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Healthy Eating

A healthy eating plan will help in managing your blood glucose levels and meeting the nutritional needs for you and your baby. It will also assist in achieving suitable weight changes. In all pregnancies, calcium, protein, iron,and folate are all important nutrients. In pregnancies affected by gestational diabetes, carbohydrates play a very important role. Your dietitian or health professional will discuss a personalised healthy eating plan with you.

Carbohydrates

Carbohydrates are nutrients that come from certain foods. They are broken down into glucose in the body. This glucose is then used as the body's main source of energy.

Foods containing carbohydrates include:

  • pasta, rice, noodles,
  • breads and breakfast cereals, crisp breads,
  • potato, sweet potato, corn,
  • legumes, for example baked beans, red kidney beans, lentils,
  • fruits,
  • milk, yoghurt, custard.

These foods are a good source of energy, vitamins, minerals and fibre. They need to be included in a healthy eating plan.

Carbohydrates are also found in regular soft drinks, cordials, fruit juices, and lollies. These foods are high in carbohydrate and provide little nutritional value. They should be restricted, as they will raise blood glucose levels very high and very quickly. Carbohydrates are also found in biscuits, cakes and processed foods such as chips, pizza and burgers. These foods are high in fat and should be limited.

It is important to spread carbohydrate foods over 3 small meals and 2–3 snacks per day.

Types of carbohydrates

Different types of carbohydrates will increase blood glucose levels at different rates.

The Glycaemic Index (GI) is a measure of how quickly a carbohydrate food breaks down to glucose and the effect it will have on your blood glucose levels.

That is:

  • Foods that have a high GI produce a fast, high rise in blood glucose levels.
  • Foods that have a low GI produce a slower, lower rise in blood glucose levels.

Low GI foods:

  • help you feel fuller for longer,
  • prevent large fluctuations in blood glucose levels,
  • may help in weight management.

Aim to at least include 1 low GI food at each meal.

Amount of carbohydrates

The amount of carbohydrate you eat is very important. This is where a dietitian or health professional can provide some guidance.

  • Aim for 2-3 serves of carbohydrate at each meal.
  • And 1-2 serves of carbohydrate at each snack.
  • 1 serve is approximately equal to 15 grams of carbohydrate.

A list of foods that contain 1 serve of carbohydrate can be found in pdf buttonthis booklet.

Try to include a variety of carbohydrates in your diet to achieve optimal nutrition.

Free foods

'Free' foods are nutritious foods that will not cause excess weight gain and will not affect blood glucose levels. These free foods include:

  • all vegetables (except potato, sweet potato, corn, legumes, taro),
  • some fruits – lemon, lime, passionfruit, small serves of berries, and rhubarb,
  • drinks – water, soda water, plain mineral water.

Fat

Fat does not directly affect blood glucose levels; however if eaten in large amounts it can cause extra weight gain and further affect how your insulin works. It is important to limit unhealthy (saturated) fats and use small amounts of healthy (polyunsaturated and monounsaturated) fats.

  • Unhealthy fats include full cream dairy products, fatty or processed meats, skin on chicken, butter, pies, pastries, cream, cakes and biscuits.
  • Healthy fats include any plant-based oils including olive, rice bran, sunflower, safflower, canola, grape seed and peanut oils, margarine, unsalted nuts, seeds, fish and avocados.

Protein and iron

An adequate protein intake will help to support the growth of your baby and iron will help to form and maintain red blood cells during pregnancy. Although protein and iron requirements are increased during pregnancy, a well balanced diet will help to meet recommendations. Include 3 ½ serves of lean meat or meat alternatives in your diet each day.

These include lean meats, poultry, fish, eggs, tofu, legumes, nuts and seeds.

Legumes also need to be counted in your carbohydrate serves.

Calcium

Calcium is essential to keep your bones strong and healthy. During the last trimester of pregnancy, your baby needs a large amount of calcium as they start to develop and strengthen their bones. If your diet is lacking in calcium, the calcium required by your baby will be drawn from your bones, increasing your risk of osteoporosis later in life. Women aged 19-50 years require 2 ½ serves of dairy per day and women aged 18 years and younger require 3 ½ serves a day during pregnancy. One serve includes:

  • 1 cup of milk,
  • 1 cup of soy milk,
  • 2 slices (40 g) of hard cheese,
  • 200 g of yoghurt,
  • ½ cup of evaporated milk.

Iodine

Iodine is important during pregnancy for your baby's growth and brain development. Discuss the need for iodine supplementation with your health care professional and consume good sources of iodine such as eggs, bread (except organic bread), milk yoghurt and fish.

Vitamin D

Vitamin D deficiency is very common during gestational diabetes and all other pregnancies. Please speak to your doctor about screening for and potentially supplementing your diet with vitamin D. Vitamin D is important for strong bones, muscles and overall health and vitamin D deficiency may increase risk of type 2 diabetes.

Folate

Folate is a B-group vitamin which is important for the healthy development of babies prior to conception and during the first 12 weeks of pregnancy. Although you are more than likely past this stage of pregnancy, the following information is important to help you prepare for future pregnancies. Folate is found in dark green leafy vegetables such as broccoli, asparagus and spinach, breads (except organic bread), fortified breakfast cereals and fruit such as strawberries, oranges and bananas. Along with consuming folate rich foods, women who are pregnant or planning a pregnancy should take a folate supplement to meet increased requirements (400 micrograms of folate a day). Discuss folate supplementation with an Accredited Practising Dietitian as some women may require a higher dose.

Omega-3s

Omega-3 fish oils are important for your growing baby (particularly in the last trimester) to assist in the development of the brain, eyes and central nervous system. The amount of omega-3s passed onto the baby via the placenta and breast milk is depended on your dietary intake. To achieve an adequate intake of omega-3 fish oils aim to consume 2-3 fish meals each week. Oily fish such as salmon, mackerel, mullet, sardines and trout are excellent sources of omega-3s. If you do not eat fish, please talk to your doctor or an Accredited Practising Dietitian about fish oil supplementation.

More information on serving sizes can be found at The Australian Dietary Guidelines link at the end of this section

Points to remember

Artificial sweeteners and sugar use

Food Standards Australia New Zealand (FSANZ) approves the use of artificial sweeteners during pregnancy, as evidence demonstrates that no harmful effects will result from their use. However, a small amount of added sugar such as 1 teaspoon of sugar in tea or coffee or on cereal, a drizzle of honey or a thin scrape of jam on toast will not spike blood glucose levels. Therefore there is no need to rely on artificial sweeteners.

Alcohol

There is no known safe level of alcohol consumption in pregnancy.

Caffeine

Avoid large amounts of caffeine. No more than 2 cups of espresso style coffee, 3 cups of instant coffee or 4 cups of tea per day is advisable.

Mercury

Most fish types are safe to eat in the recommended 2-3 servings of fish a week. However, some types of fish have higher levels of mercury and should be limited. These include:

  • Shark (flake), broadbill, marlin and swordfish - limit to 1 serve (100g cooked) per fortnight (with no other fish to be consumed during that fortnight).
  • Orange roughy (sea perch) and catfish – limit to 1 serve per week (with no other fish being consumed during that week).

Listeria

Listeria is a bacteria that can cause a food borne illness called lsteriosis. This illness can be very dangerous to your unborn baby and can lead to premature labour, miscarriage or stillbirth. To avoid Listeria aim to eat freshly cooked food and well washed fruit and vegetables and avoid the following foods:

  • soft, semi-soft and surface ripened cheeses such as brie, camembert, ricotta, blue and feta,
  • pate,
  • oysters,
  • raw seafood,
  • pre-packed salads, sandwiches and wraps,
  • bean sprouts,
  • soft serve ice cream,
  • cold processed meat,
  • unpasteurised dairy foods.

Eat regularly

Skipping meals or restricting carbohydrate foods is not the answer to managing high blood glucose levels. It is not healthy for you and can be harmful to your developing baby.

In summary

Choose a variety of foods that are:

  • enjoyable to eat,
  • a good source of carbohydrate,
  • low in fat,
  • provide the nutrients required in pregnancy (iron, calcium, folic acid, protein),
  • eat small regular meals and snacks. Include some carbohydrate in every meal and snack. Eat to satisfy your hunger while maintaining a healthy weight.

For further information, please refer to the resources: Australian Dietary Guidelines http://www.eatforhealth.gov.au and pdf button Eating well for you and your baby. Eating well for you and your baby is a Diabetes SA publication. It is a comprehensive and easy to read guide. It contains a sample meal plan, and a list of carbohydrate foods that are equal to one serve.

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The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered with the assistance of Diabetes Australia.