Plant Based Pregnancy: Safety, Nutrients at Risk, Supplements and Meal Plan

November 18, 2021

Womens Health Dietitians The PNW Clinic - Pregnancy

A plant-based diet is one which consists mostly of plant foods – think fruits, vegetables, nuts, seeds, legumes and wholegrains. For some, this may be a strict vegan diet but for others it may also incorporate some animal products on a daily, weekly or monthly basis. A plant-based pregnancy therefore, can encompasses eating a range of different dietary patterns along this plant-based spectrum throughout your pregnancy journey.

Is A Plant Based Pregnancy Safe?

In short, yes! In fact, the Academy of Nutrition and Dietetics state:

“…appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation…”

Not only is following a plant-based diet during pregnancy safe, but there are also some potential benefits to eating more plants during pregnancy backed up by research such as:

High fibre intake associated with a plant-based diet reduces risk of constipation which is a common side-effect during pregnancy
Reduced risk of pre-eclampsia and gestational diabetes mellitus (GDM)
Promoting healthy weight gain during pregnancy (excessive weight gain increases risk of GDM, pre-eclampsia, birth complications, miscarriage, childhood obesity)
Decreased risk of your future child developing chronic conditions later in life
Potential reduced risk of asthma and eczema in your future child
Emerging research suggests role of a plant-based diet in lowering incidence of post-natal depression

However, emphasis should be placed on “appropriately planned” as there are a few key nutrients during pregnancy which are harder to get from plants alone.

This is especially important as not getting enough of these essential nutrients can impair the growth and development of your unborn child negating any of the potential benefits a plant-based diet provides.

Luckily, with some careful planning and the guidance of a plant based pregnancy dietitian, it is possible to meet all your nutritional needs on a plant-based diet to ensure a healthy pregnancy and baby.

Key nutrients for a plant-based pregnancy

Protein:

Protein is a critical nutrient during pregnancy to support the growth of a healthy baby as protein is an essential building block for growing all of your baby’s tissues and organs. It also plays an important role in the development of your own uterine tissue to help support a healthy pregnancy.

Sources: Tofu, tempeh, beans and legumes, textured vegetable protein, pulse pasta, and to a lesser extent nuts and seeds

Omega 3:

Omega 3s play a critical role in promoting healthy development of infants, in particular their brain and eye development and function. Plus, intake has also been linked to promoting a normal length of gestation and even preventing perinatal depression.

Sources: Chia seeds, flax seeds, hemp seeds, walnuts

Folate:

Plays an essential role in many crucial foetal developmental processes including DNA synthesis, cell growth and nervous system development. Inadequate intake during pregnancy significantly increases risk of your baby developing neural tube defects.

Sources: Spinach, kale, broccoli, asparagus, avocado, orange, banana, strawberries, chickpeas, sunflower seeds, vegemite, bread (except organic and gluten free varieties) and fortified cereals

Choline:

Plays an important role in foetal brain and nervous system development. Low choline intakes during pregnancy have also been linked to an increased risk of neural tube defects.

Sources: Red kidney beans, chickpeas, soymilk, tofu, quinoa, broccoli, brussel sprouts, shitake mushrooms

Iron

The body’s demand for iron increases dramatically during the 2nd and 3rd trimesters of pregnancy to accommodate an increase in blood volume that occurs. Iron is also vital for the growth and development of your baby and low iron status during pregnancy increases risk of low birth weight and preterm delivery as well as post-partum haemorrhages. We recommend optimising your iron stores pre-conception and during the first trimester to help account for this significant increase in requirements.

Sources: Tofu, legumes (e.g. red kidney beans, chickpeas, lentils, baked beans), wholegrains (e.g. amaranth, brown rice, oats, quinoa, grain bread), nuts/seeds (e.g. pumpkin, sesame, hemp and chia seeds, cashews, some vegetables (e.g. spinach, kale, beet greens and white potato) and fortified products

Iodine

Plays a critical role in the development of your baby’s brain and poor intake during pregnancy has been linked to poorer cognitive performance and lower IQs in children.

Sources: iodised salt, bread (except organic and gluten free varieties), nori
*We recommend avoiding excessive consumption of sea vegetables such as boiled seaweed and kelp products as they can contain very high levels of iodine which exceed safe levels of intake.

Calcium

During pregnancy, calcium is an essential building block for developing bones and teeth and also assists in nerve function and normalizing your baby’s heartbeat. There is also some evidence linking inadequate calcium intake during pregnancy to an increased risk of developing pre-eclampsia.

Sources: Fortified plant-based milk, cheese and yoghurt*, calcium set tofu, edamame, baked beans, kale, Asian greens, chia seeds, almonds, sesame seeds and tahini

*Note – Not all plant-based dairy alternatives are fortified with calcium

Selenium

Maternal selenium intake during the first trimester of pregnancy has been linked to language and motor skill development in offspring and also plays and important role in thyroid hormone development.
Sources: Brazil nuts, wholegrain bread, baked beans, lentils, cashews

Vitamin D

Vitamin D is essential for foetal bone formation which starts in utero. This is important as infants born with lower bone density or improper bone formation are at greater risk of developing Rickets and skeletal deformities.

Sources: Small amounts are found in some plant-based products such as milks and margarines however, it is unlikely you will be able to meet your requirements from food alone. 10-20 minutes per day of sun exposure is the most efficient way for our bodies to get vitamin D however, there are many factors which can impact this.

Vitamin B12

During pregnancy, Vitamin B12 is required for cognitive neurodevelopmental processes and adequate intake is also associated with a reduced risk of neural tube defects.

Sources: Unfortunately, there are no reliable plant-based sources of Vitamin B12. There are some plant-based products (e.g. plant-based milks and meat substitutes) which may be fortified with B12; however, due to variable vitamin content and low absorption rates by the body, these foods should not be relied on to provide your B12 needs. Because of this, B12 supplementation is essential for all individuals on a plant-based diet.

Supplementation

Whilst as dietitians we usually like to focus on a food first approach, pregnancy is a key period in which supplementation is highly recommended plant-based or not.

We recommend all mothers to be start on a good quality prenatal (to boost your fertility, this should ideally be started 3 months prior to conception when possible). However, we know that with so many options available on the market, choosing which supplement is right for you is a lot easier said than done.

Not all supplements are made equally and unfortunately, there is no one-size fits all recommendation. There are a variety of factors such as your diet, medical history, family medical history, medications, age, weight and blood work which will influence the nutrients you need and in what amounts.

Plus, it is common for your supplements to change throughout your pregnancy as your nutritional requirements and status also change.

Are you planning to conceive in the next year? Get expert advice from our plant based pregnancy dietitian

Whilst we recommend you speak to a dietitian to help tailor an individualised supplementation regime, there are a few common things to look out for when choosing a prenatal:

Folate: 400-600mcg
Iodine: at least 150mcg (ideally 220mcg)
Zinc: 11mg -16.5mg
Selenium: 30mcg
Iron: 60mg
Vitamin D: 400-1000IU
Other common nutrients you may find in a prenatal include calcium, vitamin C, vitamin E and other B vitamins (e.g. thiamine, niacin, B6).
Avoid prenatal supplements containing vitamin A as these can be harmful whilst pregnant (unless indicated by your doctor/dietitian)

Alongside your prenatal multivitamin, there are a few other key nutrients you may need to supplement depending on what is covered by your multi and your specific bloodwork and diet patterns. Some of these include:

B12
Omega 3 – look for a supplement containing at least 250mg EPA/DHA
Choline
Vitamin B6
Additional vitamin D
Additional iron
Probiotic

It should also be noted that unfortunately not all supplements are vegan. This may be due to the casing or where the nutrients are derived from.

We believe it is up to you and your own values whether or not ensuring your supplements are vegan is important to you. If it is, choosing vegan supplements can be more challenging as it will limit the variety of choices available. However, as plant-based dietitians we can help guide you on some suitable options to help you feel confident that you are getting in all the nutrients you need.

Healthy Plant Based Pregnancy Meal Plan

Breakfast: Porridge or overnight oats
½ cup oats + 1tbsp ground flaxseeds + 1 cup calcium fortified soy milk
Serve with 1 cup mixed berries + 1tbsp peanut butter + 1 brazil nut chopped
Optional: cinnamon, maple syrup/brown sugar

Morning snack:
4x grain crackers with
½ cup cannellini beans mashed with ¼ of an avocado and a squeeze of lemon/lime juice

Lunch: Tofu salad wrap
1 medium/large grain wrap with
150g marinated baked calcium set tofu + 1 cup spinach/kale + ½ cup other salad veg of choice + ¼ of an avocado

Afternoon snack: Smoothie
½ banana + ¼ cup oats + ½ – 1 cup fruit of choice (berries, mango, pineapple, etc.) + 1tbsp hemp seeds + 1 cup soy milk

Dinner:
Dahl with 1 cup of cooked lentils + ½ cup wilted spinach/kale + 1 cup mixed vegetables (e.g. broccoli, cauliflower, pumpkin, peas, carrot, zucchini)
Serve with 1 cup of brown rice

Snack: Trail mix and yoghurt
¼ cup trail mix (mixed nuts, seeds and dried fruit of choice + optional dark chocolate, dried coconut, granola)
2/3 cup plant-based yoghurt

For more individualised advice on how you can optimise your plant-based diet for fertility you can book in to see our plant based fertility dietitian here.

This article was written by fertility dietitian Georgia D’Andrea.