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It's no secret that 2018 was the year of the keto diet. A year later, the trend shows no signs of slowing down any time soon. Celebs like Kourtney Kardashian, Alicia Vikander, and Vanessa Hudgens continue to spill their high-fat, low-carb eating tips on their IG stories. Recently, fitness queen Halle Berry took to Instagram to drop some of her keto wisdom as part of her infamous #FitnessFriday Instagram series.
ICYDK, doctors recommend the keto diet for a plethora of medical conditions, including diabetes, polycystic ovary syndrome (PCOS), and epilepsy. But how safe is it really during pregnancy?
“For obvious ethical reasons, we do not have any studies that say it is safe to be on the ketogenic diet during pregnancy, so I can’t really advocate for it,” says Christine Greves, M.D., a board-certified ob-gyn from Orlando Health.
The few studies that are out there specifically highlight the dangers of not having enough folic acid during pregnancy, explains Dr. Greves. She says that carbohydrates found in grains like wheat flour, rice, and pasta (all big no-no’s in the keto diet) are rich in folic acid, which is very important for fetal development, especially during the first trimester.
Women who eat a low-carb diet during pregnancy are at a greater risk of having a baby with neural tube defects, which can cause the child to develop conditions like anencephaly (an underdeveloped brain and an incomplete skull) and spina bifida, according to a 2018 National Birth Defects Prevention study. That’s part of the reason why, in 1998, the FDA required the addition of folic acid to many breads and cereals: to increase the amount of folic acid in people’s general diets. Since then, there has been about a 65 percent reduction in the prevalence of neural tube defects in the general population, according to the Centers for Disease Control and Prevention (CDC).
Despite the potential dangers of eating low-carb during pregnancy, some exceptions can be made for women who have medical conditions like diabetes and epilepsy. "In medicine, you have to weigh the risk versus benefits," says Dr. Greves. "So if you have epilepsy or diabetes, some of the medications used to treat those conditions can end up being more harmful to the fetus. In those scenarios, the ketogenic diet might be an acceptable non-pharmacological alternative for controlling symptoms and ensuring a safe pregnancy."
But since some people go on the keto diet to drop pounds, Dr. Greves notes that weight loss is not recommended during pregnancy, nor is going on a diet you haven’t tried before. “Instead, you should focus on nourishing your body and your growing baby,” she says. “By restricting carb-rich whole grains, beans, fruits, and certain vegetables, you can easily fall short of valuable fiber, vitamins, and antioxidants.”
Bottom line? If you have any questions about your diet while you're pregnant, it's always a good idea to talk to your doctor first. They'll help you make the right decision for your body and your baby.
