Plant Based Pregnancy
Larry Rossi
Drexel University
Plant Based Pregnancy
Planning your diet is a complex, time consuming task. It is shaped by culture, marketing, politics, economics, necessity, and desire. Diet is one of the biggest and most important factors in our overall health. Our diets are linked to an increase in obesity, diabetes, hypotension, cancer, and cardiovascular disease. Obesity, which represents a caloric intake well over what is needed, is s major concern. Particularly in western culture, where a diet that emphasizes high fat, caloric dense food has been implicated as a connection to several negative health outcomes.
It is accepted by heath care professionals, and pregnant women that nutritional status during pregnancy plays an important role in a healthy pregnancy. Women with poor nutrition can experience complications with labor, as well as compromised fetal growth, resulting in low birth weight. Pregnant women who gain more or less weight than the recommended amount can result in complications for both mother and baby. The incidence increases at the extremes of weight gain. What is an expected mother to be to do? An increased number are looking into dietary alternatives. One alternative, that is growing in popularity, is a vegan diet.
What is a vegan diet?
A vegan, or plant based, diet is a form of vegetarianism. It differs in that individuals following this diet consume zero animal products. This means that vegans do not eat any meat, diary, eggs, honey, or any other animal byproducts. One hundred percent of a vegan’s diet comes from plants, with the exception of mineral supplement or manufactured vitamins. Humans, are by definition, omnivores and traditionally require nutrients from both plant and animal sources in order to avoid deficiencies. Vegans are herbivores by choice. A vegan diet could offer many health benefits, but it may present nutritional challenges for a pregnant woman. The fetus is susceptible to nutritional deficiencies and excesses, making it important to understand and develop proper nutritional support for pregnant women.
Nutritional Needs During Pregnancy
The nutritional needs of a pregnant woman vary from individual to individual and should meet the needs of the woman as well as the developing fetus. There is not a certain amount of minerals and nutrients that will ensure the birth of a healthy baby. There are, however, general guidelines that correspond with optimal heath for mother and child. A wide variety of food is required, along with a well balanced diet including grains, vegetables, fruits, dairy products, protein, and fats. During pregnancy, there is a need for increased consumption of certain dietary requirements. These include calories, protein, polyunsaturated fatty acids, iron, calcium, folic acid, and vitamins B-12 and D (Tyree, Baker, & Weatherspoon, 2012, p. 43). How does a vegan mother to be meet these requirements?
Caloric Need
The total number of calories consumed daily should be enough to provide energy to both mother and child. It is affected by the mother’s body mass index (BMI) prior to pregnancy. An obese mother will require less calories than an underweight mother. Physical activity should also play into caloric need. The caloric intake should be enough to gain the recommended total weight during pregnancy. According to Paine (2010), a woman with a low BMI, under 19.8, should gain 12.5-18 kg. A normal BMI, 19.8-26.0, should gain 11.5-16.0 kg. A high BMI, 26.0-29.0, should gain 7.0-11.0 kg. And an obese woman, BMI greater than 29.0, should only gain 6.0 kg (p. 11).
Protein
The most frequent question a vegan receives is “what do you do about protein?”. The typical western diet provides considerably higher than required protein, this comes along with concerns about health risks. A vegan’s protein intake, while lower than their meat eating neighbors, is adequate. This is true if both legumes, such as beans or peanuts, and whole grains are eaten to ensure the consumption of the full compliment of amino acids. A developing fetus requires a constant supply of amino acids, which are the building blocks of protein. The protein requirement during the first trimester does not increase. However, during the final two trimesters the daily protein requirement increases from around 46 grams to 71 grams per day (Mehta, 2008, p. 410)
Protein is found in a multitude of food, including sources other than animal products and meat. These include tofu, nuts, legumes, and whole grains. However, plant sources do not, individually, provide all the amino acids that are essential. This makes it important to eat a variety of non animal based protein products to ensure all amino acids required are consumed. If an individual is struggling consuming the required amounts of protein, 25 grams of protein can be easily added to their intake by consuming 2.5 cups of soy milk or 1.5 cups of lentils into your daily menu (Tyree, Baker, & Weatherspoon, 2012, p. 45).
Polyunsaturated Fatty Acids
Polyunsaturated fatty acids (PUFAs) are required for fetal brain and nervous system development. The main source of PUFAs that comes to everyone’s mind is fish oil. Fish would be a good addition to a pregnant woman’s diet. However it should be noted that certain fish should be avoided, such as marlin, shark, swordfish, and fresh tuna, because of their high content of mercury. It should also be noted that fish oil supplements should be avoided during pregnancy due to the high amounts of vitamin A included in these supplements. Excessive vitamin A consumption has shown a link to fetal mental retardation, nervous system malformation, cardiovascular problems, and facial deformities. Since vegans do not eat fish, where are they supposed to get the PUFAs that are required? There is another source of PUFAs. It comes from the fat called linolenic acid. Linolenic acid is found in flaxseeds, soybeans, walnuts, and canola and flaxseed oil. Adding just two portions of these foods per week will meet the required amount of PUFAs (Tyree, Baker, & Weatherspoon, 2012, p. 46).
Iron
Iron is needed for formation of hemoglobin. Iron deficient anemia may develop during pregnancy due to dietary intake, as well as from the increased oxygen need of the growing fetus. However, the iron found in animal products are more bioavailable than that found in plant sources. Therefore, it may be necessary to increase iron intake for someone on a plant based diet. During pregnancy, the recommended dietary intake of iron is 27 mg per day (Mehta, 2008, p. 410). Iron is found in leafy green vegetables, such as spinach. It can also be found in soybeans, molasses, lentils, raisins, prunes, and dried apricots. Combining these iron rich foods with foods containing high amounts of vitamin C increases the absorption rate of iron. It is difficult for women to meet the recommended daily amount of iron, therefore a simple iron supplement should be recommended during pregnancy.
Calcium
Calcium is important for many body systems, such as neuromuscular conduction and cellular homeostasis. Hypocalcemia, low serum calcium, could result in tetany, or muscle spasms. Conduction of the cardiac muscles may be affected if serum calcium becomes too high or low. Calcium also affects a person’s acid-base balance. A high protein diet can lower the body’s pH. The body counteracts this with calcium, by pulling it from bones, resulting in decreased bone density. A plant based diet can help protect calcium stores, since it is unlikely that it will be high in protein. The daily recommendation for calcium is 1000 mg (Tyree, Baker, & Weatherspoon, 2012, p. 47), this does not change during pregnancy. To easily meet this requirement on a vegan diet, foods such as tofu, broccoli, bok choy, and dark leafy greens should be eaten. Another good source of calcium for a vegan is nondairy milk fortified with calcium.
Vitamin D
Vitamin D is required to absorb calcium in the gastrointestinal tract. Vitamin D is needed to maintain calcium levels of the mother, as well as provide nutrients to the developing skeleton of the fetus. Vitamin D, a hormone that is made naturally in our bodies with the aid of sun exposure on our skin, is also found in milk and other fortified foods. Vegans are at risk for a deficiency of vitamin D, especially in the northern latitudes. This is due to both diet and lack of sunlight, especially in the winter months. The daily recommendation for vitamin D in pregnant women is 600 IU (Mehta, 2008, p. 412). Vegans should eat plants that are good sources of vitamin D, such as leafy greens, broccoli, and beans. Vitamin D supplements can be added if there is a concern.
Folic Acid
One of the most important nutrients for pregnant women is folic acid. Inadequate consumption of folic acid may cause an increased risk for neural tube defects. Two of the most common neural tube defects are spina bifida and anencephaly. Spina bifida is a defect where the spinal column does not completely close. This typically results in spinal nerve damage which can cause some paralysis. Anencephaly is the absence of the skull or brain. These fetuses are frequently miscarried. While there is not a cure for these conditions, there are preventative measures that could help lower the occurrence of these neural tube defects. It is recommend that women consume 600 ug per day up to the 12th week of pregnancy. Folic acid can be found in legumes, leafy vegetables, whole grains, and citrus fruits.
Vitamin B-12
Vitamin B-12 works in conjunction with folic acid to synthesize red blood cells and DNA. It also helps maintain myelin sheaths, the insulation of nerves. Vitamin B-12 deficiencies are believed to cause neural tube defects, anemia, growth failure, and developmental abnormalities. It can also cause several maternal complications. Vitamin B-12 is not found in plant sources, it can only be consumed though animal products. Since it is only found in animal products, it is very important for vegans to take a vitamin B-12 supplement. Pregnant women are recommended to include 2.6 ug per day (Tyree, Baker, & Weatherspoon, 2012, p. 47).
Conclusion
Studies have shown that a plant based diet could help reduce the risk factors of heart disease, diabetes, obesity, high blood pressure, and certain types of cancer. When done correctly, a vegan diet is found to be at least as healthy as a omnivorous diet. Many professionals consider a plant based diet to be a healthy alternative for both the mother and the growing fetus. Pregnant women following a vegan diet should follow the same nutritional guidelines as pregnant women following a traditional diet. With careful planning, a vegan diet can provide all the required vitamin and minerals needed for a healthy mother and child. Dietary planning should take place prior to, during, and after pregnancy to ensure the nutritional health of both mother and child.
References

Fisher, M. (1999). Vegan Pregnancy. United States: Midwifery Today, Inc.

Mehta, S. H. (2008).Nutrition and prgnancy. Clinical Obstetrics and Gynecology, 51(2), 409-418. doi: 10.1097/GRF.0b013e31816fda53

Paine, J. (2010). Nutrition and pregnancy weight gain for optimal birth outcomes. New Zealand College of Midwives Journal, 43(43), 10-12.

Tyree, S., Baker, B. R., & Weatherspoon, D. (2012). On veganism and pregnancy. International Journal of Childbirth Education, 27(3), 43-49.

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Student’s Signature_Larry Rossi_________________________
Course Submitted__Nurs 346-903_________
Term_Winter 13__________
Date _3/11/14___________________