When you were first diagnosed with gestational diabetes, what was the first thing that went through your head?
If you’re like many of the women I have worked with it was something like “ohmygod I’ve been eating so much rubbish and I’m such a bad mum” quickly followed by “I’m cutting out all carbs and sugar”.
Now, there are two things here that we need to address:
- You are not a bad mum, and you did not cause this. Gestational diabetes is predominantly driven by hormones, not how many toasties and bowls of cereal you ate in the first trimester.
- Carbs raise blood sugar. But does that mean you need to cut them out? No, probably not.
First things first, let’s be very basic and define carbs.
Here I am talking about all foods with carbohydrate in them, which includes things like bread, pasta, cereals, rice, quinoa, oats, crackers, fruit and dairy. Not just sugary foods.
Australian guidelines certainly don’t recommend eliminating carbs during pregnancy, but I know a lot of you still have questions around this. And I’m all for informed decisions, so I got stuck into the current evidence to bring you what you need to know.
Carbs are our body’s preferred source of fuel
It’s speculated that our brain alone needs about 120g to function.
This is equivalent to about 8 slices of bread.
Obviously our body is smart enough to survive if we do go low carb, but it honestly seems a bit like buying a Toyota instead of a Porsche. Why would you.
Growing a human burns a lot of energy
You might have noticed that you have a big appetite and are way hungrier than normal while you’re pregnant – this is for a reason! Growing a baby burns a lot of energy. You need to match the increased demand for nutrients (and overall calories) with increased food intake.
Cutting out a whole category of foods, like carbohydrates, makes it much harder to achieve overall nutritional adequacy.
You could actually make insulin resistance worse
There are a few different mechanisms that can play into this.
In the short term, restriction of dietary carbs could lead your liver to shoot out stored carbs to help fuel your body, which may be reflected in a higher reading.
In the longer term, if you are replacing carbs with foods high in saturated fat and protein, you may unintentionally exacerbate insulin resistance. This would make blood sugar harder to control, and could create a vicious cycle where blood sugar is hard to control, so you cut carbs, which makes things worse, so you cut carbs further etc.
By contrast, inclusion of wholegrains seems to be uniquely beneficial in improving insulin sensitivity, which makes blood sugar easier to manage.
Don’t forget about folate
Whenever you cut out a major food group, you also cut out opportunities to meet micronutrient requirements. Foods containing carbs are generally a very good source of nutrients like B vitamins, and in particular folate (B9). Research actually indicates that one of the major drawbacks of a low-carb diet during pregnancy is folate deficiency. We all know how crucial folate is for the development of a healthy baby (e.g. prevention of neural tube defects), so I don’t like the sound of this at all.
Your gut bugs love carbs
Another thing we love about carbs, and particularly wholegrains, is fibre. Fibre is pretty special.
Firstly, it keeps our bowels moving. A lot of pregnant women experience constipation as a result of hormones and the baby’s positioning, so cutting out fibre isn’t a great idea from that perspective.
Secondly, we know that fibre intake is incredibly important to enable our gut bacteria to thrive.
Thriving gut bacteria produce compounds that exert benefits to our entire body, which includes improvements in insulin sensitivity.
So it makes sense to keep nurturing the gut with fibre rich carbs.
They taste good
Okay maybe you don’t think this is a major problem.
You can do anything for a few weeks, right! Wrong.
You need to be able to eat things that taste good and make you feel satisfied.
If you don’t, you’re probably more likely to “break your diet” and eat a bunch of things that have the potential to have much worse repercussions than a slice of bread ever would.
Throw in pregnancy cravings and it is a literal recipe for disaster.
Depleted, exhausted, unmotivated
Carbs give us energy. They are the preferred fuel for our muscles and brain.
Not eating enough carbs is fairly likely to leave you feeling all the exhausted, fed up, unmotivated feels. This is problematic not only from a mental health standpoint (and as a small tangent, there is also research into wholegrains and mood), but also from a physiological one. Having low energy could make you less likely to move your body, which we know is another essential piece in managing gestational diabetes.
Ketones
When we heavily restrict carbs our body produces ketones from fat, which is the goal of some people doing a keto diet. However, being in a state of ketosis is considered dangerous during pregnancy. So I really would advise steering well clear of that.
Now, onto the pros of cutting carbs
A low carb diet might help you achieve lower blood sugar levels in the short term.
And some people report feel better not eating them – everyone is different.
Aaaand that’s all I’ve got.
To be clear – I don’t think cutting out highly refined and processed carbs is a bad idea.
But completely cutting carbs (or severely restricting them) does come with risks.
The key is choosing the right type of carbs in the appropriate amounts and pairing these with a mix of other nutritious foods.
So do with this information what you will.
I hope it helps!
x
