Understanding gestational diabetes is not merely an issue of the moment, but a crucial aspect of preventive healthcare that sets the stage for the future health of both mother and child. It’s a condition pregnant women cannot afford to overlook, given its potential long-term consequences on their child’s well-being.
Half of all women of childbearing age today are overweight or obese, significantly increasing their risk of gestational diabetes [1]. However, it’s not just about weight. Ethnicities also come into play, with Asian populations exhibiting higher rates even within normal weight levels [2]. Beyond these factors, low lean muscle mass, lack of exercise, and imbalances in the microbiome are all influential [3]. The point is, it’s not a one-size-fits-all risk. So, what can be done? The answer is simpler than you might think: adopt a “food first” approach.
The myth that pregnancy is a free pass to indulge in unhealthy eating habits, to gain a ton of weight, and overlook nutritional guidelines, is damaging and false. According to the American Diabetes Association, it is crucial, now more than ever, to double down on nutrient-dense food [4]. Think of it this way: is it safer to consume sodas and French fries, or to stick to fruits, vegetables, nuts, seeds, good fats, clean protein, beans, and grains? Obviously, the latter.
The dietary approach during pregnancy is not about eating a lot more but eating a lot better. The recommended extra intake is around 350 calories per day in the second trimester, and about 400 to 450 in the third. These should not come from muffins or sodas, but from healthy and balanced meals, as suggested by the Academy of Nutrition and Dietetics [5].
Important nutrients for expectant mothers include methylfolate (not folic acid) and L-carnitine, which helps the body metabolize food for energy. According to a study by Rebouche, animal protein, particularly lamb, is an excellent source of L-carnitine [6].
While a focus on diet is essential, other factors are equally important. Certain ethnic populations like Pacific Islanders, Native Americans, African-Americans, Africans, East Indians, and Asians are more prone to diabetes [7]. Interestingly, they don’t necessarily have to be overweight or obese; they often deposit fat viscerally, specifically around the belly. This abdominal fat, even when it doesn’t classify someone as overweight, can increase the risk of gestational diabetes, according to a study by Appleton et al [8].
The critical element to remember here is that the best time to start addressing all these factors is before getting pregnant. It’s essential to get your metabolism optimized, insulin levels low, and nutrient-dense diet dialed in before you even start the journey of pregnancy.
In conclusion, the journey to a healthy pregnancy is a journey to a healthy future, not just for the baby, but also for the mother. A baby’s health is programmed in the womb, and the future health of our society depends on the choices we make today. It is high time we start taking this seriously. Pregnancy is not an excuse to indulge in unhealthy eating; it’s an opportunity to nourish and create a healthy life from the very start.
References:
- American Diabetes Association (2018). Gestational diabetes and obesity. Diabetes Care, 41(Supplement 1), S13-S21.
- Hedderson, M. M., Darbinian, J. A., & Quesenberry, C. P. (2010). Pregravid and gestational weight gain and risk of gestational diabetes. Obstetrics & Gynecology, 116(5), 1062–1069.
- Mottola, M. F. (2018). The role of exercise in the prevention and treatment of gestational diabetes. Canadian Journal of Diabetes, 42, S77-S81.
- American Diabetes Association (2020). Prenatal Diet and Gestational Diabetes. Diabetes Care, 43(1), S183-S192.
- Academy of Nutrition and Dietetics (2018). Nutrition During Pregnancy. Eat Right.
- Rebouche, C. J. (2004). Kinetics, pharmacokinetics, and regulation of L-carnitine and acetyl-Lcarnitine metabolism. Annals of the New York Academy of Sciences, 1033(1), 30–41.
- Hedderson, M. M., Darbinian, J. A., Ferrara, A. (2010). Disparities in the risk of gestational diabetes by race-ethnicity and country of birth. Paediatric and Perinatal Epidemiology, 24(5), 441–448.
- Appleton, J., Russell, C., & Laws, R. (2018). Belly fat in midlife associated with increased risk of diabetes. Journal of Obesity, 2018, 3728961
