Is It Safe to Go Carb-Free During Pregnancy?Andrea Elovson
It’s hard to escape the no-carb craze. At the grocery store you can find just about anything with a low-carb label, from tortillas to frozen dinners and more. Not since the low-fat craze has a single nutrient been so vilified. Carbohydrates are being blamed for a host of serious medical conditions including cardiovascular disease, high blood pressure, diabetes, and obesity.
But carbohydrates alone are not the culprit. Most Americans eat too many carbohydrate-rich foods that are also high in fat, sugar, and calories.
There is much debate about the efficacy of diets such as Atkins, South Beach, and The Zone, but a growing body of research confirms that reducing your intake of high-caloric, refined carbohydrates can improve your health, particularly if you are obese or diabetic.
As the old saying goes, “There is a time and a place for everything.” And experts agree that for most women, pregnancy is not the time to place yourself on a low-carbohydrate diet.
“It is recommended that half the calories a pregnant woman takes in each day should come from carbohydrates,” says Dr. Hope Ricciotti, MD, an OB-GYN and assistant professor at Harvard Medical School and author of The Pregnancy Cookbook. “Glucose, which is the byproduct of carbohydrates, is the primary fuel for the baby.”
But before you reach for those chocolate chip cookies, remember that all carbohydrates are not created equal. Consuming fast food, candy, cakes, pizza, doughnuts, and soda can lead to excessive weight gain and exacerbate symptoms of gestational diabetes (diabetes developed during pregnancy). Since these foods have little nutritional value, they cannot provide your growing baby with the nutrients, protein, and healthy fat required for optimal development.
“Even if you eat horribly the rest of your life, during those nine months of pregnancy, you do your best to attain perfection,” says Dr. Mary C. Vernon, MD, CDM, a physician of bariatric and family medicine in Lawrence, Kansas, and a member of the Atkins’ Physicians’ Council. “Basically, this means that when you are pregnant, there is never an excuse.”
So if you opt for a Snickers bar instead of an apple are you putting your baby in jeopardy? Of course not. But cutting back on junk food and eating a wide variety of fruits, vegetables, and whole grains is the best way to nourish your baby, avoid excess weight gain, improve your mood, and increase your energy level.
Why Your Baby Needs Carbohydrates
Fat and protein are critical to your growing baby, but they do not provide the glucose, fiber, and folic acid found in carbohydrates. Folic acid is a B-vitamin found in fruits, vegetables, cereals, breads, pastas, and rice. The Centers for Disease Control (CDC) recommends that all women of childbearing age get 400 micrograms of folic acid daily. Pregnant women should double this to 800 micrograms daily. Insufficient amounts of folic acid can result in serious birth defects including anencephaly (a brain abnormality) and spina bifida (incomplete closure of the spinal column).
Foods that are rich in folic acid include dark, leafy green vegetables like collard greens, kale, broccoli, and asparagus. Papayas, strawberries, oranges, lentils, and chickpeas are also great choices.
Unfortunately, only 30 percent of American women get the recommended daily allowance of folic acid through food, which is why doctors strongly recommend a daily supplement of folic acid for pregnant women.
Severely restricting your intake of carbohydrates may pose another health risk to your baby: Without a steady stream of carbohydrates, your body burns fat for energy. Although this helps people lose weight, it may also result in high levels of ketones in the blood. Ketones are a natural byproduct of fat metabolism in the liver. It is still unclear whether ketones in the mother adversely affect the fetus.
Additionally, according to a June 26, 2004, Science Daily report, a diet high in protein and low in carbs is bad for women trying to conceive or who are pregnant. And it isn’t just the absence of carbs that has an adverse affect on mothers-to-be, it is the increase in protein that low-carb diets dictate that can cause damage. A 2003 British study on pregnant mothers whose diets included a high meat/fish intake in late pregnancy found that these women developed high cortisol levels. “This is a concern since in animals, high fetal exposure to cortisol may lead to elevated blood pressure in the offspring later in life,” the study’s authors report.
“There are no studies that show the safety of a low-carbohydrate diet in pregnancy,” adds Dr. Ricciotti. “Right now all the studies that talk about what constitutes a healthy diet during pregnancy include carbohydrates.”
Why Mom Needs Carbohydrates
Americans fall short of the recommended daily allowance of 20 to 53 grams of fiber. Most get only 10 to 20 grams. Aim for four to seven servings of fruits and vegetables, and a minimum of two servings of whole-grain bread, whole-wheat pasta, or brown rice.
High-fiber breakfast foods include multigrain toast and cereals like steel-cut oatmeal, Kashi, Shredded Wheat, Wheaties, Grape Nuts, and Bran Flakes. Topping your toast or cereal with fresh strawberry slices, raspberries, or kiwi sweetens the deal and adds even more fiber and vitamins.
Try to eat whole fruits like oranges, cherries, grapefruit, and grapes instead of drinking juice. The fruit itself contains no added sugar and is a good source of fiber. Another trick to getting more fiber is leaving the skins on fruits and vegetables such as cucumbers, apples, pears, nectarines, peaches, sweet potatoes, yams, and potatoes.
High-fiber snacks include popcorn (hold the butter!), sunflower seeds, nuts, and dried apricots, peaches, nectarines, plums, and pears. Double check packages to make sure that any dried fruits you eat are dried in their skins.
Another benefit of fibrous carbohydrates is that they slow the absorption of glucose from the intestine into the bloodstream. Refined, sugary foods like cakes, cookies, soft pretzels, and doughnuts are quickly digested and broken down into glucose. This signals the pancreas to release insulin, a hormone that shuttles the glucose from the bloodstream into the cells for energy. The quick drop in blood glucose levels can leave you feeling hungry, tired, and sometimes even depressed.
“Instead of looking at carbohydrates as a whole, we should be looking at refined and unrefined carbohydrates,” says Dr. Ricciotti. “Eating unrefined carbohydrates like whole grains and brown rice is like time-released glucose. You avoid those sharp spikes of glucose and then the quick lows that may drive hunger signals and cause us to overeat.”
If you are trying to increase your fiber intake, start slowly. Too much fiber at once can cause painful gas and bloating. Eating small meals throughout the day and drinking lots of water can ease initial discomfort.
Pump Up the Protein
As great as carbohydrates are, a girl cannot live on carbs alone. The remaining 50 percent of your daily calories should come from lean protein and healthy fats.
Good protein choices include chicken breasts, pork, and lean cuts of beef. (Cuts with the words “round” or “sirloin” contain less saturated fat.) While red meat is a good source of iron, it is relatively high in fat and calories. Compromise by eating red meat once or twice a week and asking your doctor about iron supplements.
Fish is another great source of protein. Unfortunately, some fish contain high levels of mercury that can damage the nervous system of an unborn child. Avoid eating shark, swordfish, king mackerel, yellow tail tuna, tile fish, and tuna steaks.
“There is also some data that [shows] canned tuna has higher levels of mercury than the average fish,” adds Dr. Ricciotti. “I tell my patients to eat only one can a week of chunk light, which has less mercury than albacore.”
The safest seafoods are tilapia, flounder, scallops, oysters, shrimp, and wild (rather than farm-raised) salmon. The Food and Drug Administration suggests limiting your weekly intake of cooked fish to 12 ounces and cutting out all raw fish, sushi, and sashimi.
Vegetarians can get their protein from dairy foods like yogurt, cheese, and eggs. Beans and peanut butter are also good choices.
Don’t Fear the Fat
Some foods that are high in protein are also great sources of healthy fats. Salmon, for instance, contains Omega-3 fatty acids, which lower blood cholesterol. Omega-3s are crucial to fetal brain and eye development. Other fish rich in Omega-3s are anchovies and lake trout.
If fish does not top your list of pregnancy favorites, there are other ways to get this important fat. Walnuts, flax seed, and flax seed oil as well as canola and soy oils all contain Omega-3s.
Sprinkling your salads with olive oil, slicing avocados on your sandwich, and cooking with corn or canola oils rather than butter, margarine, or shortening will give your baby the unsaturated fat she needs, while keeping your heart healthy.
Steer clear of foods made with coconut or palm oil. These tropical-sounding fats are no day at the beach. Consuming too many of these hydrogenated trans-fats puts you at risk for developing certain cancers and heart disease.
Eating for Two
The belief that pregnant women should double their caloric intake is about as outdated as telling a child that he or she was found in a pumpkin patch. On average, pregnant women need only 300 to 500 extra calories a day (think in terms of a banana and a glass of milk).
What eating for two really means is being responsible for your unborn baby’s nutritional needs as well as your own. The best way to do this is to avoid the diet wars and stick to a balanced diet of lean proteins, healthy fat, and, yes, carbohydrates.
Eating moderate amounts of nutritious carbohydrates, rather than eliminating them altogether, will promote your health and that of your child long after the nine months of pregnancy are over.