Breakfast - the worst meal of the day for most
With gestational diabetes, breakfast is usually the hardest meal of the day to keep levels lowered and stabilised with. Due to 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 usually the hardest meal to tolerate.
What is the 'dawn phenomenon'?
The dawn phenomenon occurs when the body releases hormones in the early hours of the morning (hence the 'dawn' part). This happens 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 3am and 8am.
In diabetics, 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.
Breakfast cereals AKA 'GD kryptonite'!
The majority of dietitians and hospital dietary info. will suggest a suitable gestational diabetes breakfast as one of the following; Weetabix, Bran flakes, All Bran, Shreddies, Shredded Wheat, Granola, No added sugar Muesli, or porridge oats with semi-skimmed, or skimmed milk.
High fibre and low in fat, covered with a helping of lactose (milk) and sometimes they like to advise to add a helping of fructose (fruit) on top too.... so a high carb cereal covered in carbs and more carbs.
We have learnt through experience that it is very rare for ladies to be able to tolerate these cereals throughout a 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 which was once tolerated often raises levels very high (spikes), usually into double figures. Hence we named breakfast cereal GD kryptonite!
Sometimes ladies are able to move onto things like porridge oats which are low GI, but for many ALL cereals become an intolerable food which has to be forgotten until baby is born. For this reason, cereal becomes the one gestational diabetes breakfast that many crave for.
We see many ladies being told that they should be able to tolerate cereal and that they should continue to try. Ultimately this results in them being medicated, or doses of medication or insulin being increased in order to control the sugar hit from the cereals.
We have learnt through experience that it is very rare for ladies to be able to tolerate these cereals throughout a pregnancy when diagnosed with gestational diabetes.
When do you test?
The other big concern with breakfast cereals is that they spike blood sugar levels very quickly and so those that only test pre-meal levels or 2 hours after eating will miss the big rise in blood sugar levels.
Our advice is 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.
This is from a survey held in our Gestational Diabetes UK Mums and Off Topic Chat (formerly Life After GD UK) Facebook support groups Autumn 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
Which shows a staggering 91% of women with gestational diabetes in this survey could not tolerate breakfast cereals suggested by their dietitian such as bran flakes, Weetabix or porridge.
The key to a good gestational diabetes breakfast - protein, fat and planning!
The best tolerated gestational diabetes breakfast is high in protein and fat!
Because so 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 a 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.
The more protein and natural fat added into breakfast is 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.
"How do you like your eggs in the morning?"
The majority of good gestational diabetes breakfasts include eggs in one form or another and they are a good tool for food pairing.
Due to the increased insulin resistance, ladies often find a 'safe' gestational diabetes 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.
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.
Egg safety in pregnancy
Is it safe to eat soft cooked or raw eggs during pregnancy?https://www.egginfo.co.uk/egg-safety/advice-mums-and-babies
Yes - the Food Standards Agency has said that British Lion eggs can now be eaten runny or raw by pregnant women.
Eggs are one of the most nutritious foods available and can make an important contribution to the diet of pregnant women, helping them to achieve optimal intakes of vitamins and minerals.
Eggs contain specific nutrients which may help support both your health and the development of your baby. These include folate, vitamin D, iodine, selenium, choline and long-chain omega-3 fatty acids.
As with all meals, success for a great gestational diabetes breakfast means following our 8 golden rules:
- Eat little & often, ideally 3 meals and 3 snacks a day
- 'Pair' foods so that they will be tolerated better, "food pairing" is a term that we use in relation to the GD diet
- High protein
- Plenty of good, natural fats
- Low amounts of unrefined complex starchy carbohydrates at every meal
- Bulk up meals with lots of vegetables & salad
- Drink plenty of water
- Go for a stroll
Gestational diabetes breakfast shopping list:
*Items listed in green are foods which are safe GD foods, you can snack on these and they will not raise blood sugars significantly and in some cases, due to high protein, they may lower levels. If you are hungry then these are your go to ‘safe foods’ that you can eat freely
- Eggs! Lion stamped eggs if you want to eat eggs runny or raw
- Bacon or turkey rashers
- Sausages; High meat content (90% + meat content) or Quorn sausages
- Bread; Take a look at our best breads here. Burgen Soya & Linseed (found to be the best tolerated bread by mothers in our Facebook support group which is widely available), local bakery Low GI bread, Hi-Lo, 400g granary or wholemeal, brown sandwich thins (shops own brand, Kingsmill or Warburtons), rye bread, Morrisons in-store bakery pumpernickel with sunflower seeds
- Wholegrain crispbreads or crackers; Ryvita crackerbread, Ryvita crispbread, Jacobs crispbreads, shops own brands – it’s important to choose wholegrain versions!
- Fish; smoked salmon, kippers, mackerel
- Real Butter (ideally from grass fed cows e.g. Kerrygold)
- Milk; whole cows milk, almond milk, coconut milk, soya milk or lacto-free milk
- Peanut butter; Look for less than 6g total carbohydrate per 100g in any peanut butter. See our best peanut butters.
- Almond butter; Meridan almond butter
- Nuts; in their natural form without added salt, flavourings or coatings. Salted and flavoured nuts can be eaten but can have a very high salt content. Good nut choices are: Mixed nuts, almonds, brazils, cashews, macadamia, peanuts, pecan, pine nuts, pistachios, hazelnuts, walnuts. Avoid dried fruit!
- Seeds; Chia seeds, sunflower seeds, pumpkin seeds, sesame seeds, linseed, flaxseed, soya beans
- Coconut oil (for cooking)
- Fruit; green bananas, cherries, blueberries, blackberries, raspberries, gooseberries, red currants, blackcurrants, strawberries (frozen or fresh are both fine)
- Yoghurt; Take a look at our best yoghurts here. Full fat Greek yoghurt – Fage Total or shops own brand. Full fat natural yoghurt – shops own brand, or any branded. Arla SKYR with added protein. Soya yoghurts.
- Vegetables; onion, spring onions, peppers, tomatoes, avocado, mushrooms
- Cooked meats or Quorn slices; ham, turkey, chicken, beef, pork, Mattesons smoked sausage
- Cheese; all full fat cheeses including cheddars, cream cheese, cottage cheese, soft cheese, halloumi, feta, Babybels or cheese portions (avoid unpasteurised cheeses which should not be eaten in pregnancy unless cooked)
- Agave nectar (as a substitute for syrup or honey, for drizzling on natural yoghurt or pancakes) to be used in small amounts as it is still fructose and will raise blood sugar levels
- Real Cream; single or double (NOT Elmlea - this is not real cream and contains transfats)
- Vanilla extract or vanilla pods/beans
- Herbs & spices; fresh chives, paprika, cinnamon, chilli flakes
- Nature Valley Protein bars
- Natural sweetener (Total Sweet xylitol, Sukrin, Natvia, Truvia, erythritol, or pure stevia - not stevia blend sweeteners from supermarkets with the green lids)
- Yoghurt; full fat yoghurt with a few berries, nuts & seeds
- Omelettes; add cheese, ham, chicken, Quorn, chives, onion, peppers, paprika, chilli flakes - whatever takes your fancy!
- Eggs; boiled, poached, fried, scrambled - add butter or cream to scrambled eggs if you wish and chopped fresh chives, spring onions, ham or salmon for a change.
- Toast; Use only the breads suggested in the shopping list above. Please note: toast on it's own is not well tolerated as it is too carb heavy. Use 1 x 800g loaf slice, 2 x 400g loaf slices or a sandwich thin toasted. Pair toast with butter and extra protein and fats such as eggs, avocado, peanut butter, cheese, cooked meats or Quorn. Marmite & butter alone is not sufficient, so include cheese or nuts on the side.
- Full cooked breakfast e.g. eggs, bacon, sausage (high meat content), black pudding, mushrooms and a slice of toast with butter. Be wary of tomatoes, baked beans, even low sugar versions and avoid table sauces such as ketchup, even low sugar versions and brown sauce. Cooked breakfasts can be grilled, dry fried, cooked with oil sprays, coconut oil, olive oil or butter.
- Smoked salmon, kippers or mackerel with eggs or cream cheese on 2 x Ryvita
- Bacon or sausage sandwich; 1 x 800g loaf slice, 2 x 400g loaf slices or a sandwich thin and add plenty of bacon or high meat content sausages. Avoid table sauces, even low sugar versions such as ketchup and brown sauce.
- Toasties; 2 x 400g loaf slices or a sandwich thin - cheese & avocado, cheese & ham
- 2 x Ryvita with butter, marmite and cheese
- Quinoa porridge with cinnamon or berries, nuts & seeds; 1/2 cup quinoa, 1 1/2 cup almond milk, 1/4 teaspoon vanilla extract, sprinkle of cinnamon or berries, nuts & seeds. Rinse the quinoa thoroughly in a sieve. Add the quinoa, almond milk, vanilla & cinnamon (if using) to a pan and bring to a boil. Reduce the heat, cover and simmer until tender (approx. 15 minutes). Serve warm, adding more milk or cream if desired, nuts & seeds, or a few berries instead of cinnamon.
- Pancakes from our Pancake Day page
- Sweet breakfast guacamole dip; 1 mashed avocado, 1/2 mashed banana, 2 tbsp cream mashed & combined. 1 slice of 800g loaf toast with butter cut into tiny squares to dip
- Breakfast muffins; mix eggs, cheese and any ingredients you fancy as fillings together i.e. ham & spring onion, pepper, cheese & chilli flakes, spinach & feta. Grease a muffin tin with butter, olive or coconut oil. Preheat the oven to 190°c. Pour the mixture into the greased tin (leave room for them to rise) and cook until golden.
- Breakfast cups; pre-cook bacon or turkey rashers (cooked ham, chicken, turkey or Quorn can be used as an alternative). Grease a muffin tin with butter, olive or coconut oil. Preheat the oven to 190°c. Line each tin with a rasher or slice or meat and crack an egg into each hole. Bake in the oven until the eggs are cooked to your liking.
- GD friendly low carb cereal
- Porridge; the only breakfast cereal which is tolerated and for many, will become intolerable at some point. Try making with milk & cream or water, adding nuts & seeds with sweetener or agave nectar. Avoid adding fruit to porridge as this increases the amount of sugar needing to be processed. The best porridge oats are pinhead (steel cut) oats, these are oats in their natural form, as they have not been processed or stripped of the goodness and fibre. Avoid using processed oats like ReadyBrek, which are finely ground and rolled oats which are found in most shops.
- Overnight chia seeds
- GD friendly low carb nutty cereal (recipe at the bottom of this page)
Breakfast things to avoid
- All breakfast cereals , including 'healthier' options
- Breakfast biscuits
- Cereal bars
- White bread, rolls and toast
- Buttered toast - this is too carb heavy on it's own to be well tolerated in the morning, read above for information on food pairing toast
- Crumpets, waffles and pancakes made with flour
- Croissants and Danish pastries
- Fresh fruit on it's own e.g. grapefruit, melon, banana, fruit salad - add sharp berries or kiwi in small amounts to yoghurt, nuts & seeds
- Dried fruits such as prunes, figs, apricots, raisins or prunes in juice
- Fruit juices such as orange juice, apple juice e.t.c. including no added sugar or low sugar versions - fruit contains high amounts of natural sugars which raise blood sugar levels rapidly
- Jam, marmalade and other fruit preserves, including diabetic or low sugar versions
- Nutella, other chocolate spreads and sweet spreads
- Tomato ketchup and brown sauce, including low sugar versions
- Baked beans, including low sugar versions - although high in protein, the sauce contains high amounts of sugar
- Hash browns, fried potatoes, potato waffles
Carbohydrate free breakfasts and ketones
For many ladies, it becomes extremely hard to tolerate any form of starchy carbohydrate at breakfast and so many will choose to avoid them at breakfast, sticking to high protein alternatives such as omelettes or yoghurt with nuts & seeds. If you decide you would like to try this in order to control your blood sugar levels, it is important to know that this can cause nutritional ketosis. To learn more about ketones and ketosis, please see this link.
- One small or ½ a large slightly green to yellow banana (the riper the banana, the more natural sugar it contains)
- 2 large eggs
- Butter or coconut oil
- Greek (full fat) yoghurt
- A few berries
- Sweetener or agave nectar to taste (but not necessary)
- Mash the banana
- Crack the eggs into a bowl and whisk
- Add the mashed banana to the eggs and mix until blended
- Heat a frying pan and add butter or coconut oil
- Drop the batter into the pan (2 tbsp per pancake)
- Fry for 1 minute, or until the bottom of the pancake has browned slightly
- Flip the pancake over (very gently as the mixture is fairly wet meaning the pancakes can break easily) and cook the other side
- Serve warm with full fat Greek yoghurt, berries, nuts, seeds and add sweetener or agave nectar if you wish
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