Saturday, May 2, 2009

Pregnancy: What your doctor may not tell you about your diet

**Edited Sunday to include information from George Elvove, M.D., P.C.
note: In order to bring you accurate information concerning important parenting issues, I've teamed with some local professionals who have agreed to share their knowledge in each of their fields of expertise. I will regularly consult with the professionals when writing about topics like breastfeeding, babywearing, health and natural childbirth, prenatal and pediatric chiropractic care and child rearing. This post includes information from Certified Nurse Midwife Debbie Boucher and George Elvove, M.D., P.C. You can read Debbie Boucher's Snapshot Interview here.

When I was pregnant with Gabe, I asked our former obstetrician, Dr. J., (read: not Debbie or Dr. Elvove!) the type of diet I should follow during my pregnancy. She looked at me slightly confused, thought for a second and suggested following the food pyramid.

You know, Dr. J. said, a normal, healthy diet.

And though I didn't know much about achieving a healthy pregnancy and delivering a healthy baby at that point, her answer didn't settle right with me even though I liked and respected her.

But because she was my doctor and had gone to school for many years to become an OB, I didn't too seriously question her response. Well, I didn't until began reading about glucose testing for pregnant women. The whole concept of glucose testing made no sense to me. Why would you have a pregnant woman fast for eight hours, drink a sugary drink to spike her blood sugar level and then test to see how her body handles this very abnormal-eating situation. (Because who in her right mind fasts for eight hours and then gets up and eats four jelly donuts in the morning while she's pregnant? Maybe some people, but not me!) It was no surprise that I tested a point too high to be considered in the normal range. The results of the test, of course, determined that I was at risk for gestational diabetes. That means, my OB explained, that I would need to undergo the three-hour glucose test.

During that three-hour glucose test, which were quite possibly the worst three hours of my pregnancy, John and I decided to employ a different OB. I wanted an OB who would take my question about pregnancy diet seriously and not employ such strange methods of testing after my body had failed to give the most desirable results in an unnatural-testing situation. Luckily, a friend of mine had delivered with George Elvove, a pediatrician and obstetrician. Dr. Elvove delivered more than 4,000 babies during his career as an OB and was known as a natural-childbirth doctor. And he believes in providing the right nutritional care for pregnancy and lactating women, among other things. He has since retired from OB work but still practices pediatric medicine. I'm fortunate that my Certified Nurse Midwife, Debbie Boucher, did some of her training under Dr. Elvove and adopted the same pregnancy diet he recommended for all of his patients. The diet is based on Tom Brewer's, M.D., Nutrition in Pregnancy diet.

Here is the gist:

*Consume 80 to 100 grams of protein per day
*Limit consumption of carbohydrates to one whole grain per day.
*Eat at least two green vegetables per day
*Eat two to three servings of other vegetables per day
*Eat one to two servings of fruit per day
*Eat two eggs per day
*Eat one Vitamin C source per day
*Eat three to four milk products per day
*Limit fats to two to three servings
*Drink plenty of water
*Eat a yellow or orange-colored fruit or vegetable five times per week

But why follow this type of diet? Debbie Boucher, CNM, and Geoge Elvove, M.D., P.C., gave some important answers. Boucher's answers are written in green. Dr. Elvove's answers are typed in purple.

What is the goal of the diet and why do pregnant women need so much protein?
1. To help with normal growth and development of the baby.
2. To help the woman’s body through the changes of pregnancy including growth of the placenta, production of amniotic fluid, and normal blood volume increase.
3. To help prevent pregnancy complications such as pre-eclampsia, pregnancy-induced hypertension, and gestational diabetes.

"The baby requires protein to create skin, blood, muscle, bone, brain, and organ tissues," Elvove said. "If the mother's diet is inadequate, the baby will take the protein that it requires from the mother's body tissues. Protein deficiency in the maternal diet can lead to preterm labor, preeclampsia/eclampsia, and dysfunctional labor."

Why limit refined carbs? What's the difference between sugar found in bread versus sugar found in fruit?
"Refined carbs and sugar break down to glucose faster than fruit sugars and causes poor glycemic control, which basically causes glucose levels to fluctuate too much," Boucher said. "Poor glycemic control leads to blood sugar abnormalities like diabetes. It also can contribute to blood vessel inflammation which leads to cardiovascular diseases such as arteriosclerosis, hypertension, stroke, coronary artery disease, angina, and peripheral artery disease."

"A high glycemic load results in the over-secretion of insulin," Elvove said. "Excess insulin can result in gestational diabetes and a myriad of health problems in the mother. Barry Sears reviews this subject in detain in his Zone books."

Do you think it's necessary to gluclose test every expecting mother? Do you have any problems with the test?

"I dispensed with glucose testing years ago if a pregnant woman brought me a healthy diet log," Elvove said. "Gestational diabetes is entirely a disease of poor nutrition. A high dose of sugar is not healthy due to the over-secretion of insulin it causes."

While following the pregnancy diet, I felt great! I gained only 22 pounds during my pregnancy with Gabe, and I lost every single one of those pounds within three days of delivering my healthy 6 pound 14 ounce baby. During this pregnancy, I also have felt wonderful. At 20 weeks, I've gained eight pounds and our baby measured right on for our predicted due date. He also has developed well in the womb, and God-willing, he will be healthy and weigh somewhere between six and eight pounds upon delivery.

Yes, I miss my ceral often and sometimes wish I could dive into the world of yummy yummy pasta more often than I should (which is just once or twice a week and is surely made of whole grain); but I do realize that delivering a baby that isn't humongous from ingesting too much sugar is very important to me. I also do not want to contend with losing more than 20- 25 pounds after delivery because maintaining a healthy weight has become very important to me during the past three years.

Happy pregnancy and dining for two!


  1. GREAT post! I wish more people would take responsibility for their own health instead of blindly trusting their Dr.

  2. Good post! I have heard good things about Brewer's diet/food plan. Sounds healthy!

    In my experience, 100 grams of carbs really isn't a lot and not abnormal. It would be 1-2 cups of spaghetti with lots of sauce. A large portion, but not obscene. Yes, the fasting situation is abnormal.

    The three hour glucose is torture. I would never do that again.

  3. Thanks for writing this! Its so informative, and will definatly be so helpful for me when we start our family. I'm going to copy and paste it, and save it. I'm really glad I read it.

    Any other suggested reading on the subject?

  4. Great post. With DS2 I only gained 15 lbs total following this diet! He was 8 lbs. Cheers,

  5. Thanks, I'm glad you guys enjoyed reading it.
    Lydia, you could read the Zone book Dr. Elvove suggested in the article or review the Brewer diet ... but Dr. Elvove's diet is only based on the Brewer diet because of the carb thing.

  6. Thanks so much for sharing this information, I think it's really important for new mothers and expectant mothers out there. We need all the support and education we can get. Well written.
    Jennifer Dominquez


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