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 and how high blood glucose levels rise after eating a particular food i.e.

• 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 at the link at the end of this section.

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. This can further increase insulin resistance.

Eat small amounts of healthier fats such as: canola, olive, sunflower, rice bran oils; polyunsaturated margarines, avocados and unsalted nuts.
Limit saturated fats: choose lean meats, remove skin from chicken, choose low fat dairy foods.
Limit take away and processed foods e.g. pizza

Protein

Protein is essential for the growth of your baby.

Include 2 serves of meat or meat alternatives in your diet each day.

As legumes affect blood glucose levels they need to be counted in your carbohydrate serves.

Calcium

Calcium requirements increase in pregnancy. Aim to include 3 - 4 serves low fat calcium rich foods each day. Good sources include milk, yoghurt, and custard. As they affect blood glucose levels these foods need to be counted in your carbohydrate serves.

Points to remember

Artificial Sweeteners

Small amounts of sweeteners are not known to be harmful, but should be avoided as much as possible. Aspatame (Nutrasweet, Equal) (951), Sucralose (Splenda)(955), Acesulphame Potassium (950) can be used.

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

Avoid large amounts of caffeine. No more than 2 cups of coffee or 2 caffeine containing drinks or 4 cups of tea per day is advisable.

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 resource: 'Healthy Eating for Gestational Diabetes'
This is a publication by SA Health and the Women's and Children's Hospital. 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.