The internet abounds with dietary advice to help keep morning sickness at bay. Unfortunately, much of this well-intentioned (but misguided) advice centers around keeping saltines on hand at all times… Possibly some of the worst advice ever. The good news is that there are much more effective dietary measures that can be taken to combat the nausea and vomiting of early pregnancy.
Although the exact cause of morning sickness remains unknown, it can be greatly aggravated by falling blood sugar. Many women notice that if they go too long without eating, morning sickness returns with a vengeance. The advice to eat saltines when you start to feel nauseated is based on this fact and the idea is that a fast infusion of glucose into the bloodstream will quickly raise blood sugar and relieve the resulting queasiness.
The problem with this advice, as most people now know, is that empty, white-flour carbs (like those found in saltines) will cause a blood sugar spike and subsequent crash that may leave you feeling even worse once the initial effects of the carbs wear off.
Alternately, a diet higher in protein and lower in quickly absorbed carbs (sugar, white flour, etc) will help keep blood sugar at a more consistent level throughout the day. In fact one study published by the University of Michigan Medical Center showed that meals high in protein decreased nausea and digestive dysrhythmia much better than meals that emphasized carbohydrates or fats.
Although many women experience strong aversions to meat and eggs during their first trimester (probably a biological left-over from the days before refrigeration when these types of foods spoiled quickly), if you can stomach them, they’re great sources of the healthy protein your body needs to grow a baby. Don’t worry if you find it difficult (or impossible) to eat meat and eggs, you still have plenty of other good protein options available.
Smoothies made with fruit, milk and whey, egg, rice, or pea protein can satisfy cravings for sweets while also upping your protein intake. Just make sure the protein powder you choose doesn’t contain any sugar, artificial sweeteners, or additives. I feel comfortable recommending limited amounts of stevia-sweetened powders to my pregnant patients (and consuming them myself), but check with your midwife or OB if your pregnancy is high-risk or if you have concerns regarding stevia. My favorite all natural, stevia-sweetened protein powder comes in egg and whey varieties and can be found here.
Many women with food aversions can tolerate dairy products, so Greek yogurt and hard cheeses can be another good protein option. Choose full-fat dairy products that are organic and / or grassfed when possible. As Greek yogurt has increased in popularity, so have knock-offs that contain far more sugar than protein. Look for plain, unsweetened versions that contain at least twice the amount of protein as carbs. My personal favorite is Fage Total (check out their store locator to find the Classic Plain at a store near you).
Nuts are another good source of protein and can also help with salt cravings. Raw unsalted nuts pack the biggest nutritional punch, but roasted salted nuts can be a great substitute for those nutrient deficient saltines everyone keeps trying to push on you. Choose dry-roasted nuts when possible and be sure to check labels for added sugars, sweeteners, and additives.
Sometimes when you’re experiencing morning sickness you’re just going to have to eat whatever you can get (and hopefully keep) down, but if you aim to keep your protein intake high on most days while keeping sugar (including honey, maple syrup, agave nectar, etc) and starchy carbs to a minimum, you’ll greatly reduce the nausea most women experience during the first trimester.
What diet changes have you made that have helped with your morning sickness?
Jednak MA, Shadigian EM, Kim MS, et al. Protein meals reduce nausea and gastric slow wave dysrhythmic activity in first trimester pregnancy. Am J Physiol. 1999;277(4 Pt 1):G855–G861. http://www.ncbi.nlm.nih.gov/pubmed/10516152