Gestational diabetes diet
Making changes to follow a good gestational diabetes diet means achieving lower blood sugar levels, ultimately benefiting your baby hugely and reducing the risks and complications associated with gestational diabetes. But with so much varied information and advice1–5, what is a good gestational diabetes diet?
Here I will share the diet I found to work the best for me during my GD pregnancies after the outdated advice I was given did not work. Following extensive research, alongside lived experience of high insulin resistance in gestational diabetes, I created Gestational Diabetes UK and the 8 Golden Rules.
This diet is now shared in many NHS diabetes antenatal clinics nationwide. It has helped over 30,000 mothers with gestational diabetes in the UK and Ireland since I launched my Facebook support group in 2014.
Cut out added sugar
An obvious start to a good gestational diabetes diet is eliminating added sugar. When you have gestational diabetes, the body can no longer process sugar as it used to, so it is important to stop adding sugar into or onto anything. Avoid adding sugar to drinks or food. Cutting back the sugar in a cup of tea or coffee is insufficient.
It’s not as simple as cutting out sugar alone
Unfortunately, sugar is not just found in sugary and sweet things, so cutting out sugar, sweets, and cakes is insufficient to reduce and stabilise blood sugar levels.
Sugar hides in many foods and drinks and comes in many different forms.
Gestational diabetes = carbohydrate intolerance
The next step to working on a good gestational diabetes diet is looking at carbs [carbohydrates]6. Gestational diabetes is defined as carbohydrate intolerance. So this is where we focus on the next step after cutting out the added sugars.
Carbs become sugar in the bloodstream, becoming as problematic as sugar itself. However, there are different types of carbs, and they are processed at different rates, meaning it is important to select the right kinds of carbs. We will look at this in more detail later.
Simplifying the gestational diabetes diet
Getting to grips with a good gestational diabetes diet can be overwhelming and confusing. Therefore to break the dietary advice down more simply, I have created eight golden rules to follow:
Gestational Diabetes UK 8 Golden Rules
#1. Eat little and often
Avoiding eating is something that many mothers do when they are first diagnosed with gestational diabetes, as they are unsure or too scared about what to eat. This can actually have a detrimental effect on blood sugar levels.
Ideally, we want blood sugar levels that look (if we were to draw a picture) like rolling hills rather than huge spikes and crashes. The best way to achieve good control over levels is to choose sensible foods and to eat small amounts often.
Aim for three meals and three snacks a day.
If a meal or snack is missed, then blood sugar levels can drop low, and when this happens, the liver dumps stored glucose into the bloodstream.
The glucose raises blood sugar levels, and when eating the next meal, as levels are higher than they should be, they rise even higher. Following a big spike in levels, the body will signal the pancreas to produce insulin. However, with gestational diabetes, we may not be able to produce enough insulin, or hormones block the body from using the insulin we have produced. Sometimes the body will overproduce insulin and cause a big crash in levels, which starts a rollercoaster of blood sugar levels.
#2. Pair Foods – ‘GD Food Pairing’
Macronutrients (macros) are the body’s main nutritional food groups needed to function. These are carbohydrates, proteins and fats.
The three macronutrients have different impacts on blood sugar levels:
Carbohydrates have the fastest and highest impact on blood sugar levels, with 90-100% of carbs turning into glucose (sugar).
To help slow down the release of these sugars into the bloodstream, adding protein and good natural fats to the carbs helps stop the fast excessive peak in blood glucose. This is because the presence of fat will slow the gastric emptying rate7,8, and protein helps reduce postprandial [post-meal] spikes in levels too9–12. This will mean you can eat carbs more safely without spiking blood sugar levels13.
Do I have to eat paired foods at exactly the same time?
No. In fact, research suggests that if you eat macronutrients in a set order can help to reduce the postprandial glucose response14.
#3. High protein
50% of protein turns to glucose in 2 – 4 hours, so protein is a ‘safe food’ on a gestational diabetes diet. Use protein for food pairing to help tolerate carbs better and slow down the absorption of sugar into the bloodstream9,10.
#4. High Natural Fats
Fat, I hear you cry?! Yes fat! But good, natural fats such as monounsaturated and polyunsaturated fats which include omega-3 and omega-6 fatty acids.
These fats improve blood cholesterol levels and decrease your heart disease risk15,16. They also play an important role in developing your growing baby’s brain, eyes and nervous system and are essential for its growth.
Use the good fats listed below to help with food pairing
|MONOUNSATURATED FATS||POLYUNSATURATED FATS|
|Avocados||Chia, flax, sunflower, sesame, and pumpkin seeds|
|Canola oil||Flaxseed oil|
|Nuts (almonds, peanuts, macadamia nuts, hazelnuts, pecans, cashews)||*Oily fish (salmon, tuna, mackerel, herring, trout, sardines, pilchards)|
|Olive oil||Rapeseed oil|
|Peanut oil||Soy milk|
*PLEASE NOTE oily fish recommendations in pregnancy
Taking things one step further, full-fat dairy products and animal fats, which are saturated fats, go a long way to helping a good gestational diabetes diet too. This will be controversial to most people as, for many years, saturated fats have been a bad fat that should be avoided. However, recent research has challenged that saturated fats may be no worse than other ‘healthy’ fats.
Here’s an extract from the British Heart Foundation’s Senior Dietitian’s article on the research around saturated fats:
…saturated fat came back to the top of the news agenda because research we’d helped to fund suggested there isn’t enough evidence to support current guidelines on which types of fat to eat. While the latest study didn’t show saturated fat is associated with cardiovascular disease, it also didn’t show that eating more of it is better for your heart health.17
There will always be a battle between fat v’s sugar. I am not suggesting you live on high transfat takeaways or products containing hydrogenated vegetable oil for the rest of the pregnancy, but introducing ‘good’ natural fats into the diet, rather than using fat-free or diet alternatives which can be filled with refined carbs and sugar, can help gain better control of blood sugar levels18,19.
#5. Low Carb – Small serving of unrefined complex starchy carbs at every meal
Carbohydrates turn into glucose, raising blood sugar levels. However, they are extremely important as they provide the body with energy, and carbs should not be eliminated or severely restricted from the gestational diabetes diet completely. A low carbohydrate diet has been proven beneficial in the gestational diabetes diet20–26.
Choose small amounts of unrefined complex starchy carbs to eat at every meal. Carbohydrates are important as they provide energy and stop the body from entering a ketosis state27.
Carbohydrates can be found in many different foods. Naturally occurring carbohydrates include fruit, vegetables, milk, honey, nuts, grains, seeds and legumes.
There are two main types of carbohydrates:
- Simple – Sugar or glucose is a simple carbohydrate. Sugar naturally occurs in many foods, forming fructose in fruit, lactose in milk and sucrose in granulated sugar.
- Complex – Starch is a complex carbohydrate made of sugar units bonded together. Starch occurs naturally in vegetables, grains, dried beans and peas. When a complex carb is refined, it is processed more, and much of the fibre and goodness is stripped away, which can spike blood sugar levels higher and faster. Unrefined carbs are in their natural state and/or contain much more goodness which helps achieve lower, more stabilised blood sugar levels. These tend to be the brown, wholegrain and wholewheat versions.
|Refined complex carb||Unrefined complex carb|
|White flour||Wholemeal flour|
|White bread||Granary or wholemeal bread|
|White pasta||Wholewheat pasta|
|White rice||Brown or whole-grain rice|
|Breakfast cereals||Steel-cut/pinhead porridge oats|
If you are confused about carbs, don’t worry, we have a whole page dedicated to explaining carbs in greater detail.
#6. Bulk with vegetables and salad
Vegetables are actually a third type of carbohydrate known as fibrous carbohydrates. These play an important role in the gestational diabetes diet, keeping the digestive system running well and avoiding constipation. However, making better, lower-carb choices when selecting salad and vegetables is important, as some starchy or sweet ones may raise blood sugar levels too high.
Eating plenty of vegetables and salad does three things. It fills you up so you don’t feel hungry and provides important fibre, nutrients, vitamins and minerals. Dietary fibre has also been shown to help reduce blood sugar levels28–31.
Vegetables that may seem trickier to tolerate for some are tomatoes (technically a fruit), carrots, swede, parsnips, sweetcorn, peas, squashes, beetroot, peppers and canned vegetables where sugars may have been added in the canning process.
It’s also worth noting that vegetables in their raw form or cooked al dente will provide your body with more nutrients and a lower glycaemic index (have a lower impact on glucose levels) than those that have been cooked, which will be more easily digested.
#7. Drink plenty
Staying well-hydrated is very important during pregnancy and even more so if you have diabetes whilst pregnant. Drinking water doesn’t directly lower blood sugar levels but does flush excess sugar out of your system.
Staying hydrated helps control and stabilise blood sugar levels32, a major part of a good gestational diabetes diet.
You should drink at least 2 litres (10 x 200ml glasses) daily. You will need to drink even more during warmer weather or if you are exercising.
I recommend drinking a glass of water with AND between every meal and snack during the day.
Tea, coffee and fizzy drinks containing caffeine should not be included in your recommended daily fluid intake as they are diuretics. Diuretics make you urinate more frequently, causing you to lose water.
If you don’t like the taste of water, then you could try carbonated water with fresh slices of lemon and lime added to it or some sugar-free squash.
Be careful when choosing drinking squashes with ‘no added sugar’; it means exactly that, no ADDED sugar, but they still contain natural sugars. Check labels for the lowest total carbs for the best choices.
For more information on drinks, read more here.
Exercising has an insulin-like effect on cells and assists in lowering blood sugar levels33.
Resistance exercise has been shown to have the greatest benefits34,35, but it doesn’t have to be weight lifting (especially if you are not used to it); any movements such as walking, dancing, or yoga are beneficial36–39.
Where possible, going for a walk for 20 – 30 minutes after eating can help lower blood sugar levels. This does not have to be a brisk walk; even a comfortable stroll will be beneficial.
If walking is painful, any movement can help, such as gentle exercise on a birthing ball.
GD UK Dietary Related Posts
GD UK Meal Ideas Posts
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