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What can I eat? – gestational diabetes

From the moment you are diagnosed with gestational diabetes you are likely to be faced with what seems like an endless list of new tasks: more clinic appointments, more blood tests, taking medications, being more active and eating a healthy, balanced diet. No wonder it can all seem so daunting and overwhelming. One of your first questions is likely to be, “what can I eat?” But, with so much to take in, you could still come away from appointments feeling unsure about the answer. And then, there are lots of myths about diabetes and food that you will need to navigate, too. If you’ve just been diagnosed and aren’t sure about what you can and can’t eat, here’s what you need to know.

I've just been diagnosed with gestational diabetes ­– what can I eat?

This may come as a surprise, but you don’t have to go on a special diet when have gestational diabetes. Depending on your current diet, you may have to eat less of some foods and more of others. In the past, people were sent away after their diagnosis with a list of foods they weren't allowed to eat, or often told to simply cut out sugar. Nowadays, you may need to make some changes to your diet, but it’s not a case of cutting things out. Rather, you’ll need to follow the same healthy, balanced diet that’s recommended to everyone.

The main aim for managing gestational diabetes is ensuring that your blood glucose levels are under control, so your healthcare team will discuss targets that are right for you. Achieving the targets will increase your chances of having a healthy pregnancy and your food choices play a vital role in this. It is important to enjoy your meals while making changes to your food choices that are realistic and achievable. This will help control your blood glucose levels, and help prevent excessive weight gain during your pregnancy.

All carbohydrates will have an impact on your blood glucose levels so be aware of how much you eat. Try to choose nutritious carbohydrate-containing foods such as wholegrain starchy foods, pulses, fruit and vegetables as well as some dairy foods. Your healthcare team will help you understand how carbohydrates affect your blood glucose levels. You may be advised to:

  • eat less carbohydrate
  • choose better sources of carbohydrates
  • spread your carbohydrates throughout the day

Ask to be referred to a dietitian who can support you to come up with a specific eating plan that is tailored to your needs.

Is there anything I should avoid?

Avoid foods labelled ‘diabetic’ or ‘suitable for diabetics’. These foods contain similar amounts of calories and fat, and they can affect your blood glucose levels. They are usually more expensive and can have a laxative effect. Stick to your usual foods. If you want to have an occasional treat, go for your normal treats and keep an eye on your portions.

Fish is good for your health and the development of your baby, so it’s good to eat it regularly. The general recommendation is to eat at least two portions (one portion is about 140g) per week, including one or two portions of oily fish, e.g. mackerel, sardines, salmon, herrings, trout, pilchards. Oily fish is particularly beneficial to heart health but limit the intake to not more than two portions a week.

Avoid fish which tend to have higher levels of mercury e.g. swordfish, shark and marlin and limit the amount of tuna, which can have relatively high amounts of mercury compared to other fish we eat, to up to four medium-sized cans of tuna or two tuna steaks a week. It is also advisable to avoid raw shellfish to reduce the risk of food poisoning, which can be particularly unpleasant during pregnancy.

It is also important to avoid certain types of cheese, raw or uncooked eggs and meat, liver and unpasteurised milk. Always wash fruits and vegetables thoroughly to remove any soil and dirt.

Your healthcare professional can discuss, in more details, the foods to avoid.

What should I eat for breakfast, lunch and dinner?

Try one of these ideas for breakfast, lunch and dinner to get you started:

Breakfast

  • a bowl of wholegrain cereal, such as porridge, with semi-skimmed milk, or
  • 2 slices of wholegrain toast with spread and/or jam, or
  • lower fat/sugar yogurt and fruit.

Lunch

  • a chicken or ham salad sandwich, or
  • a small pasta salad, or
  • soup (containing lots of vegetables and pulses) and a wholegrain roll.

Dinner

These ideas may not look much different from what you eat already, and your favourite recipes and meals can usually be adapted to be healthier without you noticing too much difference. Easy changes to make are to:

  • reduce the fat, sugar or salt content of your food
  • include more fruit and vegetables
  • reduce your portion sizes.

Making any of these changes would certainly help, but there is no need to go over the top and radically change everything.

What sort of snacks should I eat?

It usually isn't necessary to eat snacks between meals if you aren't taking any medication for your gestational diabetes. If you treat your diabetes with certain medications that put you at risk of hypos (low blood glucose), you may need to snack. However, if your medications are making you snack regularly to prevent hypos, speak to your healthcare team. Regular snacks can make it difficult to maintain a healthy weight, and this can affect your diabetes management in the long term.

If you do get peckish between meals, choose healthier snacks such as fruit and vegetables, vegetable sticks with lower fat hummus, yogurt, avocados, nuts and seeds. The key is to plan for these snacks, be mindful of your portions and monitor their effect on your blood glucose levels.

Limit your intake of calorie-rich, but nutritionally poor, snacks and drinks, such as sweets, cakes, crisps, fizzy drinks, energy drinks etc.

What about alcohol?

There is some uncertainty about the safety of alcohol intake in pregnancy. Therefore, the safest option is not to drink alcohol at all while you’re pregnant. It is particularly important to avoid alcohol during the first three months of pregnancy as alcohol may be associated with increased risk of miscarriage.

We all know that binge drinking is not good for our health. For pregnant women, getting drunk, or binge drinking (defined as more than 7.5 units of alcohol on a single occasion) can be harmful to the unborn baby.

Alcohol can also make hypoglycaemia (hypos) more likely to occur if you treat your gestational diabetes with insulin or glibenclamide.

What is recommended in the long term?

A healthy, balanced diet – that means eating regular meals, choosing good sources of carbohydrates and watching your portions, including fruit and vegetables, and eating less saturated fat, sugar and salt.

Pregnancy isn’t the time to be on a really strict diet.

Don’t aim to lose weight while you’re pregnant – this could be unsafe for you and your baby. However, small changes to your diet and physical activity levels can help you to avoid gaining excess weight during your pregnancy. This will help you to manage your gestational diabetes better and increase your chances of having a healthy pregnancy.

People with gestational diabetes are at a high risk of getting the condition again in subsequent pregnancies as well as getting Type 2 diabetes in the future. Therefore, it is very important to continue your healthy eating plan after having your baby in order to manage your weight and reduce your risk of developing gestational diabetes in subsequent pregnancies, as well as reduce your long-term risk of getting Type 2 diabetes.

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