Whole Plant-based Eating During Pregnancy

Pregnancy is one of the most exciting and challenging times in a woman’s life. This is the time period when women should adopt healthy lifestyle practices to reduce chronic health issues, birth defects, and suboptimal fetal development. A healthy pregnancy can be accomplished by limiting stress, achieving appropriate weight gain and participating in physical activity during pregnancy. The consumption of a wide variety of whole plant based foods, appropriate vitamin and mineral supplementation, safe food handling, and the avoidance of alcohol, tobacco and other harmful substances substance are vital to achieve a good outcome.

As plant based diets continue to gain popularity, more women of child bearing age will choose to follow this eating pattern during pregnancy. Obtaining all of the recommended nutrients during pregnancy while excluding meat, dairy, and eggs may seem like a daunting task due decades of misinformation. This article provides evidenced based guidelines addressing all the major nutrients that need to be consumed during pregnancy.

Protein

Protein is a macronutrient composed of organic compounds called amino acids. Protein is essential for the growth and repair of bodily tissues (part of organ tissues, muscle, hair, skin, nails, bones, tendons, ligaments and blood plasma), is an important component of enzymes and hormones, can be used as an energy source of carbohydrates is limited and is involved in acid/base balance to maintain a neutral environment in our bodies. Pregnant women should be eating at least 60 grams of protein per day. This can be accomplished by eating at least 3 servings of plant based, high in protein foods per day

• Sources of protein can include tofu, legumes, nuts, seeds, or vegan meat substitutes
• Examples: 1 serving = 1 cup of beans or lentils, 1 veggie patty, 2 cups of soymilk, ¼ cup of nuts or seeds, 3 oz. of tofu or 3 tablespoons of nut butter

Iron

Iron deficiency anemia is the most prevalent micronutrient deficiency worldwide. During pregnancy iron needs are greater due to the increased formation of red blood cells for the mother and baby. Iron deficiency anemia is associated the increased risk of preterm delivery, low infant birth weight, and infant mortality.

• Recommended that pregnant women supplement 30 mg iron per day (60-120 mg/day if anemic).
• In addition to iron supplementation, include plenty of plant based sources of iron.
  • Legumes, tofu, nuts, seeds, whole grains, and dark green leafy vegetables
  • Eat or drink foods that are vitamin C when taking iron improve the absorption
    • Orange juice/ citrus fruits, pineapples, kale, kiwi, potatoes, broccoli, bell peppers, strawberries
  • Cooking in cast iron will help increase the iron content in food

Zinc

Zinc is involved in many aspects of cellular metabolism. It plays a vital role in protein synthesis, immune function, protein synthesis, DNA synthesis, wound healing, and cell division. Zinc also supports normal growth and development during pregnancy. Mild zinc deficiency is associated with growth retardation, preterm delivery, and low birth weight. Severe zinc deficiency is associated with congenital malformations and spontaneous absorption.

• Recommend zinc intake during pregnancy is 11 mg per day.
• Select a prenatal vitamin that has about 10-15 mg of zinc
• Plant based foods that contain zinc include legumes, nuts, seeds, whole grains, breakfast cereals, and veggie meats.

Calcium

Adequate calcium intake will ensure the infant properly develops bones and teeth as well as have normal muscle and nerve function. Pregnant and non-pregnant women have the same calcium needs which are 1,000 mg per day.

• Good sources include calcium fortified orange juice, fortified soy or almond milk, almonds, broccoli, beans, blackstrap molasses, and tofu.

Iodine

Iodine is a mineral that is essential to the development of a baby’s nervous system and brain. Iodine deficiency can make infants more susceptible to mental retardation.

• Pregnant women are recommended to consume 220 mcg per day
• Use iodized salt
• Sea vegetables such as hijiki, arame, and kombu are rich sources of iodine

Vitamin D

Vitamin D is known as the sunshine vitamin. The human body creates Vitamin D when ultraviolet rays from sunlight strikes the skin. People with a light skin completion should get direct sunlight for 15 minutes a day. Darker skin completions may require up to 45-60 minutes a day of sun expose to synthesize adequate amounts of vitamin D. Vitamin D is needed for the absorption of calcium and it prevents the baby from developing rickets.

• Recommended intake of 5-10 mcg or 200-400 IU per day
• Vitamin D can be obtained from sunlight, fortified foods, or a vitamin supplement
• Prenatal vitamins usually have vitamin D
• Plant based foods that contain vitamin D include:
  • Vitamin D fortified orange juice, fortified soymilk, fortified cereal, mushrooms radiated with UV light.

Vitamin B12

Vitamin B12 is a vitamin produced by bacteria in soil. Due to the use of herbicides, fertilizers, and the cleaning of vegetables before consumption, plant-based foods are not a good source of Vitamin B12. It is important that this vitamin is supplemented. Vitamin B12 deficiency can lead to irreversible brain damage, delayed development, and loss of reflexes.

• Recommend 3 mcg per day of vitamin B12 from fortified foods or supplements
• Prenatal vitamins should contain vitamin B12. Vitamin B12 supplementation should continue after pregnancy so that your baby can continue to receive it through breast milk.

Folic Acid

Folic acid is the synthetic version of the vitamin folate. Since many people consume inadequate amounts of foods that are high in folate, folic acid is often supplemented during the preconception period. A deficiency in folate is the leading cause of neural tube defects such as spina bifida and anencephaly infants. These neural tube defects occur during the first month of pregnancy.

• Important to also eat foods high in folate
  • Dark leafy green vegetables, asparagus, broccoli, avocado, Brussel sprouts and legumes
• Since many women consume adequate amounts of folate rich foods, folic acid is recommend at 400 mcg per day prior to conception and 600 mcg during pregnancy.

Omega 3 fatty acids

Important for the neurological and vision development

• Recommended intake of 200-300 mg of DHA per day
• Plant based sources of omega-3’s such as walnuts and flaxseeds are not efficiently converted to DHA & EPA. Supplementation is needed
• Don’t take omega-3 supplements derived from fish oil due to the possibility of impurities and heavy metal contamination.
• Micro-algae based omega -3 supplements are the safest option. Available on amazon.com
• Not all prenatal vitamins have omega-3 fatty acids

Key Points

1. Eat an extra 300 calories per day during the 2^nd and third trimesters. These calories can be obtained by eating higher fat plant based foods like nuts, nut butters, avocados, walnut oil, olive oil, or flaxseed oil
2. Eat or drink sources of vitamin C to improve iron absorption (OJ, oranges, broccoli, peppers)
3. Continue to take your prenatal vitamins until you stop breast feeding
4. MAKE SURE YOU BREAST FEED
5. I would recommend that you take a micro-algae based omega-3 supplement that has 200-300 mg of DHA.

Citations

Davis, B., & Melina, V. (2014). Becoming Vegan: The Complete Reference to Plant-Base Nutrition. Book Publishing Company.

Procter, S. B., & Christina G., C. (2014). Position of the Academy of Nutrition and Dietetics: Nutrition and Lifestyle for a Healthy Pregnancy Outcome. Journal Of The Academy Of Nutrition And Dietetics. Academy Of Nutrition And Dietetics, 1141099-1103.