When I decided, at age 40, that I wanted to try to have a child, I knew I faced a few elevated risks over younger women: first and foremost, I might not be able to conceive at all. I mentally prepared myself—as much as I could, anyway—for that and other possibilities, including the higher risk of the baby having a genetic defect.
So far I’ve been fortunate. The one risk I hadn’t given much thought to—the higher chance of developing gestational diabetes—is the only one that has been a factor in my pregnancy. I’m fairly healthy, I have no history of diabetes in my family, and I try to eat well—lots of fresh fruits and vegetables and few highly processed junk foods.
But older pregnant women—and that means even women as young as in their late 20s, believe it or not—can have a harder time regulating insulin, leading to increased blood sugar levels. Gestational diabetes, if not controlled through diet and exercise, can cause high-birth-weight babies and potentially lead to delivery complications, as well as increasing the risk that the child will develop obesity and type 2 diabetes later in life. For the mother, there’s also the risk of high blood pressure and a higher likelihood of developing type 2 diabetes in the future.
I haven’t been diagnosed with gestational diabetes so far. But because my blood sugar was a little high during my early glucose tolerance test (this is given to all pregnant women around 28 weeks, but women of my age are also sometimes tested earlier), I was advised to exercise more frequently and follow a low-carbohydrate diet, the same advice given to those with the diagnosis.
The last thing a pasta-loving pregnant lady with a sweet tooth wants to hear is that she should cut out carbs. I have always been skeptical of the low-carb diet craze, suspecting it was a ploy by meat-lovers to make eating triple bacon cheeseburgers acceptable—as long as they’re sandwiched between lettuce leaves instead of a bun.
Luckily, the diet prescribed for me was not so extreme. The point is not to lose weight or to cut out carbohydrates entirely, but to limit them and to ration out their consumption throughout the day, always combining them with protein and a little bit of fat.
There were a few surprises in the information the dietician gave me. An unpleasant one was that my usual breakfast—a bowl of cereal—was out. Even sugarless, high-fiber varieties far exceed my maximum allotment of 30 grams of carbohydrates for the morning meal. (Blood sugar levels are especially prone to spiking in the morning, so the breakfast allotment is lower than that at lunch and dinner.) On top of that, I was surprised by how many carbs there are in a glass of milk—about 13 grams per cup. My other favorite breakfast, a bagel with cream cheese, was also way over the mark. Instead, I’ve switched to a whole grain English muffin with peanut butter.
On the upside, I’m not going to starve. In addition to the three regular meals, I’m supposed to eat a morning and afternoon snack, plus a smaller evening snack. And I can still have pasta, but instead of a big bowl of it on its own, it should be a side dish or mixed with enough vegetables and protein so the carb portion is limited. The happiest news of all? On those rare occasions when I am allowed to squeeze in a little treat, I was told it’s better to go for ice cream than sorbet, because the fat helps slow down the breakdown of carbs. Can do, doc.