There are a number of people who wish to sustain their vegan lifestyle during their pregnancy and consult a naturopath on how to keep with this lifestyle without harm to the growing baby. While I always recommend and educate my patients on the benefits of consuming small amounts meat in order to avoid nutrient deficiencies during this crucial time of growth and development, I also respect and support my patients wishes if they choose to continue with their vegan lifestyles and help them fill in the nutrient gaps. A vegan diet is healthy in many ways – vegans tend to be thinner, have lower cholesterol, lower blood pressure, better blood sugar control and reduced risk of cardiovascular disease, even when compared to vegetarian diets.1,2 Research behind vegan diets and the effects on pregnancy is still lacking. A recent review study was not able confirm whether vegan diets are beneficial or detrimental to the overall pregnancy, though there may be some evidence that vegan/vegetarian diets may lead to lower birth weights.3 Despite the research, it is important that we address the more logical notions of a vegan diet – meat contains nutrients that are important for pregnancy and plant sources alone might not be able to provide the amounts needed for pregnancy. Here are a few dietary and nutrient suggestions I recommend for pregnancy sustained with a vegan diet.
Protein
Protein is an obvious macronutrient that if not properly supplemented, can affect the growth and development of the fetus. Protein intake does not have to be in high amounts – in fact high protein supplementation appears to provide no benefit and may actually be harmful to the fetus, compared to balanced protein intake, which can improve fetal growth and reduce risk of still birth in low birth weight babies.3 It’s recommended that the total protein intake during pregnancy be 71g daily. There are a number of plant-based protein options that provide adequate amounts of energy and protein for the developing baby. Good vegan sources of protein include nuts and seeds, legumes, whole grains, and soy (in moderation, organic). Example of protein portions: 1/2 cup of cooked lentils, or 1.5 cups of soy milk roughly equals to about 10g of protein. One great way to ensure a healthy amount of protein is to use vegan-based protein powders, which are typically alkaline in nature (whey protein tends to be more acidic, which may not be favourable in pregnancy). Pea and brown-rice based proteins are recommended over soy-based products.
Calcium
Calcium typically a mineral of concern as vegan diets do not contain dairy products. Calcium is important for the development of bones, cartilage for the baby and may reduce the risk of mom developing pre-eclampsia during her pregnancy.4 The WHO recommends that total daily calcium intake during pregnancy should equal to 1.2-2g daily.4 Vegan sources of calcium include foods such as leafy greens (broccoli, collard greens kale, bokchoy, 1 cup raw =roughly 100mg), soy products (organic recommended, 1 cup cooked edamame = 100mg, tofu 1/2 cup = 500mg) and almonds (1 ounce = 75mg). In order to achieve the daily amount of calcium, supplementation may need to be implemented as well. A good prenatal vitamin should contain about 150mg of calcium per daily dose in order to make up the difference that may be lacking in the diet. Additional supplementation on top on what’s in your prenatal and diet is typically recommended for pregnant vegans and should be recommended by a qualified health-care provider.
Iron, B12
Iron and B12 are two nutrients that are almost exclusive to animal products. While you can find iron and B12 in vegan sources, they are typically in very low amounts and cannot be relied on to reduce risk of deficiency. Iron deficiency has been linked to low birth weight and preterm births and is routinely screened during pregnancy. 30mg of elemental iron daily is recommended pregnancy. Iron supplementation in the form of ferrous bisglycinate is what most naturopaths now recommend as you need less of it to improve levels (better absorbed), and is associated with fewer gastrointestinal effects.5
B12 deficiency in pregnant moms is highly associated with neural tube defects, despite adequate supplementation of folic acid. It is also linked to spontaneous abortions and can cause overt B12 deficiency in the baby after birth if enough is not transferred during pregnancy.6,7 Prenatal vitamins should be enough to supplement the amount of B12 needed for pregnancy, and should contain a daily dose of at least 500 mcg of B12 in it’s activated, methylcobalamin, form. Based on blood levels of B12, a qualified health care provider should recommend additional B12 and iron supplementation on top of diet and what’s in your prenatal vitamin.
Taurine
Taurine is an amino acid that is generally not recognized as an essential nutrient in the way of perinatal nutrition, but it is extremely important for fetal and infant growth. During pregnancy, the majority of mom’s taurine is shunted to the placenta and transferred to the fetus during development – particularly to the brain.8 Maternal taurine deficiency has been linked to increase risk of gestational diabetes in the mother, which may translate in to blood sugar problems in the baby after birth. This is thought be to caused by impairment in the formation of the pancreas due to taurine deficiency.8 Taurine deficiency can also delay growth, and impair development of the nervous system in the developing baby.8 Newborns are not able to synthesize taurine and rely on taurine from maternal breast milk, which makes it important for mothers to have adequate levels in the their bodies before, during and after pregnancy. Dietary sources of taurine are limited to meat products such as chicken and fish, therefore if you are not getting these sources from your diet, supplementation may be essential. Taurine can be safely supplemented in to a vegan diet, however it’s recommended that you consult with a qualified health physician before supplementing this during your pregnancy.
Maintaining a vegan diet can lead to better health outcomes as those who are vegan tend to be more conscious about eating foods that heal and help the body. During pregnancy the body requires more nutrients to aid the development of the growing fetus. As long as one is aware and can consciously overcome the nutrient deficiencies that may arise from a vegan lifestyle though diet and supplementation, resulting pregnancies can lead to healthy growth and development of mom and baby.
Dr. Tanya Lee, N.D. received her Honours Bachelor of Science degree in Biochemistry and Biomedical Sciences from McMaster University, and was trained as a Naturopathic Doctor at the Canadian College of Naturopathic Medicine. Dr Lee practices full-time between two clinics located in Toronto and Milton Ontario and has been voted Milton’s favourite Naturopath in 2013 and 2014. Her primary care practice focuses on family medicine, treating a wide variety of conditions such as hormonal (endocrine) disorders, fertility, digestive problems, cardiovascular disease, diabetes, insomnia and fatigue. She has a special interest in the treatment of autoimmune diseases, paediatric and perinatal health. Tanya offers her clinical knowledge to a number of publications, including the Natural Path.
References:
- Turner-McGrievy G, Harris M.Key elements of plant-based diets associated with reduced risk of metabolic syndrome. Curr Diab Rep. 2014;14(9):524. doi: 10.1007/s11892-014-0524-y.
- Le LT, Sabaté Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients. 2014 May 27;6(6):2131-47. doi: 10.3390/nu6062131.
- Ota E al Antenatal dietary advice and supplementation to increase energy and protein intake. Cochrane Database Syst Rev. 2012 Sep 12;9:CD000032. doi: 10.1002/14651858.CD000032.pub2.
- Hofmeyr GJ al Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014 Jun 24;6:CD001059. doi: 10.1002/14651858.CD001059.pub4.
- Milman N et. al Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. J Perinat Med. 2014 Mar;42(2):197-206. doi: 10.1515/jpm-2013-0153.
- Ray JG et. al. High rate of maternal vitamin B12 deficiency nearly a decade after Canadian folic acid flour fortification. 2008 Jun;101(6):475-7. doi: 10.1093/qjmed/hcn031. Epub 2008 Mar 12.
- Molloy AM Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. 2008 Jun;29(2 Suppl):S101-11; discussion S112-5.
- Aerts L, Van Assche FA. Taurine and taurine-deficiency in the perinatal period.J Perinat Med. 2002;30(4):281-6.