Pregnancy is a really weird metabolic state, often leading to insulin resistance (to spare glucose for the foetus?) and one churning out ketones. Even neonates are peculiar, seeming to run on ketones, despite subsisting on carb heavy milk. All in all it's hard to apply the paleo heuristic to pregnancy, especially when normal advice like 'listening to your body' leads to one following seemingly absurd cravings, so I'm going to avoid trying to prescribe what-a-paleo-should-eat-when-pregnant.

It sounds to me as though your food aversions might well not reflect anything biologically significant (e.g. one ought not to eat fatty meat). Rather, what your cravings (celery sticks, watercress and bananas and custard) seem to have in common, is just an urge for pretty bland pretty light foods. My first suspicion would therefore be that your new tastes are a defensive mechanism to avoid any potentially risky foods, much like young children are often considered to be naturally averse to new foods and especially to greens etc that might be potentially toxic. I imagine that if you were just recovering from a stomach illness of some such, then you'd eat pretty similar things: custard, bananas etc.

As to what to do in practise: at least if you can eat butter, then you have a source of some fats. Other than that, you'll need to get your calories from somewhere, so I would posit that sweet potato (or some other tuber) would be your best bet and would also hit your carb craving. They're not at all low carb, it goes without saying, but doubtless better than custard. They'll also hit a large number of nutritional bases, if you're missing out meat and offal. Indeed, if you eat them for all your non-meat calories they'll give you about 40g of protein too.

I personally believe that your body is a lot smarter than some book. Paleolithic women didn't have the WAP or Mark Sisson, so ate whatever it is that they craved. If it's vegetables now, don't fight it. What's the point of forcing yourself to eat something you don't like? Sounds too much like dieting to me! I bet in another couple of months you'll crave fatty meat like the deserts crave rain! :)

Some ideas to try to up the fat intake:

• Coconut milk or coconut oil blended in some fruit smoothies, if you can tolerate the cold and icy texture. That might be a way to get in some fats without fats' typical warm greasiness that is notorious for setting off nausea.

• Guacamole. OK, this stuff actually repulsed me while I was pregnant early on, but these things vary in terms of how they'll affect people. If you can eat your carrot sticks and celery with some guac, you'll be getting a nice dose of fats (yes, omega-6 heavier, but if you're eating salmon you're probably offsetting that nicely).

• If you're OK with cheeses, try an artichoke dip with cheese crisps.

Also be careful about excess Vitamin A intake (esp. with liver and pate). (I know, I know! Yet another thing to add to the GIANT list of "what to watch out for" during pregnancy, but...). I haven't yet read anything refuting claims/studies that too much can be bad for the developing baby.

Good luck to you navigating these rough seas! ;-) Hopefully by 2011 you'll be smooth sailing.

I have been looking into what might be considered to be an optimal diet during pregnancy as hopefully we will be starting a family in the next year. Some really interesting info can be found in the comments section of Dr Michael Eades blog post found in this link:

http://www.proteinpower.com/drmike/ketones-and-ketosis/metabolism-and-ketosis/

Dr Eades has replied with the following:

The medical literature (at least with animal studies; no one could ethically do such studies with humans) is pretty clear that ketogenic diets are NOT good for the developing fetus. I’m not an expert on this issue as it applies to developing fetuses, so I check with my friend Larry McCleary who is a pediatric neurosurgeon, low-carb advocate, and well read in the nutritional fetal development literature. He says that in the fetal brain most of the lipid synthesis is from glucose and to a smaller degree, lactate. Beta hydroxybutyrate (a ketone) is not a major contributor. In addition, the enzymes in the pathway from BHB to acetyl CoA in the fetal brain are poorly developed. Post natally they activate. Hence, BHB is not a major provider for ATP generation in the fetal brain. For these reasons he feels that a ketogenic diet might not be the best diet during pregnancy. But having said that, I (and he) don’t think a high-carb diet is the diet of choice either. A moderate carbohydrate diet with plenty of colorful fruits and vegetables along with healthy servings of meat would be ideal in my opinion.

The guys over at Perfect Health Diet also have a post on diet and pregnancy which I think is worth a read: http://perfecthealthdiet.com/?cat=46

Also the book Real Food for Mother and Baby: The Fertility Diet, Eating for Two, and Baby's First Foods by Nina Planck has been recommended to me. While it is not WAPF approved as her other book is (called Real Foods, I think??), I still think it is worth a look and is on my 'to be purchased list'. :-)

I don't know if we will ever understand these weird pregnancy craving things. When pregnant with my brother, my mother craved raw meat. She compromised by slightly cooking the outside of meat to kill germs before eating it. But when pregnant with me, she craved rootbeer! My advice is do what you can to not barf and eat anything healthy or kinda healthy that does not make you barf. If you want to eat celery, then eat it! Make sure your salmon is wild caught and that should have less toxins in it. Maybe also try something like sardines which are lower in the food chain and thus collect less toxins. Track your basic nutrient intake on fitday.com and take high quality supplements to cover anything you might be lacking. And get your vitamin D. And congratulations on being such a good mother as to be caring and doing what you can even before the baby is born!

I had the same issue during my first trimester. I ate a lot more guacamole and cheese than I usually would have, and meat in general turned me off - even bacon! I'm now about to start my 3rd trimester and can't get enough meat, so hang in there. Everything points to my baby being really healthy so far, so I'd agree with the others and say trust your instincts (as long as your instincts aren't leading you to copious amounts of ice cream and cupcakes). :)