Why Nutrition Matters in Gestational Diabetes (GDM)
Poorly controlled GDM poses short- and long-term risks for both mother and baby. Medical nutrition therapy (MNT) is the first-line treatment, combined with:
- Weight monitoring
- Blood glucose self-checks
- Safe physical activity
Goals:
✅ Stabilize blood glucose
✅ Ensure adequate nutrition for fetal growth
✅ Support healthy pregnancy weight gain
Pregnancy Weight Gain Guidelines
1. U.S. Institute of Medicine (IOM) Recommendations
(Table 1)
| Pre-Pregnancy BMI | BMI (kg/m²) | Singleton (kg) | Twins (kg) |
|---|---|---|---|
| Underweight | <18.5 | 12.5–18 | – |
| Normal weight | 18.5–24.9 | 11.5–16 | 16.8–24.5 |
| Overweight | 25–29.9 | 7–11.5 | 14.1–22.7 |
| Obese | ≥30 | 5–9 | 11–19.1 |
2. Taiwan-Specific Guidelines
(Table 2)
| Pre-Pregnancy BMI | BMI (kg/m²) | Singleton (kg) |
|---|---|---|
| Underweight | <18.5 | 10–18 |
| Normal weight | 18.5–23.9 | 9.6–15 |
| Overweight | 24–27 | 8–14 |
| Obese | >27 | 6–12.4 |
Key Difference: Taiwan uses lower BMI cutoffs for overweight/obesity.
Dietary Strategies for GDM
1. Macronutrient Balance
| Nutrient | Recommendation | Notes |
|---|---|---|
| Carbs | 35–50% of calories | ≥175g/day + ≥28g fiber |
| Protein | 1.2–1.5g/kg/day | Prioritize plant-based, fish, lean meats |
| Fat | 25–35% of calories | Minimize saturated/trans fats |
Carb Counting Made Easy (Table 3)
- 1 serving = 15g carbs:
- Dairy: 300ml milk
- Fruits: 1 baseball-sized fruit or ½ banana
- Grains: 20g rice, 55g sweet potato
Pro Tip:
- Corn = grain, corn shoots = vegetable
- Small tomatoes = fruit, large tomatoes = vegetable
2. Low-Glycemic Index (GI) Choices
(Table 4: Factors Affecting GI)
| Low-GI Choices | High-GI Traps |
|---|---|
| Brown rice | Sticky rice |
| Whole grains | White rice |
| Whole fruit | Juice |
| Dry rice | Congee |
GI Categories:
- Low: ≤55
- Medium: 56–69
- High: ≥70
3. Meal Timing & Composition
- Small, frequent meals: 3 meals + 1–3 snacks
- Pair carbs with protein/fiber: Slows glucose absorption
- Avoid:
- Sugary drinks (even “natural” sweeteners)
- Deep-fried, breaded, or sweet-glazed dishes
Critical Reminders
- No extreme diets: Severe calorie/carb restriction harms fetal development.
- Medication adjustments: Insulin users need customized meal plans.
- Pre-existing diabetes: Same glucose targets but tighter monitoring.
Take-Home Messages
🔹 Weight matters: Follow local guidelines for healthy gain.
🔹 Carbs aren’t the enemy—just choose wisely.
🔹 Low-GI + balanced meals = Steadier glucose.
”Your plate shapes your baby’s future—one balanced bite at a time.”
(Sources: IOM, Taiwan MOHW, ADA)