Breakfast cereal AKA ‘GD kryptonite‘!
The majority of dietitians and hospital dietary info. suggest a suitable breakfast being breakfast cereal such as Weetabix, Bran flakes, All-Bran, Shreddies, Shredded Wheat, Granola, No added sugar Muesli, or porridge oats.
High fibre and low in fat, covered with a helping of lactose (milk) and sometimes they like to advise adding a helping of fructose (fruit) on top too…. so a high carb cereal covered in carbs and more carbs.
Carb overload!
We have learnt through experience that it is very rare for mothers to be able to tolerate these cereals throughout pregnancy when diagnosed with gestational diabetes.
Many will be able to tolerate them earlier in pregnancy when insulin resistance has not yet peaked. Then as the pregnancy progresses and insulin resistance increases, overnight, a cereal that was once tolerated often raises levels very high (spikes), usually into double figures, hence we have named breakfast cereal ‘GD kryptonite!’
Sometimes mothers are able to move onto things like porridge oats which are low GI [glycaemic index], but for many, all cereals become an intolerable food which has to be forgotten until the baby is born. For this reason, cereal becomes a craving food for many people with gestational diabetes.
We see many patients being told that they should be able to tolerate cereal and that they should continue to try having it, and ultimately this results in them being medicated, or doses of medication or insulin being increased in order to control the sugar hit from these cereals.
If it’s not broken then you don’t need to fix it!
If breakfast cereal works for you then that’s great. Don’t stop eating it if it is not causing you any problems, but eat it in the knowledge that tolerance to it can change (literally overnight) and please be careful if advising others with gestational diabetes that it is a ‘tolerable food’ as for many it is very tricky to tolerate.
Beware of potentially misleading and overpriced products
In recent years we have seen many new breakfast cereals come to the market which are boasting to be lower in sugar or higher in protein.
We have tried and tested many of these cereals which are available in most supermarkets to buy and still have not found one that more than a handful of ladies have had continual success with, unfortunately.
There are some extremely expensive high-protein cereals available to buy in some health food stores and online which are easier to tolerate, however, for most, the cost of these cereals is prohibitive.
A new widely available cereal which is working for many [2023]
One newer cereal which is widely available which many mothers with gestational diabetes are experiencing better levels from is a Marks & Spencer breakfast cereal. The M&S High Protein Choco Crunch cereal comes in a 500g box, it is vegan and currently retails at £3.20.
Milk compared
Lactose, the naturally occurring sugar in milk, can have varied results in different people.
It’s advisable to perform a ‘milk test’ if you want to consume larger amounts of milk
Have a glass of milk as a ‘snack’ (ensure you do not eat or drink anything else, so this will impact the results) and then test your blood sugar levels to see how it affects you after one hour. If you get good results (below your one-hour post-meal target, below 7.8 mmol/L for most), you can tolerate milk; if you see high blood sugar levels, avoiding milk or swapping to a different type of milk is best.
Milk with a higher protein and fat content will help pair the carbs, making it more tolerable.
The table below compares 100ml of each type of milk. All the milk listed is fresh (chilled) milk, with dairy alternatives being Alpro UNSWEETENED milk drinks, with the exception of rice and hemp milk, which is long life. Note: 4g of carbs is equivalent to 1 teaspoon of sugar.
| milk per 100ml | carbs (g) | protein (g) | fat | calcium (mg) |
| ✔️ almond milk (no sugars, Alpro) | 0 | 0.4 | 1.1 | 120 |
| ✔️ soya milk (no sugars, Alpro) | 0 | 3.3 | 1.8 | 120 |
| ✔️ hemp seed milk (Good Hemp) | 0.9 | 0.1 | 2.7 | 120 |
| ✔️ lacto-free whole milk | 2.6 | 3.3 | 3.6 | 108 |
| ✔️ coconut milk (no sugars, Alpro) | 2.7 | 0.1 | 1.2 | 120 |
| ✔️ hazelnut milk (Alpro) | 3.1 | 0.4 | 1.6 | 120 |
| ✔️ Arla BOB semi-skimmed milk | 4.6 | 4.6 | 1.7 | 150 |
| ✔️ Graham’s gold top | 4.7 | 3.7 | 5.0 | 134 |
| ✔️ whole milk | 4.7 | 3.5 | 3.7 | 124 |
| ❌ semi-skimmed milk | 4.8 | 3.6 | 1.8 | 124 |
| ❌ Arla BOB skimmed milk | 4.9 | 4.6 | 0.4 | 147 |
| ❌ skimmed milk | 5.0 | 3.6 | 0.3 | 130 |
| ❌ 1% milk | 5.0 | 3.6 | 1.0 | 127 |
| ❌ oat milk (no sugars, Alpro) | 5.6 | 0.2 | 1.5 | 120 |
| ❌ rice milk (no added sugars, Tilda) | 13.1 | 0.2 | 0.9 | 120 |
[Information taken from Tesco and Waitrose websites, correct June 2023]
Missing the spike with breakfast cereal?
A big concern with breakfast cereals is that they can spike blood sugar levels very quickly and so those that only test pre-meal levels or 2 hours after eating can easily miss the peak in blood sugar levels.
Following a big spike in levels, you can also get crashes in blood sugars. This may make those only testing at 2 hours or pre-meals believe that things are tolerable.
For further information on testing blood sugar levels and testing to check for spikes, please see this page.
What to do about breakfast cereal?
My advice is if you want to try breakfast cereal, try a sensible option, i.e. not sugar puffs or crunchy nut cornflakes, but something like Shredded wheat, Weetabix, Bran Flakes, Lizi’s Low GI granola e.t.c. Measure out the amount to the right serving size eg. 30g and add things like cream, nuts and seeds to increase protein and natural fats, but if you don’t tolerate it, give the porridge a try.
You can tweak porridge to make it more suitable by adding nuts, seeds or cream to help increase the protein and natural fats. If you are unsure of how well you tolerate lactose, then a milk test is a good idea (explained here) and depending on the result you may get better results from a milk alternative or try making porridge with water instead.
The porridge from most shops is rolled oats, but there is a better form of porridge that gives lower blood sugar levels called pinhead porridge which is steel-cut rather than ‘rolled’ and is the wholegrain with the outer husk removed. These links show Hamlyns Pinhead Oatmeal and Goodness Pinhead Oats which can be bought online.
If you still get high readings from porridge then it is advisable to keep breakfast cereals locked in the cupboard and step away from them. Add them to the list of post-GD treats to have once your baby has been born.
Try a lower-carb alternative
You are not unusual if you cannot tolerate breakfast cereal
This is from a survey held in our Gestational Diabetes UK Mums and Life After GD UK Facebook support groups in the Autumn of 2016.
916 women answered:
- 73% (666) could NOT tolerate ANY breakfast cereals, including porridge
- 12% (107) could tolerate only porridge or porridge oats, but no other breakfast cereals
- 6% (61) could NOT tolerate cereal after around 32 weeks gestation (between 32 – 36 weeks insulin resistance worsens)
- 9% (82) could tolerate some breakfast cereals throughout their pregnancy
This shows a staggering 91% of women with gestational diabetes in this survey could not tolerate breakfast cereals suggested by their dietitians such as bran flakes, Weetabix or porridge.
Breakfast – the worst meal of the day to control
Due to the natural raises in blood sugar levels at dawn (the dawn phenomenon), we are more insulin resistant at the start of the day. This means that out of all the meals we eat, breakfast is the hardest meal to try to keep within our targets. Because of this, it is also extremely important to always eat breakfast to help stabilise your blood sugar levels for the rest of the day.
The Dawn Phenomenon
This occurs when the body releases hormones in the early hours of the morning (hence the ‘dawn’) in all people, diabetic and non-diabetic. These hormones (including cortisol, glucagon, epinephrine and growth hormone) cause blood sugar levels to rise, giving the body a boost and wake-up call to start the day. This can happen anywhere between 3 am and 8 am.
In people with diabetes, not enough insulin is produced, or insulin is not able to be used effectively in order to process this boost in glucose, resulting in high fasting levels. For more information on high fasting levels please read here.
It is extremely important to try to eat breakfast as soon as you can after waking. This helps to stabilise levels for the rest of the day.
The key to a good GD breakfast is protein, fat and planning!
The best-tolerated breakfasts are high in protein. As many ladies struggle with increased insulin resistance in the mornings, breakfast has to be adapted so that it contains only small amounts of complex starchy unrefined carbs, or the breakfast has to be split in two i.e. one piece of toast is eaten, wait for an hour and test levels and then the second piece of toast can be eaten (paired with protein and good natural fats of course). This makes the carbs easier for the body to process, eating little and often and not requiring as much insulin to process the sugars. In some cases, the starchy carbs have to be removed from breakfast completely.
More protein and natural fat added to breakfast are extremely beneficial, albeit inconvenient for some. Planning breakfasts and preparing them the day or night before may be necessary if you do not have time to cook breakfasts in the morning.
Boring breakfasts… “How do you like your eggs in the morning?”
Unfortunately, due to the increased insulin resistance, ladies often find a ‘safe’ breakfast that they get good numbers from. When trying different things they may struggle to tolerate them and therefore they may end up eating the same breakfast repeatedly for many weeks or months.
Keep your eyes on the prize and remember this is not forever. You may feel like you are going to turn into a chicken if you eat another egg, but it will be worth it when you’re holding your baby in your arms!
Information on eggs. Dippy or runny eggs? Look for the Lion stamp…
There is varied information given regarding eating eggs during pregnancy. Eggs (as long as you have no allergies) will become your best friend whilst having gestational diabetes! They have many vitamins, minerals and heart-healthy fats. Most importantly they are high in protein and therefore become a food that will be tolerable for your blood sugars and will actually help keep levels lowered and stabilised. The majority of good GD breakfasts include eggs in one form or another and they are a good tool for food pairing.
Egg safety in pregnancy
At the time of the salmonella and eggs scare in 1988, the Department of Health recommended that recipes for uncooked dishes involving raw eggs should be avoided, and that lightly cooked eggs should not be served to vulnerable groups – i.e. infants, pregnant women, elderly and debilitated people.
This advice, however, pre-dated the introduction of the British Lion scheme in 1998. Since the British Lion scheme was introduced in 1998, however, these risks have been effectively eliminated from Lion-marked eggs and a report published by Government food safety advisors, presented on 29 January 2016, concluded that British Lion eggs can safely be eaten runny, even by pregnant women, babies and elderly people. Read more here.
GD friendly low carb cereal with no added sugars
There are also the following pages which may be helpful:
Our gestational diabetes diet and 8 golden rules
My Instagram account has lots of additional ideas too