Vegan diets have been criticized as being unable to provide key nutrients necessary to sensitive life stages including pregnancy. However, research has shown that vegan diets that include a wide variety of whole plant-based foods can give an expecting mother all of the nutrients that she and her developing baby need. According to a position paper on vegetarian diets from the Academy of Nutrition and Dietetics, “well-planned vegan, lacto-vegetarian, and lacto-ovo vegetarian diets are appropriate for all stages of the life cycle, including pregnancy and lactation.” Women who follow a vegan diet are at no greater risk of pregnancy complications than women who do not, and may have a lower risk of postpartum depression, C-section delivery, and maternal or infant mortality. However, experts are in agreement that well-planned vegan diets include careful monitoring of nutrient intake in order to ensure adequate levels. Improperly balanced vegan diets, like any other poorly-planned diet, could be deficient in some key nutrients that are particularly significant during pregnancy including protein, omega-3 fatty acids, iron, zinc, iodine, calcium, vitamin D, vitamin B12, and choline. A low intake of these 9 nutrients could compromise a mother's or infant’s health or even result in pregnancy complications. Keep reading to see how expecting mothers can meet the recommendations for each of these nutrients while following a vegan diet!
Protein
Protein needs rise throughout pregnancy as a mother maintains her own protein needs, and also provides protein for her baby to develop muscles, bones, and organs. While protein needs do not change in the first trimester of pregnancy, they increase by about 25 grams during the second and third trimesters to around 75 to 85 grams of protein per day, depending on the mother’s pre-pregnancy weight (daily protein needs during the first trimester are 0.8 grams of protein per kilogram of body weight). Protein is especially important in the second and third trimesters of pregnancy because protein deposition in fetal, placental and maternal tissues increases to around 21 grams per day (daily protein needs during the second and third trimester are 1.1 grams of protein per kilogram of body weight). Because all essential amino acids can be found in plant proteins, plant-based protein sources are sufficient to meet these needs. Soy products, pseudocereals (quinoa, amaranth, buckwheat), chia seeds, hemp seeds, and pistachios have adequate amounts of all the essential amino acids in a proportion similar to animal foods, and the consumption of these complete proteins should be encouraged. Additionally, beans, whole grains, and other nuts and seeds, are excellent sources of plant-based protein in vegan diets.
Omega-3 Fatty Acids
Omega-3 fatty acids, essential fatty acids that can only be obtained from the diet, are important for neurodevelopment, the timing of gestation, and healthy birth weight. While exact requirements during pregnancy have not been established, it is recommended that pregnant women include 2 daily servings of omega-3 rich foods in their diet. For vegan pregnant women to obtain adequate omega-3 fatty acids, a variety of sources should be consumed such as flax meal, flaxseed oil, hemp seeds, chia seeds, and walnuts. However, the type of omega 3's in plant-based products, alpha-linolenic acid (ALA), is not easily converted to docosahexaenoic acid (DHA), the most important type of omega 3 needed during pregnancy. Therefore, an algae-based DHA or EPA/DHA (eicosapentaenoic acid and docosahexaenoic acid) combination, should also be encouraged.
Iron
Iron is used to make hemoglobin, a substance in red blood cells that carries oxygen throughout the body. There are two main types of dietary iron: heme and non-heme. Because heme iron comes from animal sources, those adhering to a vegan diet only consume non-heme iron. Non-heme iron is less absorbable than heme iron because of phytates, oxalates, and polyphenol content found in plant-based foods. For this reason, vegan individuals may need nearly twice as much iron as non-vegans. During pregnancy, the demand for iron increases as the expecting mother provides blood and oxygen to their baby. Because of this, plant-based pregnancies require 50 mg of iron per day, almost double the normal recommendation during pregnancy. It is recommended that those following a vegan diet incorporate iron-rich foods like beans and lentils, raisins, blackstrap molasses, and iron-fortified bread and cereals. It is also important to consume good sources of vitamin C like citrus fruits, which help to increase iron absorption by five-fold.
Zinc
Zinc is important for a baby’s growth and development, wound-healing, and maintaining a strong immune system. The current recommendation for dietary intake of zinc in pregnant women is 11 mg per day. Zinc can be found in beans, peas, lentils, soy products, nuts, seeds, wheat germ, miso, whole grains, enriched bread, fortified cereals, and vegetables. Zinc absorption is commonly lower in plant-based diets high in phytates, fiber, and calcium. Zinc should also be taken separately from iron supplements, as iron can reduce zinc absorption. Zinc bioavailability can be enhanced by soaking and cooking legumes or sprouting grains, nuts, seeds, and beans. Consuming zinc-containing foods with acidic ingredients like tomato sauce or lemon juice can also help to increase zinc absorption.
Iodine
The estimated average requirement for iodine in pregnant women is 200 μg per day. While seaweed and kelp are high in iodine, their content can vary greatly, and they may be high in concentrations of harmful substances like heavy metals and arsenic. Iodized salt, which contains on average 380 μg per teaspoon, is a safe option for reaching iodine requirements in pregnant women, as long as high blood pressure isn't an issue. By using about 1/2 teaspoon of iodized salt in food preparation, divided throughout the day, you can easily get the recommended amount of iodine. Make sure to talk to your healthcare provider first if you have a history of high blood pressure or preeclampsia, as salt intake may need to be restricted. Prenatal supplements are also an option as most will also include iodine.
Calcium
Calcium is needed in higher amounts during pregnancy to aid in the baby’s skeletal development. The bioavailability of plant-based calcium sources varies greatly and may be disrupted by oxalates, phytates, and fiber. High-oxalate plant-based calcium sources such as rhubarb, beet greens, spinach and Swiss chard have low calcium absorption rates (as low as 5 percent). On the other hand, low-oxalate calcium-containing foods like kale, mustard greens, turnip greens, and broccoli have absorption rates between 50-65 percent. In comparison, around 30 percent of the calcium in milk, cheese, and yogurt is absorbed. Vegans are recommended to consume at least 8 servings of calcium-rich foods daily to reach a total of 1200 to 1500 mg per day. Calcium-rich mineral water can also help vegans to meet their daily requirements. For those struggling to reach these goals, a low-dose calcium supplement may be a good option. Check with your healthcare provider before supplementing with calcium.
Vitamin D
Although Vitamin D requirements do not change during pregnancy, it is the most common deficiency among vegans (as well as non vegans!) and is, therefore, an important consideration throughout pregnancy. Spending time in the sun is the best source of vitamin D. Vegan sources of vitamin D are limited and include fortified non-dairy milk, orange juice, cereals, and UV-treated mushrooms. A supplement may be a good choice for those with difficulty obtaining vitamin D from food. Check with your healthcare provider to have your vitamin D levels checked to determine how much vitamin D supplementation is needed before supplementing.
Vitamin B12
While small amounts of vitamin B12 can be found in seaweed, fermented products, porcini mushrooms, and sprouted beans, it's likely an inactive form of B12. Therefore, these products shouldn't be relied upon as B12 sources. Nutritional yeast and some plant-based milk varieties may be fortified with vitamin B12. Vitamin B12 can also be found in animal and dairy foods (of note, animals are often a source of B12 because they're given supplemental B12 since the soil has been depleted of B12, which is where B12 was traditionally found). Because of this, vegan diets typically require additional planning to get adequate amounts of vitamin B12. Vitamin B12 is important for the production of blood cells and DNA, for using fats and amino acids, and for brain development and maintaining a healthy nervous system. Pregnant vegans can get vitamin B12 from fortified foods including non-dairy milk, bread, some meat substitute products, soy products, cereals, and some types of nutritional yeast. Eating these foods in small amounts at frequent intervals can help to increase their absorption. Pregnant or not, B12 is recommended as a daily or weekly supplement for vegans.
Choline
Choline is necessary during pregnancy for developing healthy cell membranes, nerve cells, and brain and tissue development. Choline recommendations during pregnancy are 450 mg per day. Choline can be found in tofu, navy or kidney beans, some vegetables, nuts, seeds, and grains. Some prenatal vitamins also contain choline in amounts ranging from 10 to 55 mg. Consult with your healthcare provider or dietitian to see if a supplement is needed based on your current diet.
Addendum: Plus one more crucial vitamin during pregnancy: Folate!
Folate is an essential nutrient for general health, particularly in the context of pregnancy. It has a significant impact on fertility and plays a critical role in supporting the healthy development of the baby's brain, spine, and neural tube during the early stages of pregnancy. Taking a folate supplement before and during pregnancy may decrease the risk of the baby developing issues with the neural tube, which forms in the first 12 weeks of pregnancy, can be significantly reduced.
Luckily, many plant-based foods also have folate, such as dark leafy greens. beans, peas, broccoli, avocado, oranges, and bananas. The amount of folate needed during pregnancy is 600 mcg a day.
While vegan diets are often presented as lacking many components essential for a healthy pregnancy, they are actually plentiful in nutrient-rich foods including grains, legumes, vegetables, fruits, nuts and seeds, vegetable fats, and herbs and spices. With careful planning, a vegan diet can certainly meet the needs of an expecting mother and growing baby.
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Hi! My name is Katie Philippi and I am a student in Georgia State University's Coordinated Program for Dietetics. I have loved getting the opportunity to learn more and more about food and nutrition, and have taken a special interest in sports nutrition, intuitive eating, and disordered eating. Outside of nutrition, I enjoy traveling and spending time outdoors with friends, cooking, and trying new restaurants whenever I get the chance!
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