Pregnancy and Keto?
Scochrane86
Posts: 374 Member
Ok, I need some help. I may, or may not be pregnant with a VERY SURPRISE baby #3 (will know for sure in a couple days). but I am wondering about Keto and pregnancy? I have had such great success and feel great on Keto, I can't imagine going back to my normal diet.
Anything I should know? or is Keto just not ok while pregnant??
Anything I should know? or is Keto just not ok while pregnant??
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You just have to up your carbs to 50 I believe. Congrats! When I get pregnant again I will still be doing keto. Hopefully I don't crave juice again lol1
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hmikkola92 wrote: »You just have to up your carbs to 50 I believe. Congrats! When I get pregnant again I will still be doing keto. Hopefully I don't crave juice again lol
my biggest pregnancy cravings are fruit salad!0 -
So I had to do some research on this myself. During pregnancy you cannot be in ketosis. Ketones cross the placenta and can cause the brain to not develop properly. Also glucose is very important for a developing baby. Your blood glucose levels naturally rise during pregnancy to supply the baby with the necessary energy to grow. The besy recommendation I found is to increase carbs to about 40% of your diet, but get them from whole food sources, like starchy vegetables and fruit. I hope this helps.0
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http://www.lowcarbdietitian.com/blog/guest-blog-post-is-it-safe-to-go-low-carb-during-pregnancyIs It Safe to Go Low Carb During Pregnancy?
With the wide adoption of low-carbohydrate diets, many people question if they are safe during pregnancy. While quite a few women use a lower carbohydrate diet to conceive (since they are especially useful for women struggling with infertility[1]), most medical professionals discourage women from continuing this diet during pregnancy. I find it ironic that if you tell your doctor that you plan to eat low carb during pregnancy, they’ll say it’s unsafe, but if you say you plan to eat a diet based on fresh vegetables, meat, fish, eggs, dairy, nuts, seeds, and a little fruit, they’ll encourage you to stay the course. The controversy over the safety of low carbohydrate diets in pregnancy stems primarily from misconceptions around ketosis. It’s incorrect, but widely accepted, that ketosis during pregnancy is harmful to a developing baby.
When I first dove into the research, I was shocked to find that studies on healthy, non-diabetic pregnant women (eating a “regular” diet) show a marked elevation in ketones after a 12-18 hour fast, which is akin to eating dinner at 8pm and having breakfast at 8am (or skipping breakfast entirely).[2] What’s more interesting is that pregnancy actually seems to favor a state of ketosis. Compared to non-pregnant women, blood ketone concentrations are about 3-fold higher in healthy pregnant women after an overnight fast.[3] And in late pregnancy, metabolism shifts to a state of catabolism, making ketosis even more frequent.[4] Knowing this, I would expect that every pregnant woman experiences ketosis at some point during her pregnancy (particularly if she experiences nausea or food aversions!).
I find it hard to believe that our bodies would perpetuate a state of ketosis if it was truly harmful to a baby, but I continued my research into the topic. The majority of studies on ketosis are actually looking at diabetic ketoacidosis (DKA) or starvation ketosis, not nutritional ketosis (induced by eating a low amount of carbohydrates).
First, let me state that diabetic ketoacidosis is an extremely dangerous phenomenon, pregnant or not, that occurs in people with insulin dependent diabetes. This is classically due to skipping insulin shots, incorrectly dosing insulin, or taking inadequate insulin to cover unexpected elevations in blood sugar. Unlike nutritional ketosis or starvation ketosis, DKA is accompanied by unnaturally high levels of ketones from complete insulin deprivation and blood sugar levels at least three times higher than normal, which profoundly and dangerously alters the acid-base balance in the body. The blood sugar levels seen with DKA are themselves teratogenic (can cause birth defects), so this state should obviously be avoided by pregnant women. Some studies have suggested the metabolic effects of diabetic ketoacidosis may harm fetal brain development.[5]
However, to assume that all ketosis is harmful to a developing baby is illogical. For example, nutritional ketosis (the type of low level ketosis sometimes experienced on a low carbohydrate diet) is accompanied by normal blood sugar levels, blood ketones at very low levels (in general, thirty-fold less than what’s seen in diabetic ketoacidosis), and normal acid-base balance in the blood. So if a woman eats a lower carbohydrate diet during pregnancy, she might experience ketosis from time to time, but it’s not anywhere close to ketone levels induced by DKA in a pregnant woman with uncontrolled diabetes. Even if a woman tests positive for urinary ketones, it’s highly unlikely her blood ketone levels will be elevated. Studies on pregnant women who test positive for urine ketones rarely have detectable levels in the blood.[6]
Despite all the medical warnings about ketones “harming the fetus”, it turns out the fetal brain actually gets approximately 30% of its energy from ketones.[7] In fact, ketones are used by the growing fetus to synthesize a variety of essential cerebral lipids, which perhaps helps explain why ketosis is more common in the third trimester. [6]And get this: Ketones are so important for fetal development, that researchers believe the fetus manufactures its own ketones. Umbilical venous blood samples (fetal blood supply) indicate significantly higher ketone concentrations compared to maternal levels in healthy pregnant women in their second and third trimesters.[8]
So although the fetus requires glucose for growth, it also requires ketones. Either fuel provided in excess is harmful to the developing fetus, but as long as a mom is consuming enough calories and maintaining normal blood sugar levels, the baby will get just the right mix.
Given all of this information, I’ve changed my stance on the recommended carbohydrate levels for pregnant women and believe that it is safe to go low carb during pregnancy - at least lower than the arbitrary “minimum” of 175g per day suggested by most dietitians.
Now before you cut out all carbs, know that there are a variety of carbohydrate foods that pregnant women should continue to eat, including vegetables, fruit, nuts, seeds, and if they are tolerated, dairy and legumes. Eating fewer carbohydrates generally means women will eat less refined grains, junk foods, and added sugars, leaving more room for nutrient-dense foods that provide a growing baby with essential nutrients.
Many women do just fine eating a more moderate level of carbohydrates in pregnancy, so I do not believe everyone needs to goes low carb. But if you have medical conditions that are tied to blood sugar issues, such as gestational diabetes, preeclampsia, or you simply want to prevent excess weight gain, you should know it’s safe to eat a lower carbohydrate diet while pregnant.
*This article includes excerpts from Lily’s book, Real Food for Gestational Diabetes: An Effective Alternative to the Conventional Nutrition Approach, which includes an entire chapter exploring the research on ketosis during pregnancy.
About Lily:
Lily Nichols, RDN, CDE, CLT is one of the country’s most sought after ‘real food for pregnancy’ experts whose approach to nutrition embraces real food, integrative medicine, and mindful eating. You can learn more about Lily by visiting her popular blog, www.PilatesNutritionist.com and get her book, Real Food for Gestational Diabetes (and snag an exclusive FREE guide on managing gestational diabetes) at www.realfoodforGD.com.
References
[1] Mavropoulos, John C et al. "The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study." Nutr Metab (Lond) 2 (2005): 35.
[2] Metzger, BoydE et al. "" Accelerated starvation" and the skipped breakfast in late normal pregnancy." The Lancet 319.8272 (1982): 588-592.
[3] Felig, Philip, and Vincent Lynch. "Starvation in human pregnancy: hypoglycemia, hypoinsulinemia, and hyperketonemia." Science 170.3961 (1970): 990-992.
[4] Herrera, E. "Metabolic adaptations in pregnancy and their implications for the availability of substrates to the fetus." European journal of clinical nutrition 54.1 (2000): S47.
[5] Rizzo, Thomas A et al. "Prenatal and perinatal influences on long-term psychomotor development in offspring of diabetic mothers." American journal of obstetrics and gynecology 173.6 (1995): 1753-1758.
[6] Coetzee, EJ, WPU Jackson, and PA Berman. "Ketonuria in pregnancy—with special reference to calorie-restricted food intake in obese diabetics." Diabetes 29.3 (1980): 177-181.
[7] Institute of Medicine (US). Panel on Micronutrients. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Panel on Macronutrients Panel on the Definition of Dietary Fiber, Subcommittee on Upper Reference Levels of Nutrients, Subcommittee on Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. National Academies Press, 2005.
[8] Bon, C et al. "[Feto-maternal metabolism in human normal pregnancies: study of 73 cases]." Annales de biologie clinique Dec. 2006: 609-619.
HTH.2 -
It's becoming more and more common for women to stay keto while pregnant.
There's a small Facebook group called KetoBabyGains that was created by the KetoGains people where you'll see plenty of women had perfectly healthy pregnancies and babies while keto.
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hmikkola92 wrote: »You just have to up your carbs to 50 I believe. Congrats! When I get pregnant again I will still be doing keto. Hopefully I don't crave juice again lol
I agree, at least that.
I was put on a low-carb diet by my OB after developing gestational diabetes. It wasn't that low, but it was lower carb. Everything was perfect. The baby is now a 6-year-old evil-super-genius. If I had to do over all my pregnancies (I have 4 children) I would do them all low-carb.6 -
So I had to do some research on this myself. During pregnancy you cannot be in ketosis. Ketones cross the placenta and can cause the brain to not develop properly. Also glucose is very important for a developing baby. Your blood glucose levels naturally rise during pregnancy to supply the baby with the necessary energy to grow. The besy recommendation I found is to increase carbs to about 40% of your diet, but get them from whole food sources, like starchy vegetables and fruit. I hope this helps.
@TKattWood welcome to MFP forums.
What you posted sounds like something from a Fake New source perhaps. Would you post links to your research?
One does need to be careful about everything when pregnant.1 -
baconslave wrote: »hmikkola92 wrote: »You just have to up your carbs to 50 I believe. Congrats! When I get pregnant again I will still be doing keto. Hopefully I don't crave juice again lol
I agree, at least that.
I was put on a low-carb diet by my OB after developing gestational diabetes. It wasn't that low, but it was lower carb. Everything was perfect. The baby is now a 6-year-old evil-super-genius. If I had to do over all my pregnancies (I have 4 children) I would do them all low-carb.
I was going to say, isn't low carb basically what you're put on if you develop gestational diabetes? I remember when I got tested for it I was horrified at what I would have to give up eating. Now I've done it for over a month
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@baconslave covered this the best. I just want to add that right now with diabetes reaching epidemic proportions (the red line in my avatar represents the growth rate of diabetes in the US since 1980), and the fact that children born to women who have gestational diabetes are SIGNIFICANTLY more likely to have diabetes as an adult, that would be my main focus. I will have to dive through all my research to find the exact number, but from the top of my head, I believe the increase was double or more.1
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@Scochrane86 - I forgot to say CONGRATULATIONS!!!!!!1
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Thanks for the info all
Turns out, I am not pregnant, and/or had a chemical pregnancy.
But it is ok and I am focused on getting this body in top shape
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GaleHawkins wrote: »So I had to do some research on this myself. During pregnancy you cannot be in ketosis. Ketones cross the placenta and can cause the brain to not develop properly. Also glucose is very important for a developing baby. Your blood glucose levels naturally rise during pregnancy to supply the baby with the necessary energy to grow. The besy recommendation I found is to increase carbs to about 40% of your diet, but get them from whole food sources, like starchy vegetables and fruit. I hope this helps.
@TKattWood welcome to MFP forums.
What you posted sounds like something from a Fake New source perhaps. Would you post links to your research?
One does need to be careful about everything when pregnant.
There is a mouse study that says such things.
But do mice have the same ketone requirements for their brain as humans? Inducing ketosis takes 90% fat and 1% carb. Not like humans, many of which naturally slip into ketosis overnight on a regular basis. Is that a natural state for a mouse like it is for people? Some mice are opportunistic omnivores. But not in the way humans are. They aren't miniature, hairy people. So while we can extrapolate certain things from mice studies, one mouse study doesn't tell if human brains are affected adversely. (NPR had a piece on that this week, I believe. Drugs that are tested on mice very, very often do not work on humans). After all, babies are largely in a ketogenic state while breastfeeding. That is natural. Breastfed babies do not have poor brain development from being in ketosis from breastmilk. And since babies produce their own ketones in utero, and blood levels of the mother are low/normal, they baby isn't going to become disabled due to a natural process that has occurred in humans since their creation (or evolution. Or both. Whichwhatever.)2 -
baconslave wrote: »GaleHawkins wrote: »So I had to do some research on this myself. During pregnancy you cannot be in ketosis. Ketones cross the placenta and can cause the brain to not develop properly. Also glucose is very important for a developing baby. Your blood glucose levels naturally rise during pregnancy to supply the baby with the necessary energy to grow. The besy recommendation I found is to increase carbs to about 40% of your diet, but get them from whole food sources, like starchy vegetables and fruit. I hope this helps.
@TKattWood welcome to MFP forums.
What you posted sounds like something from a Fake New source perhaps. Would you post links to your research?
One does need to be careful about everything when pregnant.
There is a mouse study that says such things.
But do mice have the same ketone requirements for their brain as humans? Inducing ketosis takes 90% fat and 1% carb. Not like humans, many of which naturally slip into ketosis overnight on a regular basis. Is that a natural state for a mouse like it is for people? Some mice are opportunistic omnivores. But not in the way humans are. They aren't miniature, hairy people. So while we can extrapolate certain things from mice studies, one mouse study doesn't tell if human brains are affected adversely. (NPR had a piece on that this week, I believe. Drugs that are tested on mice very, very often do not work on humans). After all, babies are largely in a ketogenic state while breastfeeding. That is natural. Breastfed babies do not have poor brain development from being in ketosis from breastmilk. And since babies produce their own ketones in utero, and blood levels of the mother are low/normal, they baby isn't going to become disabled due to a natural process that has occurred in humans since their creation (or evolution. Or both. Whichwhatever.)
@TKattWood there is a mouse study per @baconslave that supports what you read. Sorry.1 -
Be careful when looking at mouse studies in regard to anything having to do with nutrition. They are vegetarian with far lower fat and protein needs than humans. The best they can do is support the need for human studies.1
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cstehansen wrote: »@baconslave covered this the best. I just want to add that right now with diabetes reaching epidemic proportions (the red line in my avatar represents the growth rate of diabetes in the US since 1980), and the fact that children born to women who have gestational diabetes are SIGNIFICANTLY more likely to have diabetes as an adult, that would be my main focus. I will have to dive through all my research to find the exact number, but from the top of my head, I believe the increase was double or more.
Thanks... now I have another thing to watch for and discuss with our youngest (since my wife was gestational with her). The biggest issue will be her total addiction to sweets... sigh.0 -
Scochrane86 wrote: »Thanks for the info all
Turns out, I am not pregnant, and/or had a chemical pregnancy.
But it is ok and I am focused on getting this body in top shape
*wink* dodged the bullet0
This discussion has been closed.