Balancing the Vegetarian Way and
Optimizing a Healthy Pregnancy: PART 1
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.