Ketones & Low Carb in Pregnancy

[hugebelly]

I've name changed for this.

Recently pregnant and I saw my GP today. I'm 5'6 and weigh 13.5 stones - overweight/ obese. Never lost weight from my first baby.

My GP has said that I shouldn't gain weight in my pregnancy and suggested a low carb diet to help me with this. Having done Atkins in the past, I asked him about ketones and he replied that trace/ low ketones are fine.

For anyone out there in 'the know', is this okay? Having read a few threads on the pregnancy board, some midwives get angry if you're in ketosis and some don't. Just a bit confused as my GP really knows his stuff.

Advice if you have any, thanks!

I lost weight in both pregnancies (not intentionally) and had two 9 pounders. Only one midwife was concerned with the ketosis but I had lost quite a bit by the time I saw her. Sorry, I 've been no bloody help at all!

I wouldn't have thought low carb was the way to go though. Balanced diet smaller portions.

Be careful. I usually follow a low carb diet and am often in ketosis. I have had two GPs in different countries say that is fine for me but a bad idea for baby.

Yesterday my urine sample had ketones in it (I know why - it is still hard for me to remember to eat carbs) and the midwife said it was a bad idea.

Maybe lower carb and very slow burn carbs is a better idea. Try to drop any refined stuff at all (including pasta/white bread/rice) and switch to getting your carbs from fruit and veg instead.

In order for a real low carb diet to work you need to eat plenty of fat as well, you must not do low carb/low fat it will make you very sick - I speak from experience here and it can be hard to keep the level of fat down when you are pregnant (again experience).

Ask to see a dietician to help you. I had gestational diabetes during pregnancy and the dietician told me a portion of carbs was essential with every meal, but that it should be complex carbs, like wholemeal seeded bread, lentils, boiled new pots not mash. Basically anything that digests more slowly.

I realise that my opinion will differ from most everyone else's on here, but I've read A LOT about nutrition (I've been studying it for myself for about 10 years) and I can find no evidence for a high protein diet being at all healthy.

Carbs have been given a bad rep because eating refined sugar, cakes, cookies, white bread, white rice, etc does make you gain weight. But eating true wholemeal bread, pasta, noodles, couscous, quinoa, lentils and brown rice will not. These are essential and good for you, and carbs are the primary source of a body's energy. Just eat the good ones, not the bad ones. (This is actually the (revised) advice from Atkins Inc.)

Also, all fruit and veg contain some carbohydrates, as well as some protein. If you eat a variety of these foods, you will get your carbs, protein and plant-based fats which are all good for you. Then just limit the amount of animal-based fats, and not only will you have an incredibly healthy diet involving most foods, but you will not gain excess weight. There are tons of recipes on the internet that are free if you need ideas. It's also less expensive to cook this way.

Doctors, by the way, are given approximately 1-2 total hours of nutrition training while in medical school. I personally have never met a conventional doctor who knew the first thing about nutrition.

disclaimer: I'm a nurse.

Low carbs is THE WORST for pregnancy. a low/trace is not "fine" he doesn't understand a thing about women's health and pregnancy if he offered you something like that!!!

I had GD with DS, and was on a diabetic diet (especially for diabetic people, fitted for me by a dietician who specializes in GD)- and it too included carbs. even diabetic people (who allegedly aren't allowed carbs) need carbs to sustain themselves!!

I didn't gain weight in my pregnancy (ended up 10 pounds lighter then when I started) but you will gain weight even if your original body mass doesn't change (i.e.- you will not accumulate more fat)- the weight of baby, water, your blood volume, etc.

Thanks for your input everyone.

I don't think my GP intends me to do a carb free diet, just low carbs. I'm going to cut out refined sugary food and snacks and as an diet, I shall probably eat:

Breakfast: Scrambled eggs on toast with tomatoes/ omelette and toast.

Lunch: chicken/ poached salmon salad and avocadoe. Fruit.

Dinner: Lamb/ Beef with veg and new pots/ wholewheat pasta. Sugar free jelly.

Snack: Cucumber/ Carrot sticks and fruit.

Obviously, I eat out and inevitably I shall have the odd chocolate bar (Easter's approaching) and the above is just a guide. It's looks rather healthy to me and a radical improvement on my existing diet.

Having looked at a carb counter, there's an enormous amount of carbs/ sugar in fruit!

I agree with Shiri. I don't know much about nutrition/I have no formal training, but I did have severe anorexia for almost 10 yeras, so picked up quite a bit along the way in various forms of treatment. When I was anorexic, I was pretty much continually in ketosis, only coming out of ketosis in "bulimic" stages. Personally, and this was also the case for everyone else I met in every hospital I was in, being in full ketosis coincided almost excatly with a lack of periods. In other words, the ketosis went hand in hand wth the body failing to produce the usual female hormones. I cannot for a minute imagine that this is a good thing in pregnancy which is hormone driven.

I won't go into all the reasons why here, but cutting out a whole food group is NEVER a good thing. Although carbs are not vital in the same way as certain vitamins are, they are important. Most significantly, a lack of carbs in the diet (and being in ketosis generally) causes osteoperosis. For instance, after years of anorexia, I now have significantly reduced bone density as a direct result of ketosis.

Could you consider a low GI diet rather than a high protein diet to ensure that you do not gain excessive weight during this pg?

Hugebelly

When I was pregnant last year I checked with the doctor as I was losing weight just through healthy eating (no dieting as such but basicallly ate low GI foods, lots of veg etc and cut out all the sweets/biscuits etc). I lost a stone in the first 6 weeks and was concerned about the impact on the baby. My doctor felt that as long as I was eating a balanced healthy diet there shouldn't be a problem.

Unfortunately I miscarried last year - but as I'm now pregnant again (6 weeks and roughly the same size/height as you), I'll be watching this thread with interest. My aim is just to eat healthily rather than watch my weight per say.

PS spot the overweight usernames!

Riven - when I did the Atkins diet about 8 years ago, my cholesterol dropped too, from 6.1 to 4.9. I lost 3 stones over the course of about 5 months, so I suppose it can be done. Haven't a clue what tryglicerides are, so I don't know if they went down aswell.

thefatladyscreams - it's interesting that your GP said it's fine for a big weight loss in pregnancy, but you're right, healthy eating is the way to go. I just didn't realise how much refined sugar I ate - it's in everything. LOL at the usernames .

I'm not increasing my protein, just eliminating refined carbs, which can't be a bad thing .

My cholesterol is much better when I am low-carbing, it probably is different in children Riven and your DD's situation/needs are completely different from an overweight adults.

I agree with you that there is just no way to know what is going on in those little kidneys, which is why I eat more heavy grains and fruit to keep myself out of ketosis when pregnant.

It absolutely is the healthiest diet in the world for me usually. I am a lean, muscular 75kgs when I watch my carbs, when I started I was almost 140kgs (7 years ago - so you need to maintain as well).

hugebelly the food you listed sounds good - but you need more veg - low carb veg is excellent eat lots and lots of it.

Morloth - 140kgs to 75kgs is seriously impressive!

Took a looooong time (with a pregnancy in the middle).

Hugebelly.. I am 5ft 7 and pre pg weighed 14.5stone.. I have put on 2 stone, and all the medical professionals I have seen have been happy with this .. This is my 4th Baby.

Not once has someone mentioed to me about not putting weight on and I am 39weeks tommorrow..

threeplusone I think the problem with me is that I used to be 10 stone before DD1, gained 4 stone with her and never lost it (laziness and gluttony). I'm very uncomfortable at 13.5, which is probably why my GP suggested that I don't gain any more.

I know nothing about low carbs etc. in pregnancy but just wanted to suggest slimming world as it's recommended by the Royal College of Midwives (or whatever they are called!) and I know a few pregnancy women who have followed it to manage their weight gain with success.

I can't help but think that you'd end up feeling a little shitty going low carb as a lot of the time carbs are the only thing that make me feel vaguely human (am 15 weeks)