One of the most frequent questions I get asked these days is about the safety of a KETO diet during pregnancy. Man, there are A LOT of opinions out there about the matter so let’s dive in to the pros and cons of a ketogenic diet during pregnancy.
What is KETO
If you’ve been living under a cave for the past few years, you may never have heard of this now popular diet trend. If you haven’t been living under a rock, then you’ve likely heard a little about the ketogenic diet. First made popular in the medical treatment of neurological disorders like epilepsy in the 1920s, the ketogenic diet has made a modern comeback as an extreme modification to the low carb craze that started sometime in the late 2000’s. Today keto is being marketed as the latest trendy diet to help you shed unwanted fat, control high blood sugar, have more energy and think more clearly.
Eating keto is pretty simple but also pretty complex depending on your bodies response to dietary carbs and protein. In order for someone to truly reap the benefits of keto, they have to enter a state of nutritional ketosis which means that there are no available CARBS in the body (the body’s preferred energy source) to metabolize so the body is forced to utilize other energy sources such as FAT. This metabolic state produces KETONE bodies which can be measured in the urine or the blood and blood sugar levels remain normal or low- normal. Ketone bodies are a sign that the body is burning fat for energy, not carbs. It’s important to note that nutritional ketosis is different from starvation ketosis or diabetic ketoacidosis, which also produce ketone bodies but have a different mechanism for how they are produced.
Back to nutritional ketosis…Here comes the tricky bit, in order to get into ketosis you have to keep CARB intake to a bare minimum….for many leafy greens and non starchy veggies only and the bulk of your diet should contain FAT and some PROTEIN. For some, having too much protein can kick them out of ketosis and when this happens, much of the benefits of the keto diet such as mental clarity and energy may be lost. The real pain in the ass part about keto is for the first little while, most women need to diligently track, measure and weigh their food in order to stay in ketosis which, for some women who may have struggled with disordered eating may be triggering, for others, it may just be non sustainable and annoying.
This is by NO means a total summary of the Keto diet but should give those with little info a bit of a background.
Why Keto may be good for some women
I dabbled in the keto world before keto was kind of a thing and this was a typical small meal/snack.
-
If you’re trying to conceive and have diabetes or PCOS a temporary ketogenic diet may be all you need to help you ovulate more regularly.
-
If you are obese and are preparing to conceive, this diet may help you shed pounds quickly and take charge of your diet which will reduce the risk of pregnancy complications when you do conceive.
-
You have been diagnosed with Gestational Diabetes (GD) and are having a hard time regulating your blood sugar with a low glycemic diet.
-
If you aren’t an endurance athlete (some male athletes do well on keto but very rarely do women) and feel good on this diet, have a healthy BMI, ovulate regularly, sleep well and have abundant energy without being diet obsessed, this may work for you. Women from Inuit, Masai and women who are natives of Greenland and Alaska may be included in this group.
KETO may be unhealthy for some women
-
If you are underweight or already have a low body fat (Under 23{f061691ba7220d88be23c216ba0701b88f7cb50120c5dfc52e143cf80de1ff51} which is considered optimal for fertility).
-
If you have a history of disordered eating or restriction
-
If you have adrenal fatigue or unbalanced hormones (unless it’s verified PCOS and NOT lean PCOS…don’t know, send me a message, I can help) Why? Going keto can temporarily RAISE cortisol levels.
-
If you are healthy and pregnant eating a real food diet
-
If you are trying to conceive
-
If you are with in the first 6 months of breastfeeding
What does science say about ketosis during pregnancy
Well, there just haven’t been many or really any studies done on healthy women in nutritional ketosis during pregnancy. I don’t really think there ever will be any reputable trials done either as earlier studies done on diabetic women or done on women who are in starvation based ketosis have yielded non positive results and doing further studies may be simply viewed as being unethical.
There was one study done on mice in 2013 and published in the peer reviewed BMC Pregnancy and Childbirth journal that showed that a ketogenic diet when fed to healthy mice during gestation caused “ alterations in embryonic organ growth. Such alterations may be associated with organ dysfunction and potentially behavioural changes in postnatal life.”
Studies done on women who were in diabetic ketosis during pregnancy, showed that indeed ketosis could be harmful for a developing fetus however they were not able to ascertain if this harm was caused by high ketone levels, high blood glucose levels or simply an improper acid base balance or most likely a combination of all three.
Studies done on women in starvation ketosis also showed that there was harm to the developing fetus putting the baby at risk for preterm birth, inadequate growth ect Again, however, we cannot prove that it was the ketone bodies that caused this as during a period of starvation a baby is deprived of much more than just glucose and is lacking CALORIES and important micronutrients.
What we do know about nutritional ketosis during pregnancy
Pregnancy actually can actually naturally produce a temporary state of ketosis on it’s own, especially during the third trimester. That being said, during this state of temporary ketosis, blood glucose levels remain normal providing fuel to the developing baby. A steady stream of glucose is crucial to a developing infant…too much or too little can cause issues.
Babies can utilize ketones for fuel some of the time. Neonates are often found to be in a state of ketosis. This is a smart adaptation because often times it can take anywhere from 3-5 days before a mothers milk comes ‘in’ and babies need to utilize their fat mass for fuel, as a result, they easily slip into ketosis. A study in Japan noted, “When normal neonates and neonates testing positive for ketosis were compared, no statistically significant correlations were found with regard to birth mass, gestational period, or gender. However, neonates with ketosis tended to have low mass gain rates in the 5 days from birth and a statistically significant difference was found in this regard in comparison to normal neonates”.
From this data we can theorize that although neonates (aka babies once they are born) can utilize ketones, which is a crucial survival adaptation in the early weeks, when metabolism may be CATABOLIC (breaking down tissues for fuel) while waiting for milk to come in and learning how to feed. We can also assume that during the ANABOLIC (building tissues) times during all of pregnancy especially the third trimester, having low glucose availability may not be ideal and that while a baby can survive on ketone bodies, alone, in the absence of glucose, they may not thrive….and so, it is important that a mom maintain health blood sugar levels when dipping into ketosis either purposely or inadvertently.
What do real women say about a keto diet during pregnancy
Some women I’ve spoken to have found that keto is the ONLY thing that helped control their gestational diabetes and kept them off insulin. For these women, keto may be a miracle diet because as we know, in terms of blood sugar levels, the key to a healthy pregnancy and healthy baby is to have a normal blood sugar. If keto brings your blood sugars back into the normal range, GO FOR IT!
Some other women I’ve spoken to have tried keto in pregnancy or were keto before pregnancy and found that they simply craved and needed more carbohydrates from real food (think squash, potatoes, yams) than they did before they were pregnant. It was the only thing that got them through the first trimester. I strongly believe that, in the absence of illness or disease, you should listen to your body’s wisdom and not restrict your bodies desire for additional glucose.
What Do I think
I believe that a ketogenic diet can be a useful tool when used as a therapeutic diet for some women, especially those who have dangerously high blood sugar levels. That being said, for the average healthy woman, even if she feels she’s a touch overweight, keto can be something fun to play with when you AREN’T trying to conceive or are pregnant or are breastfeeding. Putting your body into a state of ketosis adds stress to the body and increases cortisol levels temporarily, this just isn’t good for any women in the childbearing cycle nor is it good for a developing fetus. Plus, and perhaps most importantly, a developing baby needs a constant supply of glucose during gestation in order to grow. Glucose is literally the fuel that drives baby’s development, and it comes directly from the carb content of mom’s diet.
This amazing Peanut Butter and Date shake is one of our Baby Making and Beyond recipes included in the Core 4. It includes fats, proteins and healthy carbs in healthy proportions.
HERE IS THE COOL THING…..if you ask women to eat intuitively during their pregnancies they will naturally include an abundance of healthy carbohydrate into their diets, this in addition to healthy fats and proteins. Personally, since becoming pregnant the carbohydrate content of my diet has increased from what it was. My body simply is asking for more, and I’m listening. My blood sugars are very normal, my weight gain has been perfectly inline with recommendations and I feel satisfied and enjoy food without stressing about what I eat.
I’m not saying you have the green light to throw back a bag of chips or box of cookies, but what I am saying is that quality carbs when used in sufficient but not excessive amounts can really be KEY to having a healthy pregnancy and postpartum recovery. Carbs from whole food sources contain fibre, antioxidants and many micronutrients. Curious how many to eat with percentages? Curious what carbs to include? Learn all about what we call “green light carbs” and “red light carbs”. That’s all covered in the Core 4 section of Baby Making and Beyond. Lower carbohydrate diets may be preferable to high carbohydrate diets but taken to the extreme, I don’t think a ketogenic diet is the way to go during pregnancy.
SOURCE: Meg the Midwife – Read entire story here.
