What foods to eat and what to avoid in gestational diabetes?

Nutrition during pregnancy raises many questions and doubts among expectant mothers and their relatives. The matter becomes even more complicated when we are dealing with gestational diabetes, because proper diet is the basis of treatment in this case. That is why we have prepared a practical guide in which we look at various groups of food products and suggest what to eat and what is not recommended - not only in the case of diagnosed gestational diabetes, but also in diabetes prevention.  

Food product categories

The most commonly used breakdown of products extracts 12 groups of food productsh: (1) cereal products, (2) milk and preserves, (3) meat, sausages, fish and offal, (4) eggs, (5) butter and cream, (6) other fats and oils, (7) potatoes , (8) vegetables and fruits rich in vitamin. C, (9) vegetables and fruits rich in provitamin A, (10) other vegetables and fruits, (11) dry legume seeds, (12) sugar and sweets. For the purposes of our discussion breakdown of food products has been slightly modified and simplified, making it easier to distinguish between high and low glycemic indexes.

Breakdown of food products according to IG

The table below presents product categoriesthat foodwith a division into products indicated and not recommended for gestational diabetes, due to their glycemic index (GI). The individual ones are discussed later in the text group of food products.

In the middle column we have products with a high glycemic index - these must be eliminated from the diet. On the right side of the table there are their substitutes - products with a medium or low glycemic index. 

What cereal products?

They are a source of complex carbohydrates, so they should be present in every meal. They are responsible for the greatest degree of sugar concentration measured one hour after a meal. Their deficiency will result in the appearance of ketone bodies in the urine. Bread belongs to the group of products cereals, as well as various kinds of groats. You should choose rye or rye-wheat bread (in such bread, rye flour will be listed in the first place). The bread can be with the addition of pumpkin seeds, sunflower seeds, linseed. It is not recommended to eat rolls as they mostly contain wheat flour. It is also worth paying attention to the addition of barley malt, caramel or honey, as these ingredients can increase sugar. Some patients respond well to graham bread - despite the fact that it is wheat bread. Due to its high dietary fiber content, it can give good sugar results. 

Thick types of groats are the best for dinner: buckwheat (roasted and unroasted), pearl barley, brown or wild rice, millet, bulgur, wholemeal pasta (unfortunately often only colored and not true wholemeal), chickpea, lentil or other pasta varieties of pods. Breakfast cereals should be chosen the most ordinary - oat, rye, barley, spelled. They cannot be instant flakes because they have a high glycemic index. Plain, mountain, or whole grain flakes are recommended. You can make muesli from the flakes by mixing different types of flakes with the addition of pumpkin seeds, sunflower seeds and nuts. Prepared muesli mixes are not recommended because they contain a lot of sugar.

What dairy products? 

Dairy products, especially milk, yoghurt, kefir, buttermilk contain lactose - milk sugar (milk contains the most lactose). Lactose, especially in the morning, can lead to hypoglycaemia. Since high insulin resistance is observed at breakfast time, it is worth giving up dairy products in this meal, postponing their consumption for the rest of the day. However, if later also elevated lactose-induced sugar is observed, it is worth diluting the milk with water in the proportion of 50:50. When this treatment does not help, you should consume flakes or other products with natural yoghurt or kefir (these products, along with buttermilk, have a lower lactose content). We choose yoghurts, kefirs, buttermilk only in the natural version, because fruit products contain added sugar, which can cause high blood glucose levels. Yellow cheeses are not prohibited in the diet and can be eaten. When it comes to curd cheeses, they don't have to be lean, semi-fat cheeses are enough, but with salty, not sweet additives. You can also eat cottage cheese.

Meat, cold cuts, fish, eggs

These products do not increase the sugar level within an hour after a meal - they are safe in this respect. Breakdown of products presented in the table above takes into account the principles of healthy eating. In the middle column of the table, we have a group of products that contain a lot of cholesterol and saturated fatty acids, and these ingredients will adversely affect lipids. On the right side of the table you will find healthier products. You should eat lean meats (turkey, chicken, pork loin, pork tenderloin, beef) and fish - twice a week. The most important thing is not to coat meats and fish. Other technological processing techniques are allowed: baking, stewing, boiling, steaming, grilling, frying in a small amount of fat, but without breading. It is important to maintain variety when it comes to meat selection. Red, lean meats should be included in the diet due to the higher iron content (anemia is very common during pregnancy). 

Eggs are a very good product considering gestational diabetes. Our experience shows that dishes with them are perfect for breakfast (especially in the case of patients for whom ordinary sandwiches with sausages or cheese cause too high levels of sugar). Eggs can be eaten in any form - scrambled eggs, hard-boiled, soft-boiled or in the form of an omelette.

What vegetables?

As for vegetables, from the diet you should eliminate boiled and baked potatoes, boiled carrots and boiled beets. The remaining raw, stewed and cooked vegetables can and must be included in your daily diet. Vegetables should be included in every meal. They contain dietary fiber, which delays gastric emptying, thanks to which glucose from the meal is gradually absorbed, and you will not see high blood glucose levels shortly after a meal. Vegetables can be eaten with oils and oils, there is no need to replace them with natural yoghurt.

What kind of fruit?      

Bananas, grapes, cherries, fruit in syrup, and dried fruit are not recommended. The remaining ones can be eaten, but they should be combined with a different meal and ingredients (for sandwiches, natural yoghurt, after dinner). It's safer not to eat fruit until breakfast. It is also worth not to eat 500g at once, but to divide this amount into 2-3 portions.

Fats 

Do not degrease your diet! It is not necessary to eliminate oil, oils or butter in reasonable amounts from your diet. The division contained in the above table results from the principles of healthy eating. After consuming fats, the sugar level does not rise within an hour after eating. On the contrary. The addition of fat to meals slows down the absorption of sugars from other meals. Therefore, it is important that the foods are mixed with carbohydrates, proteins and fats.

What drinks?

It is important to eliminate all kinds of fruit juices, sweetened drinks, and flavored waters from your diet. Higher sugar values ​​can be obtained by drinking grain coffee - you need to check it (drink a meal with coffee and the same without coffee, then compare the values). It is important to drink tea (all types allowed) without sugar. Sugar can be replaced with stevia or xylitol - these substances are safe during pregnancy and do not raise sugar levels.

By analyzing the individual group of food products, in the beginning it is not easy to distinguish between what we can eat in gestational diabetes and what to avoid. It will be easier with time, and for now -  it is worth referring to the above list. Good luck!  

Author: Milena Kuzaka – Trainer of personal insulin pumps, Diabetes educator, Dietician at the Diabetes Clinic, Institute of Mother and Child