This week, we are joined again by the very knowledgeable (and one of our most popular Fertile Minds podcast guests) Lily Nichols. Not only is Lily a devoted mom, but she is a stellar author and a registered dietitian/nutritionist with a flair for interpreting scientific data and applying it to the modern-day woman. She speaks with Hillary today on her work helping women learn how to prevent or manage their Gestational Diabetes. She also discusses how we test for it, what makes someone more susceptible to acquiring it, and what the long-term complications are for both mama and baby once they are diagnosed with it.
Lily presents a unique approach in helping women manage their diet and lifestyle in her bestselling books, Real Food for Gestational Diabetesand Real Food for Pregnancy.
[2:13] Lily describes what Gestational Diabetes is and is not. It is a type of Diabetes that develops or is diagnosed during pregnancy. Typically, your body is having trouble processing carbohydrates, causing high blood sugar.
[4:06] Lily uses a hybrid approach when screening for Gestational Diabetes, mixing traditional glucose tolerance tests with discussing their diet and lifestyle choices.
[7:08] Diet and lifestyle are two factors we can be proactive about in pregnancy, as well as in pre-conception.
[8:26] We are seeing that even mildly elevated is an issue, so it’s important women find out early. 49 to 52 percent have either diabetes or pre-diabetes, and most of them have yet to be diagnosed.
[8:50] We want to use A1C readings in pre-conception and in the first trimester and after that look at blood sugars. If A1C has not gone down later in pregnancy, that is a warning sign that something is going on. We recommend getting an over-the-counter glucometer and monitoring your blood sugar at home first thing in the morning and one to two hours after meals to get an idea of how your body responds to specific foods.
[12:58] Lily discusses the acceptable levels of fasting and non-fasting blood sugars in pregnant women. We naturally see lower blood sugar levels in a typical pregnancy, along with changes in the significant thyroid and the burning of more fat to send fatty acids to the baby.
[17:32] During pregnancy, if your blood sugar levels are higher than normal, there is a direct line from you to your baby to via umbilical cord. There’s also a physiological reason that women may not feel like eating during pregnancy, to try and push towards ketosis. This makes sense as to why breastfeeding is the best diet ever, as it pulls all the fat to give to the baby.
[22:19] When we have been on a sugar binge and try to come off of sugar, that is happening to the baby the first couple days, so you can imagine how jarring that is until they re-regulate.
[23:34] Even with a diagnosis of Gestational Diabetes, the recommendation of allowable daily carbs is still very high. Lily observed her clients blood sugar getting worse when they followed the protocol and found that a lower level of carbohydrates is ideal.
[27:34] The second part of Lily’s research was looking at ketones and the different part of ketosis. The benefit of the ketogenic diet becoming popular is now there is more discussion on what it means to be in ketosis and what types of ketosis are safe to be in.
[33:39] Lily observes that most women gain their weight in the second and early third trimester and tend to level out unless there is fluid retention.
[36:06] The pancreas is not accustomed to pumping out a large amount of insulin consistently.
[39:11] While it may be annoying and tedious, testing your blood sugar levels daily is well worth it for acquiring interesting data.
[40:41] We discuss the risk factors of how blood sugar issues may affect our children’s fertility and generations down the line. What we may be seeing now may be the epigenetic effect from our low-fat diet from the 1980’s.
[45:21] As you tend to get beyond the 35 and 40 BMI, you do see more pregnancy complications and macrosomia with an epigenetic carryover effect through generations and beyond.
[48:59] People feel like they have acquired a disease, but really your body is adapting to the environment in which it is currently in.
[49:18] Plan of action:
● Start monitoring A1C & post-meal blood sugars pre-conception, if possible.
● Pull an A1C in the first trimester and if it’s suspect get in touch with someone like Lily to get it under control. Check out Lily’s books AND video course, or join her Facebook group.
● Eat real food throughout your pregnancy and a reasonable amount of carbs that works for you.
● Continue to eat the same way, maybe even more good fats while you are breastfeeding to enhance your breast milk.
● Bring up your children on the same diet they were exposed to in utero and educate them about blood sugars and food in general so they can affect the next two generations in a healthy way.
Continue Your Journey:
You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.