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Low Carb for Gestational Diabetes: Opinions from Moms and Experts

Years ago when I was knee deep in research articles, I felt like a lone wolf; the only one who dared to question the conventional thinking about nutrition for gestational diabetes.

I was asking hard questions about the RDA for carbohydrates and the risks of ketosis. I knew some clinicians who promoted low carb eating among their patients, but they weren’t much help in tracking down the hard data for me to feel comfortable to entirely make the switch myself. It’s not just about professional liability, it’s about the very real responsibility of knowing that your recommendations might affect brain development of your clients’ babies.

I did eventually sort through enough research and biochemistry to make sense of it all, but I still faced a lot of scrutiny when I published the first book to ever promote a (true) low carb approach for managing gestational diabetes.

Recently, the staff at Diet Doctor, a popular low-carb website, reached out to me to ask some questions about gestational diabetes and low carb eating. I knew they were also going to be reaching out to some medical doctors who used low carb with their pregnant patients.

Check out the article here: Low Carb for Gestational Diabetes: Opinions from Moms and Experts

I was pretty happy to see that in the final article, I saw one of my colleagues names pop up, Dr. Lois Jovanovic. We both worked at the California Diabetes and Pregnancy Program: Sweet Success, her much longer than I. She’s been outspoken about shifting the nutritional recommendations for gestational diabetes to be lower-carb, but has faced a low of push back in the field, especially from dietitians.

As for me, I always appreciated her point of view, and given decades of experience beyond me, her stamp of approval on low carb was one of the reasons I kept digging deeper and deeper to uncover the origins of the “minimum” amount of carbohydrates for pregnant women and how ketones positively or negatively affect a developing baby.

I hope you enjoy hearing our thoughts on low carb for gestational diabetes as well as some case reports from moms who followed a low carb diet during their pregnancies. Check out the post over at

Until next week,

PS – By the way, my findings on carbohydrate needs in pregnancy (origins of the 175g minimum, controversies about ketosis, and nuance on the effects of different types of ketosis) are in Chapter 11 of my book, Real Food for Gestational Diabetes, and fully cited for those who want to dig in the studies like myself. I’m told that this chapter helped inspire doctors in the Czech Republic to entirely drop an arbitrary minimum level of carbohydrates from their country’s guidelines. As I write this, my book is currently being translated to Czech. I knew English and Spanish would be needed, but never did I imagine Real Food for GD would be in demand in Czech!

PPS – For health professionals interested in a deeper discussion of carbohydrate needs and pregnancy, I’ll be speaking at the MANA conference in November 2017 on this very topic. Hope to see you there.

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Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition and exercise. Her work is known for being research-focused, thorough, and unapologetically critical of outdated dietary guidelines. She is the author of two bestselling books, Real Food for Pregnancy and Real Food for Gestational Diabetes.


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  1. I’ve read real food for pregnancy ones before getting pregnant then listend to the audiobook again once pregnant. I felt like I had/have a good grasp on healthy eating and eating on the lower carb side (I’ve been gluten free for 5 years and always preferred real food options vs. gf substitutes). So when I got the GD diagnosis I was a bit in shock. As I’ve been monitoring and following your food recommendations from RFFP I’ve been able to control my after meal blood sugar no problem (usually under 110 at the 1 hour mark). However I can’t seem to get my fasting blood sugar below 98-105. When I’ve tried protein at night it spiked my number to 117 in the morning. Another night I tried an apple and got my lowest number yet of 96 (though still not low enough). Do you know if some people just need more carbs at night? I know the morning number is often out of control and more of a hormone issue but desperate for advice before turning to medication.

    • Do you happen to have my book, Real Food for Gestational Diabetes? There’s a section on this topic in Ch 9.

      Since fasting blood sugar can be incredibly tricky, my gestational diabetes course has a full 45 minute training on lowering fasting blood sugar naturally with the advanced tips and tricks from my years in clinical practice.

      With the course, you also have access to our FB group where you can connect with other moms and get Qs answered by me directly during weekly office hours. Here’s all the details:

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