eating for conceiving (important for guys and girls!)

Q&A with Lily Nichols

Hello everyone.

Today we’ve got a killer interview with Lily Nichols, a registered dietitian who literally wrote the book on real food for pregnancy. I may have been the only 19-year-old guy to read it when it first came out, but it quickly became one of my favorite health and nutrition reads. Lily just gets it.

She’s not only a stellar researcher and clinician, but also a rare combination of common sense and wisdom—two traits in dangerously short supply in the health world.

Let’s get to it.

VV: I’m a 25-year-old single guy, and many of my readers are also single. Why should people like us—who aren’t planning on having kids anytime soon—still care about nutrition and reproductive health?

LN: Because reproductive health is whole-body health. Your hormone levels, sperm quality, libido, sleep, energy, and mental health all tie back to the same systems that govern fertility. And these systems are sensitive to your diet, stress, alcohol intake, movement, and toxic exposures—whether or not you’re actively trying to conceive.

Sperm quality is a reflection of your diet and lifestyle choices in the preceding 3 months. So if and when you do want kids, your body’s readiness won’t be built overnight. Taking care of your health now lays the groundwork for whatever future you choose—whether that’s parenthood or simply thriving in your own body.

VV: We’re clearly in a fertility crisis. Different researchers point to different culprits—microplastics, nutrient deficiencies, delayed childbearing, hormonal contraceptives, etc. In your view, what’s really behind the growing struggle to conceive?

LN: The fertility crisis is multifactorial, and unfortunately, there's no single smoking gun. We're seeing a perfect storm of modern influences: widespread nutrient depletion (ultra-processed foods account for over 60% of a typical American's calorie intake), chronic stress, environmental toxins, metabolic dysfunction, sleep deprivation, and yes—delaying having kids until later in adulthood.

Fertility is a reflection of health. And when so many inputs in our modern world are working against health, fertility takes a hit.

VV: How much does the health of both parents—mom and dad—impact pregnancy viability and delivery outcomes?

LN: Far more than we’ve been taught to believe. While the mother’s health is more visible during pregnancy, research continues to show that paternal health—especially sperm quality—is a critical piece of the puzzle. For example, sperm quality has been linked to placental health and also the risk for developing certain complications, like preeclampsia.

Both egg and sperm quality are shaped by diet, environment, stress, and metabolic health months (if not years) before conception. The health of both parents influences everything from conception rates to miscarriage risk to long-term child health outcomes. It truly takes two to make a healthy baby.

VV: For couples hoping to conceive, what are three key ways they can increase their chances of a healthy, successful pregnancy?

LN: Prioritize nutrient density: Build your plate around real, whole foods—especially high-quality animal proteins (like eggs, meat, and seafood), healthy fats, and colorful vegetables. Your body needs robust nutrient stores long before conception for optimal egg and sperm quality.

Stabilize blood sugar: Even subtle blood sugar imbalances can impact ovulation, egg quality, and hormonal balance. Eating protein-rich meals, minimizing refined carbs can be very helpful, particularly for women with polycystic ovarian syndrome.

Address lifestyle and environmental stressors: This means getting adequate sleep, reducing exposure to endocrine-disrupting chemicals (think: plastics, fragrances, pesticides), and intentionally making space for rest and connection. Stress—physical, chemical, or emotional—can interfere with your body’s willingness to reproduce. It's also important to include chronic undereating as a possible stressor, which is a major cause of hypothalamic amenorrhea.

VV: Respond to this: “I’m eating for two,” says a pregnant woman.

LN: Yes, your nutrient needs increase—sometimes dramatically for key nutrients like choline, iron, and protein—but your calorie needs don't actually double.

When you look at the true increase in calorie needs from preconception to 3rd trimester, it's more like "eating for 1.1" rather than eating for 2. So it’s less about eating more and more about eating better, meaning really prioritizing nutrient-dense foods.

I’ve had healthy, fit friends “fail” the gestational diabetes screening during pregnancy. Have you seen metabolically healthy women fail this test? What are your overall thoughts on how it’s administered and interpreted?

Yes, I’ve absolutely seen that happen—especially with the glucose drink test (like the 1-hour OGTT). False positives do happen on glucose screenings, especially in women who are eating a lower carb diet leading up to the test.

These screenings can sometimes flag women as high risk who are otherwise metabolically healthy. At the same time, I’ve seen it miss GD in women who do have blood sugar dysregulation, just not at the moment of the test (false negatives). No testing method is perfect, but I believe options should be available and we should also monitor blood sugar more routinely (via home monitoring) in case the glucose tolerance test results weren't entirely accurate.

I go into the pros/cons of various testing methods and their alternatives in chapter 9 of Real Food for Pregnancy.

VV: What are the best foods for the postpartum period—for healing, recovery, and milk supply?

LN: Postpartum is a time for rebuilding—blood, tissue, hormones, and energy. You need deeply nourishing foods that are easy to digest and rich in nutrients to rebuild nutrient stores. Protein needs are particularly high in postpartum moms, yet that research has not yet made its way into nutrition guidelines.

Some of my favorites include: meat-based stews and soups, bone broth, meat and organ meats, eggs, full-fat dairy, seafood, well-cooked vegetables and starches, and plenty of electrolyte-rich beverages.

I have a lot of recipes that support postpartum recovery here. Consider having friends/family provide a meal train, as many new parents don't have the time or energy to cook.