Let’s Get This Bread: The Low-Carb Diet and Pregnancy
- On June 3, 2019

While some may regard “carb” as a four-letter word, avoiding carbohydrates in your diet while pregnant is not recommended. A study from the University of North Carolina, Chapel Hill evaluated the risk of neural tube defects (NTDs), brain or spinal cord problems that develop early on in pregnancy, as a result of eating a diet low in carbohydrates. The results indicated that women who restricted carbs while pregnant were 41% more likely to have their pregnancy affected by a neural-tube defect.1 These findings are not surprising, as carbohydrates are one of the top sources of a nutrient important for preventing NTDs: folic acid! Folic acid has been thoroughly studied, and it is common practice to increase folic acid levels during early stages of pregnancy.
Folic acid is a B vitamin. It’s organic form, folate, is found in vegetables, fruits, nuts, and beans. In 1998 the FDA mandated the enrichment of grain products such as pasta, cereal, and white flour with folic acid.2 Researchers from the CDC estimate that fortification prevents 1,326 neural tube defects annually.3 These enriched grain foods are often the ones left out when women adopt a low-carb diet. The results from the UNC study suggest that Americans may be dependent upon carbohydrates to consume adequate folic acid. This means that eliminating carbs while pregnant could significantly affect your baby’s health.
Not only may you be missing out on important nutrients if you take on a low-carb lifestyle, but it may also be more expensive. Researchers have estimated that a low-carb diet for a family of four can cost about $8.25 more per day than a diet that follows typical recommendations.4
Low-carb diets can be disguised by a variety of trendy names. The ketogenic, paleo, and Atkins diets are all examples of diet plans low in carbohydrates. Even Whole 30, a short-term diet that includes many healthy foods, is highly restrictive when it comes to carbs. Taking on a new diet during your pregnancy might affect your nutrition status, which could impact your baby’s development. There is evidence to show that a well-planned low-carb diet that includes whole grains, fruits, vegetables, protein, and nuts can be nutritionally complete.5 If you’re concerned about your carbohydrate intake (maybe you’ve been diagnosed with gestational diabetes) talk with a dietitian about healthy ways to incorporate carbs!

Written by: Diana Ricketts
Dietetic Intern, Georgia State University
Graduation Date: December 2019
University of Georgia, BS in Dietetics
References:
- Desrosiers, T. A., Siega-Riz, A., Mosley, B. S., & Meyer, R. E. (2018). Low carbohydrate diets may increase risk of neural tube defects. Birth Defects Research, 110, 901-909. doi:10.1002/bdr2.1198
- Office of Dietary Supplements – Folate. (2018, October 4). Retrieved from https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
- Williams, J., Mai, C. T., Mulinare, J., Isenburg, J., Flood, T. J., Ethen, M., . . . Centers for Disease Control and Prevention. (2015). Updated estimates of neural tube defects prevented by mandatory folic Acid fortification – United States, 1995–2011. MMWR Morbidity and Mortality Weekly Report, 64(1), 1–5.
- Zinn, C., North, S., Donovan, K., Muir, C., & Henderson, G. (2019). Low‐carbohydrate, healthy‐fat eating: A cost comparison with national dietary guidelines. Nutrition & Dietetics. doi:10.1111/1747-0080.12534
- Zinn, C., Rush, A., & Johnson, R. (2018). Assessing the nutrient intake of a low-carbohydrate, high-fat (LCHF) diet: A hypothetical case study design. BMJ Open, 8(2). doi:10.1136/bmjopen-2017-018846
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