Ketosis And Gestational Diabetes, Keto And Pregnancy is the subject of today’s article.
There are still traditional cultures that eat a very low carbohydrate diet (even in pregnancy). The ketogenic is not just a new trend; it’s part of our culture and evolution.
What is ketosis?
Three different metabolic states are associated with ketosis. General ketosis (Induced by diet), starvation ketosis (induced by fasting ), and ketoacidosis.
In nutritional ketosis, energy intake is sufficient to meet energy needs. Still, the body is offered only a small amount of carbohydrates or glucose, forcing it to switch to fat as an energy source. The body converts the fatty acids to ketone bodies in the liver.
And the production of ketones in intermittent fasting due to an insufficient calorie intake.
But diabetic ketoacidosis (only in insulin-dependent diabetics, see table) is caused by severe insulin deficiency.
When is the ketogenic diet not good for pregnant women?
If you want to try or you’re on a ketogenic diet, and you’re pregnant, you need to be careful about these points:
- You are not an insulin-dependent diabetic.
- You are taking in enough food energy to sustain yourself and the baby.
- You do not have permanently elevated blood glucose levels.
Ketosis in gestational diabetes
Women with gestational diabetes need to reduce the carbohydrates in their diet to reach blood glucose limits, but doctors sometimes advise ketosis.
However, mild nutritional ketosis in gestational diabetes should not be confused with diabetic ketoacidosis, which needs really fast medical treatment.
And a slight elevation of ketone body levels in urine is quite normal in pregnant women and is not a cause for concern.
Ketosis is normal during pregnancy.
The levels of ketone bodies already increase significantly overnight (12-18 h without food). So an elevated concentration of ketones in the morning urine of pregnant women is quite normal. And according to multiple studies show that evening snacks can reduce these levels.
Because of changes in metabolism, pregnant women generally have higher blood ketone body levels than non-pregnant women, especially in the 3rd trimester.
Besides, at the beginning of pregnancy, the body strives to hoard nutrients and energy, while in the last trimester, energy and nutrients are increasingly made available to the unborn child.
While glucose is the baby’s primary energy source, fatty acids become the energy substrate for the pregnant woman. And the body produces more ketone bodies than before pregnancy.
Ketosis and brain development of the fetus:
According to a study from 1965 by Churchill, too high ketone body levels harm brain development, lead to a lower IQ, and later learning disorders in the child.
However, these results only refer to a study in which ketone bodies were measured once in the urine. In further studies, these results could not be confirmed.
Recent scientific studies show that higher ketone body levels occur in the placenta of healthy pregnant women than in the blood.
Furthermore, healthy babies also showed elevated levels in the first month of life.
So what can you do?
It is best to eat something before the urine collection at the doctor’s office. Before going to bed, the snack also helps not have so many ketone bodies in the urine in the morning.
Perhaps you’re a bit dehydrated, especially if it is warm outside. Then it is best to drink something before your urine collection.
If these measures don’t help or feel otherwise unwell, you should discuss this with your doctor.
More healthy eating tips for pregnant women or women with gestational diabetes can be found here.
Sources:
- “Real food for gestational diabetes” book by Lily Nichols (2015).
- Felig P and Lynch V Starvation in human pregnancy: hypoglycemia, hypoinsulinemia, and hyperketonemia Science 170(3961): 990-2.
- Metzger BE et al. “Accelerated starvation” and the skipped breakfast in late normal pregnancy. Lancet 1(8272):588-92
- Liu LX and Arany T. “Maternal cardiac metabolism in pregnancy.” Cardiovascular research 101.4 2014: 545-553
- Coetzee EJ et al. Ketonuria in pregnancy- with particular reference to calorie-restricted food intake in obese diabetics 1980 Diabetes 29(3): 177-81.
- Spanou L et al. Ketonemia and ketonuria in gestational diabetes mellitus. 2015 Hormones 14(4): 644-50.
- Churchill JA et al. Neuropsychological deficits in children of diabetic mothers. A report from the Collaborative Study of Cerebral Palsy Am J Obst and Gynecol 1969105(2): 257-68.
- Freinkel N et al. The 1986 McCollum award lecture. Fuel-mediated teratogenesis during early organogenesis: the effect of increased concentrations of glucose, ketones or somatomedin inhibitor during rat embryo culture. 1986 Am J Clin Nutr 44(6):986-95.
- Muneta T et al. “Ketone body elevation in placenta, umbilical cord, newborn and mother in normal delivery.” Glycation Stress Research 3 2016: 133-140
- Lavoie C Gestational diabetes: poke, pee, and eat your carbs 2011 Can Fam Physician 57(7):756-7 (field report).
