Low-Carbohydrate Diets for Gestational Diabetes

Abstract

Nutrition therapy provides the foundation for treatment of gestational diabetes (GDM), and has historically been based on restricting carbohydrate (CHO) intake. In this paper, randomized controlled trials (RCTs) are reviewed to assess the effects of both low- and higher CHO nutrition approaches in GDM. The prevailing pattern across the evidence underscores that although CHO restriction improves glycemia at least in the short-term, similar outcomes could be achievable using less restrictive approaches that may not exacerbate IR. The quality of existing studies is limited, in part due to dietary non-adherence and confounding effects of treatment with insulin or oral medication. Recent evidence suggests that modified nutritional manipulation in GDM from usual intake, including but not limited to CHO restriction, improves maternal glucose and lowers infant birthweight. This creates a platform for future studies to further clarify the impact of multiple nutritional patterns in GDM on both maternal and infant outcomes.

Large for Gestational Age and Risk for Academic Delays and Learning Disabilities: Assessing Modification by Maternal Obesity and Diabetes

“…Additionally, studies assessing prenatal care strategies for women with gestational diabetes, including nutritional therapy, may look to assess the impact on LGA rates as well as delays in children [ 42 ]. Understanding the potential for mitigation of delays is an important next step.…”

Are mice born normally with an egg-only diet?

“…However, they critically evaluated the many low-CHO studies as low to very low quality 16 . Further low-CHO with high lipids increased fasting total cholesterol and FFA, which increased inflammation and insulin resistance 17 . WHO guideline recommended a low-fat diet (<30% of energy) and limiting saturated fatty acids to less than 10% of energy intake by replacing them with unsaturated fatty acids 18 .…”

Effects of Nutrient Intake during Pregnancy and Lactation on the Endocrine Pancreas of the Offspring

“…Half of the GD prevalence can be explained by overweight and obesity. Today, GD impacts approximately 20% of pregnancies in the world and this is close to 40% for women in Europe [33]. Evidence also links GD and/or obesity to increased risk of maternal and neonatal outcomes such as T2D in mothers and offspring obesity [34,35].…”

“…The use of low-carbohydrate diets during pregnancy has recently been extensively reviewed in the context of GD [33]. In summary, instructions for a less-restrictive carbohydrate diet, including an optimal mixture of higher quality carbohydrates with a lower glycemic index and less fat, may be preferred to a restrictive diet because of its reduced effect on metabolism.…”