Paleo Diet During Pregnancy: Nutrients, Risks and a Day

By Paleo Life Coach Editorial Team · Last updated October 15, 2026 · Checked against the Dietary Guidelines for Americans, FDA, NHS and Harvard nutrition guidance and USDA FoodData Central

If you’ve been eating paleo for a while and just found out you’re pregnant, or you’re pregnant and thinking about trying it, the question is the same: is it safe to keep grains, legumes and dairy off the plate while you’re growing a baby? The paleo diet during pregnancy has been studied exactly once, so the honest answer comes from two places: what that one study found, and whether a paleo menu can meet the higher nutrient targets of pregnancy. This guide covers both, with a full day of food counted from USDA data.

The quick version: A planned paleo diet can meet most pregnancy nutrient targets, but it drops fortified grains and dairy, so folic acid, iron, iodine, calcium and carbs need attention. Only one small study exists. Keep taking a prenatal vitamin, eat at least 175 g of carbs daily and involve your doctor.

Is the paleo diet safe during pregnancy?

There isn’t enough evidence to call it safe or unsafe. The only published study is a retrospective cohort from Tel Aviv that compared 37 women who followed a paleo diet throughout a low-risk pregnancy with 39 women on a regular diet (Lavie et al., 2019). The women had all followed paleo before pregnancy; the study excluded anyone who started it while pregnant.

Is the paleo diet safe during pregnancy?
Measure	Paleo group	Regular diet group
Glucose challenge test score	95.8 mg/dL	123.1 mg/dL
Hemoglobin	12.1 g/dL	11.05 g/dL
Ferritin (iron stores)	32.1	21.3
Pregnancy weight gain	9.3 kg	10.8 kg
Birth weight	3,098 g	3,275 g

Source: Lavie et al., Eur J Obstet Gynecol Reprod Biol, 2019 (abstract). All differences shown were statistically significant. No differences were found in pregnancy complications, mode of delivery or adverse newborn outcomes.

The authors concluded that the babies in the paleo group were “slightly lighter but appropriate for gestational age.” That’s reassuring, but this is one small study of women who chose their diet, so it can’t show cause and effect, and it says nothing about starting paleo after you’re already pregnant. Treat it as a reason not to panic if you already eat this way, not as proof that paleo is better for pregnancy.

Which nutrients can paleo miss in pregnancy?

Pregnancy raises the targets for several nutrients, and paleo removes some of the foods that usually supply them. Here’s what changes:

Which nutrients can paleo miss in pregnancy?
Nutrient	Pregnancy target	What paleo removes	Paleo foods that supply it
Folate	600 mcg DFE/day (Dietary Guidelines)	Grain products fortified with folic acid	Leafy greens, asparagus, avocado, citrus, eggs
Iron	27 mg/day (Dietary Guidelines)	Fortified cereals, beans	Red meat, seafood, spinach, eggs
Iodine	220 mcg/day (Dietary Guidelines)	Dairy; often iodized salt (sea salt usually isn’t iodized)	Fish, shellfish, eggs, iodized salt
Calcium	1,000 mg/day, ages 19-50 (Dietary Guidelines)	Dairy	Canned fish with bones, collards, almonds
Choline	450 mg/day (Harvard)	Little; paleo is often high in eggs and meat	Eggs, meat, fish
Carbohydrate	At least 175 g/day (Children’s Hospital Colorado)	Grains, legumes; low-carb versions of paleo cut more	Sweet potatoes, squash, fruit, bananas

Two points matter most:

Folic acid isn’t optional. Harvard explains that folate has to be in place in the first few weeks after conception, often before you know you’re pregnant, and that the FDA requires folic acid in most enriched breads, flours and grain products, which paleo avoids (Harvard). The Dietary Guidelines for Americans, 2020-2025 cite the U.S. Preventive Services Task Force recommendation that all women who are planning or capable of pregnancy take a daily supplement containing 400 to 800 mcg of folic acid, in addition to the folate in food (Dietary Guidelines).
Iodine is easy to miss on paleo. A two-year paleo trial in non-pregnant women saw urinary iodine fall by about half; we cover it in our paleo diet nutrient gaps guide. Harvard notes that not all prenatal vitamins contain iodine and that the American Academy of Pediatrics recommends iodized salt in pregnancy (Harvard). Check your prenatal’s label.

What does a paleo pregnancy day look like?

Here’s one day built from paleo foods and counted against the targets above. Portions are ordinary household measures; we chose foods that are high in folate, calcium and iron to see how far food alone can go.

What does a paleo pregnancy day look like?
Meal	Foods	Key contributions
Breakfast	2 hard-boiled eggs, 1/2 cup cooked spinach, 1 orange	294 mg choline from the eggs; 215 mcg folate
Lunch	Salad: 2 cups romaine, 3 oz canned pink salmon with bones, half an avocado, 1/2 cup asparagus, 2 tbsp olive oil dressing; 1 apple	183 mg calcium from the salmon; 343 mcg folate from the greens, avocado and asparagus
Dinner	4 oz sirloin steak, 1 cup cooked collards, 1 cup baked sweet potato, 1 cup baked butternut squash	268 mg calcium from the collards; 63 g carbs from the sweet potato and squash
Snacks	1 oz almonds, 1 cup raspberries, 1 banana	48 g carbs, 15 g fiber

What does a paleo pregnancy day look like?
Day total	Amount	Pregnancy target	Met?
Food folate	729 mcg	600 mcg (plus a folic acid supplement)	Yes, from food
Calcium	1,043 mg	1,000 mg	Yes
Choline	718 mg (squash not reported)	450 mg	Yes
Carbohydrate	182 g	At least 175 g	Yes
Protein	92 g	Not set here; ask your clinician	n/a
Fiber	56 g	n/a	High
Iron	17.0 mg	27 mg	No, 10 mg short
Calories	about 1,745	Varies by trimester and person	Add food as needed

Calculated from USDA FoodData Central SR Legacy: hard-boiled egg 173424, cooked spinach 168463, orange 169097, canned pink salmon 173690, romaine 169247, avocado 171705, asparagus 168390, apple 171688, broiled sirloin 173118, cooked collards 170407, baked sweet potato 168483, baked butternut 169296, almonds 170567, raspberries 167755, banana 173944, olive oil 171413; portion weights from USDA household measures. USDA SR Legacy doesn’t report iodine for most foods, so iodine isn’t totaled.

The day shows paleo’s strengths and its limit. Folate, calcium and choline are all covered from food, and carbs clear 175 g because of the sweet potato, squash and fruit. But iron reaches only 17 mg against 27 mg, even with red meat, spinach and eggs in the same day. That gap, plus the folic acid and iodine questions, is why a prenatal vitamin chosen with your clinician still matters on paleo. Our paleo diet carbs per day guide shows other ways to reach 175 g without grains.

Which paleo foods should you avoid while pregnant?

Most paleo staples are fine, but a few common ones carry pregnancy-specific risks:

High-mercury fish. The FDA’s “choices to avoid” list for pregnancy is king mackerel, marlin, orange roughy, shark, swordfish, Gulf of Mexico tilefish and bigeye tuna. It recommends 8-12 ounces a week of lower-mercury fish, or 2-3 servings from the “best choices” list (FDA). Our paleo seafood recipes list mercury levels by species.
Refrigerated smoked fish. The FDA says smoked salmon, trout and similar fish labeled “nova-style,” “lox,” “kippered” or “jerky” can carry Listeria unless cooked, while canned or shelf-stable smoked seafood is acceptable (FDA).
Deli and cured meats. Hot dogs, deli meats and refrigerated pâtés or meat spreads are on the FDA’s Listeria list unless reheated until steaming hot. The NHS also says cold cured meats such as salami, pepperoni, chorizo and prosciutto should be cooked until steaming hot (NHS).
Raw or undercooked meat. The NHS lists it among foods to avoid because of toxoplasmosis risk. Cook meat to safe temperatures with a thermometer.
Liver and liver products. The NHS advises avoiding them in pregnancy because their high vitamin A content can harm the baby.

Should you start paleo while pregnant?

The only study excluded women who started paleo during pregnancy, so there’s no data on switching mid-pregnancy. A big change in diet can also bring side effects in the first weeks; our paleo flu guide covers what people report. If you want to eat more whole foods during pregnancy, you don’t need the whole rulebook. Many of paleo’s habits (more vegetables, fruit, fish and eggs, fewer ultra-processed foods) fit any pregnancy diet without dropping dairy or fortified grains.

If you already eat paleo and want to continue, these adjustments follow from the guidance above:

Take a prenatal vitamin your clinician recommends, and check it contains folic acid and iodine.
Keep carbs at 175 g or more with sweet potatoes, squash, fruit and, if you include them, white potatoes or rice.
Eat 8-12 oz of low-mercury fish a week, including canned salmon or sardines with bones for calcium.
Use iodized salt for at least some of your cooking.
Consider relaxing the dairy rule. If calcium is hard to reach, a primal approach that includes dairy is one option; see paleo vs primal.
Ask about iron. Your clinician may check your levels and advise on supplements.

When should you talk to your doctor or midwife?

Before you change your diet, and at your first prenatal appointment if you already eat paleo. Tell them specifically that you avoid grains, legumes and dairy, so they can check your prenatal vitamin, your iron and your weight gain. Ask for a referral to a registered dietitian if you have gestational diabetes, a history of anemia, a multiple pregnancy, or you’re finding it hard to eat enough.

Don’t take high-dose single supplements, such as extra iodine, iron or vitamin A, without medical advice. Harvard notes that high-dose iodine supplements can cause thyroid problems in some women.

Frequently asked questions about the paleo diet during pregnancy

Is it safe to follow a paleo diet while pregnant?

There’s too little evidence to say for certain. The only study, 76 women in Israel who followed paleo before and during pregnancy, found no difference in complications or newborn health, and babies were slightly lighter but normal for gestational age. A planned paleo diet can meet most targets, but you’ll still need folic acid, iodine and likely iron support.

Can paleo cause low birth weight?

In the one study available, babies in the paleo group averaged 3,098 g compared with 3,275 g in the regular-diet group, about 177 g lighter. The authors described them as appropriate for gestational age with no difference in newborn outcomes. One small retrospective study can’t show that paleo caused the difference, so discuss growth scans and weight gain with your clinician.

How many carbs do you need on paleo while pregnant?

The recommended dietary allowance in pregnancy is at least 175 g of carbohydrate a day, set by the Institute of Medicine in 2005. Strict low-carb versions of paleo can fall well below that. Sweet potatoes, squash, bananas, apples and berries are paleo ways to reach it; the sample day above reaches 182 g.

Do I need folic acid if I eat lots of greens on paleo?

Yes. The Dietary Guidelines for Americans, 2020-2025 cite the U.S. Preventive Services Task Force recommendation that all women who are planning or capable of pregnancy take a daily supplement containing 400 to 800 mcg of folic acid, in addition to food folate, and the pregnancy target is 600 mcg. Paleo removes the fortified grains that supply folic acid in a typical diet, so a supplement matters even if your diet is rich in greens.

Can I eat bacon and deli meat on paleo while pregnant?

Only if they’re cooked until steaming hot. The FDA lists hot dogs, deli and luncheon meats among Listeria risks in pregnancy unless reheated, and the NHS says cold cured meats such as salami and prosciutto should be cooked first. Cook bacon fully and serve it hot; it’s also high in sodium.

What’s a good paleo snack during pregnancy?

Hard-boiled eggs, a banana or apple with almond butter, a handful of almonds with berries, or canned salmon with bones on cucumber slices. These add protein, carbs and either choline or calcium. Our paleo snacks to buy guide checks store-bought options label by label.

Your next step: take this table to your next appointment

Print or save the nutrient table above and bring it to your next prenatal visit. Ask your clinician three questions: does my prenatal vitamin cover folic acid and iodine, should my iron be checked, and is my weight gain on track? For planning meals around those answers, see our paleo meal plans.

Consider this general nutrition reading, not a replacement for advice from your doctor or midwife. Talk to your doctor before changing your diet or starting supplements during pregnancy or while trying to conceive.

Paleo Diet During Pregnancy: What the One Study Found, the Nutrients Paleo Can Miss, and a Day That Meets the Targets