Facing Gestational Diabetes as a Food Lover

What do you eat when you can't eat anything?

Rare, sliced steak with bagna cauda on a white plate.
Daniel Gritzer

In the first few months of my pregnancy, friends often asked me how I was dealing with life without wine, beer, and cocktails; without buttery pieces of toro at my beloved neighborhood sushi bar; without the various other foods most people avoid when they're carrying a baby. Early on, none of those things mattered much to me; I was too sick to crave much more than mac and cheese. Coffee and wine started to taste oddly bitter and flat to me, but it didn't seem that awful to wait 40 weeks to get back to enjoying them. My local bar always managed to serve me some creative alcohol-free concoction. (Pineapple juice and savory Cel-ray? Highly recommended.)

I took advantage of California's citrus season, buying pounds of floral Oro Blanco grapefruits and tangerines for making fresh juice. Fruit never tasted better: I sent my husband on wild goose chases for out-of-season mangoes, and celebrated the early arrival of local strawberries by eating a pint every day. And I had ice cream: pints of salted caramel at home, cones of Bi-Rite's insanely rich buffalo-milk soft serve during walks around the park. In challenging moments in those first few months, Max reminded me that "at least it's an excuse to eat all the ice cream you could desire." (I never did convince him to ship me some homemade pints of this darkest dark chocolate ice cream from New York.)

But in mid-March I found myself undergoing a hazing ritual pretty much all pregnant women experience: you show up at the hospital with an empty stomach, get your blood drawn, and then chug a bottle of extra-strong Kool-aid-like glucose solution to see how your system reacts to the sugar over a couple of hours. My post-sugar measurements were fine, but the fasting blood draw revealed a slightly elevated number—enough to make my doctors wary.

I've heard gestational diabetes explained as a long-ago adaptation: If our hunter-gatherer ancestors needed to gain weight to support the growth of a baby without getting any additional calories, the body would need to adjust how it processed the food it received. Whether or not that's the case, as many as 10 percent of pregnant women are diagnosed with gestational diabetes today when hormones released by the placenta keep insulin from properly processing sugars in their bodies.

To avoid growing an extra-large or broad-shouldered baby (as well as dangerous complications like preeclampsia), my doctors recommended a pretty drastic dietary shift, frequent exercise, and careful monitoring on a glucometer before turning to medication if the diet didn't work. People with gestational diabetes can tolerate various amounts of carbohydrates, and some can enjoy a fair number as long as they're always paired with protein. Some experts, though, recommend dialing down carbs quite a bit, and even call the condition 'carb-intolerance.' (Here's the disclaimer: every body is different, and this post is not meant to be medical advice. Consult your doctors about what you should be eating.)

For me, it meant goodbye, mocktails: the sugar level in juice—even the freshest stuff—not to mention soda, goes straight to the bloodstream and makes your numbers go bonkers. So long, morning smoothies: the system is especially sensitive early in the day, so liquified fruit had to go. In fact, I found that my blood sugar shot up even with a single piece of whole-grain toast served with my eggs.

Reading Real Food for Gestational Diabetes helped me understand this new world of low-carb living, but for the first time in my life, it began to feel like food was the enemy, not a source of inspiration and excitement.

My work at Serious Eats was like salt on a wound: I could read about, but not taste, Daniel's smooth and creamy polenta, not to mention Max's mouthwatering ice creams. Where before I had gleefully enjoyed a project tasting my way through Tartine Bakery's display case, I had to back out of stories I'd planned. There was no way I could eat everything at House of Pancakes, a Chinese spot with eleven varieties of savory pancakes. I was definitely not able to join Kenji's hunt for the best tortas in the Bay Area.

While I wanted to take advantage of my last few months of pre-baby freedom and go out as much as possible, I began to look at restaurant menus with trepidation. When a group ordered dishes to share, I passed half the plates on around the table without taking a bite. I looked away as tickets were sold for an Ivan Ramen popup in my neighborhood. I cancelled a dim sum date with some other food writers and found myself suddenly in tears. I met friends for lunch over and over at the same two neighborhood spots where I knew I could find something that wasn't piled on toast; I stuck with seltzer and lime while other pregnant friends sipped mock-margaritas. I broke all the rules of burrito-eating, unwrapping the entire foil and dumping the rice-free insides on to a plate so I could avoid the tortilla. Gifts of pie, chocolates, and other treats went to my husband's office or the compost bin. I couldn't face them.

"I ate almonds until I could eat no more almonds. I stared at the fridge and couldn't find anything I wanted."

Like some cruel joke, gestational diabetes tends to get worse as the pregnancy progresses: the insulin-blocking hormones increase over time. At first, I could have a handful of strawberries with full-fat Greek yogurt as a late-night snack, but eventually my fasting numbers rose to the point that my dietician suggested cutting them out. I felt like I was turning into one of those people who eats only ribeye steaks morning, noon, and night. I ate almonds until I could eat no more almonds. I stared at the fridge and couldn't find anything I wanted.

It's easy for the food media to discount various diets as trends, but some folks have no choice about their dietary limitations. And those people—myself included—could really use a little help getting inspired about food again. Eight months into my pregnancy, I'm still looking for gestational diabetes-friendly meal inspiration: safe but delicious food for people who love to cook but can't eat a ton of carbs. Hopefully what follows will help you if you're in the same position.

Find a Little Indulgence

J. Kenji Lopez-Alt

Since I can't lounge on the couch inhaling ice cream by the pint, I've been thinking a lot about what I can eat that's rich and comforting and indulgent and special...but still allowed on my restricted diet. Fancy ingredients can make a meal feel more like a celebration and less like a regime: springing for pricey local morels, sautéing them in butter with tender asparagus and topping them with a scoop of burrata makes a meal no one feels sad eating. Shredded duck confit turns a regular salad into something classy. Sick of scrambled eggs? Now is the time to garnish with a few truffle shavings or silky porcini or lobster meat or whatever will make you feel like you're treating yourself.


Not all people with gestational diabetes can tolerate dairy, but if you can, cheese is a jackpot. I normally shudder a bit at the price of the awesome cheeses from Cowgirl Creamery, but these days my most joyful moments involve taking down a wedge of Mt. Tam. Find the best, creamiest, most delicious (pasteurized) cheeses available where you live, and enjoy them. (I also find it helpful to keep regular ol' string cheese on hand for late night snacks.)

The Breakfast Dilemma


Toast is out. Smoothies are out. Cereal is out. Pancakes are out. For me, breakfast has become a grain-free, fruit-free zone. Some people can tolerate some carbs in the morning, but apparently I'm not one of them right now. I made so many eggs I started daydreaming about egging my own house.

Before you get to that point, it's worth thinking about what you're craving. If fruit used to be your thing, will crisp, fresh vegetables work? It may sound strange, but a peppery arugula salad with red peppers and a tart lemon or vinegar-based dressing is not bad breakfast food...especially when topped with an egg. We've started getting the first flavorful (though still greenhouse-grown) tomatoes, and so Caprese salad with some really good olive oil is now in my breakfast rotation, too. (And it's not bad topped with an egg.)

While I'm not quite ready yet to make pork chops for breakfast (though bless you if you are), I stocked up on loose sausage, both spicy and milder fennel-laced, and froze it in single-portion bags to scramble up with my eggs for a little added protein.

Having cheese around also comes in handy when it comes to eggs: add a little fresh goat cheese just before serving, or let some pepper jack melt into your scramble and you have a whole different dish. Get every fresh herb you can think of (store them properly and they'll last) then snip leaves of tarragon, basil, mint, or whatever into your eggs and breakfast salads.

Lunch, Drinks, and Snacks


If you have gestational diabetes, you can't grab a sandwich (unless you plan on just eating the innards, which I totally do sometimes, sometimes on a pile of greens.) It's harder to just 'whip something up quick' in the middle of the day when you can't grab a bag of soba noodles. Dinner's leftovers come in handy, as does having a salad (with protein in it!) prepped in advance.

A container of meaty bolognese can be rewarmed with vegetables instead of pasta: my go-to is zucchini, though sturdier stuff like broccolini is great, too.

When it comes to drinks, juices and milk are out, but that doesn't mean you're stuck with plain water. Now is the time to imagine you're at a spa: infuse your water with cucumber and lemon slices for a little more flavor. Check with your doctor about the safety of other options such as herbal teas, kefir, and kombucha. I love having iced unsweetened fresh mint or raspberry-leaf tea ready in the fridge, and I've gotten a little obsessed with tart (and almost beery) hibiscus-flavored High Country Kombucha. (I get it at a local health food store and just add a few ounces to a pint of seltzer.)

In addition to snacking on almonds (I like the dry-roasted salted ones from Trader Joe's) and cheese, I've been enjoying a sort of faux-sushi roll. I'll admit it: without rice, these really are nothing like sushi, but wrapping some crunchy vegetables and creamy avocado in sheets of nori (served with a little soy sauce) is a nice change of pace. You could also include cooked strips of pork or salmon or even crabmeat. If you're missing the rice, the answer is in cauliflower, which is remarkably low in carbs. Just pulse the raw cauliflower in a food processor until it basically looks like couscous, then saute until tender with butter or olive oil.

Rethinking Pasta and Other Starchy Stuff

J. Kenji López-Alt

While we're talking about cauliflower, let me say this: I never thought I would be the person making low carb 'pasta' dishes. But if what you're craving is mac and cheese (and you're tolerating cheese okay), then mac and cheese made with cauliflower will absolutely satisfy. The truth is, pasta doesn't add a ton to this dish in the first place, and roasting cauliflower florets before napping them in a creamy cheese sauce and baking until the top is crispy may actually end up with a more flavorful dish.

It doesn't end there: roasted cauliflower is terrific in any 'pasta bake' type dinner. Try stirring roasted cauliflower into a mix of cooked spicy sausage and tomato sauce, layer in dollops of ricotta or shredded mozzarella, top with a grating of parmesan, and bake until crispy.

I love pancake-wrapped dishes like mu shu pork, but it turns out the wrapper isn't that crucial. Make your favorite stir-fry (keeping an eye on any sauce ingredients that might have hidden sugars) and wrap in crisp lettuce leaves. If you're trying to avoid tortillas, put those taco fillings in a lettuce wrap, too!

Eat Good Meat

Daniel Gritzer

If you're a meat-eater, now is the time to buy the best meat you can find and cook it carefully. Find an excellent butcher shop (or farmers market meat purveyor) and invest in a Thermapen or Thermopop so you can be certain you won't over or under-cook a fancy cut of meat.

Make juicy pork chops with a flavorful pan sauce. Baste your steaks with butter or try a flavorful bagna cauda dressing.

Now is the time to master the perfect roast chicken and try your hand at tandoori-inspired chicken kebabs on the grill. Grill lamb chops, too, and serve 'em with an easy chopped Greek salad.

Other Comforts

I haven't found a really satisfying substitute for dessert, though some people like 100% cacao chocolates (Max recommends the one from Dandelion Chocolate), and others can tolerate a small amount of ice cream at night (I'll try not to be jealous.) A glass of cool herbal tea (or the fizzy lemon-flavored Natural Calm, a magnesium supplement that's supposed to help with the crazy leg cramps that are one of pregnancy's other joys) sometimes does the trick. But instead of thinking about sweets, it's nicer to treat yourself to a fancy cheese plate, loaded with the rich stuff and some nuts to accompany it. If they take my cheese away, it better be really close to the end of this thing.

If food was your comfort, your hobby, or your work, and gestational diabetes turns that upside down, it's time to make a list of other things that makes you happy and help you relax, whether it's tea with friends who make you laugh, a warm bath, a massage, a good yoga class, going to the movies, sitting outside with board games or a book, or looking at the adorable little clothes that will soon be occupied by a new little person who will make you forget everything that it took to get to your new life.

May 2015