A gestational diabetes diet is a healthy and nutritious diet for all pregnant women. It provides you and your baby with the nutrients you both require whilst keeping our blood glucose in check. The diet also advises on foods to avoid during pregnancy to keep your baby safe and healthy.
Gestational diabetes can be a daunting diagnosis for women who were not previously diagnosed with diabetes. Gestational diabetes, otherwise known as diabetes in pregnancy occurs as a result of many risk factors such as a strong family history of diabetes or being overweight. Due to hormonal changes in the body, our cells may not respond well to the action of insulin or our body does not produce enough insulin to control our blood glucose well. Typically, blood glucose becomes harder to control nearing the end of the pregnancy due to the effect of pregnancy hormones.
The targets for blood glucose in pregnancy are lower than for a regular diabetic. Strict control is of utmost importance as it directly involves the health and safety of your baby. Check with your doctor regarding the blood glucose targets you are expected to achieve.
What is the Best Way to Deal with Gestational Diabetes?
The key to managing gestational diabetes is through:
- Diet control
- Light physical activity
- Monitoring of weight gain
- Monitoring of blood glucose
A gestational diabetes diet includes appropriate types and amounts of carbohydrates to better manage your blood glucose. In addition, light physical activity is effective in assisting the uptake of glucose from our body cells, which in turn lowers the circulating blood glucose. It is also important to be watchful of how much weight you are gaining (dependent on your pre-pregnancy weight and current trimester) to ensure that the fetus is of an appropriate size. Strict monitoring of your blood glucose is essential as the results will affect the management by your healthcare professional.
What are the Consequences of Poor Blood Glucose Control?
- Difficult labour due to size of baby
- Macrosomia (larger sized baby)
- Miscarriage or stillbirth
- Difficulty for baby to regulate his/her own blood glucose
Key Dietary Factors in a Gestational Diabetes Diet
- Have regular meals 2-4 hours apart (2-3 hours apart if insulin dependent). In general ensure 5-6 hours apart for main meals (excluding mid-meals) and do not skip meals
- Control carbohydrate portions
- Increase intake of high-fibre foods (fruit, vegetables and wholegrains)
- Reduce total fat intake (refrain from fried, oily foods and choose low-fat dairy products)
- Have regular snacks and choose healthy options
- 1st trimester:
- Folate is an essential vitamin to prevent neural tube (forms the fetal brain and spinal cord) defects. Take your folate supplements as prescribed by your doctor.
- Vitamin A is needed for fetal development and normal vision. An excess of the active form of vitamin A commonly found in animal liver is toxic to the developing fetus, however, vitamin A from vegetable sources known as carotenoids are generally safe.
- 2nd and 3rd trimester:
- Calcium is essential for baby to form strong bones but also helps to safeguard the mother’s own stores to prevent osteoporotic and fragile bones.
- Vitamin D is important to assist in calcium absorption for bone formation.
- Iron is important to prevent anaemia in the mother as blood volume increases during pregnancy and also for the baby to store adequate iron during the first 6 months of life.
- Vitamin C is not just an immunity booster! It is required for iron absorption.
Foods to Avoid in Pregnancy
Most foods to avoid in pregnancy are related to the risk of food poisoning. For the general population, food poisoning does not appear to be a serious health issue. However, in pregnancy, pregnant women may feel the effects of food poisoning far worse than the average joe. The bacteria that cause food poisoning pose a threat to the safety of the developing fetus. Some examples of high-risk foods include:
- Cold cuts, sashimi, soft cheeses such as brie or camembert or unpasteurised dairy
- Undercooked meat, fish, poultry and eggs
- Unwashed salads
- Alcohol (to prevent fetal alcohol syndrome, no safe limit of intake established)
Drinking alcohol during pregnancy is strongly discouraged as it may increase the risk of a miscarriage or lead to fetal alcohol syndrome. No safe limit of intake has been established and hence the current guidelines are to abstain from alcohol consumption.
- High levels of caffeine intake may result in low birth weight or miscarriage. Limit intake of coffee and tea to no more than 2 cups a day. Consume them in between meals because tannins found naturally in tea and coffee can affect iron absorption.
- Animal liver and liver products contain high levels of vitamin A which are toxic to the fetus particularly in the first trimester. Limit intake to no more than 2 tablespoons per week throughout the pregnancy.
- Fish containing high levels of mercury (eg. batang fish, shark, albacore tuna) may affect the nervous system of the fetus. Have no more than 1 palm sized serving per week or avoid if preferred.
Gestational Diabetes Diet Recommendations
- Have 3 main meals a day with 2-3 mid-meals, if you are in the 1st trimester, you may choose to exclude mid-meals
- Include protein in every main meal. Good breakfast protein choices include, egg, tuna, cheese and sugar free peanut butter. Good lunch and dinner protein choices include oily fish, lean meat and poultry, lentils, beans, beancurd/tofu
- Have 2 to 4 cups of low-fat milk/yogurt/calcium-fortified soymilk daily to meet your calcium requirements
- Ensure a large serving of vegetables at lunch and at dinner, this is equal to 2 cupped palms or 5 tablespoons of cooked vegetables per meal
- Ensure 2 serves of fruit daily for adequate folate, vitamin C and fibre. Take a fruit after lunch and dinner to assist with iron absorption of iron-rich food within the main meal
- Choose wholegrains! Opt for brown rice, brown rice beehoon, wholemeal bread, wholemeal crackers or chappati
- Choose healthy cooking methods such as steaming, boiling, baking, grilling or stir-frying with less oil
- Choose healthier snacks such as syrup-free tau hway, fruit, nuts, chopped vegetable sticks, plain low-fat yogurt
- Leave behind soup (when eating out), gravy and sauces to reduce intake of excess fat, calories and sugars
Sample Gestational Diabetes Diet Plan
- 1 cup low-fat high calcium milk
- 2 slices wholemeal bread
- 1 slice low-fat cheese
- Few slices of tomatoes
- 3 pc wholemeal crackers with a thin spread of peanut butter
- 1 medium bowl brown rice (or a fist-sized portion)
- A palm-sized pan-fried salmon fillet
- 1 cup stir-fried vegetables
- 1 fist-sized apple
- 1 tub low-fat plain yogurt
- 1 small handful blueberries
- 1 medium bowl wholemeal pasta (or a fist-sized portion)
- A palm-sized grilled chicken
- 1 medium bowl steamed or sautéed vegetables
- 1 slice watermelon
- 1 cup low-fat high calcium milk
Disclaimer: This is a general guideline based on available evidence about an ideal gestational diabetes diet. Kindly consult your doctor, diabetes educator and dietitian for individualised advice.