Your Baby is What You Eat

People keep telling us all about the awesome responsibility of being a parent. About how this tiny little person will be thrust in to our arms after birth and from that moment be completely and utterly dependent on us to stay safe, grow and thrive. But I see pregnancy as an extension of that. I don’t think it begins at the moment of birth, it begins at the moment of conception. And in many ways the dependence that an unborn baby has on its mother is even greater than the dependence it will have once it’s on the outside, because absolutely everything that baby is exposed to comes through mum.

This is a difficult and emotive subject for many women with diabetes. In my experience we’re all acutely aware of how our own blood sugars have the potential to impact on our babies. Every time my blood sugar spikes a little higher than I’d like, I wonder if my baby is hurting in there. I wonder what damage is being done to fragile forming organs or, as I progress, what may be happening to the size of our child. I worry about lows that may strike out of the blue, sending me in to unconsciousness and depriving my baby of what it needs to survive.

This awareness might yet be a good thing though. I’ve been known to tell people that living with a chronic illness has some positives. (It doesn’t mean I wouldn’t trade it if I could, but I like to try and look for the silver lining.) Many people who live with diabetes are healthier, on a day-to-day basis, than our “healthy” counterparts because we have a better understanding of our own bodies and a greater awareness of what is happening within them. We’re better at listening to what we need. We see real day to day differences from the food that we eat and the exercise that we do that can often have a positive impact on the way we choose to live. In short, the idea of what we put in to our bodies affecting what we can get out of them is very real and apparent on a daily basis.

As a person with diabetes then, it’s fairly easy to grasp the idea that what we put in to our bodies whilst our babies are growing in there will affect the baby that comes out.

It’s like the old adage “You are what you eat”. Except in this case your baby is also what you eat. And a couple of pieces of research published in recent months have underlined this fact.

One study, reported here , showed how a decreased calorie intake in the first half of pregnancy could have the potential to affect the brain development and intelligence of the offspring. Granted, the study looked at baboons, but plenty of people would argue that I’m a bit of a monkey! I’m not sure that many people would presume excessive restriction of diet in pregnancy would be healthy, but it’s a worrying bit of research in the context of calorie deficit caused by morning sickness, and makes me glad that I continued to shovel food down my throat even if the choices that I made aren’t necessarily regarded as healthy ones. (Mini Mars bar, anyone?) Any food, it seems, is much healthier than none at all.

More interesting though is this study  which shows how the diet we are exposed to in the womb could alter the function of certain genes, which in turn can have later health consequences. This particular piece of research focused on the effect of low carbohydrate diets on childhood obesity. Logically you might have thought that stuffing yourself with carbohydrates would have the potential to lead to a bigger baby and fatter child, but in fact the reverse is true. A lower carbohydrate diet is actually linked to increased rates of childhood obesity. In fact, the size of the mother and the birth weight of the baby are much lower determinants for obesity than the level of carbohydrate in the diet.

This one is worrying to me because lower carbohydrate eating a powerful weapon against post-prandial blood glucose spikes. Current thinking on blood glucose management is beginning to look towards the size of glucose spikes (assessed by the standard deviation of blood glucose numbers) having as much effect on complication risk as the overall control (as assessed by the HbA1c).  This is particularly thought to be true during pregnancy and is the thinking behind the current guidance to keep the one hour post-prandial levels so low during pregnancy. And of course spikes themselves negatively impact the HbA1c anyway. Since carbohydrates raise blood sugar, minimising carbohydrate intake minimises post-prandial spikes and helps maximise stability and glycaemic control. Win-win? Except that this study has thrown a spanner in the works!

Before I ever got pregnant, I speculated with Ian – and only half in jest – that I would have to spend nine months eating a very consistent diet so that I knew exactly how to dose insulin for every meal and that most importantly I’d need to stick to a low carb diet. In the pre-conception period low carb worked very well for me and certainly contributed to me lowering my HbA1c below 6 for the first time in years. In the light of this study it seems fortunate that morning sickness hit me hard and threw any pre-conceived (pun intended!) ideas out of the window. I’m also thankful for so many low blood sugars which meant I got my quota of carbohydrates in Lucozade if nothing else.

This pregnancy thing certainly is a minefield. I feel like I can’t do right for doing wrong. Obviously I need good blood sugars, but the diet that helps me achieve those may be harmful in itself. All I can hang on to is that making the decisions about what I should and shouldn’t do whilst this baby is inside me is good practice for the millions of decisions I’ll be making for its welfare throughout its life.

Right. I’m off to find a chocolate biscuit!

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