Gestational diabetes occurs when the blood sugar level becomes too high during pregnancy because insulin cannot be produced in the right amount. There is credible evidence that following a Mediterranean diet during pregnancy significantly reduces the development of gestational diabetes. Start with step 1 to learn how to follow the Mediterranean diet during pregnancy.
The danger of uncontrolled power
A diet without any restrictions on gestational diabetes can lead to many dangerous consequences. Among them:
- circulatory failure between the fetus and the mother,
- early aging of the placenta,
- delay in fetal development,
- blood clotting and blockage of blood vessels,
- fetal weight gain,
- injuries and other complications during childbirth.
The daily menu for GDM is recommended to be divided into 6 meals. Fractional nutrition prevents a sharp increase in blood glucose levels. With this regimen, the pregnant woman does not suffer from severe hunger. It is important that the total calorie intake is not more than 2000–2500 kcal per day.
Diet for GDM should not deplete the body and at the same time prevent the collection of extra pounds. In the first trimester, a fullness of more than 1 kg per month is considered abnormal. In the second and third trimester - more than 2 kg per month. Overweight creates a burden on the body, increases the risk of edema, increased blood pressure and complications from the fetus. Try not to overeat or skip meals. The optimal interval between them is no more than 2-3 hours.
The diet for gestational diabetes should consist of protein foods (30-60%), healthy fats (up to 30%) and carbohydrates (40%). Prefer complex carbohydrates. They are consumed for a long time and do not cause sharp changes in blood glucose indicators. Also, vegetables and fruits with a minimum glycemic index are required in the diet. Make sure they are fresh, not frozen, with no added sugar, salt, sauce, or fat. Be sure to read the label on the package: the composition of the product, useful properties and expiration date.
One hour after each meal, take the meter reading. Enter the results in the self-monitoring diary.
Calorie daily menu
You can prevent the development of gestational diabetes by calculating the calorie content of the daily menu. For this, a ratio of not more than 35 kcal per 1 kg of the norm of weekly weight gain during pregnancy (BMI) and ideal body weight (BMI) is used: BMI = (BMI + BMI) × 35 kcal.
To calculate BMI, the formula is used: BMI = 49 + 1.7 × (0.394 × height in cm - 60).
|Weight gain||Fat physique||Average build||Slim build|
|Current week of pregnancy||2||0,5||0,5||0,5|
The list of approved products for gestational diabetes is quite large. You can eat hard cheeses, cottage cheese, butter, and heavy cream when pregnant. Natural yogurt is recommended for salad dressing only.
From the meat assortment, chicken, rabbit, diet veal and turkey are acceptable. Not more than 1 time per week is allowed to eat lean parts of pork. Soups are best cooked in vegetable or chicken broth. When cooking a bird, change the water 2 times. Well-established seaweed, fish and seafood. Eat no more than 3-4 eggs. per week (hard boiled or in the form of an omelet).
With gestational diabetes, soy, soy flour, and milk can be included in the diet. Peas and beans are suitable for legumes. In a small amount, use hazelnuts and Brazil nuts, sunflower seeds (not more than 150 g at a time). Peanuts and cashews are strictly contraindicated.
Vegetables are allowed potatoes (not fried only), all kinds of cabbage, green asparagus beans, avocados, squash, cucumbers, eggplant, spinach, hot peppers, green onions and spicy greens. For lunch, you can eat a small amount of raw carrots, beets, pumpkins and onions. Mushrooms are also included in the composition of dishes for diabetics.
With GDM, almost everything except grapes and bananas is allowed. Replace them with juices to get more nutrients and fiber. Use grapefruits with caution, after checking the reaction of the body.
Drink more purified water without gas. Fruit drinks, cocktails, syrups, kvass, tea and tomato juice (no more than 50 ml per reception) are suitable.
Sugar substitutes, sweeteners, preserves and jams, honey, ice cream, and confectionery can trigger high blood sugar levels. Concentrated vegetable and fruit juices, sweet carbonated drinks are no less dangerous in the diet for GDM.
Muffin and bakery products (including whole grains) should be excluded from the diet. The same applies to dietary bread, cereal and cereal made from wheat flour and other cereals.
Condensed milk, soft dessert cheeses and whey are contraindicated in gestational diabetes. Also, you can not eat fried and fatty dishes. Such food creates an additional burden on the pancreas. Overly salty, spicy and sour dishes will also not bring benefits. For the same reason, you should not get involved in brown bread (the acidity of the product is quite high).
Canned soups and convenience foods, margarine, ketchup, shop mayonnaise and balsamic vinegar are strictly prohibited.
Maternity Weekly Menu
For people with diabetes, including gestational, a special nutrition system has been developed: 9 tables.
|Day of the week||Breakfast||Lunch||Dinner||High tea||Dinner||Before bedtime|
|Monday||Coffee drink, low-fat cottage cheese with milk, buckwheat porridge||Milk||Boiled meat with milk sauce, cabbage soup, fruit jelly||An Apple||Cabbage schnitzel, boiled fish, baked in milk sauce, tea||Kefir|
|Tuesday||Cabbage salad, pearl barley, boiled egg, coffee drink||Milk||Beef liver with sauce, mashed potatoes, pickle, dried fruit compote||Fruit jelly||Boiled chicken breast, stewed cabbage, tea||Kefir|
|Wednesday||Low-fat cottage cheese with milk, oatmeal, coffee drink||Kissel||Boiled meat, buckwheat porridge, vegetarian borscht, tea||Unsweetened pear||Vinaigrette, boiled egg, tea||Yogurt|
|Thursday||Low-fat cottage cheese with milk, buckwheat porridge, coffee drink||Kefir||Boiled meat with milk sauce, vegetarian cabbage soup, stewed fruit||Unsweetened Pear||Cabbage schnitzel, boiled fish, baked in milk sauce, tea||Kefir|
|Friday||Potato-free vinaigrette, butter, boiled egg, coffee drink||An Apple||Toasted meat, sauerkraut, pea soup, tea||Fresh fruits||Vegetable pudding, boiled chicken, tea||Yogurt|
|Saturday||Doctor's sausage, millet porridge, coffee drink||A decoction of wheat bran||Mashed potatoes, boiled meat, fish soup, tea||Kefir||Oatmeal, low-fat cottage cheese with milk, tea||An Apple|
|Sunday||Boiled egg, buckwheat porridge, coffee drink||An Apple||Barley porridge, ground beef cutlet, vegetable soup, tea||Milk||Boiled potatoes, vegetable salad, boiled fish, tea||Kefir|
There are many recipes that will fit into the diet for gestational diabetes. They are based solely on healthy products.
Fish cakes. Required: 100 g perch fillet, 5 g butter, 25 g low-fat milk, 20 g crackers. Soak crackers in milk. Grind them with a meat grinder along with fish. Add the melted butter to the minced meat. Form cutlets and place them in a double boiler. Cook for 20-30 minutes. Serve with vegetables, fresh herbs or stewed cabbage.
Milk soup. You will need: 0.5 l of nonfat milk (1.5%), 0.5 l of water, 2 medium-sized potatoes, 2 carrots, half a head of white cabbage, 1 tbsp. l semolina, 1 tbsp. l fresh green peas, salt to taste. Wash and peel the vegetables thoroughly. Grind them and put them in an enamel bowl. Add water and place the container on fire. Salt the broth when it boils. Stew the vegetables over low heat until they boil. Drain the broth and wipe everything through a sieve. Pour milk into a saucepan, sprinkle potatoes, peas, cabbage and carrots. When the soup boils, add semolina and cook for 10-15 minutes.
Stewed eggplant. Required: 50 g sour cream sauce, 200 g eggplant, 10 g sunflower oil, a pinch of salt and fresh herbs. Wash and peel the vegetables. Then chop, salt and leave for 10-15 minutes. Rinse off excess salt, add a little vegetable oil and 2 tbsp. l water. Cook the eggplant for 3 minutes. Pour in the sauce and simmer for another 5–7 minutes. Serve a dish with fresh herbs.
Casserole made of bread with carrots and cottage cheese. It will take: 1 tsp. cheese-pressed sunflower oil, 200 g fat-free cottage cheese, 1 tbsp. milk, 200 g of rye bread, 4 carrots, 1 egg white, a pinch of salt and 1 tbsp. l breadcrumbs. Boil carrots and chop on a coarse grater. Add cottage cheese, bread and egg soaked in milk. Pour oil on a baking sheet and sprinkle it with breadcrumbs. Put the mass on top. Bake the dish in the oven for 25–35 minutes.
Expectant mothers should carefully choose food for themselves. This is especially true for pregnant women suffering from GDM. High blood glucose negatively affects the health of the child. If the diet is balanced, gestational diabetes can be avoided.
The energy value of food
The calorie content of the daily diet depends on the height and body weight of a woman before pregnancy. Products should be selected so that the woman’s body weight does not decrease. This is an important difference between gestational and type 2 diabetes.
The fact is that pregnant women have "ketosis of starvation." Carbohydrates are the main source of fast energy, but if it is not there, the body begins to use fats as a “fuel”. This is not bad, but not during pregnancy. The peculiarity is that a lot of available energy is needed for the development and growth of the child, and the utilization of fatty acids results in a large number of by-products (ketones), toxic for both mother and child.
That is why, if ketones are found in the urine or blood of a pregnant woman (and blood sugar is not very high), then the woman should be fed more, and not a more strict diet.
The number of calories per day is calculated based on its body mass index (BMI = body weight (in kg) / (height * height) (in meters)
Table - The energy value of the diet of pregnant women with gestational diabetes
Estimated energy value of food should be 1800-2400 kcal per day.
You can calculate it like this:
Fasting during pregnancy is prohibited!
Again, a feature of diabetes is the “accelerated starvation” phenomenon. Blood sugar tends to freely pass through the placenta to the baby, so mom quickly becomes hungry.
On the one hand, excess glucose will make the baby disproportionately large (this is also the difference between gestational diabetes - the baby is large, but his physique is wrong). On the other hand, in order to avoid hungry fainting, it is necessary to constantly maintain a sufficient level of blood sugar.
Therefore, during the day there must be breakfast, lunch, dinner and 3 snacks. You can still share these meals. That is, a woman decides how much and what she will eat in a day, and then divides it all by 6-8 times a day.
Breakfast should be as early as possible. Let small, but necessary. This applies to all pregnant women, and with gestational diabetes, it is the first meal that leads to normal sugar for the whole day.
Qualitative composition of products
To date, the following combination in the diet of pregnant women with diabetes is most recognized.
Table - Nutritional nutritional structure for gestational diabetes in pregnant women
Since this is diabetes, food carbohydrates deserve special attention. When choosing specific products, their glycemic index, the rate of increase in blood glucose, must be taken into account. This indicator has already been determined empirically for most dishes.
The lower the glycemic index, the slower the blood sugar rises. It is better to give preference to products with a low and medium value of this parameter.
The table shows the indicators of the most consumed products.
Table - Glycemic indices for certain foods
Nutrition for pregnant women with gestational diabetes should be varied. You can’t eat the same “very healthy cereal” every day.
When replacing carbohydrate-containing products, the equivalence principle is used: the allocation of various groups of carbohydrates, followed by replacement within the group.
Table - Equivalence of replaced products
Mixing different types of products in one dish slows down the increase in blood glucose.
Vitamins, micro and macro elements
There is evidence that with gestational diabetes, the need for certain vitamins and minerals is greater than that of “ordinary” pregnant women. In any case, the administration of specific drugs must be agreed with the doctor. Definitely not:
- buy mineral and vitamin complexes for people with diabetes (they may contain a large dose of fat-soluble vitamin A, which is dangerous for the fetus),
- try to fill the need with food (for example, iodine is best taken as directed by a doctor, and not walnuts, which may be "extra" for diabetes).
Vitamin D occupies a separate place. In domestic medicine, it is traditionally prescribed for children for the prevention and treatment of rickets. However, its positive effect on diabetes, including gestational, has already been proven.
It is noted that the additional intake of vitamin D reduces the likelihood of diabetes in children, contributes to their better mental development.
Although the instructions for the drug indicate that its prophylactic dose does not require laboratory tests, it is always better to first determine the content of vitamin D in the blood and consult a doctor.
Evaluation of the "correctness" of the diet
How to understand that a diet is like that and everything is done correctly? Such a criterion is an adequate increase in body weight.
|Initial body weight||Weight gain, kg|
Excessive weight is considered to be more than 1 kg per month in the first trimester and more than 2 kg in the second and third. The normal weekly gain in the first trimester is 80–170 g, in the second and third - 300–460 g.
Thus, from the foregoing, you can make an indicative menu.
Table - Menu for pregnant gestational diabetes
Since this is a treatment for gestational diabetes, it is important to note that exercise is an important component. They help improve insulin sensitivity and normalize glycemia.
Exercises should be dosed (150 minutes of active walking per week, swimming, aerobic gymnastics) and individual, taking into account the physical activity of a woman before pregnancy. It is necessary to exclude increased physical stress on the abdominal muscles.
Nutrition correction as the only therapy or in combination with physical activity, in the absence of normalization of glycemia, is used no more than two weeks.
Tableted hypoglycemic drugs during pregnancy are prohibited.
If the target blood sugar values are not reached in 2 weeks, insulin therapy is prescribed. When prescribing insulin therapy, the patient is led by an endocrinologist.
Women who have had gestational diabetes mellitus are at risk for developing type 2 diabetes in the future, which necessitates compliance with recommendations for lifestyle modifications in the future.
Early detection of a carbohydrate metabolism disorder in a pregnant woman and monitoring of this condition makes it possible to minimize the risks associated with the influence of minor chronic hyperglycemia on the formation of the fetus, the health of the newborn and the woman herself.
It is important to give recommendations for a healthy lifestyle in the future, given the increased risk of developing diabetes mellitus, and preparation for a subsequent pregnancy.