Low Carb Diets And Pregnancy

What Are The Effects Of A Low Carb Diet On Pregnancy?

Low carb diets can be used to improve fertility, manage adverse symptoms during pregnancy, and even healthfully lose weight while breast feeding. 

Keto and Pregnancy 

There has not been a voluminous amount of research conducted on the effects of low-carb diets and keto on fertility, pregnancy, and breastfeeding. From what little research there is and a small amount of anecdotal evidence, what one can discern is that low-carb diets can improve fertility, are okay during pregnancy, can help manage gestational diabetes, and that a moderate low-carb diet (50 grams a day) is okay while breastfeeding. That’s good news for women who want to exert greater control over their own health and well being!

Keto and PCOS

The keto diet is used to treat Polycystic Ovary Syndrome (PCOS).

PCOS is a constellation of symptoms caused by elevated male hormones in women. Some examples include menstrual cycles that are irregular or non-existent, ovarian cysts, sleep apnea, increased hair growth on the face and body, and decreased fertility. PCOS is a common condition, with one study revealing that it’s, “present in 12-21% of women of reproductive age. Up to 70% of women with PCOS remain undiagnosed.

In 2005, the effects of a low-carbohydrate, ketogenic diet on PCOS were documented as positive, helping participants manage their weight and decreasing the amount of male hormones in their bodies. In 2017, the journal Nutrients published, "The Effect of Low Carbohydrate Diets on Fertility Hormones and Outcomes in Overweight and Obese Women: A Systematic Review," which offered even more evidence that the ketogenic diet can be used to manage symptoms of PCOS.

These studies, however, did not touch upon the effects of a low-carb, ketogenic diet on the fertility of women who don’t have PCOS. However, according to the Office on Women's Health, which is a part of the U.S. Department of Health and Human Services, being overweight may prevent ovulation because fat cells release estrogen. The thinking goes that if you have enough fat cells releasing enough estrogen that they'll release enough estrogen to prevent ovulation and menstruation.

Keto and Gestational Diabetes

Gestational diabetes is what happens when pregnant women without diabetes get high blood sugar levels during pregnancy. It's the result of too little insulin, which is the hormone that regulates the absorption of glucose by our body's cells. As reported by the National Institute of Diabetes and Digestive and Kidney Diseases, GD can lead to both the mother and child developing type-2 diabetes, increases the likelihood of the child growing up to be obese, may cause jaundice in the baby, and can lead to a baby that's large for gestational age, which can lead to many serious complications.

If you're asking yourself, "Can diabetics do the keto diet?" the answer is, "Yes!" One of the best ways to prevent gestational diabetes and have a healthy pregnancy  is to lose weight and manage blood sugar before hand, and the keto diet is great for that. Additionally, a diet that’s lower in carbs can be used to manage the symptoms of GD once a diagnosis is received. However, doctors recommend that women with GD consume no less than 175 grams of carbs per day, which is still a lot!

As registered dietician, certified diabetes expert, and researcher Lily Nichols told The Diet Doctor, “There is no evidence that eating fewer than 175 grams of carbohydrates is harmful. The only reason medical professionals continually push a higher-carb diet is due to unfounded fears around ketosis.” More particularly, doctors fear diabetic ketoacidosis (DKA), which is completely different from nutritional ketosis. DKA is what occurs when diabetics have too many ketones in the body, which can lead to a diabetic coma.

Eating under 175 grams of carbs per day isn’t going to cause DKA. As Dr. Lois Jovanovic, former director and chief scientific officer of Santa Barbara, California's Sansum Diabetes Research Center, told Diet Doctor, "175 g of carbohydrate is stupid! Women should be going as low as it takes to keep their blood sugar regularly under 90 mg/dl (5 mmol/L)." It’s a sentiment Nichols echoes during a guest blog on the Low Carb Dietician that answers the question, “Is it safe to go low carb during pregnancy? “I find it ironic that if you tell your doctor that you plan to eat low carb during pregnancy, they’ll say it’s unsafe,” Nichols wrote, “but if you say you plan to eat a diet based on fresh vegetables, meat, fish, eggs, dairy, nuts, seeds, and a little fruit, they’ll encourage you to stay the course. “ Following the advice of Jovanovic and Nichols would mean having the sort of diet while pregnant that would allow the fetus to get both the ketones and glucose necessary for proper physical and brain development.

Eating that amount of carbs is also going to be better for both mother and child because it will entail cutting out processed foods and sneaky foods with added sugar. And if mom still has cravings, it’s possible to learn how to eat sweets while doing keto and there’s plenty of great keto friendly almond flour recipes for bagels, bread, biscuits, and even cake!

Low Carb and Breast Feeding

A moderately low carb diet may be okay while breastfeeding.

Keto and breastfeeding are not an advisable combination, so mothers will have to change their keto lifestyle a little bit. If you want to eliminate unhealthy, carb heavy foods from your diet in favor of nutrient dense foods, and maybe even reverse weight gain while breastfeeding, 50 grams of carbs is the number most often suggested. 50 grams is even the amount used by Atkins. In a blog titled, “Oh, Baby! How to Lose Baby Weight with Atkins”, Colette Heimowitz, MS, Director of Education and Research for Atkins Health and Medical Information Services, wrote, “You should be able to lose weight gradually while breastfeeding by keeping your daily carb consumption around 50 grams of net carbs or above. Nursing a baby requires a reasonable amount of calories, so you should see a gradual weight loss. The issue is that too rapid a weight loss, combined with the concomitant release of toxins stored in fat cells, might also be transmitted into breast milk. Until you wean your child, losing only 1 to 2 pounds a week should be your goal.”

To have adequate milk supply it’s essential that you’re staying well-hydrated. Low carb, high fat diets have a diuretic effect, so it’s also a good idea to drink fluids and replenish your electrolytes regularly. It’s also important for mothers to remember that a high fat, low carb diet’s appetite dulling effects may lead to a diet with insufficient calories. This can be remedied by adding some fruits to the diet so that a drop in glucose levels triggers hunger. And even though you may know what you need to know about intermittent fasting, it’s not something you should practice while pregnant or breastfeeding. Above all else, it’s important to stay informed because the effects of low carb and ketogenic diets during pregnancy are still being researched in both formal and informal settings.