The Paleo Diet And Pregnancy - The First Trimester

This articles forms part of a series covering the Paleo diet and lifestyle to support reproduction from fertility to conception, pregnancy and nursing.

Part 3 - Food Aversions, Nausea And Cravings During The First Trimester

Pregnancy is an amazing experience. However, it is also not this glamorous, idyllic period that many would have you believe. A stark reality about pregnancy that is often under-emphasized, if at all, are the food aversions, intense nausea and odd cravings. You may have heard stories and wonder how it is possible to maintain your Paleo lifestyle and nutrition choices when the thought of certain real foods turn you right off and you find yourself craving pizza, ice-cream and fried pickles. With a little forethought and preparation it is possible to make the most of your Paleo pregnancy and maintain your sanity at the same time!

A large majority of women experience some form of food aversion, nausea or vomiting and strange cravings during their pregnancy. The good news is that only a very small percentage (about 1:5000) will experience nausea and vomiting that require medical intervention. For most women, their symptoms are limited to the first trimester and are manageable with some easy adaptations.

Food Aversions

The most common food aversion experienced by a majority of women experience is to protein. It has been proposed that nausea during pregnancy evolved as a protection mechanism against toxins and other dangerous substances that could harm the developing embryo. 

Before the advent of refrigeration and sanitation, meats had greatest chance of harbouring bacteria and parasites. This in turn posed the greatest risk of harming the developing baby. In addition to protein aversion, women often feel repulsed by spicy and smoked foods. This is an interesting response as the flavours in these foods can easily mask the taste and smell of protein that is not fit to eat. There asre also numerous reports of an aversion to fresh green vegetables. Not only do vegetables certain phytochemicals which can be irritating, they have the potential for contamination with bacteria like salmonella and e.coli.

If you have been following a paleo diet rich in quality protein sources, you may find this new aversion to protein and food in general to be troubling and you may become concerned about malnutrition during this important period of fetal development. Rather than creating added stress through worrying, focus on food QUALITY rather than solely on calorie levels or macronutrient percentages. You baby will draw upon your stores and get just what he or she needs. Despite what you may have been told, the body only requires an extra 200-300 calories per day during pregnancy. Your body produces certain hormones that actually make it easier to acquire and store nutrients from your foods during pregnancy.  Feel assured that yor baby will get what it needs to grow, and your hunger will return in a few weeks. Try and stay relaxed, do your best and let your body do what it was designed to.  


Nausea is a normal response to the many hormonal changes (HCG /estrogen/progesterone) that occur during early pregnancy. This includes increases in human chorionic gonadotropin (HCG) and fluctuations in estrogen, progesterone, insulin and thyroid hormones. It is not entirely clear how nausea and vomiting  protects the developing fetus, however, several theories have been described. Nausea and vomiting could allow the pregnant woman to avoid or expel foods that may be harmful to the developing fetus. This may explain the relationship between the development of food aversions in pregnancy and the onset of nausea. The condition may also lower energy intake thus lowering levels of the anabolic hormones, insulin, and insulin growth factor. This would lead to a distribution of scarce nutrients to the placenta and fetus. A study of pregnant women experiencing nausea and vomiting during their first trimester found the symptoms were associated with a reduced risk of early pregnancy loss, particularly for women age 30 and older.

If your nausea and/or vomiting progress to severe and persistent with substantial weight loss, you may be experiencing a condition called Hyperemesis Gravidarum. This is a much more severe form of this common pregnancy concern and requires management and follow-up with your provider. Please, do not try to tough it out on your own!

Nausea tends to be exacerbated by low blood sugar. During pregnancy, blood sugar is naturally slightly higher which ensures a consistent supply of energy to the developing baby. Nausea can be viewed as a signal that the growing baby is utilizing fuel and developing well.

Eating smaller meals more often can support you and your body in coping better with both nausea and cravings.

Studies have shown that a 10mg Vitamin B6 supplement along with some ginger root or a 1mg ginger supplement have shown to be effective in reducing nausea.  Paleo foods rich in Vitamin B6 (if they can be stomached) include nuts and seeds, starchy vegetables, avocado, bananas, lean meats, dried fruits and spinach.

To help fight nausea, it is important to monitor hunger levels and when choosing to eat, ensure you are consuming some Paleo friendly starches combine with plenty of good fats These types of starchy foods tend to lack protein toxins after cooking and are low in phytates which bind to nutrients like zinc, iron, calcium, and magnesium, which your body needs during pregnancy. Starchy foods are also not often a part of food aversions and are often craved. Paleo friendly starches include:

  • Beets
  • Jicama
  • Plantains
  • Tapioca
  • Winter Squash/Pumpkin
  • Yams/Sweet Potatoes
  • Yuca

Additional Anti-Nausea Foods

  • Fresh ginger made into tea, added to smoothies or grated into purees
  • Lemon juice and zest added to water, tea or enjoyed for their aroma
  • Apple cider vinegar in water
  • Salty bone broth (with the extra addition of ginger)
  • Home-made gelatin desert or gummies


It is far from a secret that pregnancy and food cravings go hand in hand. The first trimester of pregnancy in particular is challenging, especially if you experience morning (all day) nausea. Cravings usually start in the first trimester and will often taper off or at least be more manageable by the second.

Cravings tend to fall into a few categories:


Your body needs carbohydrates (chocolate included but not exclusively) when nourishing for fertility and pregnancy. They are required for optimal hormonal functioning during pregnancy as the body becomes increasingly more insulin resistant as a way of increasing fuel availability to a growing baby. This insulin resistant can cause carbohydrate cravings particularly in the first trimester.

Carbohydrate cravings can often be social in nature, especially in our modern societies. Low carbohydrate protocols are common practice in the Paleo communities and women may view their pregnancy as a time to relax their restrictions. This often results intense cravings for these starchy and/or sweet delights.

Carbohydrates (starchy vegetables and fruits) can be thoroughly enjoyed on a Paleo diet with numerous savory and sweeter preparations. Making Paleo friendly versions of some of your favorite indulgences will ensure you are still getting nutrient density and not consuming foods that may be irritating, toxic or harmful to you.

Do your best to balance your carbohydrate rich cravings with plenty of healthy fats and some protein if you can stomach it.

Fat and Salt

Many women experience strong cravings for the fat and salt, particularly a combination of the two.  This can be attributed to the body wanting to retain excess water and build new fat stores. The combination of fat and salt seems to trigger certain pleasure centres in the brain resulting in feelings of happiness, calmness and satiation. This is when some ethically raised, well prepared Pete’s Paleo bacon can truly be happiness on a plate.


Craving ice or the strong desire to chew on ice cubes could point to possible anemia.  Low iron and anemia causes the tongue and mouth to swell. Ice relieves this and explains why it may feel especially pleasurable. Have your blood levels checked and increase the animal based heme iron rich foods in your diet.

Unconventional Cravings

Some women will crave things that are not even food, like chalk, clay, soap or sand. This is known as pica and is usually the body’s attempt to obtain minerals and vitamins that might be lacking. If this is the case for you, be sure to contact a health professional as soon as possible, as eating such things could harm yourself or your baby. 

In Conclusion

A Paleo lifestyle can be a wonderful opportunity and provide a framework for nurturing yourself and your baby during pregnancy. Understand that your first trimester might be a challenging time physically, emotionally, and spiritually. This is where being kind to yourself and practicing some self care becomes really important. Let yourself nap and snack when you can. Eat foods that appeal to you and keep a well stocked fridge and pantry to ensure you have nourishing options available. If cooking seems overwhelming, Pete’s Paleo offers many delicious, well-sourced options to suit every taste. Order a few to have ready whenever you need. Know your body’s specific needs and limitations, and embrace those! The nausea, food aversions and cravings will pass. It may take a little time, but worrying and stressing over it will only exacerbate the issue and prolong you feeling better. Some days will be easier than others and that is okay. Be gentle on yourself and be patient with the miracle.

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