Plant-based diets have gained popularity in the last few years but as you grow another human, is it still safe to continue to be plant-based?
Pregnancy means you need to pay more attention to your diet in general. While the number of calories you need doesn’t increase that much during pregnancy, the need for micronutrients (aka vitamins and minerals), which are essential to ensure your baby’s growth and development, does. In pregnancy, it’s not recommended that you play with your diet too much or (heaven forbid!) count calories or start a restrictive diet.
What does the science say?
There have never been any randomised controlled trials on the effect of a plant-based diet in pregnancy on the child’s long term health. A review published by the Royal College of Obstetricians and Gynaecologists in 2015 found no major birth defects or serious health conditions associated with mothers following a vegetarian or vegan diet.
Realistically, there is absolutely no reason that you can’t continue to follow a healthy, plant-based diet throughout your pregnancy. There is a risk of nutrient deficiency (particularly from protein, iron and B12) but those risks exist outside of pregnancy and, if you’re already managing your nutrient intake, then you should be fine to continue to do so once you’re pregnant.
“Any poorly planned diet in pregnancy has risks, whether you eat meat or not.” says nutritionist and herbalist, Brittany Darling “But if you’re following a plant-based diet, it is important to ensure both adequate macro (protein, carbohydrates and fats) and micronutrients (vitamins and minerals).”
Things to keep an eye on
The only real risk according to Brittany is vitamin B12, as there’s given there is no plant-based source (but this applies to both pregnant and non-pregnant plant-based people). Brittany advises “Most prenatal and pregnancy multivitamins contain the daily recommended dose of B12, however, absorption is often limited. Chewable, sublingual (a dissolvable tablet placed under the tongue) or liposomal B12 should be taken in addition to a multivitamin in plant-based mothers.”
It’s always best to keep monitoring the situation with your doctor. If your B12 is low, you may want to consider having B12 injections to avoid chronic deficiency that can impair your baby’s neurodevelopment.
Plant-based mothers should also think about their iodine (important for thyroid function) and choline (another member of the B-family and important for your placenta, preventing neural tube defects and your baby’s brain development). Brittany says “The majority of mothers, regardless of their dietary choices, aren’t getting enough of either of these nutrients. Australian soils are depleted of iodine and choline isn’t particularly abundant in our food supply.”
Unfortunately, apart from a blood test, there’s no real way to monitor if you’re getting enough micronutrients until it’s too late.
Brittany recommends testing prior to trying to conceive to make sure everything is at the optimal level for conceiving. It will also give you and your healthcare team time to fix anything that might be slightly off. She also recommends retesting vitamin B12, iron stores and additionally vitamin D, if you’re a winter pregnancy, towards the end of your second trimester to help optimise the nutritional value of your breast milk.
The first trimester
In the first trimester, you don’t need any extra calories, but you need to be very careful about your micronutrient intake. You’re probably going to feel nauseous (why do they call it morning sickness when it lasts all day?!), tired and potentially constipated so eating might become a struggle.
“Preconception care can take the stress out of suboptimal eating in the first trimester.” advises Brittany “If you are “fully replete” (ie. full of all the good stuff), a few weeks of doing what you have to do get through the first trimester is completely fine. Continue to take your pregnancy multivitamins but make sure you take it with food or before bed as B-vitamins can be nauseating.”
“If pregnancy has taken you by surprise, eating small, frequent meals and aiming focusing on nutrient density of foods is helpful as well as taking a pregnancy multivitamin.”
Cold foods (like cut up veggies) can help because they don’t have a strong smell, which can trigger the nausea. Brittany also advises ginger and vitamin B6 supplements to help with nausea (but make sure you talk to your healthcare provider if you decide to take B6 as it can be extremely toxic in high doses).
The second trimester
In trimester two, you need to consume an extra 340 calories per day. You’re also going to need to increase your protein intake by 28 grams per day. Focus on high protein foods like legumes and beans (Brittany recommends soaking your own legumes and beans and making sure they’re cooked well), tofu or tempeh (GMO free if possible), nuts (especially peanuts, chia seeds and hemp) and broccoli.
If you’re eating animal products, then eggs and dairy are also great sources of protein.
You also need to double the amount of iron you consume when eating plant -based and expecting. These can be found in the same foods as proteins (legumes, beans, nuts) but also in a lot of leafy greens like spinach. Don’t forget that it’s harder for the body to absorb iron from vegetarian sources than it is from animal sources. Brittany recommends consuming vitamin C rich foods like tomatoes, berries or citrus fruits with your iron rich foods to enhance absorption or, alternatively, adding wheat germ or backstop molasses to meals or cooking in cast iron to boost your intakes (who knew?).
FYI - dark chocolate is also a good source of iron!
The third trimester
In the third trimester, you’re going to need an extra 450 calories per day. The problem is that you’re going to feel like you’re about to pop and heartburn may stop you wanting to eat. Try breaking your meals up into a number of smaller meals, eat slowly and try to stay upright after you’ve eaten to help with your digestion. It’s also really important for you to keep your fluids up and this can help with digestion as well. Nutrient rich foods like avocados and nuts are really great for when you need to get your calories up but don’t feel like eating a lot.
If you do choose to follow a plant-based diet through pregnancy, it’s important to have regular checkups with your doctor to ensure you are getting all the nutrients you and your baby need. You might also want to speak to a nutritionist about how to optimise your intake of specific vitamins and minerals during pregnancy.
It might be the case that you can’t get all the right nutrients from your diet during pregnancy and there are a wide variety of supplements that can assist you. Speak to your doctor or nutritionist to help you choose something that’s right for you. You might also decide to suspend your plant-based diet for the duration of your pregnancy. That’s fine too. Try to keep an open mind and listen to your body. The most important thing is that you and your baby are happy and healthy at the end of the process.