Food, pregnancy, and gestational diabetes! Oh my!

Welcome to my blog. That feels weird to say, because I don't "feel" like a blogger. Whatever that even feels like, but anyways, this is out of my normal internet zone. I like reading some blogs, but I'm not super into writing them.

What changed that is food. I love food. And I'm pregnant, so now I super love food! Today is my first day of food journaling. I want to be sure my baby and I are getting the best nutrition possible. Before I go any further, I'll tell a bit about myself. I'm wife to a wonderful skateboarding soldier (just to clarify, that's not his MOS or job description, it's just that he skateboards and is a soldier ;) ), mother to a gorgeous and goofy little girl, and labor doula (currently on hiatus!). I'm currently 18 weeks into my own pregnancy with my second baby who will stay gender-anonymous til birth day. (Ha-ha! So don't bother asking what "it" is.)

So, why am I food journaling? It was recently told to me that since my mother had gestational diabetes, I'm at higher risk for it, therefore needing an early gestational diabetes test as well as regular testing which is done at around 28 weeks. Well, being a doula, I had to think it over and do some research and think it over again. I prefer a holistic approach to things, especially pregnancy, labor, birth, and baby-related things. I want minimal interventions and disturbances during my pregnancy, labor, and birth. Anyways, my point is that I don't want to have to do any unnecessary tests, screens, pokes, prods, etc.

So I researched Gestational Diabetes. Some good articles I came across are these:

Michel Odent's "Gestational Diabetes - A Diagnosis Still Looking for a Disease?": http://www.gentlebirth.org/archives/gdmodent.html

"The practical advice one can give to women carrying the label of 'gestational diabetes' should be given to all pregnant women. Another reason to question the practical benefits of such a diagnosis. This advice concerns lifestyle, particularly nutrition and physical activity. "

Gloria Lemay's "Helping your client avoid a gestational diabetes diagnosis": http://www.glorialemay.com/blog/?p=203

"The mother can look at the list of who is at greatest risk and decide to decline the test if her risk is low.

Women at risk:
- maternal age over 25
- - obese woman prior to pregnancy
- - previous birth of baby weighing over 10# at birth
- - previous unexplained stillbirth at term
- - family history of diabetes (esp. close relatives who became diabetic at a young age
i.e. juvenile onset diabetes)
–previous history of recurrent miscarriages
–extremes of heaviness or thinness
–history of alcohol abuse
–history of anorexia or bulimia"

Treating Mild Diabetes During Pregnancy Helps:
http://www.msnbc.msn.com/id/33091829/ns/health-diabetes/
The MSNBC article concludes with

"Dr. David A. Sacks of Kaiser Foundation Hospital in Bellflower, Calif., said switching to a healthier diet could help other pregnant women limit weight gain, too. More large babies are born to overweight or obese women who don't have diabetes, he said.
"This is a real easy therapy to apply to every single pregnant lady," said Sacks, who wrote an editorial about the study in the journal."

So, all pregnant women should switch to a healthier diet, whether they have been labeled with gestational diabetes or not.
I recommend reading Michel Odent's above article, as it is very thorough. I will go ahead and quote some more from him, regarding specifics in a healthier diet:

"Nutritional counseling should focus on the quality of carbohydrates. The most useful way to rank foods is according to their 'glycaemic index'(GI). Pregnant women must be encouraged to prefer, as far as possible, low GI foods. A food has a high index when its absorption is followed by a fast and significant increase of glycaemia. In practice this means, for example, that pregnant women must avoid the countless soft drinks that are widely available today, and that they must also avoid adding too much sugar or honey in their tea or coffee. Incidentally, one can wonder if the tolerance test, which implies glucose consumption (the highest substance on the GI), is perfectly neutral and harmless. GI tables of hundreds of foods have been published in authoritative medical journals.(7) These tables must be looked at carefully, because the data they provide are often surprising for those who are still influenced by old classifications contrasting simple sugars and complex carbohydrates. Such classifications were based on the mere chemical formula.

From such tables we can learn in particular that breakfast cereals based on oats and barley have a low index. Wholemeal bread and pasta also are low-index foods. Potatoes and pizzas,(8) on the hand, have a high index and should therefore be consumed with moderation. Comparing glucose and fructose (the sugar of fruit) is a way to realize the lack of correlation between chemical formula and GI. Both are hexoses (small molecules with six atoms of carbon) and have pretty similar chemical formulas. Yet the index of glucose is 100.versus 23 for fructose. This means that pregnant women must be encourage to eat fruit and vegetables, an important point since pre-eclampsia is associated with an oxidative stress."

This is great news to me. I eat low-GI foods already, besides the occasional roasted herb potatoes. That means I don't have much to change. Although I am going to go back to drinking my Red Raspberry Leaf tea without any honey or agave syrup. I'll save that for my favorite almond/quinoa muffins!


The article goes on to say:

"Professor Jarrett, a London epidemiologist, made a synthesis of the questions inspired by such associations. He stressed that women who carry this label are, on average, older and heavier than the overall population of pregnant women, and their average blood pressure is higher. This is enough to explain differences in perinatal outcomes. The results of glucose tolerance tests are superfluous. According to Professor Jarrett, gestational diabetes is a 'non-entity'.(19)"

I, fortunately, do not fit in that category.

Before I looked more into gestational diabetes and realized that I'm not high-risk for it, I'll admit I was worried once it was brought up at one of my first appointments that I would have to take an early Glucose Tolerance Test (GTT). Dr. Odent addresses this issue as well:

The nocebo effect of prenatal care

"After reaching the conclusion that the term 'gestational diabetes' is useless, one can wonder if it is really harmless. Today we understand that our health is to a great extent shaped in the womb.(31) Furthermore we can interpret more easily the effects of maternal emotional states on the growth and development of the fetus. In the current scientific context we can therefore claim that the main preoccupation of health professionals who meet pregnant women should be to protect their emotional state. In other words the first duty of midwives, doctors and other practitioners involved in prenatal care should be to avoid any sort of "nocebo effect".

There is a nocebo effect whenever a health professional does more harm than good by interfering with the belief system, the imagination or the emotional state of a patient or of a pregnant woman. The nocebo effect is inherent in conventional prenatal care, which is constantly focusing on potential problems. Every visit is an opportunity to be reminded of all the risks associated with pregnancy and delivery. The vocabulary can dramatically influence the emotional state of pregnant women. The term "gestational diabetes" is a perfect example.

When analyzing the most common reasons for phone calls by anxious pregnant women, I have found that, more often than not, health professionals are ignorant of or misinterpret the medical literature, and that they lack of understanding and respect for one of the main roles of the placenta, which is to manipulate maternal physiology for fetal benefit.

Prenatal care will also be much cheaper on the day when the medical and scientific literature will be better interpreted!"

Now, I'm not saying that my caregiver (whom I love and respect very much!) "did more harm than good". Because honestly, I'm food journaling now (which is aiding in watching my food intake), exercising more, and perfecting my diet. I'd say that part is more good than harm. But I was worried, needlessly.

I feel confident in my decision to not do the GTT early, since I am already doing the "treatment" as if I do have GD. I'll have the regular 28 week test at my home birth midwife's birth center with a finger prick.

So, I'll share the recipe to tonight's dinner, vegan "meat"loaf. I found the recipe online for it, but I have tweaked it to my own liking. I'll be honest, this doesn't taste like meatloaf to me, but it tastes wonderful. I'm also trying to figure out some kind of gravy, because it could use something poured lightly over it. But it does taste awesome as is.

Veganloaf


Ingredients:
1 can kidney beans, rinsed and drained
1 kidney bean can full of cooked quinoa (or you can use 1 can garbanzo beans, but I prefer the quinoa)
1 small onion
2-3 cloves of garlic, or more if you love garlic
5-6 small-medium sized carrots
1 cup bread crumbs (I used fresh whole wheat)
1/2 cup dry unsalted cashews
1-2 tablespoon olive oil
a teaspoon-full or more of: cumin, basil, rosemary, cinnamon, salt, pepper

Directions:
Preheat oven to 375 degrees.
Boil carrots until tender, drain, and mash.
Saute onion in olive oil on medium low heat until softened.
Add garlic and spices and heat another few minutes.
Food process cashews until grainy in texture. Food process bread if making crumbs fresh.
Mash beans, add cashew crumbs, and bread crumbs in large bowl.
Once all veggies are done, add to bowl and mix/mash very well until combined and sticky in consistency.
Pack mixture into a well-oiled bread pan and bake for approximately 1 hour (times may vary).
Let cool slightly before turning out, cutting, and serving.

Serves: 5-6
Preparation time: 1 hr-11/2 hr
Sorry about the crappy picture. Apparently I didn't evenly oil the bread pan!

I served last night's with home-made coleslaw. Yummy! This veganloaf is also great served with spinach kimchi, which is a simple recipe:

Spinach Kimchi

Ingredients:
1 10oz container spinach
toasted or raw sesame seeds
toasted sesame oil
Bragg's liquid aminos, Nama Shoyu, or soy sauce
3 cloves garlic, minced
1/2 cup water



Directions:
In a wok, boil 1/2 cup, add the spinach and immediately remove it from wok once it's at it brightest color. Let drain and cool in colander, then squeeze out excess water and chop into 2 inch pieces. In a medium-sized bowl, add sesame seeds, garlic, even amounts soy sauce and sesame oil (you'll have to play with the exact amounts to get a taste you like). Once you've made the marinade to your taste, add the spinach and mix so the spinach is lightly coated with the marinade. It's good to eat right away or let sit overnight!