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

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 

pregnancy nutrients vegan

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

brazil nuts are important for a plant based, vegan and vegetarian pregnancy

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 vegan and plant based pregnancy

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.

oats are a great plant based pregnancy breakfast

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.

References 

https://pubmed.ncbi.nlm.nih.gov/27886704/

https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.13280

https://www.mdpi.com/2072-6643/11/3/557/htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567027/

https://pubmed.ncbi.nlm.nih.gov/20959577/

https://pubmed.ncbi.nlm.nih.gov/30480773/

https://www.cochrane.org/CD006896/PREG_folic-acid-supplementation-in-pregnancy

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-11-75

https://pubmed.ncbi.nlm.nih.gov/25240073/

https://pubmed.ncbi.nlm.nih.gov/23425631/

https://pubmed.ncbi.nlm.nih.gov/31394787/

https://pubmed.ncbi.nlm.nih.gov/10871591/

https://www.bmj.com/content/346/bmj.f3443

https://pubmed.ncbi.nlm.nih.gov/23706508/

https://pubmed.ncbi.nlm.nih.gov/18053281/

https://pubmed.ncbi.nlm.nih.gov/31523806/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561751/

https://pubmed.ncbi.nlm.nih.gov/22623177/

https://www.health.gov.au/resources/pregnancy-care-guidelines/part-c-lifestyle-considerations/nutrition-and-physical-activity#112-nutritional-supplements

https://www.hps.com.au/wp-content/uploads/2019/04/Vitamin-and-mineral-supplementation-in-pregnancy-C-Obs-25-Review-Nov-2014-Amended-May-2015.pdf 

 

Vegan Zinc – Sources, Absorption, and Deficiency

Why zinc is important for vegans

Zinc is an essential nutrient to consider when following a vegan or vegetarian diet. It is a mineral that is distributed throughout all our body tissues and fluids. It is necessary for our body to perform a variety of important functions (1).

Some of these include:

  • Immune support and wound healing
  • Metabolism
  • Regulation of gene expression and DNA synthesis
  • Supports normal growth and development during childhood, adolescence, and pregnancy

 

Zinc requirements for vegans

Those following a vegetarian or vegan diet have higher requirements for certain vitamins and minerals than those specified for the general healthy population. These include the minerals iron and zinc.

Zinc is one of these nutrients as plant-based sources have a lower bioavailability than animal-based sources such as red meat and dairy. In other words, it is harder for our bodies to absorb this nutrient from plant-based foods.

 

It is recommended that those following a vegan/vegetarian or predominantly plant-based diet consume 150% of the recommended daily intake for the general population to ensure requirements are met.

 

Below is a summary of the daily requirements for vegetarians/vegans based on 150% of the values provided in the Nutrient Reference Values for Australians and New Zealanders(2).

Zinc RDI for Vegans

There is no difference in the RDI between older adults (70 years+) and those in their early stages of adulthood. See zinc requirements for those following a non-vegetarian or vegan diet here (4).

 

Want to make sure that you’re always getting enough zinc in your diet? Why not try one of our male or female vegan meal plans!

Cashews are a fantastic source of zinc

Best vegan sources of zinc

Zinc is present in a variety of plant-based foods. A well-planned vegetarian or vegan diet is more than adequate to meet your requirements.

It can be found in high concentrations in the outer layers of grains. As such, the best plant-based sources are minimally refined wholegrain products such as rolled oats, brown rice, and wholegrain bread and cereals.

Vegan zinc sources include nuts and seeds, legumes, soy products such as tofu and fortified breakfast cereals(1).

 

The following table lists the amounts found in different plant-based foods (3):

Zinc content of plant based foods

It is recommended that you include a variety of these foods in your diet on a daily basis.

 

This may look like:

Breakfast: ~4mg

½ cup oats + 1 cup soymilk + 30g pumpkin seeds + berries

Lunch: ~6mg

2 slices wholegrain bread + 2 tbsp hummus + ½ cup salad + 15g sundried tomato + 100g sliced tempeh

Dinner: ~6.5mg

Tofu stir fry (with 150g tofu, 30g cashews, 2 cups mixed vegetables) + ½ cup brown rice

Snacks: ~5mg

30g pecans, 1 apple, hot chocolate (2tbsp cocoa, 1cup soymilk, 1tsp sugar), 4 wholegrain crackers + 2tbsp tahini + tomato

TOTAL: 21.5mg total

 

Optimising zinc absorption

Plant-based sources of zinc are not as readily absorbed by the body. This is due to the presence of inhibiting compounds in foods that reduce absorption.

The main inhibitors are phytates which are commonly found in wholegrains and legumes.

This effect can be overcome by food-processing techniques such as the fermentation of whole grains and soaking legumes and sprouting seeds and grains.

Additionally, taking iron supplements close to meals can also inhibit the absorption of zinc as the two nutrients compete for uptake (1,4).

Foods that contain high amounts of protein are also a good choice to consider as protein binds to zinc and increase zinc absorption.

 

Read about meeting your protein needs on a vegan diet here

 

Some simple ways to improve vegan zinc absorption include:

  • Opting for yeast-leavened or sourdough bread
  • Pre-soak and rinse legumes before cooking

  • Opting for sprouted grains and seeds

  • Consume iron supplements away from meals

  • Include foods high in both zinc and protein such as legumes, tofu, tempeh and nuts

 

Signs of a zinc deficiency

Cases of deficiencies are rare in developed countries due to our abundance of access to zinc-rich foods however they are still possible.

The main reasons for developing a deficiency include poor dietary availability paired with an increased requirement during periods of growth and development or periods of stress, infection and acute trauma(2).

 

Signs of a deficiency to look out for include:

  • Reduced growth rate in children

  • Suboptimal pregnancy outcomes

  • Increased susceptibility to illness and infections

  • Poor wound healing

  • Impaired taste perception

 

Is being vegan a risk factor for developing a zinc deficiency?

No, despite differences in food choices, vegetarians and vegans tend to have similar blood levels of zinc to non-vegetarians.

Over time, the body is able to adapt to the lower bioavailability of zinc in plant-based diets by increasing the efficiency in which it is able to absorb this mineral and reducing losses out of the body. Therefore, those following a plant-based diet are at no greater risk (1).

If you are concerned you may have a zinc deficiency it is important to discuss any concerns with your GP.

 

Should vegans supplement zinc?

It is absolutely possible to meet your requirements from solely food sources when following a plant-based or vegan diet. This is always preferred over supplement use.

Whilst there is no evidence of adverse effects from consuming high amounts of zinc naturally occurring in food, excess zinc intake from long term high doses of zinc supplements may result in negative side effects. This includes negatively affecting the immune system , lowering HDL (also known as good cholesterol) levels and copper deficiency.

There are a variety of forms of zinc available in supplements. These include zinc acetate, sulfate, picolinate, monomethionine, gluconate, glycinate, orotate and citrate.

There is an upper limit of total zinc intake of 40mg/day from food and supplements (including fortified foods) and any supplementation should proceed with caution(2).

To reduce the risk of having excess zinc supplementation, it is important to seek medical advice from your GP before commencing and supplements.

 

References

  1. Medical Journal of Austral – Zinc and Vegetarian Diets

  2. Australian Nutrient Reference Values – Zinc

  3. Food Standards Australia and New Zealand

  4. Considerations in planning a vegan diet: Children

 

If you’re following a plant-based or vegan diet and want to make sure you’re meeting all your nutritional needs, take control and apply to work with one of our expert plant-based dietitians. .

This blog was co-written by student dietitian by Georgia D’Andrea. You can connect with Georgia on Linkedin.