Author | Chuan Zhi Xiao Hong Lou: Zhang Yue
Source｜Medical World Obstetrics and Gynecology Channel
Carbohydrates are almost everywhere and all the time. Studies have shown that 60%-70% of the total calories consumed by Chinese residents come from carbohydrates[1]. Based on the dietary structure where starchy foods are the staple food, it is not difficult to find that carbohydrates play a crucial role in our daily diet.
However, making the wrong choices about carbohydrates can cause many problems for pregnant women. For example, excessive intake of starchy foods can easily lead to obesity and gestational diabetes, which is extremely detrimental to the health of both mother and baby. So how should expectant mothers make smart choices about carbohydrates? Let's talk about it today.
1
What are carbohydrates?
Don't be surprised, let me first show you what carbohydrates actually are.
Carbohydrates are large molecules composed of carbon, hydrogen, and oxygen. Like proteins and fats, carbohydrates are nutrients that provide energy to the human body. Simply put, there are three types of carbohydrates: starch (beige carbohydrates), sugar (white carbohydrates), and dietary fiber (green carbohydrates).
Foods containing a lot of starch, such as rice, potatoes, noodles, and bread, are called beige carbs.
Carbonated drinks and candies contain a lot of sugar and are known as white carbs.
The dietary fiber found in fruits and vegetables is known as green carbs.
Although the dietary fiber contained in vegetables such as broccoli cannot be absorbed and utilized by pregnant women, it can prevent and relieve constipation symptoms, regulate intestinal flora, and promote intestinal peristalsis. It plays a positive role in preventing and treating obesity, colon cancer, cardiovascular disease, and diabetes in pregnant women[6] and is an indispensable substance in the body of pregnant women. In recent years, it has even been called the "seventh major nutrient". However, in the final analysis, dietary fiber is still a branch of carbohydrates.
2
What are the dangers of making the wrong carbohydrate choices?
Since carbohydrates are so common, pregnant women inevitably consume a lot of them every day. Could making the wrong choice of carbohydrates pose any health risks?
To be honest, such concerns are valid. Carbohydrates have two major, widely acknowledged culprits in pregnant women: causing obesity and gestational diabetes.
on the one hand
When carbohydrates enter the body, they are quickly broken down into tiny glucose molecules, which participate in the body's energy supply. However, when you eat too many carbohydrates, the excess glucose is converted into fat, causing pregnant women to gain weight and even become obese. The most common complication is macrosomia (large baby), which can lead to difficult labor or cesarean section for the mother, and increases the risk of postpartum hemorrhage and postpartum infection.
on the other hand
As the mother's estrogen and progesterone levels increase, the sensitivity of her peripheral tissues to insulin gradually decreases. If the mother consumes too many carbohydrates at this time and is unable to produce enough insulin to lower her blood sugar, it may lead to maternal glucose intolerance or even gestational diabetes.
In addition, since the fetus directly ingests glucose from the mother's body during pregnancy, a high-sugar environment can stimulate excessive insulin secretion in the fetus, leading to neonatal hypoglycemia. At the same time, the newborn's brain tissue has a high demand for glucose, and persistent hypoglycemia can lead to prolonged insufficient energy supply to brain cells, which can seriously affect the newborn's nervous system and even cause death [3, 4].
3
How to choose healthier carbohydrates?
In fact, if pregnant women want to avoid these harms, on the one hand, they should prevent excessive intake of carbohydrates, distinguish between "cravings" and "hunger," and not think that they can eat without restraint just because they are pregnant; on the other hand, they should also learn to selectively replace ordinary carbohydrates with some healthier carbohydrates and scientifically plan their diet.
To select healthier carbohydrates, nutritionists have proposed two important indicators: the glycemic index (GI) and the glycemic load (GL). The glycemic index compares the effect of carbohydrates on blood sugar levels in equal weights of food, while the glycemic load is an indicator that combines the amount of available carbohydrates in a food with the glycemic index.
Generally speaking, high-GI foods have a high GL value, while low-GI foods have a low GL value. High-GI foods are digested quickly, absorbed quickly, and cause a greater increase in blood glucose concentration after entering the gastrointestinal tract; low-GI foods stay in the gastrointestinal tract for a longer time, are absorbed slowly, and cause a less significant increase in blood glucose concentration. [5] For pregnant mothers, choosing high-quality carbohydrates with low GI and low GL in their diet can not only help with weight loss but also control blood glucose levels during pregnancy and effectively prevent the incidence of gestational diabetes.
4
How to choose high-quality carbohydrates that are low in GI and low in GL?
① Consider the ripeness of the food: This mainly applies to fruits. Generally speaking, the riper the fruit, the higher its sugar content and the higher its glycemic index. For example, the GI value of an unripe kiwi is 26, while that of a ripe kiwi is 52.
② Consider the acidity of food: When food contains organic acids, the body slows down the digestion of that food by digestive juices, resulting in slower absorption and a more beneficial effect on blood sugar. Common organic acids in food include acetic acid, lactic acid, malic acid, citric acid, and ascorbic acid (vitamin C). Foods we eat daily, such as apples, oranges, apricots, peppers, spinach, and vinegar, all contain organic acids. For example, noodles seasoned with vinegar have a lower glycemic index (GI) than those without.
③ Consider the food's processing precision: The glycemic index (GI) of food is closely related to its processing precision; the higher the processing precision, the higher the GI. For example, refined white rice and refined white flour have high GI values, while whole wheat flour, regular flour, and brown rice have low GI values.
④ Consider the size of the food particles: The larger the food particles, the lower the GI. For example, a whole potato cooked directly or shredded and stir-fried has a much lower GI than mashed potatoes.
Therefore, regarding carbohydrate intake for pregnant women, we recommend that they consume as few fully ripe fruits as possible within the limits of their health, appropriately increase the proportion of acidic foods, and eat a combination of whole grains and refined grains to ensure a balanced diet.
Conclusion
Of course, for a healthy and smooth delivery, pregnant women need more than just choosing high-quality carbohydrates. They also need to strictly control their total daily calorie intake and engage in moderate aerobic exercise under the scientific guidance of a doctor. This will make the pregnant woman's body more sensitive to insulin, promote the scientific utilization of glucose, greatly reduce the probability of gestational diabetes, and ensure healthier development for the baby!
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