Enjoying a Healthy Plant-Based Pregnancy

There are many misconceptions concerning plant-based nutrition, and none more contentious than those relating to pregnancy. With at least 6% of the Australian population aged 18 or older adopting a mostly plant-based, if not exclusively plant-based diet, this growing trend towards more sustainable ways of eating begs the question — is it safe to follow a plant-based diet during pregnancy?

Whether you're a seasoned plant-based eater or simply curious about incorporating more plant- based foods into your diet during pregnancy, this guide will provide valuable insights to help you make informed and nourishing choices for you and your little one.

Good nutrition during pregnancy ー why is it so important?

Research has shown that following a healthy, balanced diet during pregnancy not only supports optimal health and development of you and your baby, but may reduce the risk of your child developing a chronic disease later in life. Your choices during pregnancy may stay with your baby into their old age.

In the more immediate term, many complications in pregnancy are linked to lifestyle diseases that are responsive to improved dietary patterns. For example, pre-eclampsia is linked with hypertension, a disease prevalent in societies with a typical Western diet. A study has shown that pre-eclampsia (where pregnant women can develop high blood pressure, fluid retention, and protein in the urine) occurred only once in 775 vegan pregnancies in subjects who avoided animal-based foods. For comparison, in Australia where the typical Western diet is the norm, the prevalence of this condition is around 1 in 33 pregnancies. Pre-eclampsia can lead to eclampsia, a complication that involves damage to other organ systems such as the kidneys, and can be life threatening for mother and child.

What do the experts say?

The US Academy of Nutrition and Dietetics states that a well-planned vegan diet is appropriate at all stages of life — including during pregnancy. This position is mirrored by the British Dietetic Association, who have affirmed that a vegan diet can “support healthy living in people of all ages”.

Key nutrients for a healthy pregnancy

There are a handful of nutrients that require a little extra attention during pregnancy, whether following a plant-based diet or not. In fact, many of those essential for the development of a healthy baby are found in abundance in plant foods.

Folate

Folate — also known as vitamin B9 or folic acid — is crucial for healthy growth and development. Adequate intake of this B-group vitamin is especially important for women planning to become pregnant, or who are already pregnant. A lack of folate may lead to an increased risk of neural tube defects (birth defects of the brain, spine, or spinal cord) in the developing foetus.

It is recommended that women capable of becoming pregnant consume at least 400 micrograms of folate a day. This may be in the form of supplements, fortified foods, or a combination of both, along with a varied diet rich in folate-containing foods. Beans, leafy green vegetables, and oranges are particularly good sources.

Iron

Iron is used by our bodies to produce red blood cells, which transport oxygen to our tissues and cells. During pregnancy, requirements increase dramatically as your blood volume expands and your baby grows and develops. Generally, your baby’s needs will be met by your own iron stores. If these are low, or you lack reliable dietary sources, iron deficiency may occur.

To ensure adequate intake of this essential nutrient, emphasise iron-rich foods when planning meals. Good sources of dietary iron include whole and enriched grains, beans and lentils, soy products, nuts, seeds, dried fruits, green leafy vegetables, and even dark chocolate. To boost absorption, include a source of vitamin C with your meals such as citrus fruits, strawberries, tomato, sweet potato, or broccoli.

Protein

During the second and third trimesters, protein requirements increase slightly, by around 25 grams per day — equivalent to a couple of pieces of rye toast, topped with a nut spread, banana and a sprinkle of chia seeds. This extra protein is required to support your baby’s growth, as well as the increase in blood volume and enlargement of the breasts and uterus.

Proteins from plants contain all nine essential amino acids. However, some may be present in lower amounts; so eat a variety of foods throughout the day. Soy products such as soy milk, beans, tofu, tempeh, quinoa and hemp seeds contain all nine essential amino acids. Other excellent sources of plant-based protein include whole grains, lentils, beans, nuts and seeds.

Essential fatty acids

Omega-3 fatty acids, particularly the longer-chain docosahexaenoic acid (DHA), play a crucial role in your baby’s visual and cognitive development. Adequate intake and maternal body stores of DHA are especially important during the last trimester. Ensuring adequate stores may, however, be an issue for vegans and vegetarians who do not regularly eat foods fortified with DHA.

Alpha-linoleic acid (ALA) is a shorter-chain form of omega-3 found in flaxseeds, walnuts and leafy greens, just to name a few. Although the conversion rate for ALA to DHA increases during pregnancy, the rate is still low. A vegan DHA supplement (derived from microalgae) can be used to improve maternal DHA status. An intake of 300 micrograms of DHA per day during pregnancy is recommended.

Vitamin B12

Requirements for vitamin B12 increase slightly during pregnancy, up from 2.4 to 2.6 micrograms per day. Some studies recommend a higher intake of 3 micrograms by expectant mothers. Unlike other B-group vitamins, B12 can be stored in our bodies for some time. During pregnancy, however, only newly absorbed B12 can be transported across the placenta. Therefore, all pregnant women should consume a reliable daily source of B12 throughout pregnancy.

Iodine

Iodine is vital for the normal development of your baby’s brain and central nervous system. Inadequate intake increases the risk of congenital abnormalities, as well as other poor health outcomes. Studies have shown associations between even mild maternal iodine deficiency and decreased child cognition. Meeting your daily requirements can be easily achieved through the use of iodised salt. Three-quarters of a teaspoon is sufficient to meet the recommended daily intake (RDI) during pregnancy. If you prefer not to include added salt in your diet, a daily iodine supplement that contains 150 milligrams is recommended.

What about Choline?

There has been a lot of buzz around choline — an essential nutrient involved in the production of the chemical messengers used by our brain. Much of the attention has focused on pregnant women, especially those following a plant-based diet, and their potential risk of deficiency. An adequate intake of choline is believed to be 440 milligrams per day for pregnant and breastfeeding women. Although this recommendation is slightly higher than that suggested for non-pregnant women, there appear to have been no reports of deficiency. In fact, whole plant foods including wheat germ, soybeans, cruciferous vegetables, quinoa, and almonds are particularly good sources of this nutrient.

Managing morning sickness

Nausea and vomiting, referred to as morning sickness, is a common feature during the early stages of pregnancy. Although its exact cause is yet to be identified, there are plenty of theories as to why it might occur: fluctuations in hormone levels, immune system changes, and the role of vomiting as a defence against ingesting toxins and potentially harmful microorganisms in food have all been suggested as likely causes. If you are suffering with nausea and vomiting during pregnancy, consider:

Eating smaller, more frequent meals to avoid an empty stomach, or low blood sugar levels.
Eat healthy foods that are well-tolerated: choose stomach-calming foods that are rich in complex carbohydrates, such as whole grains or starchy vegetables, and plant-based proteins like beans, lentils, and tofu.
Drink plenty of fluids in between meals to stay hydrated.
Ask for help with meal preparation if the smell or sight of certain foods is turning your stomach.

Cravings

Although often considered to be a sign of deficiency, cravings have very little to do with nutritional status*. Instead, they are generally the result of changes in your hormone levels. If cravings are causing you concern:

Avoid low blood sugar levels, which may trigger cravings, by planning for regular meals and snacks throughout the day.
Consider the role of your emotions in your food choices - is this really a craving, or perhaps a reaction to stress or boredom?
Think of a healthier substitute, or practice mindful eating.

*The exception to this being pica, or craving non-food items, which may be the result of iron-deficiency anaemia.

With a bit of knowledge and planning, you can ensure that your plant-based lifestyle is providing the nutrients you require during this demanding stage of life and the very best start for your child.

Feeling confident in the decisions you are making for yourself and your growing baby is central to a healthy, happy pregnancy, and beyond.

If you have any concerns about the adequacy of your current diet, enlist the help of an Accredited Dietitian. We can provide you with support and guidance, to ensure your diet meets your individual needs.

The information provided in this article is intended for general informational purposes only and should not be considered a substitute for professional medical advice. Always consult with a qualified healthcare provider, such as an Accredited Practicing Dietitian, before making significant changes to your diet, especially if you have underlying medical conditions or specific dietary requirements. Nutritional needs can vary greatly from person to person, and individual health circumstances may require personalised dietary recommendations.

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