Balancing the Vegetarian Way and
Optimizing a Healthy Pregnancy: PART 1
From RMACT Nutritionist Carolyn Gundell, MS for National Nutrition Month
I counsel many vegetarians in our office in our focus on healthy pregnancy. Some are vegetarian for religious or cultural reasons and others are by personal or ethical choice. Vegetarian meal plans that are balanced with a variety of food choices can meet all nutrient needs for increasing fertility, optimizing health prior to and during pregnancy, and for breastfeeding.
Since the nutritional status of all women, vegetarian or not, directly affects pregnancy outcomes and the quality of breast milk, it is very important to be aware of nutrient needs unique to vegan/vegetarian meal plans.
Vegetarian meal plans are comprised of foods from plant sources with varying compositions:
Vegans – omit all animal food products and other animal products such as leather, wool, and silk.
Lacto – include dairy products.
Lacto-ovo – include both eggs and dairy products.
Pesco – include fish.
Pollo – eat poultry, such as chicken, turkey, and duck.
All vegetarian women looking to become pregnant should be taking a prenatal vitamin with 800 to 1000 mcg of folic acid months before conception. Folic acid alone is not enough. RMA of CT does sell vegan prenatal vitamins at each office. Contact RMACT for more information. In addition, extra supplements are often necessary for vegetarians and it is important to consult with your physician and/or nutritionist to determine supplement and dosage. Extra supplementation should never be self-prescribed. Vegetarian meal plans may be low in vitamin B12, Vitamin D, calcium, iron, protein, essential fatty acids and iodine.
Optimal Pregnancy Diet for All
One optimal pregnancy diet does fit all: Once pregnant, caloric and weight gain requirements are the same for vegetarians as for non-vegetarian women. Make sure to include the following:
PROTEIN - Protein builds new tissue and repairs cells.
Vegetarian meal plans are rich in protein when meals and snacks consist of a balanced combination of grains, beans, nuts & nut butters, lentils, seeds, and vegetables. A good variety of food sources planned daily and weekly will meet basic non pregnant and pregnant protein needs. Protein is needed in pregnancy to support growth of maternal tissue and the rapid growth of the fetus and placenta.
Protein Food Sources: Dried beans, lentils, nuts & nut butters, seeds, whole grains, soymilk, eggs, milk, cheese and yogurt products, vegetables.
IRON - Iron promotes tissue growth and increases blood supply.
Many vegetarian food sources are rich in iron, but this plant form of iron is not well absorbed. Iron absorption can be increased when a vitamin C rich food is consumed with an iron rich food. Calcium and dairy food can interfere with iron absorption so it is often best to take calcium (citrate) supplements in between meals. When tea or coffee is consumed at meals iron absorption can also be inhibited. Prenatal vitamins can be taken at bedtime to get the best absorption.
Iron needs are high in pregnancy because blood volume doubles. Iron deficiency anemia is not uncommon in pregnancy, so vegetarians should choose iron rich foods at all meals and snacks prior to pregnancy to increase their iron storage. Iron supplements may be necessary
Iron Food Sources: Iron fortified cereals and breads, whole grains, beans/legumes, dried fruit, prunes, tofu, dark leafy vegetables.
VITAMIN B12 - Vit B12 helps to form & maintain healthy nerve cells and red blood cells; makes cellular DNA.
Vegans should be especially careful to get adequate daily amounts of vitamin B12, even though it may take years to develop a B12 deficiency. Low maternal B12 in the first trimester is an independent risk factor for neural tube defects. Adult vitamin B12 deficiency results in pernicious anemia, cognitive impairment, numbness, weakness, nervous system damage, fatigue, and psychiatric disorders. A woman with a gastric bypass, taking metformin for insulin resistance, or on acid reflux medication is at greater risk for vitamin B12 deficiency. Infant B12 deficiency can cause developmental delays, anemia, lethargy, and failure to thrive. The addition of a vitamin B12 supplement for a lacto-ovo vegetarian and vegan should be discussed with the woman’s physician.
Vitamin B12 Food Sources: Milk, yogurt, eggs, cheese, B12 fortified cereals, B12 fortified soymilk, B12 fortified nutritional yeast. The following are unreliable/poor sources of Vitamin B12: tempeh, miso, fermented soy products, spirulina, seaweed, bewers yeast, leafy vegetables.
Fertility Nutrition Resources
For further fertility nutrition tips and to discuss your own optimal nutrition for fertility--before, during, and after pregnancy--come speak with me! The Fertility Nutrition Program at RMACT offers both individual consultations and seminars. Also, the following books and websites may be helpful:
Vegetarian Resource Group - www.vrg.org
Vegan Health - www.veganhealth.org
Your Vegetarian Pregnancy:A Month-by Month Guide to Health and Nutrition by Holly Roberts, D.O., FACOG, 2003.
The Everything Vegan Pregnancy Book: All you need to know for a healthy pregnancy that fits your lifestyle by Reed Mangels, PhD, RD, FADA, 2011.
More to come next week when our fertility nutrition tips for National Nutrition Month continue.
Get Your “Fertility” Plate in Shape with Nutrition for Fertility
In recognition of National Nutrition Month, this is the first of four blogs in March focusing on nutrition for fertility. The Academy of Nutrition & Dietetics (formerly American Dietetics Association) has announced this month’s theme as “Get Your Plate in Shape.” The Academy is using the new USDA’s My Plate design to remind consumers of the importance of eating balanced meals comprised of all the food groups.
We all know that this concept is easier said than done and I wish that healthy eating was as simple as choosing food groups at each meal. Before the food gets to our plates, we do have to figure out (1) when to go grocery shopping, (2) what to buy, (3) how to prepare the food, and (4) when to eat it. These decisions compete with the many other daily tasks in our busy lives.
Pregnancy Diet Planning
To achieve a healthy pregnancy diet before we create our plate, we must make time for all our meals--breakfast, lunch, dinner, and even snacks. Many women and men skip meals because they are too busy, too tired, or wrongly believe that skipping meals will help them lose weight. Long term meal skipping can cause many unhealthy metabolic changes such as weight gain, elevated fasting glucose, HgbA1c, LDL-cholesterol and triglycerides, and increased insulin resistance. Any one of these symptoms prior to pregnancy can increase a woman’s risk for gestational diabetes.
Skipping meals does not help weight loss. Meal skipping, especially breakfast and/or lunch, slows metabolism, increases drowsiness, and increases cravings for carbohydrates. The human body becomes very efficient at conserving calories when meals are skipped. The body then goes into storage mode and it stores more calories as fat.
Maternity Diet Warnings
Both skipping meals and consuming fewer calories than recommended will also contribute to poor health by causing nutrient deficiencies. A woman’s nutritional status prior to pregnancy and her maternal diet directly affect pregnancy outcome and quality of breast milk after birth. Low nutrient intake, such as foods rich in protein, folate, B12, and other B vitamins prior to pregnancy could contribute to neural tube defects and other birth defects, as well as anemia and poor growth.
Remember YOU. Your health is so very important to you and your future child. If you are a meal skipper, think ahead and plan a breakfast/lunch the night before. Take a moment to plan menus and grocery shop. Consult with Fertility Nutritionist Carolyn Gundell, M.S. at RMACT. A well-balanced meal plan will give you and your baby a healthy start.