CAN YOU HAVE A HEALTHY VEGETARIAN OR VEGAN PREGNANCY?
Q: Is it possible to have a healthy vegetarian or vegan pregnancy?
A: “The short answer is yes, absolutely,” said Dr. Shannon M. Clark, a spokeswoman for the American College of Obstetricians and Gynecologists. “You can still get all the nutrients you need, but you can’t be cavalier.”
There have not been any randomized-controlled trials, the gold standard to prove cause and effect, that looked at the effects of a vegetarian or vegan diet on pregnancy. However, a 2015 review of 22 observational studies on vegan and vegetarian pregnancies discovered no increase in major birth defects or other serious problems in offspring or mothers. The review, published in BJOG, an international journal of obstetrics and gynecology, included only healthy women. The authors said more research is needed to determine whether expecting women who have certain health conditions can safely continue a plant-based diet.
In its position paper on vegetarian diets, the Academy of Nutrition and Dietetics, the nation’s largest organization of dietitians, said a plantbased diet is healthful and nutritionally adequate for pregnant women, as long as there’s appropriate planning, since pregnant women who don’t eat meat may be at risk for deficiencies in certain nutrients, especially iron and vitamin B12.
Iron is crucial because women build up blood volume during pregnancy, and deficiencies can lead to anemia, which “increases the risk of having a low birthweight baby, and increases the risk of preterm labor and delivery,” explained Clark, a maternal-fetal medicine specialist at the University of Texas Medical Branch in Galveston.
So during pregnancy, vegetarians and vegans should take special care to eat plenty of iron-rich foods, like dried beans and peas and fortified cereals. Because the iron in plant-based foods is not as easily taken up by the body as the iron from meat, you should “cook them, soak them” or eat them with foods high in vitamin C to increase absorption, said Susan Levin, director of nutrition education for the Physicians Committee for Responsible Medicine, an advocacy group that promotes a plant-based diet. Prune juice is also high in iron.
B vitamins, including vitamin B12 and folic acid, are also critical in pregnancy. Vitamin B12 is not found in plants, but it is in tofu, soy milk, some cereals and nutritional yeast, which some vegans eat as a cheese substitute. Folic acid prevents neural tube defects to the spine and brain, which occur in the first month of pregnancy, so the U.S. Preventive Services Task Force recommends that any woman of childbearing age take a daily supplement containing at least 400 micrograms of folic acid daily.
A plant-based diet may even have upsides. A vegetarian diet in the first trimester was linked to a lower risk of excessive gestational weight gain, and “maternal diets high in
plant foods may reduce risk of complications, including gestational diabetes” Levin said.
Still, pregnancy can throw curve balls. When Clark discovered she was carrying twins, she was transitioning to a vegan diet after a year of vegetarianism but almost immediately experienced severe nausea and gastroesophageal reflux and lost her appetite.
“I broke my vegetarian diet because I needed my babies to grow,” she said. “Being underweight can be just as detrimental to a pregnancy as being overweight.”