Myth: Women with gestational diabetes can’t have sugar
Pregnancy can be a scary and uncertain time for many women. Not only are women expected to maintain their own health, but they are also responsible for their growing child’s. The stress and anxiety are only exacerbated when many women are told they have “failed” their oral glucose tolerance test (OGTT). An OGTT is the generally accepted method for diagnosis of gestational diabetes (McIntyre et al 2019). Gestational diabetes is one of the most common pregnancy complications, affecting up to 18% of pregnant women (McIntyre et al 2019). Gestational diabetes is not well understood by the public while simultaneously affecting a large proportion of them, leading to many myths and misunderstandings. A common myth is that women diagnosed with gestational diabetes cannot have sugar or desserts. This idea is wrong! As with everything, a healthy diet with gestational diabetes is all about moderation and balance.
Many people assume that a diagnosis of gestational diabetes automatically aligns with adopting a low-carbohydrate diet. A low-carbohydrate diet consists of less than 45% of daily caloric intake coming from carbohydrates (Mahajan et al 2019). Controversial evidence surrounds this dietary approach, and recent studies conflict with conventional advice to lower carbohydrate intake (Mahajan et al 2019). One study found that a higher carbohydrate diet contributed to lower fasting glucose, less insulin resistance, and reduced inflammation (Hernandez et al 2018). This study also highlighted that the quality of the carbohydrate eaten, namely complex carbohydrates, is more important to consider for blood sugar control (Mahajan et al 2019). Additionally, a low carbohydrate diet, a potentially major change from a mother’s typical diet, can contribute to anxiety and stress which can negatively impact pregnancy outcomes (Mahajan et al 2019). It is important to consider creating balance in the diet over reducing carbohydrate intake. Even modest reductions in carbohydrates can potentially lead to an imbalance in macronutrient intake and a reduction in overall energy intake (Mahajan et al 2019). During pregnancy, decreased energy intake is rarely recommended and can put the mother and child in danger (Hernandez et al 2018).
Mothers diagnosed with gestational diabetes should consider positive lifestyle changes rather than restricting carbohydrate intake (Rasmussen et al 2020). A healthy and balanced diet should result in appropriate weight gain for the mother and fetus, regardless of glucose tolerance (Rasmussen et al 2020). Additionally, the ideal diet for management of gestational diabetes includes adequate carbohydrates, fat, protein, fiber, and micronutrients (Rasmussen et al 2020). Physical activity is a significant component involved in the control of glucose levels as well, as it has been shown to improve glucose and insulin levels in pregnant women in the short and long term (Rasmussen et al 2020). Moderate intensity exercise 3-4 times per week for women with gestational diabetes is recommended to help balance glucose levels following meals(Rasmussen et al 2020). Overall, a healthy balanced diet, relationship to food, and exercise is recommended to manage gestational diabetes while glucose restriction is not recommended. Pregnancy is tough enough as it is, and restricting carbohydrates following diagnosis of gestational diabetes may only make it more difficult!
Reviewed by: Jessica Strosahl, UGA Dietetic Intern
References
Hernandez TL, Mande A, Barbour LA. Nutrition therapy within and beyond gestational diabetes. Diabetes Res Clin Pract 2018;145:39-50.
Mahajan A, Donovan LE, Vallee R, Yamamoto JM. Evidenced-based nutrition for gestational diabetes mellitus. Curr Diab Rep 2019;19(10):94.
McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis Primers 2019; 5(1), 47: 1-19.
Rasmussen L, Poulsen CW, Kampmann U, Smedegaard SB, Ovesen PG, Fuglsang J. Diet and healthy lifestyle in the management of gestational diabetes mellitus. Nutrients 2020;12(10):3050.
