Shamila H
Shamila H's treasured sonogram. Image Credit: Supplied

She’s held on to that black-and-while photograph of the twins swimming in her womb. It was a 12-year wait before their introduction and she’s rather fond of the memento. Gulf News reader Shamila H knew she wanted to have babies, but she had suffered from polycystic ovary syndrome (PCOS), which wouldn’t cause infertility but would interfere with ovulation making it difficult.

One of the things that can help a PCOS sufferer is shedding some weight. US-based WebMD explains: “When you have PCOS, shedding just 10 per cent of your body weight can bring your periods back to normal.”

The 40-year-old Saudi Arabia-based Clinical Psychologist says: “I had a very irregular cycle over six months, sometimes even a year. If I don't take medication, I wouldn't get my cycle. The doctors, they tell you lose weight. But they don’t tell you how to lose the weight. You know, that was the struggle. I tried various diets. I even went on the blood type diet … nothing was working. Sometimes, I was losing a bit of weight and then I would gain it back. Nothing was consistent.”

Shamila H
Shamila H Image Credit: Supplied

“I also tried the ketogenic diet – I was just doing things like randomly from the internet, not having carbohydrates, which helped me to lose weight. But I hadn’t been doing nutritional keto until the year 2020, when I got pregnant,” she recalls.

The ketogenic diet is one that focuses on a low carbohydrates, high fat and medium protein intake, forcing your body to generate ketones, which then use fat for energy instead of carbohydrates

Helpful, unhelpful
Nutritionist Farah Hillou, at The Chiron Clinic, explains that there are two sides to the keto coin: “Some reported benefits to the ketogenic diet include improved insulin sensitivity, reduced triglycerides, better energy levels, less hunger, and fat loss. However, it’s not recommended for individuals with diabetes taking insulin, or individuals with gallbladder issues that can impact fat digestion. Moreover, there is lack of evidence to suggest the health effects of going on a keto diet long-term. Taking into consideration that toxins are stored in fat cells, it would be wise to support detoxification in the liver to help remove these toxins as weight and fat are lost.

It was June of 2020 when Shamila stumbled across her keto coach, who helped her transition to a ‘nutritional keto’ lifestyle, which focused on whole foods and good fats, shying away from anything processed.

“When I was doing keto, previously, I had an in vitro fertilisation (IVF). That failed. It was just unexplained and it just failed,” she says. This time it worked! I began my keto journey on June 1 and I started my IVF in July. By the end of August I was pregnant,” she says.

As someone with a high risk pregnancy – Shamila was over 35, suffered from PCOS and was doing IVF – she was under constant monitoring. “I was taking progesterone injections, progesterone shots throughout my pregnancy. So this was making my body gain a lot of water,” she says.

Managing keto and cravings

The ketogenic diet is nothing if not restrictive and pregnancy is notorious for unleashing that sudden desire for a food or drink. “This is one of the things that I was scared and worried about,” admits Shamila, adding, “But to tell you the truth, Shirley D’souza, my Keto Coach, was my support. When I was telling her that I was craving such and such things, she would be telling me, ‘you know, your body's missing this’. If I was craving for chocolate, for example, she’d say, ‘you're missing magnesium in your body’, so do this. So it was going on like this.”

What was on the menu?
Shamila recalls what she was eating during her pregnancy months: “It was very nutritional. So I was having a lot of the seeds: pumpkin seeds, sunflower seeds. I was having a lot of red meats in terms of organ meats like kidneys and liver. Of course, well cooked. Everything was pasteurised; my eggs were being pasteurised. And there were lots of greens - spinach, I used to have a lot of juices, avocados. I was having my fish, just well cooked.”

“But I had aversions. I love steaks, but I couldn't even smell meat being cooked at home.”

Shamila says she’d head out of their house while her husband got a dinner – rich in meats – cooked. “He would cook my food, and then I'll come back once it was done,” she recalls.

She adds that in spite of the keto formula, owing to other factors, she put on quite a lot of weight during her pregnancy – “I was 75kg to start with and when I was in the last trimester I had reached 100kg, you know, with the babies’ weight and the water weight and everything,” she says.

Four weeks after they were born, Shamila had dropped 15kg.

A doctor speaks
Dr. Vidyasaraswathi Uluvana , Specialist Obstetrics and Gynaecology , Aster Clinic, Al Nahda, warns against the keto diet, saying: “Pregnancy on keto is simply not safe as in keto diet ketones are used instead of glucose as energy source which is not good for the growing babies. Glucose from carbohydrates are the primary source of energy for baby's growth and development. Instead of eliminating the carbohydrates, a healthier approach is to avoid carbs from junk foods like candy, chips, cookies, cakes, sweets, etc. Pregnant women are advised to consume complex carbohydrates like sweet potatoes, squash and fruits like apples, berries, etc.
“Also, another important factor to be remembered during early pregnancy is drastic weight reduction can harm the development of babies and can cause some abnormalities in the babies, so it is advisable to attain an optimal weight before embarking on pregnancy.”
Meanwhile, Yale University paper on managing Gestational Diabetes – a condition where you develop high blood sugar levels during pregnancy – proposes a more balanced approach. “You need to find a balance between eating enough carbohydrates to get the energy and glucose you need, and limiting the carbohydrates you eat to control your blood sugar level. The best way to do this is to spread them throughout the day,” it suggests.

Giving up keto

Keto, says Shamila, really helped her with her pregnancy and her mental health, but she still gave it up post-delivery. It’s because of the demands of the early days of motherhood. “Delivery was a bit tough and sudden,” she says. “I just went for a check-up. I just went to monitor their heartbeats. And the doctor told me, ‘you're dilated three centimetres, and I'm sorry, just for the weight of the smaller twin’. I have to get you on, you know, on a C-section right now.

“I lost a lot of blood during my delivery. And I had to have like blood transfusion and stuff. I was 35 weeks, six days along. I was going through even tachycardia, because my blood iron levels were low.”

After giving birth when Shamila got home, she admits sheepishly, “For 12 years I've been trying to get pregnant. I didn't know how to take care of a baby. And I found myself with two babies. Twin A was 2.9 kilos when born and twin B was 1.9kg. Twin B had low sugar levels, his cortisol level was high up and he was crying … it was hectic.”

“Things were just out of control with for me and my husband. And so then we were just no time for cooking. No time for planning. We were just ordering from outside,” she laughs, already planning a return to keto in a few months. For now though, the world centres around her babies – who’ve gone from 2D blurbs on a much-awaited sonogram to animated 3D colourful pops of joy.

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