Six Months to Change the World: Learn the importance of eating right during the last six months of your pregnancy to protect your child's health
By Dr Pierre Dukan
Pages - 241
What is the book about? - Sugar, essentially. And how not to curse your little one with a tendency towards diabetes
Essentially, Six Months to Change the World is about what a pregnant woman should eat during the last six months of pregnancy. Why is it not ‘Nine months to change the world’ you may wonder. Because the author’s approach focuses from 12 weeks of pregnancy onwards due to this being the time when the pancreas is formed in the foetus and secretes insulin. It is from this point onwards, the author argues, that the maternal diet can have a huge impact on the health and future wellbeing of the baby with regards to obesity and diabetes.
The book contains a lot of background information, working through the obesity and diabetes epidemic, sugars and the lobbies that promote them (always good to get a bit of politics in, right?), a description of how insulin and the pancreas operate, the genetics of human nutrition, epigenetic, scientific evidence to support his theory and then finally, a diet plan in the last chapter. You have to get through plenty of text and description before reaching any practical advice, which is all stored up for the reader in the final chapter. The diet plan is relatively basic in the sense that it basically just lists what foods have a high glycemic load (sugars that enter your blood stream quickly) and which are low.
What does the book NOT cover - pregnancy nutrition in general
The focus of the book and the dietary advice is on maintaining steady blood sugar levels and controlling insulin secretion in order that the baby has a strong pancreas to fight a good fight against obesity and diabetes in later life. Therefore, the book majors on sugar, fast acting carbohydrates and following a diet of foods with a low glycemic load. The book is NOT a comprehensive consideration of pregnancy diets and nutrition. For example, it doesn’t really talk about nutrient density, how to get sufficient folate, vitamin supplementation required in addition to food, the optimal ratio of protein to carbs and fat or any particular diets (paleo, vegetarian, vegan etc). Instead, it concentrates mostly on how to slow sugar from entering the bloodstream and reduce insulin spikes, information that is helpful for everyone, regardless of whether you suffer from diabetes, you are overweight or have PCOS. You do have to get all the way through the book before reaching the advice on diet, which is contained in the final chapter (more on the advice given below).
About the author
There is no doubt that the author has the authority to talk on this topic. Unlike me wittering on about what I’m eating during pregnancy, this book is written by Pierre Dukan, a French doctor specialising in nutrition (an actual expert in his field). Dr Dukan has written other literature on food, including a book on the Dukan Diet, so has a well-established background from which to preach on this topic. He has watched the obesity epidemic ravish France and his patients struggle with their weight, thereby encouraging him to delve further into possible causes and solutions of this modern day medical disaster. In summary, the guy knows what he's talking about.
My favourite part of the book - the overall message
The overall message of the book regarding the impact of diet on a growing baby was super, as was the focus on sugar intake and controlling insulin. The message that pregnant women are 'eating for two' and therefore can eat whatever and however much they like is an all too common one. Turns out that is utter rubbish and this book is one of many educational reads that will tell you why.
Frustrations with this book - do you think I'm the fish Dory from Finding Nemo?
Being insulin resistant, having PCOS and therefore being higher risk for gestational diabetes, which I have now just been diagnosed with, this book looked right up my street. I was excited to get stuck in and read what a specialist would advise me to eat for optimal pregnancy health. In many ways, I am the ideal recipient of this information. It was written for people like me, who wake up fantasying about cake and can’t keep their mitts out of the biscuit tin. The problem with this is that people like me (#insulinissues) probably already follow a low GI diet, know the dangers of fast acting carbohydrates and the benefits of protein and fat in balancing a meal. And other than a few helpful tip bits (outlined in the Takeaways from the book section below) I unfortunately didn’t gain very much more from reading it. Honestly, this book wasn’t written for the likes of me. It was, dare I saw it, a little too basic.
In my view, the information could be condensed down in to a couple of chapters, producing a cracking pamphlet. But as a book I found it a tad tedious at points and started to skim read, something which does not feature on my CV as a skill for good reason. Two aspects that really got my goat were 1) the 20 pages in chapter 3 where the author canters through the 10 fundamental needs of humans, which didn't seem to fit neatly into the book but was instead a unashamed plug for another of his books, and 2) the constant repetition of the message that the baby's pancreas develops in months 4 and 5 of pregnancy requiring the mother to be careful of sugar levels, which had me question whether the author had mistaken a human reader with the forgetful fish Dory from Finding Nemo. It is no doubt an important message, but I remember it from the paragraph before, the page before that and the 10 mentions in the chapter before that. Well, at least it was hammered home.
In an attempt to be helpful, I think the main message can be condensed down into the following:
Summary of the book
Your growing baby is vulnerable to the amount of sugar in your bloodstream, as sugar passes through the placenta barrier. The baby’s pancreas starts to form and secrete insulin around months 4 and 5 of gestation. If the mother’s blood sugar levels are too high, due to fast acting carbohydrates and invasive sugars in the modern diet, this can harm the development of the baby’s pancreas and lead to the baby being potentially vulnerable to obesity and diabetes later in life. The baby has to create more of its own insulin in order to counteract the high levels of sugar in the mother's blood. In order to avoid putting a strain on the developing pancreas, the mother should maintain steady blood sugar levels by:
replacing white sugar with regular sugar (surprisingly the advice wasn't to refrain from using added sugars)
switching from white bread, rice and pasta to wholegrain varieties
switching from fruit juices to whole fruit
Particularly during months 4 and 5 of pregnancy eliminate beer (would a pregnant woman be drinking beer?), potatoes, bread, cornflakes, aggressive kinds of rice (I have an image of quarrelsome rice trying to pick a drunken fight outside a pub), biscuits made with white flour, sugar, sweets, fizzy soft drinks, sorbet, dates and noodles. There are plenty more lists of things that should either be avoided entirely in months 4 and 5 or eaten only in moderation at other times in the pregnancy, including ice cream, some canned fruits, ripe bananas, conventional shop bought ketchup, pre-packaged pizza and waffles. This is great diet advice, but it all seemed a little... well, obvious. Most of the foods listed are well-known sugar divas that most people would guess to avoid.
Who is this book for? And who may wish to avoid it?
For me, this should have been strictly a ‘borrow from the library only’ book and frustratingly I discovered it on the shelves of my local library shortly after I’d finished reading my newly purchased copy. Damn.
Many people suffering with infertility are so well read on their conditions, improving fertility and general health and wellbeing that they could write a PhD thesis on their topic of specialist interest. If this is you, and if you have already taken your diet into consideration, this book is likely to be too basic. It is more suited to those who are pregnant without having ever looked at their nutrition, or have recently been diagnosed with gestational diabetes or similar. My friend's GP told her that the food eaten during pregnancy had no impact on the baby because it took whatever nutrition it needed from the mother regardless of what she consumed. My god. This book is ideal for that GP. Otherwise, I would only recommend it if you answer ‘no’ to the majority of these questions:
Are you aware that what you eat during pregnancy can impact on the development of your baby?
Do you follow a low sugar diet and/or natural whole foods diet low on fast acting carbs?
Did you know that the pancreas creates insulin?
Have you heard of epigenetics and/or have a basic understanding of what it is?
Have you read books, information sites, or listened to podcasts on PCOS?
Are you already taking active steps to manage your blood sugar or insulin?
Do you have a better memory than Dory from finding Nemo?
If ‘yes’ is the dominant answer, I would suggest that this may be a ‘library only’ book for you, and there is definitely a copy in the Godalming library in Surrey! (Again, damn).
Takeaways from the book: top learning points that you may not have known before reading
The book does contain helpful background, evidence and medical science and I definitely learnt a new thing or two:
That the pancreas is created and starts secreting insulin within the growing foetus in months 4 and 5 and that the mother's blood sugar goes through the placenta barrier to the baby.
The same raw ingredient, e.g. corn, can range vastly on the glycemic index depending on how it is processed, with more processing meaning higher up the index (and less good for blood sugar).
As recommended as a stupendous read by the author, I bought the book Pure, White and Deadly: How Sugar Is Killing Us and What We Can Do to Stop It by John Yudkin in order to continue my obsessive reading about the white stuff.
How long did it take to read?
4 weeks, which is a long time considering the length of the book. After a fair wind in the beginning, I struggled mid-way and had to gently encourage myself to get to the practical dietary advice in the final chapter.
The book Six Months to Change the World has a great message about being conscious of what we eat in pregnancy and maintaining steady blood sugar levels and is written by a doctor who clearly understands this field and is imparting his wisdom. It would be a great book for someone who is either pregnant or trying to get pregnant and eats a 'standard American diet' (SAD? aren't we all). But for those of us who have read multiple books on blood sugar, diabetes, insulin resistance or have altered our diets considerably to boost fertility, this book may come across as a little basic.