Can You Do the Atkins Diet While Pregnant?


Baby Boy High-Top Brown Shoes with a Few Scattered Toys
How I ate low carb while pregnant.

Doing low carb while pregnant used to come with loads of controversy. Today, the Atkins Nutritionals, Inc. company recommends Atkins 40. Since Atkins 40 didn't exist in 1975, here is how I ate low carb while pregnant.


The Atkins Diet has traveled quite a distance from its humble beginnings in 1972, but that first Atkins program gave me a strong foundation from which to build the diet that would eventually allow me to lose over 100 pounds.

These prior experiences that I had were essential to the creation process. They helped me sort out the low-carb myths from the facts, and design a diet plan that worked for me.

Today, I can see the helpful patterns and realities that I couldn't see as I was traveling through the challenges.

Like all things in life, the path we travel is often circular, rather than straight. We are so sure that we KNOW what we want, even though we don't possess the self-knowledge required to understand.

In my 20s, I thought I knew it all, and that the Atkins Maintenance plan was going to be a breeze. All I had to do was weigh myself every day and if the number was higher than a 5-pound gain, I would just jump back onto Atkins Induction.

That worked . . . for awhile, but honestly, I wasn't strong enough to go it alone, so by mid 1976, I had regained all the weight I had lost, plus more.

When I woke up, I ran back to Atkins 72.

The weight gain was oh-so-common when you live your life in office dresses and sweat pants. You don't see the pounds creeping back on until it's too late. Fate has a weird sense of humor.

Dragonfly Caught in a Spider Web
Maintenance is harder than you think.
It's easy to go mind-blind and gain the weight back.



About a month after returning to Atkins, and getting to 150 pounds, I discovered I was pregnant.

Can you even follow the Atkins Diet while pregnant?

In 1972, Dr. Atkins revealed that he recommended low carb to all of his pregnant patients, but what exactly did he mean?

[This is part 2 of a multi-part series that reveals How I Lost Over 100 Pounds Tweaking the Atkins DietIf you haven't read it yet, click on the above link. There, you will also find all of the other links in the series, as they become available.]

Pink Booties and Blue Tennis Shoes for Babies

Dr. Atkins View on What is Appropriate for Pregnancy


Before I get back to my story, I want to give you the quote about pregnancy that Dr. Atkins published in the 1972 Second Edition book. This is taken from the question and answer section in the back:

Q: Can I follow this diet during a pregnancy?

A: I recommend this diet to all my pregnant patients; I certainly cannot recommend to them that they load up on carbohydrates. Most obstetricians do a good job, however, of preventing an undue weight gain during pregnancy.

That stance was still valid in 1984.

I don't know if Atkins clarified the point in 1992, since I no longer have access to that book, but in 2002, he did. In fact, Dr. Atkins felt is was so important that he mentioned it four times in the 2002 version, but I'm just going to quote one of them so you know what his stance was shortly before he died:

“Also, pregnant women and nursing mothers may do the Lifetime Maintenance phase but should not do any of the weight loss phases of Atkins.

Over and over again, he said that the weight-loss phases were not appropriate for pregnant women and nursing mothers, including pre-maintenance.

This is an important point to understand because today, the ANA recommends Atkins 40 for those who are pregnant or nursing, which is not complementary to Dr. Atkins perspective, so what exactly did Dr. Atkins mean by Lifetime Maintenance?


What is Lifetime Maintenance on Atkins?


While some people have interpreted Dr. Atkins statements to mean absolutely no ketosis, Lifetime Maintenance is eating at your Critical Carbohydrate Level for Maintenance and taking in enough calories to maintain your current weight. 

It would be unhealthy to move to a level of carbs and calories that would cause a huge energy surplus, so today, I realize that a healthy low-carb diet for pregnant women may or may not involve ketosis. Ketosis isn't the deciding factor in whether it's safe to restrict carbs. Your insulin sensitivity would be a better determinant.

This means you don't have to eat over 100 carbs per day or even go back to your old way of eating. If you go back to eating how you ate before, you'll become what you were before.

There's no way around that.

Giant Bacon Cheeseburger and Pile of French Fried Potatoes
Going back to how you ate before Atkins
will only make you fat and unhealthy.


How you ate then, good or bad, is what created your obesity, so it doesn't make sense to force you to go back to an unhealthy, mindless diet.

The urges you get and your own personal rules for living are still functioning as they always have, and those old thought habits will take over if your new lifestyle hasn't become second nature to you yet.

You don't want to destroy what you've already accomplished, so eating more carbohydrate than your body can use is ridiculous, but you still need a nutrient-dense diet that supports healthy growth for the baby.

I didn't have this clarification in 1977, and I was so sick that I probably wouldn't have listened anyway. There was no way I was going to count carbs and calories, staying within a tight margin, when I could barely get out of bed in the morning to go to work.

In all honesty, my first pregnancy isn't all that clear in my memory. My sense of time is distorted. The challenge was simply to keep going when the mind really didn't want to.

What I Ate for the First Three Months While Pregnant


By mid 1976, diet sodas had hit the shelves, but my pregnant body rejected it. I couldn't eat or drink anything that contained sugar substitute.

I couldn't eat junk food either, so real sugar wasn't that much of a problem, except for an occasional Dr. Pepper that I sometimes needed to get through the work day. I ate no cookies or cakes or potato chips or anything like that. I was lucky to be able to eat food at all.

Where many pregnant women only suffer with morning sickness when they first get up, or smell something that doesn't agree with them, I had it all day long. Around the point where I missed my first period, all smells, everywhere I went, were highly magnified, and most of them were nauseating.
  • I couldn't eat breakfast.
  • I couldn't eat lunch.
  • I could only eat dinner shortly before I went to bed.
  • If I ate any earlier in the day, it wouldn't stay down.
So, for the first two or three months, I did what the low-carb community would call Intermittent Fasting today, but it was by default. I didn't do it deliberately. It was just the only way that I could get something to stay down.

The doctor's office told me to eat Lipton chicken noodle soup and munch on soda crackers throughout the day, but I opted for something more substantial.

I picked up a family-sized box of Banquet Fried Chicken and a few cans of green beans, and lived on that.

The frozen chicken was easy-to-fix late at night, and salty. I don't remember what the carb count was for the chicken because I wasn't counting, but breading in those days hadn't gotten out of hand yet, so I'm guessing it was less than 20 carbs.

[After checking the Banquet website, the nutritional stats say 10 net carbs for a 3 ounce portion, so my original estimate was pretty close.]

All I cared about at the time was giving my body the protein it needed.

I ate two pieces of chicken just before going to bed, with maybe half a cup of green beans, and nothing else during the day. I managed to sleep through the resulting nausea, so there was no gag reflex to reject it.

My now-ex tried to get me to eat french fries once. Despite the fact that I couldn't eat lunch, he still insisted on taking me out. After dropping me back off at work with the fries and a Dr. Pepper, I threw the fries in the trash and sipped on the soda throughout the afternoon.

At my 12 weeks checkup, the doctor tried giving me a Vitamin B-12 shot. He said that it would give me some relief for about a week. I was shocked at just how quickly it worked. Within only a few minutes, the nausea was completely gone!

Don't remember what I ate that day.

However, by the next morning, the nausea was back with a vengeance, so the doctor never gave me another one. He said it would be too expensive to give me an injection every single day. I think they cost something like 10 bucks each.

He did give me a prescription for something to help combat the nausea, which helped quite a bit. It didn't take all of the sick feeling away, and I still had to be careful about what I ate or smelled, but with the meds, I was able to eat:
  • a couple of soft boiled eggs for breakfast
  • a little bit of chicken vegetable soup for lunch
  • and Banquet chicken with canned green beans for dinner
At 16 weeks, the doctor was thrilled that I hadn't gained any weight.

Since I'd been on the meds for a good month, I had been able to add fruit to my diet, which I took with me to the office. I was also able to enjoy a wider variety of vegetables. I'd also added a piece of whole-grain toast to my soft-boiled eggs for breakfast.

Occasionally, I'd have a half a cup of mashed potatoes with my chicken dinner instead of the vegetables.

Potential Gestational Diabetes


Although my weight was stable, the doctor was concerned because I was spilling sugar into my urine.

I got a stiff warning about not dieting while pregnant, but he backed down after I told him exactly what I was eating. He said the lack of weight gain was probably because I was eating a healthy diet that didn't include potato chips and candy bars.

However, he wanted to watch my blood sugar. He suspected that I might have gestational diabetes.


All women become insulin resistant to some degree while pregnant. This resistance to insulin places less control over glucacon, which tells the liver to dump its glycogen supply into the bloodstream to feed your body's cells, organs, and brain.

Since a pregnant woman has to supply enough blood glucose for both self and baby, this is a perfectly normal situation.

In some women, however, the blood glucose situation gets out of hand. Possibly, because you either can't make enough insulin to keep glucagon in check or you were insulin resistant before you got pregnant.

Your blood glucose passes through the placenta to the baby, so if your blood glucose is high, the baby's blood glucose will also be high. This triggers the baby's pancreas to secrete additional insulin to handle the load.

Extra blood sugar also causes the baby to grow larger than normal, defined by the Mayo Clinic as a baby that is 9 pounds at birth, or larger.

Due to the excessive insulin in the baby's body, additional complications at birth may include:
  • respiratory problems
  • jaundice
  • hypoglycemia
Today, gestational diabetes is taken far more seriously than it was in 1976. Many doctors, if not all of them, will screen you for potential gestational diabetes around 24 to 28 weeks, whether you have sugar in your urine or not.

Luckily, at 20 weeks, my urine was clear, even though I was eating more carbs than the month before.

My New Pregnancy Diet


My diet at home didn't change all that much, but I became more conscious of what I was eating and drinking throughout the middle trimester. This was before the advent of the Internet, so I was at the mercy of books I could get at the local public library.

Many books told me it was perfectly safe to diet while pregnant, but weight-loss goals should be aimed at keeping your weight stable, rather than seeing a fat loss on the scale. True fat loss would then manifest after you delivered. Since this coincided with what Atkins taught in 1972, it's basically what I did.

I ate only when hungry, just enough to satisfy, and didn't eat anything when I was not. I stuck to what I believed were healthy or semi-healthy foods, and avoided all junk, except for an occasional bowl of ice cream or a Big Mac.


Chicken, Potatoes, Tomatoes, and Veggies
I never had odd cravings. I just ate real food.
But I also ate just enough to satisfy and
I didn't eat if I wasn't hungry.

I never had odd cravings. Mostly what I craved was meat and vegetables, just real food, so that's what I ate.

Occasionally, I would go out to lunch with my co-workers. They were partial to a local all-you-can eat pizza buffet, but the company also served broasted chicken, which was chicken fried in a pressure cooker using minimal oil, so I usually ordered the two-piece chicken with a few deep-fried potatoes.

I tried to eat the chicken with a salad bar once, but the salad didn't settle on my stomach very well.

More Wacky Blood Glucose Levels


At 24 weeks, there was sugar in my urine again.

Sugar in the urine is Glycosuria and occurs when the body excretes some of the excess blood glucose.

In normal conditions, the kidney absorbs the glucose and sends it back to the bloodstream. The kidney can't handle a huge load, though, so when your blood glucose rises above 180 mg/dl, some of that glucose will show up in the urine because the kidney dumps it instead of recycling it.

I was never told how much sugar was spilling over into the urine, but even a trace indicates that your blood glucose is above 180 mg/dl.

It also wasn't well known then that most women who go into gestational diabetes have Type 1-1/2, rather than Type 2. They make enough insulin to cover their own needs, but can't make enough when pregnant.

There were two doctors at the clinic I was going to, so the second doctor looked over my records, and also gave me a stern warning about dieting because I still had not gained any weight. Again, I recited what I was eating, and again, the doctor backed down.

They were not used to someone eating healthy foods while pregnant, I guess.

At 28 weeks, my urine was clear. The doctor didn't know what was going on, but said he wouldn't test me for diabetes unless I had sugar in my urine for two months in a row.

I never did. It was always every other month, like clockwork.

Why I was Nauseated All the Time


I ran out of prenatal vitamins and had to go a couple of weeks without them.

Miraculously, the nausea also left around the same time. I still couldn't eat junk, but I was finally able to eat a salad. I also started craving ice cream, but we didn't have any in the house, so I pushed through the cravings by feeding them more meat. Oddly enough, upping the protein content of my diet caused my cravings for ice cream to go away.

Once the vitamins arrived, however, I had a total relapse.

I had to go back to my initial Intermittent Fasting routine. After a week of not being able to eat anything but Banquet Fried Chicken and canned green beans again, it finally dawned on me that maybe the iron in the vitamins was making me sick. I stopped taking the vitamins, just to test, and the nausea left.

Needless to say, the vitamins went into the trash.

The Last Trimester


At this point in my pregnancy, I was no longer ill, so I moved to a healthy whole-foods diet. I didn't actually limit carbs, but I was partial to:
  • protein foods
  • vegetables
  • white potatoes
  • fruit
  • whole-grain bread
I also started eating tacos again.

Oddly enough, at 32 weeks, my hunger suddenly went through the roof. No matter how much food I ate, I simply could not get full.

I also started to gain weight starting at 33 weeks.

I put on about a pound a week, which the doctor said was normal, since the baby grows a lot between 32 and 36 weeks.

By 37 weeks, I was up an additional 7 pounds, for a total of 10. The doctor was pretty upset about that 7 pound gain. After months of congratulating me for not gaining very much weight, now that I was, he was irritated and lashed out at me for eating too much junk.

I hadn't eaten any junk. I couldn't. I just ate more than I did before, but he didn't believe me.

After Delivery: Weight Loss Results


There were complications, not due to what I had been eating (just want to make that clear), so they prepped me for a "C" section, but labor went too quick for that.

If I remember correctly, it took less than four hours from start to finish. The baby was so big, and came so fast after my water broke that I was in the delivery room for a full hour after delivery, while the doctor made repairs.

The baby weighed almost 10 pounds and had severe jaundice. This is the same son who would later be diagnosed with Gilbert syndrome, a genetic liver abnormality where the liver doesn't break down bilirubin in the bloodstream fast enough.

The condition is hereditary and you only get it if both of your parents either have the condition themselves or are carriers for the gene.

The hospital kept me in intensive care for two days because they couldn't stop the bleeding. Eventually, they gave up trying to get me to clot, put me in a regular room, and just watched me closely. [This is a symptom of celiac disease.]

I was released to go home after 4 days.

I completely lost my appetite.

With zero interest in food, I literally had to force myself to eat anything for dinner. Just the thought of food and eating made me feel ill, so I did quite a bit of fasting during that time. I found the site of food disturbing.

Everyone around me was frustrated and concerned about my lack of appetite. I didn't understand what they were upset about. I was happy to have lost all interest in food. I didn't see it as a bad thing.

My now-ex insisted that I order a small side salad when we went out to dinner, instead of just sitting there nursing a glass of ice water. I did that, but it wasn't easy to choke it down.

I don't know if forcing those salads triggered something or if my appetite would have returned on its own anyway, but by my 6-week checkup, I was eating again.

At weigh-in, I'd lost 30 pounds, for a net loss of 20 pounds!

The doctor was thrilled and apologized for being so rude at my last appointment. It was ALL baby! he said excitedly.

He did test me for diabetes, finally, but it came back negative.

“Your blood sugar is high enough to make you fat,” he said, “but not high enough to be called diabetes. You probably did have gestational diabetes, since the baby was so big.”

This supports the idea that gestational diabetes is found in those with Type 1-1/2. I made enough insulin to keep below a diabetes diganosis after delivery, but not while I was pregnant.

Nothing was said about my blood's inability to properly clot after delivery. Today, I suspect it was due to celiac disease. A lack of Vitamin K is very common in celiacs, and since those bleeding problems corrected themselves after going gluten free, it suggests that I've had this autoimmune condition for a very long time.

Another Doctor-Prescribed Low-Carb Diet (in Detail)


In my own experience, low-carb diets are not new, and certainly not as revolutionary as I thought they were in 1975.

I've had a lot of doctors try to hook me up with some version of a low-carb diet plan, so I really wasn't all that surprised when the doctor brought up a low-carb diet that was supposed to solve my overweight problem for good.

With a net loss of 20 pounds, I must have weighed about 130, so I was no longer obese. Just 30 pounds overweight. The doctor told me about this fantastic low-carb diet that I really needed to go on, and promised me that I could lose 10 pounds a month if I took it seriously and stuck with it.

Within 90 days, I could be a new person.

Apparently, he was on the plan himself and he'd lost 20 pounds in two months. I wasn't really sure if it would work, as it was higher in carbohydrate than the Atkins Diet recommended, but I figured it wouldn't hurt to hear him out.

He ran for his desk and brought back a sheet of instructions:

Breakfast:

  • 1 ounce Total cereal
  • with low-fat milk
  • small banana or a few strawberries
He said the cereal was not negotiable. It had to be Total, for the vitamins and minerals. If I was craving eggs, I could have one or two, but I had to eat the full ounce of Total every morning.

Lunch:

  • 6 ounce can of tuna, packed in water
  • ½ cup low-fat cottage cheese
  • up to ½ pound steamed vegetables
  • with a pat of butter
He told me to mix the tuna and cottage cheese together, instead of using mayo.

Afternoon Snack:

  • 1 apple

Dinner:

  • 6 to 8 ounces of meat, poultry, or fish
  • up to ½ pound steamed vegetables
  • with a pat of butter

“Once a month, when you go out to eat, you can order a side salad with regular dressing and a baked potato with butter to go with your meat entree,” he said. “By keeping the potato a “going out” thing, you elevate it from just an everyday food to something special. It will give you something to look forward to.”


This menu contains about 65 to 85 carbs, depending on the type of vegetables and fruit you choose. Asparagus, spinach, and broccoli are super low in carbs, while brussels sprouts, onions, and tomato are higher. That banana will cost you 20 carbs, while strawberries are only 5 to 8.

New Low-Carb Diet Results


I have no idea if my Critical Carbohydrate Level for Losing (CCLL) was that high, or not. All I know is that at 45 total carbs, on Atkins, the urine test strips were still testing dark purple.

Between having to eat the exact same cereal every single day and that nasty tuna-cheese mixture for lunch, I only lasted a few days.

The bodybuilding community eats this way all the time, and has good luck with it, but even my own Protein Sparing Modified Fast, which I'll talk about in a future post, was much more palatable than this low-carb menu was.

I just couldn't choke it down, and especially not day after day.

To make matters worse, my State Disability check for maternity leave didn't show up in time to pay the mortgage, so the house went into foreclosure, and we ended up selling to get out from under it all.

Life turned into a huge financial nightmare, and my low-carb diet got lost in the shuffle.


Part 3: My Second Attempt at the Atkins Diet (an in-depth view of Atkins 92, how I did the diet, how fast it came off, and Dr. Atkins real perspective on fiber in 1999)

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