Pregnancy Nutrition DOs & DONTs (without the Fearmongering Diet Culture) with Dr. Jess Knurick

In todays episode of Bite Back with Abbey Sharp, I chat with Dr Jessica Knurick, a fellow registered dietitian who specializes in pregnancy nutrition with a PhD in physical activity, nutrition and wellness. We will be discussing how diet culture and wellness culture loves to pray on pregnant people. We will chat about the actual impact of mom’s diet during pregnancy on baby’s health and development, and which foods you should absolutely avoid vs which are a risk/benefit analysis. We will be debunking myths around the glucose tolerance test and so called “toxins” in baby formula (and Jess will explain why they include sugar and seed oils). And we will chat about when to be concerned about pregnancy weight gain, and tips for making peace with your changing body and food. Note: This episode includes exclusive woman language, but we acknowledge that not everyone who is a mother or experiences pregnancy identify as a woman. Check in with today’s amazing guest: Dr. Jessica Knurick Follow @drjessicaknurick https://www.jessicaknurick.com References: https://pmc.ncbi.nlm.nih.gov/articles/PMC6526983/ Disclaimer: The content in this episode is for educational and entertainment purposes only and is never a substitute for medical advice. If you’re struggling with with your mental or physical health, please work one on one with a health care provider. If you have heard yourself in our discussion today, and are looking for support, contact the free NEDIC helpline at 1-866-NEDIC-20 or go to eatingdisorderhope.com. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •✨ Reach Your Weight & Health Goals — Without Dieting! Pre-order The Hunger Crushing Combo Method, Abbey’s revolutionary additive approach to eating well. Learn how to boost satiety, stabilize blood sugars, reduce disease risk, and improve your relationship with food — all while getting the best nutrient bang for your caloric buck. With 400+ research citations, cheat sheets, evidence-based actionable tips, meal plans, and adaptable recipes, The Hunger Crushing Combo Method is the only nutrition bible you’ll ever need. 👉 Pre-order today! 🛒 Where to Purchase: Amazon Barnes & Noble Amazon Kindle Apple Books Google Play Kobo Apple Books (Audiobook) Audible abbeyskitchen.com/hunger-crushing-combo • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •✉️ Subscribe to My Newsletters: Abbey’s Kitchen Newsletter 📘 Check out my FREE E-Books: Hunger Crushing Combo™ E-Book Protein 101 E-Book 👋 Follow me! Instagram: @abbeyskitchen TikTok: @abbeyskitchen YouTube: @AbbeysKitchen Blog: abbeyskitchen.com Book: The Mindful Glow Cookbook • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 🎧 Don’t forget to subscribe on Apple Podcasts, Spotify, or wherever you listen — and leave us a review! It really helps support the show ❤️ 💬 If you liked this podcast, please like, follow, and leave a review — and let me know who you’d love to hear about next! ⭐ ⭐ ⭐⭐ ⭐ Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

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• 0:30Speaker 04

  So I think people just really need to understand that if you have a placenta, you can have gestational diabetes.

• 0:40Abbey Sharp?

  Welcome to another episode of Bite Back with Abbey Sharp, where I dismantle diet culture rules, call it the charlatan spinning the pseudoscience, and help you achieve food freedom for good.

• 0:58Abbey Sharp?

  Happy Nutrition Month, my friends. This month, I am going to be featuring a bunch of my fellow dietitian colleagues and really just drawing on their unique areas of expertise. And if you've ever been pregnant, or are thinking about being pregnant, or know someone who has been pregnant, you are going to really appreciate today's episode. You know, us women are subject to so many body pressures throughout all stages of our lives, but society has like a very unique penchant for policing pregnant bodies. From societal expectations to medical interventions, pregnant women are often subject to scrutiny over their every decision:

• 1:43Abbey Sharp?

  what they eat, how much weight they gain, how they deliver, and what they feed their newborn. This non-stop surveillance teaches us that when something goes wrong, whether that's gestational diabetes, miscarriage, or a child with developmental delays, it's because of something we didn't do right. You know, in an era where choice and personal agency are supposed to be celebrated, most pregnant Folks often feel completely incapable of making decisions that are best for them. If we drink coffee, or are too tired to exercise, or give in to those McDonald's cravings, we are branded as bad moms before we even give birth.

• 2:26Abbey Sharp?

  That fear, guilt, and shame teaches us to be fearful of our changing body, to distrust our innate intuition, and to clamp down even harder on diet culture rules. Thankfully, my guest today is here to provide us with science-based information during this tumultuous and confusing time. Dr. Jessica Nurek is a fellow registered dietitian who specializes in prenatal nutrition with a PhD in physical activity, nutrition, and wellness. We will be discussing the actual impact of mom's diet during pregnancy on baby's health and development. We will be debunking myths around the glucose tolerance test and so-called toxins in baby

• 3:07Abbey Sharp?

  formula, and we'll be chatting about when to be concerned about pregnancy weight gain, and any tips for making peace with your changing body and food. A quick disclaimer that for simplicity, we will be using exclusionary woman language, but I fully appreciate that that does not encompass all of the identities affiliated with motherhood. And also, my general disclaimer that the information in this episode is never a replacement for personalized healthcare. And finally, I would love if you would follow or subscribe to the podcast and leave me a review, because as a new podcast, it really, really does help me out. All right, folks, let's get into it.

• 3:51Abbey Sharp?

  Thank you so much for joining me, Jessica, and like for being part of this big science communicator army, just helping to take down diet culture and pseudoscience misinformation online. I'm so happy that you're here.

• 4:03Speaker 04

  I'm so excited to be here. Thanks for having me. Excited to talk to you about this stuff.

• 4:07Abbey Sharp?

  Oh, yeah. So I mean, I'm a mom of two and I know, you know, it's, I'm just so grateful that I had my first pregnancy like seven years ago, pre TikTok days. So it was just really like the Facebook mom group that I had to wade through and that was like problematic and stressful enough. Like, you know, as you know, so much judgment, so much sharing, so many arguing about like very sensitive topics like formula, bed sharing, sleep training, etc. Women telling you to put breast milk on everything and any brush, right? But I feel like the mom group has nothing on the advice of TikTok experts that new moms are exposed to today. And I thought, you know, before we kind of set

• 4:51Abbey Sharp?

  the record straight on some very specific messages that we are seeing coming up often in this space, why do you think that expectant and new moms are just such a target for all this quackery?

• 5:04Speaker 04

  Yeah, I mean, well, first I would agree with you because I had my first pregnancy in 2019 and even then it wasn't, it wasn't as prevalent because I think TikTok just really, really exacerbated a lot. And then my second pregnancy was in 2022 and that was when I really started realizing just how much misinformation was targeted at pregnant women and new moms. And that's when I started that I got kind of, I was like kind of late to the TikTok game, but that's when I started going on social media. Because I was just like, this is wild. Like, we need like people who are actually kind of like combating some of this stuff because it's just taking over and it's so terrible. Women are already so anxious, right, of, of everything that is going on. And so I think that it's, it's an opportunity for people in a negative way to take advantage

• 5:49Speaker 04

  of kind of a vulnerable population who is, who is going through a period of time where they are hyper fixated on learning, by the way, right? They're probably reading more and trying to absorb more information than they ever have because who knows how to be pregnant and have a baby, right? We, we don't, we don't just know that. So we have to learn. And so when you become pregnant or you're trying to conceive, like you're, you're really absorbing a lot of information and, and people know that. And so they're putting out a lot of information and they're targeting, and they're targeting them with a lot of misinformation, unfortunately. And it is a vulnerable time where we are very susceptible to misinformation.

• 6:24Abbey Sharp?

  Hundred percent.

• 6:25Speaker 04

  Because really, we want to all just do what's best for our babies. And if someone is telling you that, you know, this is so dangerous for your baby or so on and so forth, it can be very easy to just kind of eat that up and take it at face value.

• 6:38Abbey Sharp?

  A hundred percent. And, you know, I always, I just think about my own experience, too. Like, there's just all these rapid, unpredictable changes happening during pregnancy. And like you said, this just heightens anxiety and this need for control. And what's one of the best and only ways, perhaps, that we can feel like we are in control of this new uncharted territory is what we eat or our lifestyle.

• 7:00Speaker 04

  Yeah.

• 7:00Abbey Sharp?

  And, you know, the anxious mind craves control. And so, you know, by making all of these sacrifices to have this clean, non-toxic diet during pregnancy, at least we have this sense, this feeling that we're doing everything we possibly can to control the outcome. And that, like, in some ways, it's, it's meant to be empowering, but it's actually very much disempowering because, you know, in a lot of ways, you're teaching yourself to, to kind of quiet your own natural intuition. And I also just think there's so much pressure on moms to be perfect. And that starts with this, like, ideal, like, pregnancy. It follows with, like, you know, to produce this healthy, developmentally, normal child.

• 7:43Abbey Sharp?

  And if anything goes wrong along the way, it is because of something we did or did not do. And I see this so clearly with all of these kind of clean eating, you know, diet protocols that moms are putting themselves on to prevent different problems like autism or ADHD, for example.

• 8:01Speaker 04

  Right. A lot of things that really are not in your control nutritionally, right?

• 8:05Abbey Sharp?

  Exactly. So this kind of brings me to, I guess, what might be a controversial and sensitive kind of topic or question about the impact of mom's diet on baby's health. And I just want to flag that, you know, before we get into that, I want to make it super, super clear that Jess and I are dieticians, right? So, of course, we cannot deny that nutrition is important during this phase and obviously every other phase of life. But for a lot of women, this can be a very, very hard time to even think about optimizing nutrition. And you're not a failure if you can only stomach Saltines or like in my case, salt and vinegar chips.

• 8:48Abbey Sharp?

  Like even dieticians don't always eat the way that we know may be most beneficial. So like Jess, what was your imperfect diet staples in pregnancy?

• 9:01Speaker 04

  Yeah, I mean, I, my first pregnancy, I, I ate ice cream every single day. So and I'm not even, I don't really even like ice cream. Like I don't even eat it that much outside of pregnancy. But I had to have something like creamy or like that every day and take my husband. And I actually, I, there's a story that sticks out in my brain of like, one time my husband came with me to, to get ice cream and he didn't get any himself. And I was so irrationally upset at him for not eating the ice cream with me. Only in pregnancy.

• 9:30Abbey Sharp?

  I mean, I'd probably do that still now, but um, yeah, like we, we all have these stories. Again, I'm a dietitian. I had the best intentions of eating well in my pregnancy. In my second pregnancy, I would wake up and I would think, okay, today is the day I'm going to eat vegetables. And I would order myself a Greek salad with the best intentions of eating it. And as soon as I saw it, I was like, my body was like hell to the no. I would eat the feta cheese pieces off and then give the salad away. Cause I could not even be in the presence of those greens. And I did this like multiple times a week, being like, today's the day, today's the day I'm gonna eat salad. And then I would just eat feta cheese for dinner.

• 10:12Abbey Sharp?

  So I really always want to, you know, like I, I tell pregnant moms that your body is like super scrappy. And it will pull from your resources to get baby what it needs during those kind of periods when your diet is beige and bland, right? Fed is best.

• 10:28Speaker 04

  Absolutely.

• 10:29Abbey Sharp?

  And all calories, like all calories are good calories at this stage. And you know, for a lot of women, getting anything in is a huge accomplishment. Plus we take a prenatal vitamin for a reason, right?

• 10:40Speaker 04

  Yeah, I mean, especially in that first trimester, like there, there's just so many symptoms. And just getting any energy, as you say, is really, is really the key.

• 10:48Abbey Sharp?

  Yeah, exactly. What with that kind of disclaimer put in there? How much and in what way does what we eat when we are pregnant actually affect baby's health?

• 11:00Speaker 04

  Yeah, I mean, so as you say, our bodies are very resilient and they they can really be scrappy and produce a healthy baby in in pretty extreme conditions. But that being said, there are optimal, there is, there's a way to optimize nutrition for optimal outcomes. And, you know, all things being equal, there's a number of different ways that we can optimize, optimize your nutrition during that time. But I do want to say all things aren't equal for everyone, right? And so so that even down to some people experience morning sickness or nausea their entire pregnancy, right? Those of us who are lucky experience it maybe for a few weeks, maybe just in the first trimester, and then it kind of goes away.

• 11:44Speaker 04

  And then others, really, it's for that whole, whole entire pregnancy. And so, you know, when I'm working with those types of people, it's, it's more trying to get any kind of energy in. And then, as you say, using a prenatal vitamin to help kind of fill in some of those gaps. But there, there's a lot of research out there in terms of the importance of perinatal nutrition, both in the pregnancy period and in the postpartum period, on neonatal outcomes and on outcomes for the mom. And so, so nutrition, when we're talking about nutrition, we're looking at, you know, we're thinking of energy, macronutrients, different fats, proteins, carbohydrates, and then also micronutrients and different, different vitamins and minerals. And there's a lot of research to indicate that pregnant people are deficient in a lot

• 12:28Speaker 04

  of these nutrients, not only during pregnancy, but also going into pregnancy. And so that's why one of our, one of the strategies to help combat that is to recommend some people get on a prenatal vitamin even before they're pregnant, right? When you, I like to kind of say, when you start thinking about trying to conceive, that's a really good time to start getting on a prenatal vitamin so that you can optimize those nutrient stores going into pregnancy. Because when, when a lot of the data kind of shows, when they're looking at outcomes, I mean, it can affect things like, obviously, macrosomia, which is having a large baby or a low birth weight or small for gestational age, but also things like cognitive development in the, in the. In the offspring and then also into childhood and even adulthood,

• 13:13Speaker 04

  pregnancy nutrition can have an impact on metabolic health in the offspring into adulthood. And there's lots of research to show there's lots of longitudinal studies that have looked at this and some very interesting data looking at kind of low energy when fetuses receive low energy in pregnancy and then also a lot of deficiencies in those micronutrients and how that has an effect on things like hypertension and diabetes and cardiovascular disease and then also dementia and mood disorders as well. And so, so really optimizing nutritional stores can be very impactful on the baby and then also on the mom.

• 13:50Abbey Sharp?

  Wow. And are there any particular vitamins that we see come up more frequently in the literature that are particularly important for long-term health benefits?

• 14:01Speaker 04

  Yeah, yeah. So, um, energy is one of them, right? So just getting calories. So that's why we say like sometimes it's literally just helping the mom to get calories. But then when we're looking at actual like nutrients, omega-3 fatty acids is a big one, DHA. A lot of people are deficient in DHA and it has a strong link to neurodevelopmental and cognitive outcomes in the offspring. Vitamin D is also one. There's a really good longitudinal study out of the Boston area. It's called Project Viva and they, they looked at about 2,000 different infants starting in 1999 and it's still going on. It's still ongoing and they found a lot of different impacts, specifically with vitamin

• 14:44Speaker 04

  D and later asthma and wheezing in childhood. They also looked at things like the diet quality. So making sure you're getting a lot of nutrients, like nutrient density in your diet on lower risk of preterm birth and then healthier birth outcomes as well. And then, and then the omega-3 as well and looking at neurodevelopmental outcomes. There's a lot of good data on that.

• 15:07Abbey Sharp?

  Amazing. That's super helpful.

• 15:23Abbey Sharp?

  Now I want to kind of like flip this for a second. We just kind of talked about like the nutrients that are, you know, beneficial. I want to talk about the laundry list of foods that apparently are no-nos for pregnant folks, because if you did a Google search of basically any food ever, you're going to find it on some kind of list of why you should not eat it during pregnancy. What do pregnant people actually need to know when it comes to like unsafe foods during pregnancy?

• 15:52Speaker 04

  Yeah, so I actually just gave a talk on this last week at a medical conference on kind of refocusing nutrition advice in pregnancy, on using a more inclusive approach versus an exclusive approach, which is what's done right now. A lot of the times they're given, you know, a foods to avoid list without a lot of context on why to avoid it. And I'll tell you, one time I had a message from a woman, and I've got, I've received many of these since, but this is the first time I ever did. And she had forgotten she was pregnant. And I know that kind of seems like, how could you do that? But she had just, it was, she was just like mindlessly, like at a party and she ate a sandwich, a deli, a deli meat sandwich. And she sent me this message just literally so scared. And she was like, did I hurt my baby, you know, from eating this

• 16:35Speaker 04

  deli meat sandwich? It was very, that became very clear to me that like, people aren't understanding why these recommendations are made, right?

• 16:42Abbey Sharp?

  Right.

• 16:42Speaker 04

  And so if you just tell somebody not to eat deli meat, it's like, well, why? And then, and then if they do eat it, it's, it's like a terrifying experience, right? And they're like, what, what just happened? So, um, right now, a lot of the times they're given these exclude, and you're right, they could, if you Google any, anything in pregnancy, it will, that you can find an article on Google that tells you it's dangerous. Like I get like, can I have grapes in pregnancy?

• 17:06Abbey Sharp?

  Don't Google stuff. Don't Google stuff.

• 17:09Speaker 04

  Exactly, but a lot of the, the reason that a lot of these recommendations are made are for food safety reasons. So the vast majority of them are for food safety reasons. But what we've found is that, you know, particularly listeria, because pregnant people are at a higher risk of listeria infection because you're immunocompromised when you're pregnant. But listeria, I think people think it's a lot more common than it is. You know, listeria infection is not that common, listeriosis. And anywhere from, I think it's the CDC numbers are something like 1,500, around 1,500 cases a year. And, and the last research I saw, it results in about 15 total cases of fetal loss per year. So 15 total cases of fetal

• 17:54Speaker 04

  loss. Like, that is not a very high rate, right? And so, so it's, it's, we, I think we tend to think it's, it's a lot more impactful than it is. But that's, having said that, you still want to be careful with food safety in pregnancy, right? You just, just like we would be more careful driving in pregnancy, which is way riskier than eating. But, so a lot of them come from food safety and just being able to reduce the risk of foodborne illness. But foodborne illness is really, and you probably, if you've followed kind of outbreaks over the last five to 10 years, you've probably noticed they are random and in all foods. So from, from leafy greens to mushrooms to ice cream to deli meat to

• 18:38Speaker 04

  cheese, like just all foods. Deli meat really, you know, in the 90s, it really was out, how would I say it? It was more proportional in terms of like the foodborne illness risk. But there's been a lot of people putting higher like regulations on deli meat manufacturers. And so it's come down quite a bit. So I like to not think of like, in terms of food safety, I like to teach food safety principles versus telling people they can't have specific foods because there are higher risk of food safety. For, for most foods, there are some that are really like unpasteurized dairy products are really like, just the relative risk is so high that it makes sense to avoid in pregnancy.

• 19:19Speaker 04

  Mercury fish is one that like we all should avoid anyway. But in pregnancy, you would want to do that. But that's, this is a good example of kind of using it, using inclusive language instead of exclusive with fish. A lot of people say, you know, avoid high mercury fish and people here avoid fish.

• 19:35Abbey Sharp?

  Yeah.

• 19:35Speaker 04

  Instead of saying, you know, include low mercury fish because fish is so important. And we just talked about DHA and it's a wonderful source of DHA for cognitive neurodevelopmental benefits. And so kind of just changing that language can be really helpful, I think.

• 19:51Abbey Sharp?

  Yeah, so helpful. Because you're right, like I, I think all of these food rules are so stressful to keep up with. Like it really weighs on us. Like I just remember in my second pregnancy and I had already like gone through this roto. And I'm a dietitian. So, you know, I was having kind of severe anxiety and I went to dinner. And without thinking, I ordered pasta alla vodka because it is my favorite pasta dish of all time. And then of course, when I got home, I was struck with this realization that holy shit, this is made with vodka. And no website, I Googled every recipe, every website, and no website could tell me how much vodka. Like it was such a range and nobody could say how much was retained after cooking.

• 20:33Abbey Sharp?

  So I am not joking when I say I did not sleep a wink that night. I laid on the couch and I just with my eyes open convinced that I had just killed my baby.

• 20:43Speaker 04

  Yeah.

• 20:43Abbey Sharp?

  And it was like, you know, even the people like me who understand science, who understand the dose makes the poison. We fall victim to this, you know, unspeakable anxiety around food when, when we're pregnant. It's, it's, it is really, uh, it's, it's hard to shake. It's hard to, to escape because it is everywhere.

• 21:05Speaker 04

  And it's like, it's just a unique period of time where I feel like you're more susceptible than ever, you know? And, and, and so anyone can just now, unfortunately with the way social media is literally anyone can just get on and make a video telling you, which I see all the time because they're sent to me, like to avoid pineapple because it's going to lead to miscarriage.

• 21:23Abbey Sharp?

  Right.

• 21:24Speaker 04

  And it's like, when you see that and you don't know that that's not true, you know? You're just, you're, you're very susceptible to seeing it and then being like, oh my gosh, I can't have pineapple. And then it's like, it's like a minefield. Like what can't you eat? And it just becomes exhausting.

• 21:37Abbey Sharp?

  It is. And I think what unfortunately, and this is true for basically all wellness culture and all pseudoscience that gets proliferated online, is it starts with like this like teeny tiny kernel of truth, or like a teeny tiny like mechanism that may be truthful, but then nothing else is considered. How much you would need to eat to actually cause harm? Like, how much is in, like, are you eating thousands of pineapples? Because I think you'd be harmed by like, like, the acidity, basically, before your baby would die of a miscarriage because of it. And all of these things, right? No one's understanding the absolute risk here.

• 22:17Speaker 04

  Absolutely. And to your point, like with pineapple, I mean, this comes from studies in rats showing that a little bit of pineapple extract that's literally placed onto uterine tissue of pregnant rats caused contractions. And so that's extrapolated in this world to mean like pineapple is going to lead to miscarriage, which is just silly if you understand anything about like how humans digest pineapple and how the dose makes the poison and all of that.

• 22:42Abbey Sharp?

  Right. We're not rats. We don't put pineapple extract on our uterus cells. Like, like, a lot of things would have to fall into place for this to be a legitimate concern.

• 22:54Abbey Sharp?

  But I want to talk about kind of neurodevelopmental health, because we kind of talked more about kind of like the physical health. Like, there's so much misinformation and fear mongering around, for example, neurodivergence, like autism and causing neurodivergence by something you eat or don't eat. And of course, like, this is now seeping into conversations just around like clean eating and toxin-free living during pregnancy. Can you speak to the facts here? Like, you know, is what women are eating or not eating causing autism?

• 23:26Speaker 04

  Yeah, I mean, I'll put a disclaimer that I'm not an autism researcher, and it's not

• 23:32Speaker 04

  super my area of expertise, but there's not data to indicate that diet is related to autism, and certainly not the increase in autism rates that people are seeing. It's much more the case that we're seeing an increase in detection and ability to diagnose. Autism, autism is a very, very strong genetic component to it.

• 23:52Abbey Sharp?

  Yeah.

• 23:53Speaker 04

  And, and so this fear mongering that's going around about how, you know, our kids are getting autism. I saw a video the other day about how, um, because kids are drinking formula, our formula is causing these autism rates. And it's just like, first of all, that doesn't make any sense because breastfeeding rates are more significantly higher than they were in the seventies, eighties and nineties today. So I mean, it just, it falls apart right there, but even to think that it has this genetic or this diet component is, is just ridiculous. And it's just fear mongering and playing on people's emotions.

• 24:27Abbey Sharp?

  It is, and, and it's, it's also offensive and, and very discriminatory, you know, like, like you mentioned, like autism and other neurodivergences influenced by a complex interplay of genetic predispositions. Some environmental factors maybe, but there's never been a single dietary factor that's been proven to cause or prevent autism, never. And, you know, honestly, what this narrative does is pass so much shame on moms specifically, if their kids do present as neurodivergent. When there was nothing that they could have done differently, other than, I don't know, maybe mate with like a neurotypical partner.

• 25:04Speaker 04

  Yeah, exactly. Right.

• 25:05Abbey Sharp?

  So frustrating that that's, you know.

• 25:08Speaker 04

  Choose your parents differently.

• 25:10Abbey Sharp?

  Yeah, yeah. Choose your parents. Like exactly. Like that, that's what unfortunately a lot of, a lot of health outcomes come down to. Like, yeah, well, okay, choose your parents differently. We can't really do that. So.

• 25:21Speaker 04

  You know what the most ironic thing is too, is that all of these people are, you know, really targeting this group of people with this fear mongering. Saying that like all of these different things out here are, are going to negatively impact your baby while causing them so much stress and anxiety from all of this. Which actually that stress and anxiety could have negative impacts on their babies. You know what I mean? It's just like, it's, it's ridiculous.

• 25:45Abbey Sharp?

  I mean, just look at my example of the parcel of vodka. Like I didn't sleep. Like, right. That, of course, that not sleeping is far worse than whatever minute amount of vodka may have been left like residually in the pasta sauce. Like, so I just feel like, you know, we're doing people so, such a harm to them and to their babies by kind of perpetuating some, all of this misinformation and fear mongering. Okay. So I want to talk some. Other dangerous kind of pre-postnatal recommendations and myths that I know that you see a lot online, that a lot of these kind of pseudoscience peddlers are pushing. One is that you should refuse the glucose tolerance test. So first of all, why is the test important?

• 26:29Abbey Sharp?

  And why do so-called experts suggest you should skip it?

• 26:34Speaker 04

  Okay, so the oral glucose tolerance test, it's given between 24 and 28 weeks of pregnancy, generally, because that's when we see insulin resistance. I mean, insulin resistance increases. So your body's, your cells' resistance to insulin increases in all normal, healthy pregnancies. And so around that 24 to 28 week mark in that second trimester is about the time where we see insulin resistance increase enough where we could detect blood glucose regulation issues in individuals with gestational diabetes. The oral glucose tolerance test is used, it's the gold standard all around the world, by the way, not just in the United States, all around the world, to screen for and diagnose gestational diabetes. And it's used because it really stresses the system.

• 27:17Speaker 04

  And so you need, you need a stress to the system. You know, if you're just kind of looking at your blood glucose with what you eat daily, you may miss those underlying issues that are happening, maybe at the 24 to 28 week mark, that then increase maybe by 35 weeks. And if you're not monitoring throughout the rest of your pregnancy, you would miss those, you would miss that case of gestational diabetes. So we're really trying to stress the system with the oral glucose tolerance test. And so that's what we're doing. So you take, it's a 10 ounce drink and for the screen, in the United States, it might be different in Canada, but in the United States, we do a two-step screening process where we do a one-hour test. And then if you screen out of that, you're done.

• 27:59Speaker 04

  And if you, if you don't, you go on to a three-hour test. And so what we're looking at is, is your body making enough insulin to meet the demands of insulin resistance that is occurring in your pregnancy? And that's what that allows us to do. So it's a 10 ounce drink, it's 50 grams of sugar, straight dextrose, which is glucose for, for the test, it's an oral glucose tolerance test, so we need that glucose. And, and you drink it, and then you get your blood drawn at a couple of different time periods. There is a strong, I have no idea how it started, but a strong effort on social media to discredit the glucose test, to make people scared of the glucose test.

• 28:44Speaker 04

  It is a concentrated amount of sugar, but it's not like that outlandish. Like people, if you have like a frappuccino, you know, I'm not saying everyone drinks frappuccinos, but or like a soda, it's about comparable to that. And so, um, actually, I think it's way less than what a frappuccino is. I'm not sure of the sugar content in that.

• 29:03Abbey Sharp?

  Yeah.

• 29:04Speaker 04

  Yeah. So, um, I, I am not a hundred percent sure where it comes from. I do think that it makes for good content. So lots of people get lots of views when they, when they fear monger the glucose test. I also think that a little bit of chemophobia comes into play, a little bit of orthorexia comes into play because of like drinking this concentrated drink, like glucose drink, which we wouldn't drink otherwise, right?

• 29:27Abbey Sharp?

  Right.

• 29:27Speaker 04

  But I like to think of it, it's, it's a medical test. Like we also wouldn't drink oral contrast for a CT scan every day, right? Just like we wouldn't drink Glucola every day.

• 29:37Abbey Sharp?

  Right.

• 29:37Speaker 04

  But yeah, yeah, it's, it's definitely an area that I battle a lot. And there are also like healthcare providers that kind of buy into this idea and like offer these alternatives. And, and the alternatives, you know what? If we need alternatives for people who, because some people really, they have a hard time stomaching this drink. I think that that's fine, but we have to be honest that the alternatives are not as good as the oral glucose tolerance test, and they will miss more cases of gestational diabetes.

• 30:07Abbey Sharp?

  Right. Yeah, I, I've been in a lot of mom groups where people are like sharing tips on what to eat and not to eat before the test to basically cheat it so that they pass. And first of all, that's a bad idea because you want to know what's going on. There's no point in taking the test if you're not going to do it perfectly or properly. And again, I just really think it comes down to this, like there's so much shame in failing the test because gestational diabetes for a lot of folks is seen as something that we are in control of with our diet. But the reality is like, I mean, I worked with gestational diabetes, with with folks with gestational diabetes, running workshops for them. And I remember seeing all their diet recalls every day and thinking,

• 30:49Abbey Sharp?

  holy shit, these women's diets are way healthier than mine. Like, loads of women with healthy diets and healthy body weights will get gestational diabetes. Um, so I do think there's that kind of shame that like, oh, I clearly wasn't treating my body well enough because I got gestational diabetes. And there's that the fear of of that kind of having to grapple with that for a lot of people. So they'd just rather cheat it or not do it.

• 31:16Speaker 04

  Yeah, you're absolutely right. I mean, that's where a lot of these videos come from that are like, how to pass the gestational diabetes test. And I try to drive home this idea. It's the the goal is not to pass. The goal is to identify if you have gestational diabetes, right? If you do or do not. Um, but so this also comes into play when, um, like, women are trying to cheat the test or or I'm sorry, when they're trying, when they're thinking that, um, there's all this shame wrapped up in it. And I think that is a reason that a lot of people are looking for these alternatives or looking to skip the glucose test as well, because I get a lot of comments on some of my videos that are like, well, I'm skipping the test because I'm I'm healthy, right? Or I eat really healthy. So I don't have gestational diabetes, so I don't need to do it. And it's this, this thought process,

• 32:00Speaker 04

  and I don't think that people understand. And this is kind of why I try to tell people, you know, if you have a placenta, you can have gestational diabetes, right? Because you're and and as you mentioned, there's lots of people who are seemingly very low risk who get gestational diabetes. And that's why we screen everybody. That's why we started doing that in the United States, was doing this like, full screen. Um, and so I think people just really need to understand that. And and I think some of that shame is wrapped up in diet culture.

• 32:27Abbey Sharp?

  So unfortunate, but you know, that's the culture we live in right now. And it's very vicious during pregnancy and after.

• 32:49Abbey Sharp?

  Well, I want to talk about baby formula for a second because it's such a painful subject for so many women. You know, despite this movement to de-stigmatize bottle feeding, it has been drilled into us that breast milk is the perfect baby food. And of course, we want perfection for our baby. That said, for a lot of women, breastfeeding is just not going to be a viable option, even if we desperately want it to be. So it's very painful and shameful when we see some like charlatan in the grocery store going off about the dangers of infant formula or calling it poison or toxins, because unlike breast milk, it has this like, long list of chemical sounding ingredients, oils, sugars. Just to kind

• 33:32Abbey Sharp?

  of set the record straight, why is infant formula formulated the way it is?

• 33:37Speaker 04

  Yeah, I mean, so infant formula is meant to mimic breast milk. And the science behind the evolution of infant formula is just fascinating. And it's so, we're so lucky to live at a time where we have this available, because before, if there was no infant formula, a lot of babies didn't make it if breastfeeding wasn't available. And, and, you know, there were wet nurses who could step in to like breastfeed the infant. And people don't realize that, that there were plenty of women, you know, 100 years ago, who couldn't breastfeed. And, and different things needed to be done. And they had to concoct their own formulations. And a lot of things went wrong with that, like electrolyte imbalances and things like that, which we also see today with people trying to

• 34:20Speaker 04

  make their own formula. Because it's not an easy thing to do. And so, yeah, breast milk, the, the science behind it, and the, and the way that it's formulated is meant to mimic breast milk as close to possible as it can. And, and what's really cool, I mean, there's lots of research going on, because right now, they, you know, they can mimic the nutritional components of it, but there are some other components of breast milk that, that you just can't mimic, right? And that's, yeah, and that's why, that's why you do see a disparity a little bit in, in terms of like, health outcomes. But in terms of The nutritional components, the chemicals quote unquote that you see in formula, if you if I listed out the chemical composition of breast milk, you would see all of those chemicals in breast milk as well.

• 35:04Abbey Sharp?

  Right.

• 35:04Speaker 04

  And so I think that it's it's this idea, you know, for example, the fatty acid composition, those fats have to come from somewhere. And so in some of our like gentle formulas that we use, because some babies can't have lactose in the formula, in the formulation, like cow from cow milk, that you have to get the fats from somewhere. And so a lot of the times, those fats come from what is colloquially known as seed oils. And so there, there is this outrage about seed oils right now. But I think there's a fundamental misunderstanding of seed oils and the and the impact that they have on our health. But but literally, they're just being used in in formula, in some of these infant formulas, to mimic the fatty acid profile of breast milk.

• 35:50Abbey Sharp?

  Right. Yeah, I know. Again, it's a lot of people just get all up in arms about words that they can't pronounce. And they see, they see them as chemicals, but like cyanocobalamin is literally vitamin D three. And it's like, most of the ingredients that you see in, you know, in a table for infant formula are just like vitamins, the words for vitamins. And they are big words. I understand they're big words. But they're the vitamins that we would need to mimic breast milk. And I also just like, you know, thinking about this, I want to point out that I feel like a lot of these common recommendations that go against the scientific community, all stem from this appeal to nature's fallacy.

• 36:31Speaker 04

  Yeah.

• 36:32Abbey Sharp?

  And we've talked about nature's fallacy on my podcast already, but it basically assumes that something is inherently good or beneficial or better because it's quote unquote, natural, or conversely, that something is bad or harmful because it is quote unquote, unnatural. And I think pregnancy and motherhood is just more susceptible to this fallacy in general, because it's just being, it is like being drilled into all of us that, you know, everyone's motherhood experience is the epitome. Of what nature has intended for women. And, you know, and I think that's a really hard concept for a lot of people to grapple with, especially for those, let's say, when we talk about breastfeeding, I always said like breastfeeding

• 37:15Abbey Sharp?

  was the most unnatural feeling like experience for me. It was like the most humbling, most devastating, most like so hard, the hardest thing I've ever done in my life. It in no way felt natural to me, at least not with my first.

• 37:31Speaker 04

  Well, and I think people forget that, like, nature, this might sound harsh, but nature doesn't really care about keeping you alive.

• 37:37Abbey Sharp?

  Yes.

• 37:38Speaker 04

  Nature, nature cares about keeping enough people alive to produce the next population of people, but that doesn't mean that everybody has to live, right? And so there's a lot of things in nature that can, can kill you.

• 37:52Abbey Sharp?

  Nature's cruel.

• 37:54Speaker 04

  Yeah. And so we, we love, I mean, nature is great, but also nature is cruel and not, not everything that's natural is, is great. And I think we see this a lot with like even with vitamins, right? And people saying synthetic vitamins are terrible and natural vitamins are better. And that's not, I mean, and I always like to say, you know, like synthetic vitamin D can prevent rickets. Synthetic vitamin C is going to prevent scurvy, you know? And so, so I don't know what you mean when you say that it's not gonna, it's like, it's not good. Right. It is, it's, it's good and it oftentimes can be actually absorbed even better than, than kind of the natural sources.

• 38:33Abbey Sharp?

  Totally. Now, I just want to put diet culture messages that we hear online aside for a second. And I want to kind of talk about what we hear from healthcare providers themselves, especially as it pertains to weight gain during pregnancy. Because, you know, typically we hear we're supposed to gain this very specific narrow range of weight. We're supposed to gain a pound a week. And I know, because I hear this from a lot of women, that this can cause a lot of anxiety, especially for women who have struggled with their relationship with their body and food in the past, when things don't follow this predictable, perfect trajectory. And obviously, like, we're human, so it never does. How much should women actually be worrying about their weight when it comes to pregnancy?

• 39:19Speaker 04

  Yeah, so the, the research on weight gain in pregnancy is, what's important to understand is that it's based on averages of populations and it's not based on the individual. And so we can create, and we have to in research, we can create these stratifications, right? And so we, and we have those, you know, if you're underweight and that's certain BMIs, if you're normal weight, if you're overweight, and then if you're obese. And those, those are like categorized based on BMI. And as I'm sure you've talked about many times, BMI is a, you know, it, it's important in research and we need it in research for these stratifications. We don't really have a better metric in research to use for stratifying groups. But at an individual

• 40:02Speaker 04

  level, it can be very meaningless, right? And so these weight gain suggestions, that's what they are. They're based on large data sets that kind of look at healthful outcomes in individuals and how much weight they've gained in a pregnancy. But that's again, going to vary based on the individual. So what I like to do is, I like to talk, especially when I'm talking to healthcare providers, is try to get them to understand that the emphasis should really be on the behaviors that we're doing in pregnancy and, and focusing on nourishment, focusing on nutrient density, focusing on, you know, all of the things that are, that are going to go into your physiological health. Because weight is just

• 40:43Speaker 04

  kind of like a, it's kind of like a symptom of that, right? Sometimes. And so not focusing necessarily on the weight, but focusing on, on the actual nourishment of the individual. Because again, at an individual level, those numbers that we fixate so much on, they can be meaningless for, for some person. They can fall into a group and maybe their body, for example, I gained more in my pregnancies, both of them. I didn't weigh myself in my second pregnancy, which is also something we could talk about, about how you don't have to do that.

• 41:13Abbey Sharp?

  I didn't weigh myself in my second either.

• 41:15Speaker 04

  Yeah, I did in my first and I gained more than the recommended amount of weight, but it was, that was totally fine for me. I was metabolically healthy. My babies were healthy. I was healthy. Like it was, it was fine. And then in my second, I realized, oh, I don't actually have to weigh myself. And so I just said to my, um, I had a midwife and I just asked them at each, when they went to weigh me, I was like, can we just not weigh me? Can you write that in my chart? Now, sometimes, and that's an option for you. And sometimes, um, you know, sometimes physicians will, uh, need to if there are like other issues at play, but you also can have that blinded and you don't have to, you don't have to hear the weight. Um, and they can just kind of look at it. So that's an option too.

• 41:55Abbey Sharp?

  Totally. And, you know, I feel like this, this discussion about our body just kind of seems to get worse after the baby comes out. Um, so just before we kind of close off here, I wanted to briefly talk about the immense pressure that women feel largely due to social media, of course, to bounce back after birth. Um, so like, what are some of the messages to new moms that you give who are struggling to just embrace that postpartum body in the fourth trimester?

• 42:24Speaker 04

  First, just block all those accounts that you see doing that. Um, uh, but second, I really, really, I think some people don't even know, um, like I'll say fourth trimester and they've never heard that term before. And so I really try to like play up this fourth trimester because it's such a critical period of time for nourishment, like replenishing nutrient stores, recovering from a crazy experience you just went through for nine months and your body just went through. Um, and then also bonding with your newborn baby, right? And just like, just like soaking up that magical period of life that you're, you don't get to experience very often. And so when we think about the fourth trimester, that's the first 12 weeks after pregnancy and

• 43:06Speaker 04

  the focus really should be on what, what I just kind of talked about, really replenishing nutrient stores that are depleted. And a lot of nutrients, if you, if, if a person does breastfeed, Nutrient needs, a lot of nutrient needs increase during that time. And I don't think that people really realize that. And this is kind of a gap in care that we see, particularly in the United States. I'm not sure how it is elsewhere, but we, you know, you have like one six week follow up appointment with your OB GYN. And not a lot of emphasis is placed on nutrition. And, and like I said, a lot of nutrients increase in need during lactation. I mean, iodine, vitamin B12, vitamin C, vitamin D, well, vitamin D kind of stays the same, but protein needs increase, just a lot of nutrients.

• 43:51Speaker 04

  And, and so staying on that prenatal vitamin, focusing on nourishment. I think that the idea is to change the narrative, right? Change how we view it, change it as, again, this is one time in your life that you have. And there's a lot of good data to show that this period of replenishment is, can affect your health later in life. And so really thinking, okay, I'm going to focus on replenishing my body. I'm going to focus on rest. I'm going to focus on bonding with my baby. I'm going to focus on, you know, ensuring that my milk supply is good for my baby and, and really keeping the focus on that versus getting back to my pre-baby body weight.

• 44:30Abbey Sharp?

  For sure. Yeah, I love this. And I think this really just so nicely sums up, you know, my approach to nutrition as well as like, you know, focusing on what we can add in that nourishing mindset rather than just kind of like, okay, we need to start cutting things. I got to get back into, you know, like that rush to, to kind of succumb to, to diet culture.

• 44:49Abbey Sharp?

  But thank you so much, Jess. This was such a great conversation and I am sure it will be so helpful for so many women listening, both who are pregnant, who are thinking about pregnant, who know pregnant folks. I just think that this is, this is something, you know, universally that we can all kind of appreciate seeing here in diet culture. So, thank you.

• 45:10Speaker 04

  Yeah, I really appreciate you having me on and I, I just love this group of people so much and working with this group of people. And it's just a, such a wonderful time period that I think, you know, unfortunately in this day and age that we're, we're dealing with a lot more than I think other generations have in terms of just messaging and information. And so if I can help to alleviate some of that noise, that's kind of what I'm here to do.

• 45:33Abbey Sharp?

  Amazing. Well, thanks so much.

• 45:35Speaker 04

  Yeah, thank you, Abbey.

• 45:52Abbey Sharp?

  That was so cathartic, actually, for me. And I'm sure it will really resonate with so many other women, moms, moms-to-be. You know, so many of us have been through this. But if you've spent your whole young adult life trapped in diet culture, you know, pregnancy can obviously be a particularly triggering time. But with a very small, little mindset shift, it can also be a uniquely powerful season to start your intuitive eating journey and relearn your body's cues. Even if those cues are at times more towards salt and vinegar chips instead of salad, as was in my case. But there's just something about growing a human inside you,

• 46:35Abbey Sharp?

  along with all of the aggressive hormonal changes that come with it, that helps us hone in on our body attunement skills. Just think about how intently you're trying to pick up on that, like, first little baby flutter or kick. Or, for my fellow IVF infertility warriors, how badly you're, like, waiting for that first little hint of nausea to set in. I know it's hard to think about morning sickness in any kind of positive light when you're really in the thick of it. But the point I'm making is that pregnancy is a time of heightened awareness of our body sensations. We can actually use this to kickstart our journey collecting data on how foods make us feel completely judgment-free.

• 47:19Abbey Sharp?

  Now, maybe you're saying, "Um, Abbey, I am listening to my body, and all it's gotten me is Saltines and Gatorade." Even if I'm not judging myself for these aversions and cravings, I still want to make sure I'm getting the nutrients that my baby needs. And that is the awesome thing about intuitive eating. Gentle nutrition is baked into the framework. So if you're trying to utilize this unique season of life to learn to leave diet culture behind, but you still want to optimize nutrition as best as you can, here are some gentle nutrition tips.

• 47:58Abbey Sharp?

  First of all, just eat enough. Just eating enough calories is significantly more important for the health of your baby than the minutia of what foods you do eat. Yes, there will be weeks, maybe even months, where you can't touch any of your go-to sources of protein, or when the color on your plate is completely nonexistent. Unless, of course, you count like flaming hot cheetos. But if you're listening to your hunger cues and simply eating enough calories to honor those cues, chances are more than good that your baseline macros like your carbs, fat, and even protein needs are going to be met.

• 48:42Abbey Sharp?

  And where we fall short on micronutrients? That is what our prenatal supplement is for. Number two, shift your mindset from one of food shaming to food celebration. I hear from women all the time how guilty they feel for not being able to eat as quote unquote "healthy" as they might want to. You know, they feel this tremendous amount of shame when the only food that they can stomach is like a Big Mac and fries. While diet culture may see quote unquote junk or quote unquote toxins for your unborn child, I actually see a lot of amazing nourishment to support growth. So in the Big Mac and fries, we got protein and iron in the beef, we got fat and calcium

• 49:27Abbey Sharp?

  in the cheese, carbs in the bun, and a ton of vitamin C and potassium in those fries. Plus, don't forget about tip one: we want to just eat enough. Sometimes we just gotta celebrate the wins because honestly, pregnancy can be just hard enough. And then finally, if you're feeling up to it, think about the foods that you can tolerate and how you could possibly give them a little nutrition upgrade. So for example, if all you can stomach right now is like simple carbs like muffins or pancakes, could you add some cottage cheese or protein powder to your mix? Or if you're living off saltines, could you add some? thinly sliced apple or cheese on top.

• 50:11Abbey Sharp?

  If you're struggling with like strong odors in cooked meats or eggs, could you do a cold protein shake or smoothie? And if you cringe at the sight of a vegetable, could you stomach a piece of fruit instead, which honestly offers the same beneficial fiber and micronutrients as those greens? Not all of these are going to be good options for you, but use this unique time to experiment and collect data on how foods make you feel. Think about every little piece of information that you managed to gather about your symptoms, your cravings, your aversions, your hunger, as just getting you one step closer to having a healthy intuitive relationship with food long term. And folks, that is all that I got for you guys today.

• 50:56Abbey Sharp?

  I would love if you would share this episode with any of your fellow moms or moms to be who would appreciate some evidence-based facts and some gentle tips for helping them get through this particularly vulnerable time of life. And a really, really big thank you again to Dr. Jessica Nurek for joining me today in helping me bite back against diet culture. As always, I will leave a link to her platforms below. And please, guys, don't forget to leave me a review. It really helps me out as a new podcast to just spread the word. But signing off with Science and SaaS, I'm Abbey Sharp. Thank you for listening.

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