Plant-based diets are highly misunderstood and many people still cite outdated studies to support their disapproval of this dietary pattern.
Even if the position paper on vegetarian diets from the Academy Of Nutrition And Dietetics clearly states: « Well-planned vegan, lactovegetarian, and lacto-ovo vegetarian diets are appropriate for all stages of the life cycle, including pregnancy and lactation », many still fear pregnancy on a plant-based diet. Although some nutrients do require special attention in those who are pregnant on a plant-based diet, most of them can be easily obtained in optimal amounts with careful planning.
The Benefits
Well planned plant-based diets are associated with lower and healthier BMI’s, a reduced risk of chronic disease, auto-immunity and cancer, and healthier moms tend to have healthier pregnancies. Studies have shown that well-planned plant-based diets were associated with less preeclampsia, less gestational diabetes and birthweights identical to those born to non-vegan mothers. Plant-based diets can make for healthy mothers before, during and after pregnancy, even helping them reach their healthy pre-pregnancy weight safely and gradually. Although plant-based diets are naturally nutrient dense and protective in this way, certain nutrients can be a concern, due to their increased requirements during pregnancy. During pregnancy, the health of the baby and mother is always the priority, but that doesn’t mean we disregard the other benefits of eating a plant-based diets, which also decreases carbon footprints and animal cruelty. It’s like having vegan cake and eating it too!
Plant-predominant diets during pregnancy could also help protect against a variety of paediatric diseases, including wheezing, diabetes, neural tube defects, orofacial clefts, and certain pediatric tumors
The Risks
All dietary patterns come with their list of pros and cons and plant-based diets are no exception. During the first trimester, calorie requirements remain for the most part, unchanged, but nutrient requirements do change. Adjustments must be made to the diet in order to compensate. Luckily, plant-based diets are so nutrient dense, that simply eating a wider variety of healthy whole plant-based foods will suffice in reaching most of those targets. In the second and third trimester, calorie requirements will increase by 15-20%. Since the plant-based diet is naturally low in calorie density, care must be exercised to ensure adequate calorie intake. The pregnant woman on a plant-based diet can look for more calorie dense foods, including nut and seed butters, oils or avocados for example, in order to add calories without adding too much bulk, since this could increase the possibility of nuisance side effects like nausea and heartburn, which are already common in pregnancy.
Protein requirements do also increase considerably during the second and third trimesters. The additional 50% increase in daily protein requirements can be attained by adding high protein plant foods at each meal and snack. These could include soy products, legumes, nuts and seeds (and their butters), as well as higher protein grains like quinoa. Soy milk will also help hit calcium and protein requirements while decreasing the risks of fullness and gastro-intestinal nuisance symptoms.
Specific Nutrients Of Concern
Some nutrients deserve special attention, whether on a plant-based diet or not. Iron deficiency is the most common mineral deficiency in the world, regardless of your diet. Dramatic increases in iron requirements during pregnancy further increases the attention this nutrient deserves. Plant-based diets contain non-heme iron, which has a slightly lower level of absorption. Care must be taken to ensure adequate iron intake. This can be mitigated by including iron rich foods, like beans, lentils, soy foods, whole grains and fortified cereals for example. Iron absorption can be further increased by adding vitamin C rich foods at the same meal, as well as limiting certain foods known to reduce iron absorption, like tea or coffee, during the same meals where you’re consuming iron rich foods.
The intake of other nutrients, like omega-3 fatty acids, could be lower in plant-based diets. Since omega-3 fatty acids play a vital role in brain development, one could easily argue that supplementing with DHA could be advisable for all. Other ways to ensure adequate levels are to include plant sources of ALA (nuts and seeds for example) regularly in the diet, as well as to avoid factors known to reduce the conversion of ALA to DHA, like smoking, consuming alcohol or consuming trans fats. Although many other vitamins and minerals are needed in higher amounts in pregnancy, the nutrient density of the plant-based diet helps achieve those goals.
Special attention is deserved by choline, iodine, vitamin D and vitamin B12. These are frequently present in lower amounts in plant-based diets, and deficiencies during pregnancy can come with devastating consequences. Supplements are recommended in most cases, and consuming fortified foods regularly are never a bad idea.
My Plant-Based Pregnancy Conclusion
Although we’ve already discussed the health benefits of a plant-based diet in the general population, most of these benefits do apply to non-pregnant women planning a pregnancy. A healthy mother will have more chances of carrying out a healthy pregnancy and giving birth to a healthy baby. As with any diet, nutrient consumption must be adjusted during pregnancy to compensate for the variations in calories, protein and nutrient requirements through all trimesters. Well planned plant-based pregnancies are associated with normal birthweights, reduced preeclampsia and are completely supported by the Academy Of Nutrition And Dietetics. Care must be taken to ensure proper nutrient intake and extra attention has to be given to important nutrients that are at a higher risk of being insufficient, like iron, choline, iodine, omega-3 and vitamins B12 and D. These are important nutrients for fetal health and well-being and with the advent of fortified foods and supplements, no child should fall victim to poor dietary planning, no matter what dietary pattern the chosen by the mother. Any responsible doctor should discuss prenatal vitamins with women who are pregnant or planning a pregnancy. These supplements remain relevant whatever your dietary pattern is! Before planning a plant-based pregnancy, consider discussing with a medical doctor knowledgeable in this field or with a registered dietitian. Well planned plant-based diets have the potential to give your child a headstart!
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Kaiser, L. L., Campbell, C. G., & Workgroup, A. P. C. (2014). Practice paper of the Academy of Nutrition and Dietetics abstract: nutrition and lifestyle for a healthy pregnancy outcome. J Acad Nutr Diet, 114(9), 1447. https://doi.org/10.1016/j.jand.2014.07.001
Health Canada. (2009). Prenatal Nutrition Guidelines for Health Professionals: Background on Canada's Food Guide. https://www.canada.ca/en/health-canada/services/publications/food-nutrition/prenatal-nutrition-guidelines-health-professionals-background-canada-food-guide-2009.html
Baroni, L., Goggi, S., Battaglino, R., Berveglieri, M., Fasan, I., Filippin, D., Griffith, P., Rizzo, G., Tomasini, C., Tosatti, M. A., & Battino, M. A. (2018). Vegan Nutrition for Mothers and Children: Practical Tools for Healthcare Providers. Nutrients, 11(1), 5. https://doi.org/10.3390/nu11010005
