What type of pregnancy diet should I follow if I have gestational diabetes?

Julie Redfern

registered dietitian

Good nutrition is especially important during pregnancy if you've developed gestational diabetes. Diabetes develops when your body can't efficiently produce or use insulin, a hormone made by the pancreas that allows cells to turn sugar in your blood (glucose) into usable fuel.
When large amounts of glucose accumulate in your blood, it means that your cells aren't getting the fuel they need. High blood sugar can be harmful for you and your developing baby, so it's important to try to control it.
One way to keep your blood sugar levels under control is to follow a specific meal plan. I strongly recommend seeing a registered dietitian who can create a diet particularly suited to you, based on your weight, height, physical activity, and the needs of your growing baby, as well as your level of glucose intolerance. She'll also take into account your personal food preferences.
(Note: If dietary changes aren't sufficient to keep your blood sugar in a healthy range, you'll need to take insulin as well. If your practitioner prescribes insulin injections, you'll need to meet again with your dietitian to reassess your diet.)
A dietitian starts by determining how many calories you need each day. Then she teaches you how to determine portion sizes and how to balance your meals with just the right amounts of protein, carbohydrates, and fat. She also assesses your current eating habits to make sure you're getting enough vitamins and minerals.
Here are some general dietary guidelines:

• Eat a variety of foods, distributing calories and carbohydrates evenly throughout the day. Make sure both your meals and your snacks are balanced. The American Diabetes Association recommends that you eat three small-to-moderate-size meals and two to four snacks every day, including an after-dinner snack.
  
  Your meal plan may contain fewer carbohydrates than you normally eat. It's best to include complex carbs (those containing more fiber) and spread them out over the day. Pair lean protein with carbohydrates at all meals and snacks. Protein helps to make you feel fuller, sustain energy, and give you better blood sugar control.
  
• Don't skip meals. Be consistent about when you eat meals and the amount of food you eat at each one. Your blood sugar will remain more stable if your food is distributed evenly throughout the day and consistently from day to day.
  
• Eat a good breakfast. Your blood glucose levels are most likely to be out of whack in the morning. To keep your level in a healthy range, you may have to limit carbohydrates (breads, cereal, fruit, and milk), boost your protein (eggs, cheese, peanut butter, nuts) , and possibly avoid fruit and juice altogether.
  
• Include high-fiber foods, such as fresh fruits and vegetables, whole grain breads and cereals, and dried peas, beans, and other legumes. These foods are broken down and absorbed more slowly than simple carbohydrates, which may help keep your blood sugar levels from going too high after meals.
  
•  Limit your intake of foods and beverages that contain simple sugars such as soda, fruit juice, flavored teas and flavored waters, and most desserts – or avoid them altogether. These foods can quickly elevate your blood sugar. Ask your healthcare practitioner about using foods sweetened with an artificial sweetener if you need a sweet fix.
  
• Milk is high in lactose, a simple sugar, so you may need to limit the amount you drink and find an alternative source of calcium. If you're looking for a new beverage of choice, try club soda with a squeeze of lemon or orange, or unsweetened decaffeinated iced tea.
  

Moderately increasing your activity level is also a good way to help keep your blood glucose levels at normal levels. Again, speak with your diabetes educator or practitioner about the right amount and intensity of exercise for you.

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