it’s by itself as opposed to when we eat an orange, for example, and there’s vitamin C and folate, and other B vitamins, and fiber and all these good things we probably don’t even know about yet, are working together with that in our body. Whereas if we just pluck vitamin C out of the orange and we take it, it may have a different effect on our bodies.
Ali: Right. Yeah, that’s a great point.
Karly: Well, I guess this is my last question about vitamin D. So, here’s a lot of synthetic vitamin D, and I know that when you start manufacturing synthetic vitamins they can be a slightly different shape which can really change the way that the body responds to them or the way they fit onto a receptor, or just the way they behave in the body. And it’s kind of tricky with vitamin D because like you were saying there aren’t a lot of sources. Do you have a vitamin D supplement where you’re like, “this is it. This is the shit”.
Ryann: Honestly, I go with…I like Pure Encapsulations. I like that brand. I like Thorne, Seeking Health, that’s a good one, too. I think that it depends on what the client wants to use too, and what they’re willing to do. Some people really like drops, you know, like liquid stuff.
Ali: That’s what I have. Is it true that like – I have the Klaire labs liquid one – is the liquid better absorbed? That’s what I tell myself when I’m like, “this is gonna go right into your body”.
Karly: It does, straight into my cells!
Ryann: Honestly, I don’t know that that is better absorbed, but usually with your vitamin D, like I said, you kind of want to make sure you’re also getting its buddies with it like the vitamin K2, and the magnesium, and calcium, those things too.
Karly: Mhmmm, really great information.
Ali: So much good info, yes.
Karly: I bet everyone’s reeling right now trying to digest it.
Ali: Totally. Well, let’s kind of finish up by you telling us about, I know you have a cookbook, and your online program or your prenatal nutrition library. So maybe tell us, what are your offerings and where can people find you?
Ryann: Yeah, I’m super excited. So, my biggest platform is Instagram so @prenatalnutritionist is where I share content everyday. That’s awesome. And, then I have a cookbook, so the Feel Good Pregnancy Cookbook. That is available on Amazon for pretty cheap and it has really awesome recipes in it all the way from preconception to postpartum as well. And then my newest, newest resource which just launched in June of this year, 2020, is the prenatal nutrition library. So this was created because when you find out you’re pregnant you basically start googling everything, right? You’re just like, “what is this? And can I take that? And is this safe? And all…everything under the sun you just start googling and what you get is 20 different answers that all say different things, and…right? And you don’t know if they’re trustworthy. Like, who wrote this? There’s no resources or references or anything like that. So, basically the prenatal nutrition library is the alternative to Googling everything and losing your mind.
Ali and Karly: I love this.
Ryann: Yeah, so it’s one place where you can go to search different topics, A-Z related to prenatal nutrition. We have all the nutrients in there, minerals, I shouldn’t say all. A lot of them. What we do is add new content every Monday based off of member’s suggestions. So, sometimes people are really into red raspberry leaf tea and they’re like, “we want to see more information on this”. So, whatever the members want to see, that’s what we spend time researching, writing, and we get you the most up to date evidence based research on that certain topic. So, it’s amazing and it’s growing and I’m creating an app for it now. Crazy.
Ali: Awesome, look at you, I like this.
Ryann: I know, I got in there and then 75% of the members were like, “this would be so much cooler if it was an app”. So, I’m like, “guess I’m creating an app now!”.
Ali: Right, well Do it!
Ryann: Yeah, so it’s gonna be cool it’s gonna be an app so you can download it on your phone. There’s gonna be an awesome search feature so if you are wanting to look up oranges you can type in oranges in there and see more information on oranges. And then there’s a forum too, where you can ask questions, too. Of course, we don’t have every single topic in there yet, but, there is a forum where you can ask me questions. I’m in there answering questions every week which is so cool. But, yeah, that’s just www.theprenatalnutritionlibrary.com
Karly: That sounds fantastic.Ali: Ok, well we’ll definitely link all of this: your cookbook, the prenatal nutrition library, your Instagram, and then whatever resource, oh yeah, that article about protein being really important. So, check out the show notes if you’re listening in your podcast app or on the website because that’s where all this stuff will be. Alright, well, anything else you want to add in before we wrap it up?
Ryann: No, thanks for having me you guys. It’s been super fun chatting.
Karly: Thank you, you’re the best!
Ali: Of course, this was awesome!
Karly: You answered so many of my questions. Hopefully the listeners also had some of my burning questions.
Ryann: I’m sure
Ali: Yes, totally. Thank you all for listening to another episode of the podcast. We appreciate you so much. If you want to buy some vaginal steam herbs, which have really been selling like hot cakes lately, check out our website: birthkweens.com. That’s also where all the episodes and show notes are in addition to iTunes and all of that good stuff. And then we have a couple of other cool things in our shop. And while you’re online you can leave us a review and a rating in iTunes if you haven’t yet. We so appreciate those. Oh yeah, and check out our Birth Kweens podcast community group if you haven’t yet on Facebook and our Instagram @birthkweens. And that’s it, we’ll talk to you next time.
Karly: Bye bye!
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