I am so smart! S-M-R-T!
There's a blog that I follow called My OB Said WHAT?!?. It's a collection of things that actual care providers have said to their pregnant/birthing clients. I don't usually respond to it except to express sympathy occasionally, because it's really a place for women who feel violated or mistreated to vent.
Today's, however, was a really good one. I always read the comments, because a lot of hilarious, snarky women reply to these entries and their comments are frequently worth the time. However, there was one comment to which I felt the need to reply, since it was incorrect, and displayed a very common misconception. I'm really proud of my answer, so here's the conversation.
Original Post
“Oh! Don’t do that! Fruit has calories!” - OB to mother who declined a stool softener because she was not constipated and told the OB that she ate plenty of fruit and vegetables.
My Reply
This OB definitely misspoke, but pregnancy is a diabetogenic state and you really do want to minimize the amount of sugar you take in. Eating a large variety of vegetables gets you the same nutrition as fruits, but without the sugar. Too much sugar can increase the baby’s insulin levels and lead to hypoglycemia right after birth, as well as high birth weight. Some fruit is fine, but since pregnancy increases your insulin production and therefore makes you crave sugar, it’s a good idea to limit it!
That being said . . . somehow I doubt this OB went through the trouble of explaining that to this pregnant mama. After all, explaining and educating puts power in the mother’s hands, and we can’t have that, can we? *eyeroll*
"Mama Wrench" Replies to Me
Fruits are also extremely nutrient dense, and you need to eat a LOT of fruit to create the same pancreatic overload of processed sugars that most of us overconsume. And you can get just as much sugar from certain vegetables as fruits - beets, carrots and sweet potatoes are EXTREMELY nutrient dense but have as much sugar as an equivalent serving of most fruits. As long as Mom isn’t washing down all those fruits and veggies with a litre of Coke and a slice of chocolate cake, she’s probably not going to eat herself into GD unless she’s predisposed to it anyway.
My Response to "Mama Wrench"
For the most part I agree with you. However, the carbohydrates in most vegetables (beets and sweet potatoes included) tend to be in a more complex form than those in fruits. If your body has to work to break down the carbohydrates, then they are released more slowly into the bloodstream and do not create the same reaction from the pancreas. Fructose is a fantastic source of energy and fruits are great in moderation, but one or two per day is plenty for the pregnant mama, especially if she is at risk for GDM. The thing is, a LOT of women are predisposed to GDM and you don’t always know ahead of time!
The big difference between the vegetables you mentioned and fruits is the type of sugar. Yes, they have the same type, but the difference is in the chemical composition. The majority of the carbohydrates in fruits comes in the form of fructose, which is a monosaccharide. This means that it is formed of a single ring of carbon atoms, bonded to functional groups consisting of H and OH (hydrogen and hydroxy groups). The single ring can enter the bloodstream directly without being broken down first, and will have the same effect on the pancreas as glucose and galactose, which are the other two digestible monosaccharides found in our diet.
The other major sugar that is found in plants is sucrose, which is a disaccharide, meaning it is formed by a glycosidic linkage between two different hydroxycarbon rings. In order to enter the bloodstream, the body had to expend some energy to break sucrose down into its component pieces (glucose and fructose) in the duodenum of the small intestine.
Take a look at this chart:
http://en.wikipedia.org/wiki/Fructose#Fructose_and_starch_functionality_in_food_systems (compiled from values given on the USDA website)
As you can see, while vegetables on the whole have the same carbohydrate content as fruit, their sugar levels are on average lower. While fruit sugar load is in the 8-12% range (on average), vegetables are in the 4-7% range (again, on average). This means that vegetables tend to present more of their carbohydrates in the form of oligo- or polysaccharides, which require more time and energy to digest and therefore do not create sudden fluctuations in blood sugar levels.
So while I agree that fruit is better for you, I have to disagree with your argument that vegetables have as much sugar as fruit, and that they affect the pancreas in the same way. As far as I’ve studied, that is simply not true and the numbers contradict it.
(And they say midwives don’t have an adequate science background!)
She hasn't replied yet, but another reader replied and thanked me for the information. :)
Today's, however, was a really good one. I always read the comments, because a lot of hilarious, snarky women reply to these entries and their comments are frequently worth the time. However, there was one comment to which I felt the need to reply, since it was incorrect, and displayed a very common misconception. I'm really proud of my answer, so here's the conversation.
Original Post
“Oh! Don’t do that! Fruit has calories!” - OB to mother who declined a stool softener because she was not constipated and told the OB that she ate plenty of fruit and vegetables.
My Reply
This OB definitely misspoke, but pregnancy is a diabetogenic state and you really do want to minimize the amount of sugar you take in. Eating a large variety of vegetables gets you the same nutrition as fruits, but without the sugar. Too much sugar can increase the baby’s insulin levels and lead to hypoglycemia right after birth, as well as high birth weight. Some fruit is fine, but since pregnancy increases your insulin production and therefore makes you crave sugar, it’s a good idea to limit it!
That being said . . . somehow I doubt this OB went through the trouble of explaining that to this pregnant mama. After all, explaining and educating puts power in the mother’s hands, and we can’t have that, can we? *eyeroll*
"Mama Wrench" Replies to Me
Fruits are also extremely nutrient dense, and you need to eat a LOT of fruit to create the same pancreatic overload of processed sugars that most of us overconsume. And you can get just as much sugar from certain vegetables as fruits - beets, carrots and sweet potatoes are EXTREMELY nutrient dense but have as much sugar as an equivalent serving of most fruits. As long as Mom isn’t washing down all those fruits and veggies with a litre of Coke and a slice of chocolate cake, she’s probably not going to eat herself into GD unless she’s predisposed to it anyway.
My Response to "Mama Wrench"
For the most part I agree with you. However, the carbohydrates in most vegetables (beets and sweet potatoes included) tend to be in a more complex form than those in fruits. If your body has to work to break down the carbohydrates, then they are released more slowly into the bloodstream and do not create the same reaction from the pancreas. Fructose is a fantastic source of energy and fruits are great in moderation, but one or two per day is plenty for the pregnant mama, especially if she is at risk for GDM. The thing is, a LOT of women are predisposed to GDM and you don’t always know ahead of time!
The big difference between the vegetables you mentioned and fruits is the type of sugar. Yes, they have the same type, but the difference is in the chemical composition. The majority of the carbohydrates in fruits comes in the form of fructose, which is a monosaccharide. This means that it is formed of a single ring of carbon atoms, bonded to functional groups consisting of H and OH (hydrogen and hydroxy groups). The single ring can enter the bloodstream directly without being broken down first, and will have the same effect on the pancreas as glucose and galactose, which are the other two digestible monosaccharides found in our diet.
The other major sugar that is found in plants is sucrose, which is a disaccharide, meaning it is formed by a glycosidic linkage between two different hydroxycarbon rings. In order to enter the bloodstream, the body had to expend some energy to break sucrose down into its component pieces (glucose and fructose) in the duodenum of the small intestine.
Take a look at this chart:
http://en.wikipedia.org/wiki/Fructose#Fructose_and_starch_functionality_in_food_systems (compiled from values given on the USDA website)
As you can see, while vegetables on the whole have the same carbohydrate content as fruit, their sugar levels are on average lower. While fruit sugar load is in the 8-12% range (on average), vegetables are in the 4-7% range (again, on average). This means that vegetables tend to present more of their carbohydrates in the form of oligo- or polysaccharides, which require more time and energy to digest and therefore do not create sudden fluctuations in blood sugar levels.
So while I agree that fruit is better for you, I have to disagree with your argument that vegetables have as much sugar as fruit, and that they affect the pancreas in the same way. As far as I’ve studied, that is simply not true and the numbers contradict it.
(And they say midwives don’t have an adequate science background!)
She hasn't replied yet, but another reader replied and thanked me for the information. :)