eat more

I had a consultation with a nutritionist this week. My blood sugar levels have been up and down and my doctor wants them to even out a bit. Not to worry, everything is absolutely fine with the pregnancy. My doctor is just being extra cautious because I’m here rather than in the United States. He found me an American nutritionist who lived in Nairobi for several years, so has a good idea of what kinds of food are and are not available and she knows what life in general is like in this region. She’s also worked with celiac disease and gestational diabetes (ugh, I hate that term, but technically I have it based on a couple unusually high glucose readings).

Basically, I have to eat more. My weight gain has been slow and steady, but she wants to see it increase a bit now that I’m entering the third trimester. I have to stop eating so much dried fruit and stop drinking juice and I have to increase my healthy fats. I should start taking a calcium supplement, since I’m not getting as much dairy here as I would be in the United States. That all sounds reasonable enough. I just have to buckle down and force myself to eat the same foods, day in and day out, until I get back to the States in a few weeks. And see if any other Americans around here have some TUMS I can buy off them, for the calcium.

And the nutritionist knows this, too. She understands that I’ll basically be on a peanut butter and avocado diet for the next month, since they are the easiest of the healthy fats for me to obtain here. She knows I snack on the dried fruit to add a little bit of variety to the limited fresh fruits that are available. And she knows I’ll expand my dietary horizons as soon as possible. It was nice talking to someone who has an understanding of what it’s like here. Other nutritionists I talked to didn’t really understand the living conditions and gave me lists of foods that are impossible to find here, which I can’t really fault someone for if they haven’t been here; but they also didn’t seem to grasp the gluten-free diet, which is troubling.

So, no sugar, no gluten. But eat more. It's hard to do that when your food options keep getting narrower.

day 1 without sugar -- not very successful

I've decided to make a concentrated effort to give up refined sugar for the rest of the pregnancy. (Notice I haven't gone all the way and said "entirely eliminate" yet. Baby steps. Attainable goals.) Just to avert any worrying, it has nothing to do with diabetes or any other pregnancy-related issues. It's something else that I'm trying to manage holistically. (It's a personal thing that I'd rather not spell out specifically.) I've already given up wheat, because of the celiacs. I refuse to give up fruit and dairy to solve this problem, because without them I have few other food groups to choose from. The only thing I can realistically eliminate at this point is refined sugar. And if the problem isn't better after a few months, I'll look into further options.

So this morning my smoothie was nothing but fruit and yogurt, sans juice. I refrained from all chocolate throughout the day. I did not eat the leftover crepes sucre for an afternoon snack. I did fine except for lunch.

I neglected to tell my housekeeper about the new no-sugar rule. And when he served strawberry ice cream for dessert at lunch time, I couldn't help but have some. I ate about half of what I usually would -- my usual amount is about half of what he actually serves. But eat some I did.

I don't feel guilty exactly, but I feel like I really need to reign in on these occasional treats, or else they'll turn out to be not-so occasional.

One thing that should help me manage is the sugar shortage going on in the country right now. If it's not for sale at the markets, it can't be bought and turned into delicious baked goods.

what I eat while pregnant

I have celiac disease, I live in Africa, and now on top of that I'm navigating the world of eating for two. The gluten-free part is easy. The lack of variety here is my big challenge. I haven't really had cravings, but I've had some very strong aversions, which makes the lack of variety even more challenging. Like every expectant woman I want to make sure the baby and I are getting enough of everything that we need.

A friend here gave me her copy of What to Expect When You're Expecting and I immediately turned to it for dietary guidelines. Most of the foods on the list are either unavailable here or inedible for me, which didn't surprise me. What surprised me was the gigantic amount of food that they want you to eat in one day! I'm working hard to gain the weight I need to with the proper nutrition, but I can't get anywhere near the daily calorie recommendation. (My husband looked at it too and was amazed. He doesn't even eat that much, and he's a fit, athletic guy who consumes mass quantities.)

I have a gluten-free prenatal vitamin. I'm eating a lot of quinoa and quinoa pasta, which has protein and folic acid. I'm also eating a lot of rice and beans, another good source of protein and folic acid. I try to get one serving of meat per day, but sometimes meat is my greatest aversion. I started making my own yogurt and I found a nonfat powdered milk that I can tolerate, so I'm getting plenty of calcium and my healthy yogurt bacteria. Every morning I start my day with a tropical fruit smoothie. (Sometimes on the weekends I make a banana-chocolate milkshake instead for a treat -- with my yogurt and nonfat milk of course.) I can get broccoli, carrots, lettuce, tomatoes, zucchini, and cucumbers here for my veggie intake. The baby craves carbs more than anything so I'm baking my own bread and eating cereal like mad. And my ultimate comfort food is Annie's gluten-free macaroni and cheese.

Besides the nonfat milk, I also drink a ton of water. Most of the other beverage choices here are too sugary for me and even before the pregnancy I drank them sparingly. I occasionally have caffeine-free coffee or tea. I gave up caffeine and alcohol as soon as I found out I was pregnant, and within two weeks my blood pressure plummeted from borderline too high to the low end of normal.

I know my efforts are paying off with every visit to my local nurse, who checks my blood pressure and does a urinalysis every other week. Without adequate medical care here (for anything more in-depth I have to go to Nairobi, South Africa, or even Europe or the States), my diet has to be my primary source of health maintenance. As you can see, I'm eating good stuff, but I am dreaming of the day several months from now when I will be back in the United States and can walk into any grocery store to face a huge variety of food.