Keto During Pregnancy: Safe Or Not?

The ketogenic diet, or keto, is a high-fat, low-carbohydrate, and moderate-protein diet. It is known to cause rapid weight loss, reduce inflammation, and stabilize blood sugar levels. However, it is not recommended for pregnant women due to the risk of nutrient deficiencies, increased cholesterol, and potential harm to the baby's development. While some women have reported successful keto pregnancies, the overall consensus is that it is not worth the potential risks.

Nutrient deficiencies

Carbs are a no-go on the keto diet, including fruits and most vegetables, which are rich in vitamins, iron, and folate—all essential for a healthy pregnancy. For example, folic acid is key to brain and spine development and can be found in carb-rich foods like fortified cereal, enriched bread, and beans. Similarly, brightly coloured fruits and vegetables are rich in vitamins, iron, and folate, which are necessary for the development of a healthy baby.

Additionally, the keto diet is high in saturated fat, which can cause health problems like higher cholesterol, putting a strain on the heart and, therefore, the pregnancy.

Furthermore, the keto diet can lead to low levels of vitamin D (needed for healthy bones and teeth), vitamin E (for healthy muscles and blood), vitamin B-12 (for a healthy spinal cord and nerves), and folic acid (to prevent a neural tube condition in babies called spina bifida).

Overall, the keto diet may prevent pregnant women from consuming a variety of nutrient-dense foods, which could negatively impact their health and the development of their baby.

Risks of ketoacidosis

Diabetic ketoacidosis (DKA) is a serious and life-threatening condition that occurs when there is a buildup of ketones in the blood, causing the blood to become more acidic. This can happen when the body doesn't produce enough insulin, which is key to helping sugar enter cells in the body. Without enough insulin, the body starts to break down fat for fuel, leading to a buildup of ketones.

The risks of ketoacidosis include:

• High levels of ketones can poison the body.
• Ketoacidosis can lead to a diabetic coma or even death.
• Ketoacidosis can cause a loss of consciousness.
• It can lead to swelling inside the brain (cerebral edema), which is more common in children.
• Fluid buildup in the lungs (pulmonary edema).
• Damage to the kidneys or other organs due to fluid loss.
• Low levels of potassium (hypokalemia), which can affect the heart, muscles, and nerves.
• Low blood sugar (hypoglycemia), which can occur when insulin is administered to treat ketoacidosis.

While the keto diet has become popular for weight loss, it is not recommended for pregnant women due to the risk of nutrient deficiencies and the potential impact on the baby's growth and development.

Lack of research

There is a lack of research on the effects of the keto diet on pregnant women. This is because it is not considered ethical to use pregnant women as subjects in clinical studies. As a result, most of the research on the keto diet during pregnancy has been conducted on animals, particularly mice.

Some studies on mice have shown that a keto diet during pregnancy can cause alterations in the growth rates of embryos and the development of structures and organs such as the spine, heart, and brain. These changes may be associated with future dysfunction. However, another study found that exposure to a ketogenic diet increased sociability and reduced depression-like symptoms in the offspring of the mice.

There is limited evidence from case studies on the safety of ketogenic diets in pregnant women. In one case report, two pregnant women with epilepsy followed a ketogenic diet during their pregnancies. One woman had no complications, while the other gave birth to an infant with ear abnormalities. However, it is unclear if the abnormalities were caused by the diet or other factors.

Overall, there is a need for more research on the safety and potential benefits of the keto diet during pregnancy. Pregnant women should consult with their healthcare providers before starting any new diet, including the keto diet.

Weight loss concerns

Weight loss is a common concern for many people, and it's natural to want to maintain a healthy weight during pregnancy. However, when it comes to the keto diet and weight loss concerns during pregnancy, there are several important considerations:

Nutritional Needs

During pregnancy, the body requires a variety of nutrients to support the growing baby. The keto diet's restriction of carbohydrates can lead to a lack of essential vitamins, minerals, and fibre. Pregnant women need colourful fruits and vegetables, rich in vitamins, iron, and folate. These foods also provide fibre, which can help with pregnancy constipation. A prenatal vitamin can provide extra nutrients, but it's best to obtain them from a diverse diet.

Weight Loss Risks

While the keto diet may aid in weight loss, it's not recommended for pregnant women trying to lose weight. Unless advised by a doctor, pregnant women should not aim to lose weight. Instead, the focus should be on consuming a balanced diet with a variety of nutrient-dense foods. Unintentional weight loss during pregnancy could be detrimental to the baby's growth and development.

Health Complications

The keto diet's high-fat content, particularly saturated fats, can lead to health issues for the mother. Excessive saturated fat consumption can increase cholesterol levels, putting strain on the heart and impacting pregnancy health. Additionally, the keto diet may not provide enough folic acid, which is crucial for the baby's brain and spine development.

Morning Sickness and Food Aversions

Pregnancy often comes with morning sickness and food aversions, particularly to meat, eggs, and cheese, which are staples of the keto diet. This can make sticking to the keto diet challenging and may lead to an increase in carbohydrate intake to manage these aversions.

Long-Term Health Impact

There is limited research on the long-term health impact of the keto diet during pregnancy. While it may aid in weight loss, the potential risks to the baby's development are unclear. Some studies on animals have shown alterations in growth rates and organ development, but these findings may not apply to humans.

In summary, while weight loss may be a concern, the potential risks of the keto diet during pregnancy outweigh the benefits. A balanced diet with a variety of nutrient-dense foods is generally recommended to support the health of both the mother and the baby. It's important to consult with a healthcare professional before making any significant dietary changes during pregnancy.

Alternative diets

While the keto diet is not recommended for pregnant women, there are other diets that can provide a balanced and nutritious approach to eating during pregnancy.

Balanced Diet

A balanced diet is always recommended for the health of both mother and baby. This includes a mix of nutrient-dense foods such as eggs, lean meats, calcium-rich foods (like cheese, milk, yoghurt, and calcium-fortified soy milk), fruits and vegetables (e.g. avocados, red bell peppers, spinach), seafood (especially low-mercury fish like salmon and sardines), whole grains, and legumes.

Low-Carb Diet

A low-carb diet is a more flexible approach that still provides the benefits of low-carb eating without the potential risks associated with ketogenic eating. A carbohydrate goal of 75-150 grams per day is generally recommended for pregnant women, unless advised otherwise by their healthcare provider. This can include small quantities of healthy, high-quality carbs like rice, fruit, oats, plain whole Greek yoghurt, and potatoes.

Foods to Avoid

Pregnant women should avoid restrictive diets that could lead to nutrient deficiencies. Simple carbs from junk food, such as cookies, sugary cereals, candy, chips, soda, and ice cream, should be limited. However, it is important to note that not all carbohydrates are equal, and complex carbs like berries, apples, beans, sweet potatoes, and squash can be beneficial.

Foods to Include

In addition to the food groups mentioned above, it is important to include healthy fats during pregnancy. This includes foods like fish, nuts, seeds, coconuts, and avocados.

Prenatal Vitamins

It is also recommended to continue taking prenatal vitamins throughout pregnancy to ensure adequate nutrient intake.

Frequently asked questions