September 17, 2018
The Perfect Diet for a Mother-To-Be Through a Macronutrient Lens - Part II Carbohydrates.
Carbohydrates are made up of sugars and starches. They are used as a major storage form of energy for cellular function. They are also involved in DNA, RNA
and coenzyme function throughout the body. The majority of our diet is and should be made up of carbohydrates. Unfortunately, it is the place where many people struggle with their food choices as here we find the super tasty, but unhealthy foods like soda, cake, white bread, chips and much more. Conversely, healthy carbs like salad, carrots, apples, asparagus and all of the whole vegetables and fruits should be a mainstay of the diet.
When we consider carbohydrate intake during pregnancy, we have to remember that the female physiology changes throughout pregnancy. The system wants to enhance glucose production, storage and transportation to the growing fetus and will maximize the use of ingested sugars for the baby. As discussed earlier in the book, the microbiome and metabolic pathways shift throughout pregnancy for the benefit of the child's growth. We also looked at recent data regarding mortality and carbohydrate consumption showing that the not too much and not too little approach seems best for human mortality avoidance at roughly 50-55% of daily food intake. (Seidelmann et. al. 2018)
They key with carbohydrates and pregnancy or life in general boils down simply to quality first and quantity second.
A quality carbohydrate is one that is high in both fiber and phytonutrients. Broccoli is a great example, whereas bread is not. We can also look at something called the glycemic index and glycemic load. Simply stated - the glycemic index is a measure and a number given for how fast a food type turns to glucose in the bloodstream on a scale of 0-100. Glycemic load on the other hand is a measure of the glycemic index multiplied by a volume of carbohydrate consumed. This is a more accurate way of predicting the response of a given person to a given carbohydrate. Understanding this concept is critical to discerning the effect on mom and baby.
What we know now is that pregnant women and their offspring will overgrow if they over-consume highly glycemic foods like potatoes, white bread, chips, cakes, sugar beverages, and much more. Here is a list of highly glycemic foods based on load.
When a pregnant mother consumes a diet loaded with standard American highly processed glycemic foods like bread, pasta, chips, cookies and general fast food, she will have increased insulin levels in her blood stream which acts as a growth hormone for her baby while increasing fat deposition and weight gain in herself. Insulin sensitivity will alter negatively on a diet that is persistently highly glycemic. This ultimately can become gestational diabetes mellitus or frank diabetes mellitus. (Butte 2000) (Clapp 2002) Switching to a low glycemic diet positively effects the weight and healthy metrics of a child. (Moses et. al. 2006) (Zhang et. al. 2011)
According to the Recommended Dietary Allowance for a pregnant woman, carbohydrate consumption should be around 175 grams per day which is roughly 3.8 grams per kilogram for an average woman on 120 pounds in weight.
What to do?
1) Consume a whole foods diet that is based on vegetables and fruits primarily. We want lots of phytonutrients and fiber in the maternal diet. The more colorful and varied the foods are the better the phytonutrient makeup.
2) High quality whole grains like oats, buckwheat, quinoa, amaranth and teff are excellent fiber based carbohydrates.
3) Severely limit the intake of refined carbohydrates of any kind including white and wheat bread, pasta, chips, cakes, and cookies. Also limit refined potato and rice foods. Rice is in a special category now for pregnant women and children as it is often contaminated with arsenic from the soil.
4) Learn which foods spike blood sugar the most from the glycemic load list and aim to limit their intake.
5) Eat about 50-60% of your daily macronutrient intake as carbohydrate.
6) Aim for 25 to 40 grams of fiber daily. Trying to get higher volumes of fiber in the diet is very beneficial.
In Defense of Food
Lancet Seidelmann Article
Linus Pauling Institute Glycemic Load Foods
The American Journal of Clinical Nutrition Butte Article
Proceedings of the Nutrition Society Clapp Article
The American Journal of Clinical Nutrition Moses Article
The American Journal of Clinical Nutrition Zhang Article
Perinatology.com RDA Information