Is A Keto Diet Safe If You’re Pregnant?

The keto diet is attracting fans everywhere, with many swearing it’s the most effective weight-loss plan they’ve ever tried. But is it safe to follow a keto diet when you’re pregnant?

M9GKM0 Keto diet concept. Balanced low-carb food background. Vegetables, fish, meat, cheese, nuts on a dark background.

More and more people are turning to a keto diet as the answer to their weight issues. Its focus on high-fat, low-carb foods means you can enjoy meat, eggs, fish and even dairy. Who wouldn’t like to eat bacon and eggs as often as they want? But is a keto diet safe if you’re pregnant?

The ketogenic diet is about getting your body to run on fat – a state known as ketosis. While there are many foods you can eat freely, there are others you might be surprised to learn you should avoid – such as root vegetables, red apples, grapes, legumes and tropical fruits.

These restrictions are at the root of some experts’ concerns. While a keto diet might work for you and your lifestyle normally, what about if you’re pregnant? Is it safe?

Keto and conception

The keto diet has been recommended for many women who suffer from the polycystic ovarian syndrome. A common symptom of PCOS is difficulty in conceiving; studies have shown that ketosis is helpful in addressing this.

Dr Michael Fox, a fertility specialist at the Jacksonville Center for Reproductive Medicine in Florida, US, recommends women follow a ketogenic diet for two or three months before trying to conceive. This, he says, ensures their bodies have adapted before pregnancy.

The case for keto in pregnancy

“It’s completely safe for women to eat a ketogenic diet in pregnancy. Women in ancient times were certainly ketotic during pregnancy,” says Dr Fox. His experience is that a keto diet reduces cases of miscarriage, pre-eclampsia, gestational diabetes and morning sickness.

Pro-keto experts say ketosis is a natural part of being human, highlighting the way we fast from dinner to breakfast. As many pregnant women suffer from nausea, poor appetite and aversions to certain foods, their bodies enter temporary ketosis on a regular basis.

Ketogenic and low-carb diet expert Lily Nichols has helped hundreds of pregnant women. Her book, Real Food for Gestational Diabetes has a whole chapter on misconceptions around ketosis in pregnancy.

She says: “I find it ironic that if you tell your doctor you plan to eat low-carb during pregnancy, they’ll say it’s unsafe. But if you say you plan to eat a diet based on fresh vegetables, meat, fish, eggs, dairy, nuts, seeds and a little fruit, they’ll tell you to stay the course.”

She concedes some pregnant women do feel better if they eat more carbs, especially during the early stages. In that case, she says, they should go for it – but try to opt for nutrient-dense foods.

In late-stage pregnancy, it’s also been found that ketosis happens naturally.

The case against keto in pregnancy

On the other side of the coin, there’s the view that pregnant women should not be dieting.

Nutritionist Dr Charles Seltzer, based in Philadelphia, US, says nourishing the unborn child should be the main focus during pregnancy.

“Ketogenic diets steer you away from nutrient-dense foods like fruit, which are packed with vitamins and minerals. These are crucial for the development of a baby,” he explains.

If a mum-to-be needs to lose weight in order to give birth safely, he adds, she should only diet under close supervision from someone who knows what they are doing.

Dr Seltzer also believes limiting carbs is inadvisable during pregnancy as it can lead to diminished energy levels. The brain and muscles’ preferred fuel are carbohydrates, and restriction them can lead to grogginess and a lack of motivation.

He says people see significant weight loss on keto diets because muscle includes large amounts of water and sugar. Take the sugar away, and you will get weight loss.

He openly admits he’s not a fan of keto diets in general. “People will come to my office and say, ‘Keto worked, I lost weight on it five times’,” he says. “If you need to lose weight on five separate occasions, is it truly working?”

Before you decide

It’s confusing when there are so many case studies both for and against a keto diet in pregnancy. The most important thing is to take advice, especially if you haven’t followed a keto diet before.

Talk to your doctor or hospital consultant. If you have friends who have followed keto during pregnancy – or those that have decided against it – ask about their reasons and experiences. Discuss it with your partner.

Explore both sides of the argument before making a choice. And when you do, make sure it’s right both for you and your unborn child.

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