A registered dietician weighs in on the pickles, peanut butter, and ice cream, oh, my!

By Alex Van Buren
October 12, 2018

The way pregnancy transforms women’s relationship to food is not as black-and-white as nausea, attractions, and aversions. Some go from satiated to ravenous in a matter of moments, maybe after smelling a slice of pizza from a block away. (That sense of smell is heightened, remember!) Carnivores may suddenly find themselves loathing the site of meat and fish. Vegetarians might crave spicy Italian sausage.

It’s easy to feel like you’ve lost complete control over something that’s largely been an autonomous decision during your life. I’m 21 weeks pregnant, and when people ask how I’m feeling I say, “Large and not in charge.” A small robot controls my need for Chinese food one minute, Italian the next, and an entire jar of Kalamata olives on demand. I have a fairly positive relationship with food, but found myself curious about the wild feelings and cravings we have during pregnancy, and whether they signify anything on a nutritional level. I spoke to Jennifer McGurk, a registered dietician and certified eating disorder specialist who aligns herself with the intuitive eating movement. The proprietor of Eat With Knowledge in Nyack, New York—and a mother who has experienced pregnancy first-hand—she had a lot to say.

Is there anything to the cravings theory? There are those who suggest that a craving for steak might suggest an iron deficiency, for example.

When you are pregnant, you have a completely different body experience than in quote-un-quote normal life. A pregnancy will affect every single system in your body. It not only affects your digestion, which is what we think of when we think of cravings, but it affects your hormones, your muscles, and your adipose tissue (which is like your fat mass). Of course women are going to have different cravings for different things, and of course they’re going to eat differently. A lot of times people have this emotional response to it, because they’re not used to feeling all these different cravings. We can have different cravings for different foods based on nutrition deficiencies, so I definitely do not want to rule that out, but a lot of times we have cravings for certain foods because of our energy levels, or our food preferences. Sometimes we have cravings for food because we have been restricting some of those things. A lot of times women say, “Oh, I can’t have ice cream, ice cream is something that I can’t have, but now that I’m pregnant, I can have whatever I want!” I would say that there are a lot of physiological things but also mental and physical things happening that all produce cravings.

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How does one eat intuitively during pregnancy without getting into a difficult spot, health-wise?

Intuitive eating is not just eating whatever you want. I feel like if you know that two pints of ice cream is not gonna actually make you feel your best self and is going to contribute to your high blood sugar if you have gestational diabetes—if you don’t have gestational diabetes, your insulin is going to kick in and it’s going to be OK—intuitive eating would probably say that’s not the best relationship to food if that’s not the best choice for you. What portion size or amount of food will work for you in that situation? Maybe for one person it is two pints of ice cream. Maybe for another, it’s half a pint of ice cream. What is the amount of ice cream you need to be satisfied? That is a number-one priority. You know you want to get satisfaction, but you also have to balance it out with nutrition that’s really going to work for you and your growing baby. Having two pints of ice cream is not the best idea to get a meal in when you are pregnant. … Maybe having ice cream after a nourishing dinner meal, if that’s what you’re craving, can be totally appropriate.

Some nutritionists say you should stifle cravings during pregnancy. What do you think?

I would say that your cravings are so individual—and we could study all the nutrition science in the world—but when it comes down to it we all have unique genetic makeups, we all have different personalities around food, and different amounts of importance that food is in our lives. For people that can say, “Oh, get over your craving and move on,” and who who can do that pretty easily, you know, that’s totally fine, but for  people who have cravings and are really attached to cravings and need to honor those cravings… I’d say that there’s nothing wrong with knowing that that’s what works for your body. We’re all different.

If you have different cravings throughout your pregnancy and you can still eat and get nourished and have different food groups and have an overall balanced diet, I’d say there’s nothing wrong with honoring your cravings. If you’re eating ice cream every single day for dinner, you might want to look at that and kind of push yourself out of your comfort zone and see if you can get a little more nourishment for you and the baby. … The first trimester you are usually experiencing so much [gastrointestinal] discomfort that it’s just really important that you get in [any] food at that time, because you are probably going to have so many aversions to different things.

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That matches what my ob-gyn said about the first trimester. How is that trimester different?

We have a lot of reserves--especially if we’ve been eating healthy and nourishing our bodies before we got pregnant--for folic acid, for iron, and we can get different nutrients in that first trimester without our body having to eat salad and meat every day. (The only thing I wanted were bagels and pasta!) I totally understand having all this GI distress … it’s just important for you to eat … if you can, [and] get the nutrition you need. Once you start to feel better from a hormone point of view, you can focus a little more on what intuitive eating looks like as your pregnancy progresses. It might look different each trimester.

How do cravings change over the course of a pregnancy?

During the first trimester, nutrition recommendations are a little off-limits depending on how someone feels because it is just all about getting their nutrition in, with their meals and snacks, whatever they can stomach. In the first trimester, even if you’re not having active vomiting or diarrhea or constipation, you typically have a lot of nausea and tiredness, so carbs are usually what are craved, because those things satisfy your nausea and your tiredness. Carbs will give you that glucose, which is what your brain uses for energy on a cellular level. Glucose is really the thing fueling your body with energy. … I don’t know if it’s the glucose or the food itself but pasta, bagels and toast are very comforting when we are nauseous.

How do cravings and nutritional needs change during the second and third trimesters?

You’re probably craving a lot more food in general because you’re moving out of the sickness phase of the first trimester and into [the] second trimester, which everyone says is the sweet spot in terms of having energy. … You’re probably craving a little more normalcy in the things that you eat. Going back to the old patterns of eating is probably very common here because you’re finally eating again. Your body might be a little ravenous because if you haven’t been eating so much the first trimester, [you] might have an increased appetite in the second trimester and be hungry for more food. That’s not true for everybody.

Do people crave specific things in second and third trimesters?

Personally I loved olives, pickles, all the vinegar type of things. I don’t know that there are any specific scientific reasons why we crave certain foods in terms of a lack or deficiency. As your pregnancy progresses in the second and trimester you are going to be craving different things as you change with all those different systems that are changing like your digestion [and] hormones. As you get farther along and are at the end of your pregnancy some people actually report cravings for tinier meals. As your babies grow up into your stomach a lot of times people don’t have the capacity to eat so much at the end. Sometimes people shift from three bigger meals during the day to maybe six, seven, eight smaller meals during the day.

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Why did raw chicken and fish—especially the latter, since Omega-3s are important during pregnancy—repulse me in the first trimester?

I would say it’s probably all your sensory systems being kind of on overload. Your sense of smell is very heightened when you’re pregnant. The smells of fish and things that might be totally fine in your normal life wouldn’t be OK when you’re pregnant. It’s not what your body… wants to smell in that very moment.

How common is it to feel like you’re being completely controlled by the fetus in terms of cravings?

Intuitive eating for moms and moms in any space, whether pregnancy or postpartum, looks different than intuitive eating in general. In motherhood, you are not going to have any control over anything anymore. … You have someone else that you have to look after in terms of knowing that that person is going to be attached to you in terms of your decisions about food and intuitive eating. … Here’s my soapbox: Merging your old life and who you are with your new role as a mom is one of the most beautiful, messy things that you go through.

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Alex Van Buren is a Brooklyn-based writer, editor and content strategist whose work has appeared in The Washington Post, Bon Appétit, Travel + Leisure, New York Magazine, Condé Nast Traveler, and Epicurious. Follow her on Instagram and Twitter @alexvanburen.