Whole30 and the OGTT

[(m)eat to live]

I'm pregnant and up until now, I've been including some dairy and select grains, due to major gag issues eating many meats and vegetables. Now I'm considering doing a second Whole30 since my food aversions are (finally) under control. I'd like to eat really clean for this last trimester to give baby as much of a health boost as possible, but I'm wondering about Whole30/Paleo and the oral glucose tolerance test that is given to pregnant women.

 

I've read a few blogs where people said that being Paleo made them fail the test because their bodies (naturally) freaked out when ingesting a ton of sugar like that in one sitting.

 

Should I just wait until after I take the test to start? I'm supposed to take it next week. I don't want to have a falsely elevated insulin response as a result of the diet change, but in theory, shouldn't eating clean HELP my insulin response? Has anyone taken the OGTT while on a Whole30 or very strict Paleo diet?

 

Thanks in advance!

[Heather Robertson]

Ooo I'm curious about this. I'm still in the queasy/strong aversion phase. I'm slowly getting back on track since it's getting slightly better. I have a while before I have to take that test, but I'd like to be prepared and eating as clean as possible! I'll be following this discussion!

[Renee Lee]

Melissa's offline for her Tuesday, but I've shot her a note to ask her to weigh in on her experience with this.  Eating low-ish carb Paleo definitely has the potential to make you fail the 1hr test, which means you'll have to take the 3 hr test. I don't think the rapid blood sugar spikes are particularly healthy for momma or the baby...so I'd do everything I could to find an alternative, or otherwise opt out of the test.

 

I think some doctors will let you track your blood sugar levels on your own over a period of time, some will let you opt out if you don't have any of the risk factors, etc...

 

I'm interested in what M has to say, though, so stay tuned!

[Egre4926]

I think I remember Melissa suggesting to someone earlier this year to eat some paleo friendly (contradiction I know) foods like white rice in the week or so leading up to the GTT. That way your body has some higher glucose based carbs, & doesn't go into shock when you drink the high amount of sugar.

I'm also interested in what Melissa comes back with, as I'll be doing this some time in the next trimester.

[Jenni D]

I think it depends on your doctor, but when I talked to my original OB (I started my pregnancy in Dallas but moved to Oklahoma at the end of my pregnancy), she and I discussed my diet, and although her nurse looked at me like I was nuts when I said I wanted to talk to the doctor before consenting to the glucose test, the doctor herself was a-ok with me skipping it.  At that point she knew how seriously we take our health and our diet, and she knew my husband is a Type 1 diabetic, so I'm VERY familiar with what blood sugars should look like throughout the day.  The month before my test  was scheduled, I had tested my blood sugar 4-5 times a day...once in the morning when I woke up, then a couple of hours after each meal, and then once before bed.  I showed my OB the numbers on the glucometer history and she gave me the thumbs up to skip the normal glucose test.  When I came to Oklahoma, the first OB I saw asked if I had taken the glucose test and before I could even explain WHY I hadn't taken the normal test she told me the test wasn't optional, and then proceeded to tell me that my baby already had bad genes because my husband and sis in law had Type 1 diabetes.  Needless to say, I did not see her again.    My 3rd OB didn't even ask about it, probably because at that point I was like, 34 weeks preggo. 

[Melissa Urban]

First, I can't tell you what to do on this one. If you take the test and fail (as is quite likely), you're in one set of circumstances. If you don't take the test, and then somewhere along the way you develop the condition, well, that's another issue. You're going to have to weigh this out for yourself.

 

I do NOT advocate eating white rice or other starchy carbs for a few days before the test. Things aren't that acute, and it's not like your insulin sensitivity or sugar vs. fat-burning state is going to change dramatically in a few days.

Robb Wolf has written about this a few times, here and here and here. I know he doesn't put as much stock in the A1C as he used to, but it still may be a less invasive/damaging option.

 

I will tell you what I did, as long as this is not construed as advice in any way. I had been eating this way for years. I had just done some major bloodwork with my functional medicine doc not more than a year prior to getting pregnant, which showed a perfect fasting blood glucose, A1C, and HS-CRP. I spoke with my doctor about the way I was eating during the pregnancy (I had not gone off the rails to any significant degree at any point during my pregnancy). And then I refused the test, as my risk factors for gestational diabetes were ridiculously low.

 

Hope that helps.

Melissa

[(m)eat to live]

Thanks for sharing your experience, Melissa! I haven't been eating as cleanly as you, I'm sure, but I would imagine my diet is still worlds away from the SAD that doctors are used to seeing. I considered outright refusing the test, but I was told that my insurance might refuse to pay for any complications/medical issues that arise due to undiagnosed gestational diabetes. I'm not terribly concerned that I have it, but then again, I don't really want to fight with my insurance if something should come up...

 

I find it frustrating that these docs have been reminding me at every appointment how important it is to eat a healthy diet... and then they ask me to drink two sodas worth of sugar and red food dye in a matter of minutes!

 

I will ask about the A1c, and maybe a food journal and glucose meter for home use, for a week or so. Maybe that will satisfy the requirement.