Gestational Diabetes Treatment Plan
Many women with gestational diabetes have healthy pregnancies and healthy babies because they follow the treatment plan that their health care providers set up for them.
One of the most important things you can do to help ensure a healthy pregnancy is to make regular health care appointments and keep them.
A general treatment plan to control gestational diabetes may include these items:
- Knowing your blood sugar level and keeping it under control
- Eating a healthy, balanced diet
- Getting regular, moderate physical activity
- Maintaining a healthy weight gain
- Keeping daily records of your diet, physical activity, and glucose levels
- Taking medications as prescribed, you may need a medication if:
- Your blood sugar level is too high.
- Your blood sugar level is high too many times.
- Your blood sugar level remains high, but you are not gaining much weight or are not eating poorly.
- You cannot safely add physical activity to your treatment plan.
Is There Any Study That Compares Low Carb Versus Low Fat Diet
When it comes to low-carbohydrate verses a low-fat diet, the studies are predominantly being done on those with health problems including diabetes, metabolic syndrome and obesity.
The outcomes measured are weight loss as well as blood sugar levels, cholesterol and triglycerides .
1.Foster GD, et al. A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine, 2003.
The New England Journal of Medicine randomly placed 63 individuals in either a low-carbohydrate or a low-fat group that had calorie restrictions. This study lasted for one year.
Study results: The low-carbohydrate group lost more weight compared to the low-fat group
2. Samaha FF, et al.A low-carbohydrate as compared with a low-fat diet in severe obesity.New England Journal of Medicine, 2003.
The New England Journal of Medicine conducted a study with 132 individuals with an average BMI of 43 and considered severely obese. Most of the subjects had Type 2 diabetes and metabolic syndrome. The study lasted for six months.
Study results: The low-carbohydrate group lost an average of 12.8 pounds while the low-fat group lost only 4.2 pounds. There was also significant improvement in triglycerides and cholesterol level.
3. Sondike SB, et al. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. The Journal of Pediatrics, 2003.
The study lasted for 12 weeks.
Weight Loss: The LC group lost 6.9kg while the low-fat group lost 2.1kg.
How Many Carbs To Get Into And Stay In Ketosis
A comprehensive study conducted in 2018 confirmed that a person could consume up to 50 grams of carbs per day while remaining in ketosis. The study also confirmed that a female should limit daily carbs to 40 grams maximum per day to stay in ketosis.
- Standard ketogenic diet: 70% of your intake is from fat, with 20% from proteins, and 10% only carbohydrates.
- Cyclical ketogenic diet: an ongoing cycle of 5 low carbohydrates days followed by 2 high carbohydrate dates
- Targeted ketogenic diet: You can eat more carbohydrates around the time you complete high intensity workouts.
- High protein ketogenic diet: 60% of your intake is from fat, with 35% from proteins, and only 5% from carbohydrates.
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Definition Of A Low Carb Diet: What You Need To Know
Remember, there are no specific guidelines for bariatric patients beyond what the healthy recommendations for adults is. The Dietary Guidelines for Americans and the Institute of Medicine’s recommendations for carbohydrates are based on a percentage of total calories rather than an absolute number:
- 45-65% of total daily calories.
Now that’s more carbs than a bariatric patient can usually physically fit down in a day.
- 40% however, is doable.
A diet consisting of 40% of total calories coming from carbohydrate is:
- Considered low carb of total calories after all!)
- Low but not TOO low
- Enough to prevent low energy and food cravings
Note: If youre still in the recovery stages, this calculation wont be practical. Its best used once you’re healed and on the bariatric diet for life.
What Is A Low Carb Diet
A low-carbohydrate diet consists of eating protein and fat with less than 100 grams of carbohydrates each day.
It consists of eating eggs, meat, fish, fruits and vegetables, nuts, seeds, good fats such as avocados and olive oil.
It also means NOT eating highly processed foods, sugar, high fructose corn syrup and low-fat foods. If it has more than 5 ingredients, you do NOT want to eat it.
Eating leftovers makes eating a low-carbohydrate diet easy.
Simply cook your meats and vegetables separately and store them in the refrigerator separately. In no time at all, you will have a variety of meats and vegetables to mix and match for a unique meal throughout the week.
Eat plenty of big salads. Take advantage of the Romaine lettuce heads, organic lettuce and the variety of mixed salads available in the produce section. Top with your favorite source of protein or leftovers from dinner the night before.
It is always best to make your own salad dressing using extra-virgin olive oil, your favorite vinegar, herbs, mustard, lemon and season with Himalayan Pink Sea salt and pepper to taste.
Just so you are clear about eating a low-carbohydrate diet, take a look at the following list:
Foods to AVOID:
- Dark chocolate that contains a minimum of 70% cocoa
- Beverages include coffee, tea or water
Each meal should be composed of one of three items:
1. Meat and poultry, fish and other seafood, eggs.
- Eggs: It is better to choose Omega-3 enriched eggs. Theyre healthier.
2. Fats and Oils.
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What Counts As A Low Carb Diet
Theres no clear definition of exactly what constitutes a low carb diet, and whats low for one person may not be low for the next.
An individuals optimal carb intake depends on their age, gender, body composition, activity levels, personal preference, food culture, and current metabolic health.
People who are physically active and have more muscle mass can tolerate a lot more carbs than people who are sedentary. This particularly applies to those who do a lot of high intensity exercise, like lifting weights or sprinting.
Metabolic health is also a very important factor. When people develop metabolic syndrome, obesity, or type 2 diabetes, their carb needs change.
People who fall into these categories are less able to tolerate a lot of of carbs.
Summary
The optimal carb intake varies between individuals, depending on activity levels, current metabolic health, and many other factors.
What Are Net Carbs
Net carbs refer to the amount of carbs a food contains after subtracting the fiber.
Its generally accepted that the fiber in whole foods isnt digested and absorbed.18 However, not all experts on carb-restricted diets agree on this point.
Additionally, in people with type 1 diabetes, fiber may distend the stomach and trigger the release of hormones that raise blood sugar.19 Therefore, you can either subtract the fiber carbs in whole food to get the net carbs or count total carbs, depending on your personal preference and tolerance.
Here is an example of how to calculate net carbs: 100 grams of cauliflower contains 5 grams of total carbs, 2 of which come from fiber.
5 grams of total carbs minus 2 grams of fiber = 3 grams of net carbs.
On the other hand, many processed low-carb foods display labels indicating their net carbs, which reflect their total carbs minus added fiber and sweeteners known as sugar alcohols. Studies have shown that some of these additives can be partially absorbed and raise blood sugar levels.20 Therefore, the term net carbs on packaged foods may be very misleading.
When calculating net carbs, only subtract fiber from whole foods. In any case, we recommend sticking with whole foods and avoiding processed and packaged low-carb products.
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Lowering The Risk Of Heart Disease
It was previously thought that increasing fat in the diet may result in a negative impact on our cholesterol levels and increase the risk of cardiovascular disease .
Research studies have shown that intake of fat in the diet can affect cholesterol levels. However, large meta-analyses have found no relationship between saturated fat intake and CVD or mortality rates. This suggests that lowering carb intake and replacing with increased protein and fat will not increase risk of CVD as previously thought.
To further support this, a recent Prospective Urban Rural Epidemiology study, involving over 135,000 participants from around the world, also found that populations with higher fat intake had reduced mortality rates. Its important to keep in mind that this was an observational study, so we cannot draw solid conclusions from it. However, this study does make the previously held belief that increased fat intake leads to increased mortality much less likely.
Key points:
- Contrary to previous beliefs, lowering carb intake and increasing protein and fat intake does not increase your risk of heart disease.
- A suggested theory of why low-carb diets protect against heart disease is that they help to protect our blood vessels.
What Do I Need To Get Started Counting Carbohydrates
To get you started counting carbohydrates, pick up these items:
- A calculator
- Measuring cups
- A food scale
It is tempting to eyeball or guesstimate food measurements. However, when you first begin carbohydrate counting, dont guess. Use measuring cups to see what portion sizes look like you may be surprised! For some foods, weighing out your food portion on a food scale may also be helpful. Estimating 1/2 cup of breakfast cereal, or selecting one ounce of bread or fruit isnt as easy as you might think.
To sum up, here are some tips about getting started with carbohydrate counting:
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Is A High Protein Diet The Same As A Low Carb Diet
Protein is an important element in building lean muscle tissue and when it is combined with exercise, it yields results.
Normally, your body burns carbohydrates for energy however when you cut or reduce carbohydrates, the body goes into ketosis.
Your body burns its own fat for fuel making your fat stores a primary source for energy and you lose weight.
Bottom Line: A high protein diet can be balanced with a low-carbohydrate diet by focusing on high-quality protein and plenty of vegetables without the processed foods.
Keto Diet Vs Low Carb: Differences
First up, your carbohydrate intake will differ depending on whether youre following a keto diet or simply low carb. With a low carb diet you’d be expected to eat 50-150 grams of carbs per day, but keto diets are restricted to just 50 grams, says Morgan.
Protein intake is another factor that differs. Low carb diets generally require a large intake of protein, but keto diets moderate your protein consumption to between 20-22% of your total calories. Keto diets also require a large intake of fats compared with low carb diets to compensate for the protein and carbohydrates.
Normanton says if your goal is to build muscle, then going low carb could be a better option, as glucose is needed to repair muscle. Many people also feel that a low carb diet is an easier transition and therefore some start with that, then move onto keto, she says. The keto diet is also very popular with athletes and some marathon runners swear by it as their bodies are fat adapted and it can help them maintain endurance for longer periods of time without needing carbs to refuel.
Morgan says that these symptoms generally last for a week or less, but in extreme scenarios they have been known to last to a month, so it’s important to be mentally prepared and fully equipped with an experienced professional to guide you before you decide to start your diet.
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Exercise It Can Be A Ketone Boosting Tool And A Keto Dieters Worst Nightmare
The right type of exercise at the right time can help you achieve ketosis more quickly and boost your bodys ketone levels.
For example, if your goal is to achieve ketosis as rapidly and healthily as possible, then it is best to use high-intensity training as a tool to deplete glycogen and low-intensity exercise as a tool to encourage fat and ketone burning. What exactly does this look like?
If you are just starting the ketogenic diet, then you should focus on using exercise to deplete your glycogen stores, so your body is forced into ketosis more quickly. Heres how:
- Do at-least one hour of high-intensity activity first thing in the morning
- This can be heavy weight-lifting, cross-fit training, high-intensity interval training, etc.
- After the workout, focus on recovery, rehydration, and mineral supplementation.
- For even better results, do not eat anything until dinner time.
After depleting glycogen, you should use low-intensity exercise to enhance fat burning and increase ketone levels. Heres what that looks like:
- Do at least 30 minutes of low-intensity activity every day
- This can be a brisk walk, cycling, dancing, etc.
- For even better results, do this first thing in the morning before eating.
However, if you do so much high-intensity exercise that it overwhelms your body with stress, then you may impair your ability to stay in ketosis. This is because stress can shut down ketone production.
How Does Food Affect Blood Sugar Levels
Many factors, including exercise, stress, and illness, affect your blood sugar levels. That said, one of the largest factors is what you eat.
Of the three macronutrients carbs, protein, and fat carbs have the greatest effect on blood sugar. Thats because your body breaks down carbs into sugar, which enters your bloodstream.
This occurs with all digestible carbs, including refined sources like chips and cookies as well as whole, unprocessed sources like fruits and vegetables.
When people with diabetes eat foods high in carbs, their blood sugar levels can surge. High carb intake typically requires high doses of insulin or diabetes medication to manage blood sugar.
Given that people with type 1 diabetes are unable to produce insulin, they need to inject insulin several times a day, regardless of what they eat. However, eating fewer carbs can significantly reduce their mealtime insulin dosage.
SUMMARY
Your body breaks down certain carbs into sugar, which enters your bloodstream. People with diabetes who eat a lot of carbs require insulin or diabetes medication to keep their blood sugar from rising too much.
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Do I Need To Eat A Minimum Amount Of Carbs
The short answer is no. In fact, you technically dont need to eat any carbs at all.
When carbs are restricted, your body switches to using fat and ketones rather than sugar as its main energy source.15 Aside from your red blood cells and a small portion of your brain and kidneys, which do require glucose, your cells can use fatty acids or ketones as fuel.16 You can learn more about this in our complete guide to ketosis.
Your body is actually capable of making glucose for any cells that need it, even if you dont consume any carbs. This is because your liver can convert amino acids and glycerol into glucose. This process is known as gluconeogenesis.
In their 2005 textbook Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids, the U.S. Food and Nutrition Board of the Institute of Medicine states:
The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed.17
Interestingly, there are nine essential amino acids found in protein and two essential fatty acids, but there is no such thing as an essential carbohydrate.
However, there are valuable nutrients in many low-carb foods that contain some carbs, such as vegetables, nuts, and seeds. These foods also provide fiber, flavor and texture, which can enhance your eating experience.
Why Everyone Has A Different Carb Limit For Ketosis
At ruled.me, we recommend that everyone starts their ketogenic diet with the carb limit of 35 grams of total carbs. However, if you are not getting into ketosis or you want to find your personal keto carb limit, then you must know the other factors that contribute to ketosis.
Although this is a nuanced topic that is impacted by many different variables, lets stick to the four things that you have the most control over when it comes to achieving ketosis. Below, well go over these.
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Know The Carb Counts And Serving Sizes Of Foods
Most low carb diets only allow for 20 to 50 grams of carbohydrates per day. Because of this, it is essential that people following low-carb diets choose foods that have a lower carb count but a high nutritional value per serving.
The foods in the quantities listed below all contain approximately 15 g of carbs:
- 1 tennis ball sized apple or orange
- 1 cup of berries
- 1 slice of bread
- 1/3 cup of cooked rice
While the foods listed above all contain roughly equal amounts of carbohydrates, they are not all nutritionally equivalent. The dairy products on the list contain protein and vital nutrients, such as Vitamin D and calcium in addition to the carbohydrate content.
The fruit and vegetables also contain essential vitamins and minerals. Choosing whole-grain varieties of bread and rice will provide more nutrients than white varieties, even though the carb content is similar.
