Cravings During Pregnancy
Just what drives those midnight runs for bacon and Bing cherries?
It's enough to turn a vegetarian into a carnivore, a champion of low-fat diets into a Ben & Jerry's addict, and a foodie into someone who can't even stomach the thought of sitting down to a meal.
You're pregnant. Look out taste buds, here comes a rush of hormones hell bent on turning your gustatory preferences inside out. At least for some of us. Just what drives those midnight runs for bacon and Bing cherries?
Are these weird cravings for pickles and ice cream trying to tell you something important, or are they a force to be resisted? And why are some women plagued by them while others barely change their diets? And while we're at it, has any pregnant woman ever actually craved pickles with ice cream? We may never know.
One of the few studies that ever attempted to determine why women might crave different foods was conducted in Sri Lanka and published in the Indian Journal of Public Health. Of 1,000 women surveyed for the study, 47.3 percent reported craving certain foods: 65 percent craved sour food, 40 percent unripe fruits, 47 percent meat and fish, 30 percent ripe fruits, and 22 percent breadfruit.
Interestingly, the study also noted that "pregnancy cravings [were] significantly higher in women who married after a love affair than in those who had an 'arranged' marriage," as well as in "women who were superstitious (e.g. believed in devil dancing) than in those who were not."
Other reports show that up to 80 percent of women experience cravings during pregnancy, but even the experts can't agree on where these cravings come from or what they mean.
Amanda Orr doesn't believe in devil dancing, but still has no idea what came over her one day in a Washington D.C. grocery store.
"I was just doing some random grocery shopping, wandering down the aisle when I saw this box of instant mashed potatoes, au gratin," recalls Orr, a public relations director at a bank. "I'd never eaten them before in my life, but I literally wanted to chew into the box. I left all my other groceries in the cart and took the box home to my husband and said, 'Make this for me, right now.'" He obliged.
Marcia Pelchat, PhD, a cravings expert at the Monell Chemical Senses Center in Philadelphia, says there are many theories as to what causes pregnancy cravings but little in the way of evidence. Fruit and ice cream cravings may be your body's way of making sure you get the vitamin C and calcium your baby needs to develop, Pelchat says, but there's no scientific proof.
"Generally speaking, there is very little evidence that cravings are related to bodily need," says Pelchat, who researches physiological psychology. "We'd all really like to think that we're being virtuous when we give the baby salty potato chips, and perhaps we are, but there's just no proof."
But Kay Daniels, M.D., an obstetrician at the Lucile Packard Children's Hospital in Palo Alto, California, says she absolutely believes in the wisdom of the body. "I've heard enough stories over the years about women craving the same types of things -- especially high-carb foods during the first trimester -- that I believe it's something the body must need."
Sally Brady, a doula (birth coach) in Seattle, agrees with Daniels. A strict vegetarian for 13 years, Brady suddenly began craving salty pork products when she became pregnant with her first child.
"I was at a restaurant and saw a woman eating a BLT, and I was just like, 'I have to have that!'" says Brady, who endured severe nausea throughout the greater part of her pregnancy. "I had a brief moment of feeling guilty, but I had so few food choices that didn't make me sick at that point, I just decided that whatever my body wanted was what it needed."
Anecdotal evidence for meat cravings during pregnancy is rampant; but so are meat aversions. Some of the most common cravings are for sour foods, carbohydrates, and sweets. Some have theorized that this is a Darwinian mechanism intended to ensure that pregnant women get enough calories to nourish the developing fetus, especially if they're nauseated and not keeping much food down. Others suspect pregnant women might just be seeking comfort food because they feel so bad.
Need for sweet and sour
A number of reputable studies, Pelchat says, show an increase in carbohydrate and sweet cravings in women during the perimenstrual period (the few days before and after menstruation begins), when many of the same hormones are released as during pregnancy.
"There is a lot of evidence that hormones may drive these cravings, but no one has any idea what the mechanism might be," says Pelchat. "Another hypothesis is that it's habitual. Women are feeling crummy, they feel like indulging, so they eat carbohydrates or chocolate." Chocolate is believed to cause the release of endorphins and/or serotonin, chemicals in the brain that make us feel better, she says.
Aside from the boxed potato incident (she never ate them again), Amanda Orr craved chocolate chip ice cream on a regular basis. Overall, however, Orr says her body steered her away from junk food and towards a diet she would like to be keeping up today: lots of fruits, vegetables, and protein. "I wish I were in tune with my body now the way I was when I was pregnant," quips Orr, who gave birth to a baby girl in August 2004. "But now I'm back to my old, less healthy ways."
One U.S-based study of taste changes across pregnancy was published in the Annals of the New York Academy of Sciences. It showed a wide variance among women but did find some commonalities:
- Salt. An increased preference for salty foods -- hello, potato chips and pickles! -- as the pregnancy progressed. According to Pelchat, this might be explained by increased blood volume and the subsequent need for more sodium.
- Bitter. A decreased aversion to bitter tastes as pregnancy progresses.
- Sour. An increased preference for sour foods -- hello again, pickles! -- especially during the second and third trimesters. The authors speculated that this could be the body's attempt to make sure you get a varied diet later in the pregnancy.
The fact that many fruits are both sweet and sour may help explain why it's such a common pregnancy craving, says Daniels. Sour tastes also seem to help curb nausea. Daniels' own mother craved Bing cherries during her pregnancy but never ate them before or after. And Daniels, during her nine months, had an insatiable craving for white rice with vinegar. "I remember sitting at the dinner table surreptitiously pouring vinegar over my rice," Daniels recalls with a laugh. "My husband caught me once and said, 'What on earth are you doing?' and I said, 'I don't know, but I want it, so leave me alone.' "
"I was also a huge chocoholic in real life but couldn't touch it throughout my pregnancy," says Daniels. Nevertheless, before she was even out of the recovery room after giving birth to her son, she demanded chocolate.
As a doula, Sally Brady has witnessed similar scenes in the recovery room: one woman asked for a chocolate peanut butter shake while another wanted a sausage pizza-flavored Hot Pocket immediately after giving birth. Brady, of course, was happy to fulfill her clients' wishes.
"In general, I think people crave what they need, unless all you need is McDonald's. Then you've kind of got to wonder what's going on," says Brady. "Maybe all you need is love."
Interview with Amanda Orr, a pregnant mother
Interview with Sally Brady, a doula from Seattle
Interview with Marcia Pelchat, PhD, physiological psychologist and cravings expert at the Monell Chemical Senses Center in Philadelphia
Mayo Clinic. Early signs and symptoms of pregnancy: Things you might notice before you start prenatal care. February 2005.
Nemours Foundation. Eating During Pregnancy. July 2004 http://kidshealth.org/parent/nutrition_fit/nutrition/eating_pregnancy.html
Wijewardene K. et al. Dietary cravings and aversions during pregnancy. Indian Journal of Public Health. 38(3):95-8. July-September 1994.
PR Newswire, Motherhood Maternity Survey of 1,000 Pregnant Women -- Sex, Cravings and Greater Fears! Nov. 18, 2004.
Monell Chemical Senses Center. Faculty. http://www.monell.org/Faculty/pelchat.htm
Interview with Kay Daniels, MD, an OB-GYN at the Lucile Packard Children's Hospital in Palo Alto, California
Demissie, T. et al. United Nations University. Food aversions and cravings during pregnancy: Prevalence and significance for maternal nutrition in Ethiopia. http://www.unu.edu/unupress/food/V191e/ch05.htm
American Fitness Professionals & Associates. Can Food Alter Your Mood? http://www.afpafitness.com/articles/FOODMOOD.HTM
Duffy VB, et al. Taste changes across pregnancy. Annals of the New York Academy of Science. 1998 Nov 30;855:805-9. Abstract. http://www.annalsnyas.org/cgi/content/abstract/855/1/805
Middlesex-London Health Unit. Nutrition Know-How for Pregnancy-Quiz. h
St. Joseph's Hospital. Some Suggestions for Nausea and Vomiting of Pregnancy. http://www.sjhc.london.on.ca/sjh/programs/wmnshlth/nausea.htm