Food Aversion In Pregnancy: Definition, Causes & Treatment

Although in one study, 69% of pregnant women reported food aversion, the global prevalence may actually be as high as 79%. Food aversion in pregnancy is usually characterized by an intense dislike for a specific food’s taste and smell and may coexist with morning sickness. The offensive nature associated with it results in a refusal to eat the undesirable food.

In one 2021 study of Ethiopian pregnant women, food aversion was associated with a high degree of malnutrition — those who did not have aversions reported a more healthy, balanced, nutritious intake.

Another older study in Fiji showed that women who had food aversions frequently craved foods high in the nutrients lost from their food aversions, alleviating potential malnutrition. 

Let’s examine the definition of food aversion, some hypothetical causes, how long it typically lasts, treatment modalities, and coping mechanisms for dealing with it.

What Is A Food Aversion?

Food aversions exist in children and have a diagnostic mental health code. However, here we are talking about a symptom common in pregnant women not related to a mental health disorder. Physiological changes or cultural influences during pregnancy often cause a woman to develop strong dislikes for specific food items.

Food aversions appear suddenly and are characterized by an extreme repulsion to foods with strong smells. Culturally based aversions do not share these symptomatic characteristics and may represent more of a food avoidance rather than aversion.

Food aversions characteristically involve strict avoidance of food items. Depending on how the mother-to-be copes with her dilemma, this may or may not cause nutrient deficiencies. Symptoms such as coughing, gagging, or vomiting may occur if the woman ingests the averted food, and nausea and gagging may occur upon sight or smell.

What Causes Pregnancy Food Aversions?

There are many theories about why food aversions develop during pregnancy. Several have been listed below and require further research.

Cultural Influences

Some food aversions are culturally based. For example, in some villages in India, women avoid fruits because they are associated in their society with them, causing harm to their unborn babies. Their regional beliefs are that many fruits cause preterm birth, skin diseases, and miscarriages.

Sharing cultural stories about these adverse pregnancy outcomes drives food aversions in one region. It is not about adverse reactions to foods, nor does it fit the typical definition of food aversion.

Hormonal Shift Changes

Hormonal shifts may contribute significantly to food aversions during pregnancy. Increased human gonadotrophin, or HCG, occurs in the first trimester and is possibly associated with morning sickness and food aversions. Brain remodeling of the neurocircuitry affects taste perceptions and appetite, possibly playing another role in its development. 

Taste And Smell Changes

Women have a heightened taste and smell during pregnancy, contributing to many food aversions. Foods with an intense smell, like garlic, may often be avoided, although foods without a strong smell, like chicken, are also seen as repulsive. 

Some women report a metallic taste in their mouths when eating food, so taste distortion affects food aversion. One study showed that 30% of women changed their diet during the first trimester due to taste changes, and the foods disliked most often were beans, fish, and vegetables.

Fetal Protection Theory

Another reason for food aversion development is the learning theory or fetal protection hypothesis. This theory states that pregnant women have aversions to food because they feel it may harm their baby. Furthermore, it is noted that the woman learns to vomit the toxins from the offending food that is caused by the nausea created by her feelings of aversion.

Food aversions may have evolved over time to protect women from metabolic syndrome and gestational diabetes. Fruits, blackberries, and spicy foods are commonly avoided in the fetal protection theory.

Compensation Of Placental Growth Theory

Then there is the compensation of placental growth theory, which states that malnutrition in the first trimester favors placental development and, thus, the fetus’s survival.

Nausea And Vomiting

Furthermore, just the symptoms of nausea and vomiting in response to hormonal changes may cause food aversions. Women learn to associate their symptoms with certain smells and tastes and try to avoid those foods to prevent nausea and vomiting from occurring.

Food Aversions Common In Pregnant Women

While most foods women react strongly to during pregnancy also have a detectable odor, this is not always the case.

Foods commonly associated with aversions are the following:

• Garlic.
• Meats (especially fish).
• Coffee and tea.
• Eggs.
• Fruits and vegetables.
• Fatty foods, in general.
• Spicy foods.
• Beans.

Consequences Of Food Aversion

The most notable consequence of restricted eating is the development of malnutrition. This is generally due to an inadequate intake of fiber or micronutrients. A calorie deficit is a risk for approximately 21% of pregnant women who fail to gain the recommended amount of weight during their pregnancy.

Some of the most commonly disliked foods are excellent protein sources, such as meat, fish, beans, and eggs. Pregnant women should eat at least 71 grams of protein daily or 10%-35% of their calories as protein, and this group of avoided foods contains the most protein. Avoiding these foods may quickly lead to protein deficiency at a time when needed the most for fetal growth and development.

Fruits and vegetables contain magnesium, zinc, folic acid, and fiber, among many other micronutrients needed during pregnancy. At least 28 grams of fiber daily is required to prevent pregnancy-related constipation. Many pregnant women do not get enough folic acid – 29.4% in one study — risking neural tube defect, leg paralysis, or anemia.

Eggs are a great source of protein and choline, which is needed for brain and nervous system development. However, in a recent 2022 study, only 7% of the study participants consumed the recommended amount of choline, and only 17% of the need was met by the prenatal supplement. Choline is of crucial importance in this population.

If you can’t tolerate beans, try more tofu. Sneak some veggie burgers in your meal plan. Increase your fiber from whole grains or fresh fruits and vegetables, if tolerated.

Don’t like red meat or fish? Try the white meat of chicken or turkey without the skin. It is all about making nutritional swaps to keep your nutrients adequate.

Some aversions may benefit your health, such as those related to fatty foods and caffeinated beverages. Both of these foods can cause adverse maternal or fetal outcomes during pregnancy.

How Long Do Food Aversions Last During Pregnancy?

Food aversions are generally noticed during a specific pregnancy term and are usually associated with morning sickness, although not when culturally influenced. Depending on the cause and severity, the symptoms may vary.

When Do Food Aversions Start In Pregnancy?

Food aversions usually present themselves towards the end of the first trimester, intensify during the second trimester, and diminish during the last. Cultural food aversions will last the entire pregnancy or as long as their culture dictates.

When Do Food Aversions Stop In Pregnancy?

The food aversions will stop when the cause resolves or is removed.  This aversion usually stops around week eleven, although it may continue throughout pregnancy.

Treatment Of Food Aversions In Pregnancy

Despite the significant impact food aversion may have on the health of the mother and fetus, little research on the topic exists. Some treatment strategies include the following:

• Hide the food in another food so it cannot be tasted.
• Change the texture of the food; instead of frying meat, bake it, broil it, or grill it.
• Work with a therapist to unlearn your behavior and sensitize yourself to the averted food.
• Slowly increase exposure to the food.
• Make new food associations, possibly with the help of therapy.

How to Cope With Food Aversions During Pregnancy?

Look at the severity of your food aversions. If you suddenly develop an intolerance for fast foods because they are too fatty, don’t sweat it. You will not lose weight or become malnourished from not eating fast foods. 

If, however, you have a severe coexisting case of nausea and vomiting, causing you to overly restrict your diet, you should seek help from your doctor. Milder restrictions can be coped with by doing the following:

1. Make an appointment with a Registered Dietitian Nutritionist to see how you can balance your diet to get all your nutrients while avoiding the foods you dislike or that make you ill.
2. Try substituting foods from the same food group you are avoiding to avoid a nutritional deficiency.
3. Keep that protein intake up. Swap out foods you can’t stand for high-protein foods you can tolerate. Add a high-protein drink supplement if you need a protein boost.
4. Keep the odors down by using the fan above the stove or running a separate fan in the kitchen to clean out offensive cooking odors.
5. If the smell of eggs bothers you, consider eating them in a restaurant.
6. Since hot foods are more aromatic, try eating them chilled or at room temperature.
7. Adding sauces or marinating meat may reduce the undesirable metallic taste. Sometimes, using plastic utensils helps with this aversion.

Conclusion

Food aversions during pregnancy are extremely common worldwide in all cultures. They happen for various reasons, some due to physiological changes during pregnancy, and some are cultural or learned behaviors. Food aversions in pregnancy are usually defined as feelings of revulsion towards specific foods that result in a refusal to eat those items.

Foods averted are usually ones with a strong odor or those perceived as harmful to the unborn baby.

Most aversions develop late in the first trimester and resolve by the third, although some last the entire pregnancy. Managing a food aversion is important for quality of life and ensuring a nutritious, balanced diet. If not properly managed, food aversions have been associated with malnutrition.