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Eating out with gestational diabetes

Gestational diabetes (GDM) can sometimes make you feel like you’re missing out. Missing out on a casual snack, a rich and creamy meal, that extra soda or that piece of cake you’ve been coveting. And GDM comes about at a time in your pregnancy when you’re probably tired and want to indulge a little. Annoyingly GDM is there, shaking its head at you, ordering you to put down the hot chips and put your hands where it can see them.

By now, after looking through GestationalDiabetesRecipes.com, hopefully you’ll have noticed that there is in fact a whole lot of delicious food you can eat despite how you felt after your initial diagnosis. And yes, cooking with GDM does take planning and some re-thinking your approach to food, but once you understand the basics you’ll feel empowered and hungry!

So managing your meals in the ‘safety’ of you own kitchen is all well and good, but what happens when you want to eat out or order in? Here are some helpful tips for approaching these kinds of meals.

Article written by Lisa Taylor (GestationalDiabetesRecipes.com founder) and Natasha Leader (Accredited Practising Dietitian & Credentialled Diabetes Educator and GestationalDiabetesRecipes.com In-Kitchen Dietitian)

 

“Surely it’s okay just this once…”

It’s tricky to say just how often eating out should be done. It depends on the quality of what you’re eating and your overall health. When you’re pregnant there is more to think about from a food safety perspective, which can reduce your options and can in turn push you towards not so healthy options – unless you plan carefully. Food prepared outside the home is more likely to be higher in sodium (salt) and unhealthy fats compared to what you might make at home and this has implications for general health in the long term. Despite all this, eating out or ordering in with GDM is possible if you approach it with some know-how.

 

A guide to eating out

Vietnamese/ Malaysian/ Thai

In Australia the backbone of most Vietnamese, Thai and Malaysian cuisine is fresh vegetables. However jasmine rice and palm sugar are often also key ingredients. So depending on your carb choice, this type of food can be a good option if you avoid the coconut milk and fried food and go easy on the rice.

Better choices

  • Clear soups (such as Tom Yum) containing seafood, lean meat or chicken, and vegetables, are good low fat choices.
  • Choose meat dishes served in chilli based spicy sauce or oyster sauce, rather than satay sauce, which is very high in fat (see above).
  • Spicy salad dishes such as Yum Nuah and Lap Gai are low fat, however they contain meat served at room temperature, which isn’t recommended during pregnancy. Other salads such as pawpaw salad may be a good choice (depending on the food safety guidelines you are following).
  • Steamed rice or noodles are better choices than fried rice or noodle dishes such as Mee Grob and Pad Thai.

Occasionally

  • Any dish containing coconut milk is high in fat. It is best to avoid these when you have GDM and longterm only include them occasionally.
  • Dishes in peanut sauce are also very high in fat, so try these only occasionally. The high fat content can play havoc with your glucose levels as the fat tends to block your body’s insulin from doing its job of clearing glucose from your blood stream).

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • 1/3 cup steamed rice or rice noodles
  • ½ cup wheat noodles

Greek and Lebanese

These foods are traditionally fresh, tasty and offer a healthy range of meat and vegetables. Even though it’s hard to know exactly how much carbs is in something like a meat and rice stuffed tomato, it’s neat portion packaging (a small fist full of carb) and a handy way to portion count. Use the following tips for navigating these styles of cuisine.

Better choices

  • Grilled dishes such as fresh souvlakia or kebabs are good choices for meat eaters. Accompany them with plenty of salad rather than extra eggs or cheese (as is the tradition).
  • Baked Lebanese bread is a low fat accompaniment- just keep track of the amount you have. Peeling the two layers apart is a good option to make it go further.
  • Greek meals such as stuffed tomatoes, stifado (lamb, potato and onion stew) and even moussaka are reasonably low in fat.
  • Keep an eye on the amount of carbs in salads that contain things like cracked wheat or pulses.

Occasionally

  • Fried dishes such as calamari are high in fat so think about grilled instead.
  • Greek and Lebanese desserts are absolutely loaded with sugar. For example one small piece of Greek or Lebanese dessert such as baklava contains three carbohydrate exchanges (45g of total carbohydrate). Think about saving this for a special occasion post-pregnancy.

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • ¼ Lebanese bread
  • 1 cup hummus
  • (1 lady finger)
  • 3 dolmades (stuffed vine leaves)
  • 1 small kibbi (a dish made from chopped meat and bulgur wheat)
  • 1 serve (about 5 tablespoons) taramasalata (fish roe dip)* should be avoided in pregnancy
  • 1 serve (about 5 tablespoons) skordalia (garlic, bread, potato and olive dip)
  • 3 falafel

Japanese

Many people assume Japanese is the ultimate healthy fast food. That would be true if you were only eating raw fish* because it’s lean and full of omega 3 oils. But Japanese food can also contain hidden sugar and salt. Also any food that has been pre-prepared and may be sitting there for a while has a higher risk of containing listeria. So decrease that risk during pregnancy and choose restaurants that have a high food turnover. This is when the faster the food, the better. And ensure your food is prepared in a clean kitchen where good hygiene is practiced.

Better choices

  • Dishes cooked in a broth, such as sukiyaki (meat & vegetables) and yosenabe (seafood and vegetables) are both delicious and low fat.
  • And meat skewers are okay as long as they aren’t dripping in high carb sugary sauces. Opt for meat that has been marinated and not just coated in a sauce.
  • A salad with a freshly grilled piece of meat or fish.
  • Steamed dumplings are better than fried.

Occasionally

  • Miso soup, pickled vegetables and soy sauce are in high in sodium (salt) so consume these in moderation.
  • Avoid too much sushi rice (high carb and high GI), mayonnaise (high fat) and tempura (fried/high fat).
  • Some Japanese desserts contain a lot of coconut, and are consequently high in fat so try choosing something else like a serve of fresh fruit.

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • 1/3 cup steamed rice
  • ½ cup noodles (soba, ramen, udon)
  • Approximately 8-10 steamed dumplings

*(Raw fish (or other meat) isn’t recommended during pregnancy because of the risk of listeria.)

Italian

This can be a good option depending on the venue, as Italian food covers a broad range of styles, flavours and cooking methods from grilled meats to fish, vegetable dishes, salads and pasta. Pasta and breads are obviously high-carb but other GDM-unfriendly ingredients include excess oil or cream or cheese.

Better choices

  • Pasta can be okay if it’s not covered in creamy buttery sauce and if you only eat a modest amount. Homemade pesto LINK is delicious as are pasta tossed with fresh vegetables, a little sugo (Italian tomato sauce) and herbs.
  • Risotto can be okay if it’s not overly creamy or buttery.
  • With pizza try toppings like fresh tomato, sardines, Parmesan cheese, herbs and fresh arugula/rocket.
  • Lean more towards simply prepared and cooked meat and fish or vegetables side dishes, and if you simply must go for something rich, ask for the sauce separate so you can add less than the kitchen might.

Occasionally

  • Often we’re at restaurants to celebrate something. If there is dessert involved, balance out your carb intake through the rest of the meal (by choosing a better choice from the above list) and save your carbs for a small dessert.
  • Pasta with oily, creamy buttery sauces (sorry creamy pesto, boscaiola and carbonara).

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • 1 small bowl minestrone
  • ½ cup pasta
  • 1 appetizer sized cannelloni dish (1 ½ tubes)
  • 1 appetizer sized lasagna or ravioli
  • 1 slice of a small pizza (traditional thin base)

Indian

Much of Indian restaurant food will be high in saturated fat (ghee, peanut oil, fried), high carbohydrate (breads, lentil-based dishes, potato, rice, chutneys) and might not offer much in the way of fresh vegetables. If it’s takeaway/ to-go it may have also been sitting there for some time so be sure to eat somewhere you know serves fresh food and is hygienic, to avoid listeria or salmonella.

Better choices

  • The best thing is to avoid the above-mentioned ingredients and aim for lightly cooked vegetable dishes, a small serve of plain rice, tandoori/ tikka grilled meat and simple yoghurt accompaniments.
  • Vindaloo dishes are lower in fat than Korma curries.
  • Baked breads (naan, roti, chapati) are much lower in fat than the fried breads (pappadums, parathas, puri) however they are likely to be more problematic for your glucose levels than using Basmati rice or lentil as your carbs.

Occasionally

  • Coconut is very high in fat so look for curries in vegetable or tomato based sauces, rather than in coconut milk.
  • Fried appetizers such as pakoras or samosas are best avoided for now
  • Indian desserts are dense in sugar and sometimes deep fried, so if you are desperate for sweetness think about having a yoghurt lassi instead.

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • 1 cup dahl
  • 1 large or four small pappadums
  • ½ roti
  • ½ chapati
  • ½ naan bread
  • 1 parathra
  • 1 puri
  • 1/3 cup cooked rice

Mexican

In Australia where this was written, Mexican food is currently the hottest thing since sliced bread (unfortunately both being high-carb). But the Australian take on Mexican cuisine tends to take advantage of our fresh flavours and produce and doesn’t reflect popular American Tex-Mex, which boasts a hefty dose of vitamin Cheese.

Better choices

  • Grilled meats and vegetables, when eaten with a moderate serve of rice or a tortilla are okay.
  • A small amount of beans is okay (approximately one handful) but go easy on the cheese and cream. I’m talking about you nachos.
  • Generally, sauces and condiments are fine as long as they are vinegar and not sugar-based.

Occasionally

  • Anything covered in cheese or cream unfortunately.

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • 7 corn chips
  • 2 tacos shells
  • 1 corn bread
  • 1 tortilla
  • 1 enchilada
  • 1 tostada
  • ½ cup refried beans
  • 1 tamale

Chinese

Communal eating (shared dishes) is great but it makes it harder to track the amount of carbs you’re eating. When ordering a range of dishes to share, serve yourself a portion of each at the same time so you can see the amount of carbs directly on your plate.

Better choices

  • The best meal options here are short soup, combination soup or other clear soups.
  • Combined meat and vegetable dishes are better than meat alone and opt for stir-fried or steamed dishes that are both excellent low fat choices.
  • When it comes to carbs, steamed rice or noodles are better than fried rice.

Occasionally

  • Avoid really fatty meats like pork belly or crispy duck – or remove excess fat and skin (which kind of takes the fun out doesn’t it?)
  • Beware of meals prepared in ‘sweet and sour’, honey, lemon, and plum sauces. They contain large amounts of sugar and are best avoided.
  • Unfortunately Yum Cha is limiting as pork buns cause glucose levels to skyrocket and fried entrees should be avoided…so it’s a game of counting the dumplings and ordering extra greens.

Quick reference (Each is equal to 1 carbohydrate exchange which equals 15g of total carbohydrate):

  • 2 bowls of short or long soup
  • 1 medium spring roll
  • 3 small dim sum/dumplings/wonton
  • 1/3 bowl (or 1/3 cup) boiled rice

Café food

Café food is convenient and often the menu will offer similar things to what you might prepare at home. General rules are – ask for the wholegrain option and avoid fried foods (chips, battered fish, wedges etc.) If you know it’s an address that specialises in super-sized portions, perhaps consider sharing the order.

Better choices

  • When you think café do you think coffee and cake? Well if you’re thinking sweet treats, try and order a high protein/ low-carb meal like a salad with tofu or other protein and save your carbs points for cake- just don’t double up on carbs.
  • For breakfasts look for eggs (baked eggs, omelettes, scrambled) with toast and low-carb sides (salad, vegetables, proteins).
  • Try grilled fish, or any grilled lean meat. (If there is a rim of fat on the meat, cut it off and leave it on the plate. The extra fat is your insulin’s enemy.)
  • Ask for salad to be served with no dressing and give it flavour by adding vinegar or a squeeze of lemon juice.
  • Boiled or jacket potatoes are much lower in fat than chips.
  • Dessert selections (see below for more info) often include fruit salad, which is a light and refreshing way to finish a meal.
  • Remember you do need to have some carbohydrate with each meal – bread or potatoes are usually available.

Better dessert choices

  • Fresh fruit
  • A small selection from a cheese platter (hard cheeses)
  • A scoop of gelato or ice cream
  • Share a slice of cake with a friend if you’d had a low-carb main meal
  • Petit fours
  • Chocolate mousse is better left as it contains raw egg

 

What do I need to know if I’m eating out and taking insulin?

When you’re eating out make sure you don’t inject your insulin until your plate is in front of you. You don’t want to have given your insulin only to find the kitchen has lost your order or dropped your plate and will be another 30 minutes.

If you go to the same restaurant or cafe often, learn from experience how your BGL responds to that food and discuss altering your dose with your healthcare provider if you feel you need more or less for certain dishes.

If you are eating later than usual make sure you include an extra snack so it doesn’t become too long between meal/snack times.

If you are eating late and also on overnight insulin, don’t worry about taking these at a similar time – it won’t cause a problem with hypoglycaemia (low blood glucose levels). The mealtime insulin will work on the food, the overnight insulin doesn’t have the same immediate action so will be kicking in later anyway.

Last updated June, 2013

  • Lara says:

    Thank you so much the above is really helpful! I was starting to think I wouldn’t be able to go out for dinner until bub is born using your guidelines I will find this much easier. Thanks!

  • Cassie says:

    Oh thank God someone has done this! I just found out I have GDM and am 8weeks pregnant. I am having so much trouble keeping my BGL down and getting my meal times and testing times right. I was so sure I would have to bring food with me everywhere but now I am more confident with eating food away from home.
    Thankyou Thankyou Thankyou!!!

  • Ai says:

    Hello:) Loving this site, so helpful!

    I just wanted to point out, being Japanese, I’m having to avoid A LOT as most sauces, broth contain so much refined sugar. I would say avoid Sukiyaki at all cost. Traditional way to make it is to basically cook the meat and vegetables in pure soy sauce and white sugar!

    • Lisa says:

      Hi there, Thanks for your comment. It must be really challenging to change your diet so radically during your pregnancy! Hope you’re going well. Lisa x

  • Kathy says:

    Lisa,
    I had gestational diabetes 27 years ago at age 35 with my 3rd(and last child). I have been able to control my blood levels through diet all these years. Two weeks ago during my regular 3-month checkup to check my overall health due to taking meds for high blood pressure/cholesterol my A1c was off the richter scale. My dr. started me on pills immediately and I have been checking my blood daily. I have been more stringent on food choices and have been surfing the net for new ideas. I came across your site and immediately bookmarked it. I love your recipes! I am Chinese so am familiar with julienne veggies. Your section on International fares is especially useful to know. I love dim sum and know I am limited now. I guess you would say I was lucky to have 26 years(vs. the norm of 10 years for the “disease” to return). I will surely reference your recipes to add pizazz to my meals to help me cope living with diabetes.
    Thank you so much for your wonderful inspiring site!
    Kathy

    • Lisa says:

      Hi Kathy! Wow, that must have been such a shock getting that diagnosis 26 years later. It sounds like you have your head around it all though – good for you. I’m so pleased the website has given you some good ideas. Eating with diabetes should still be delicious right!? Happy new year and best wishes, Lisa x

  • Crystal says:

    Hi Lisa,
    I was diagnosed with GDM on Monday. This is my 2nd pregnancy, but I didn’t have GDM with my 1st. I’m 38 years old, work full-time in Sales, have a 2 year old toddler and am currently 29 weeks pregnant with my 2nd child.
    Considering my busy schedule and my already relatively healthy diet, I was shocked to fail my diabetes screening. Portion control and 6 meals a day completely freaked me out and risks to my baby did too. How am I going to do it all!? Obviously this diagnosis has rocked my world and I’m still adjusting. I love your site, thank you!

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I’m Lisa Taylor, the mum behind GDRecipes. I created this site after having GDM myself & because I love food. I’d like to inspire, motivate & support you to cook & eat well during your pregnancy with GDM & beyond. Come read my story. My kitchen is your kitchen. ... Read more

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