Pregnancy and the Vegan Diet
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We began this archive as a means of assisting our visitors in answering many of their health and diet questions, and in encouraging them to take a pro-active part in their own health. We believe the articles and information contained herein are true, but are not presenting them as advice. We, personally, have found that a whole food vegan diet has helped our own health, and simply wish to share with others the things we have found. Each of us must make our own decisions, for it's our own body. If you have a health problem, see your own physician.
Pregnancy and the Vegan Diet
by Reed Mangels, Ph.D., R.D.
From the Vegetarian Resource Group
Topics in this article:
Table 2: Sample Menu Plan for Pregnant Vegans
"My doctor says I have to drink a quart of cow's milk a day; my parents are convinced I'm doing something harmful; and I'm even starting to wonder if my diet is all right." Even the most committed and knowledgeable vegan may face doubts when pregnant. After all, the so-called experts are all questioning her dietary choices.
Actually, it is reasonably simple to follow a vegan diet throughout pregnancy while eating foods that meet your needs and the needs of your baby. I know; I've done it twice. In addition, a series of studies 1,2 at The Farm, a community where vegan diets are a part of a socially responsible lifestyle, have shown that vegans can have healthy pregnancies and healthy children. Here are some things to consider.
How much weight you gain during your pregnancy has a marked impact on the baby's size and health at birth. Table 1 will help you to calculate how much weight you should gain. If you were underweight prior to your pregnancy, you should try to gain 28-40 pounds. Average weight women should aim for a 25-35 pound weight gain, and overweight women should strive to gain 15-25 pounds. Adolescents may need to gain 30-45 pounds. A general trend is to have little weight gain for the first 12 weeks. Then, in the second and third trimesters, a weight gain of a pound a week is common 3. Figure 1 shows recommended patterns of weight gain based on your pre-pregnancy body mass index (BMI). Select the graph corresponding to your pre-pregnant BMI. Your weight gain will not necessarily fall on the dashed line but should be approximately parallel to the line 3.
Many vegans begin pregnancy on the slim side and may gain weight very slowly. If this sounds like you, you will need to eat more food. Perhaps eating more often or eating foods higher in fat and lower in bulk will help. I found it easiest to drink extra calories and treated myself to a soy milk shake (soy milk blended with fruit and tofu or soy yogurt) in the evening for a few weeks when weight gain was low. Other concentrated sources of calories include nuts and nut butters, dried fruits, soy products, and bean dips. Table 2 shows some ways of getting some extra calories - you need about 340 extra calories per day in the second and 450 calories per day in the third trimester. If, on the other hand, your weight gain seems too high to you and your health care provider, look at the types of food you are eating. Simply replacing sweets and fatty foods with fruits, vegetables, grains and legumes can lead to more moderate weight gain. Daily exercise, as approved by your health care provider, can also help.
Step 1. Take your pre-pregnant weight (in pounds) and divide it by your height (in inches) squared; then multiply by 700. BMI = lb/in 2 x 700. For example, if I weigh 110 pounds and am 60 inches tall, my BMI is 110/3600 x 700 = 21.4.
Step 2. Use your BMI to find your pre-pregnancy weight-for-height status and the amount of weight you should try to gain in pregnancy.
BMI Weight-for-height status Recommended
<19.8 Low 28-40 pounds 19.8 to 26 Average 25-35 pounds 26 to 29 High 15-25 pounds <29 Very high no less than 15 pounds Adapted from reference 3.
Young adolescents and black women should attempt to gain at the upper end of the given ranges since these groups tend to have higher rates of low birth weight infants. Higher weight gains seem to reduce the risk of having an infant whose weight at birth is very low and who is at risk for complications. Short women (under 62 inches) should attempt to gain at the lower end of the given ranges.
Figure 1: Weight Gain in Pregnancy
Source: Adapted from Reference 3.
Select the graph corresponding to pre-pregnancy BMI. Weight gain will not necessarily fall on the dashed line but should approximately parallel the line. The vertical line at the right of each graph shows the range of recommended weight gain.
Calcium and Vitamin D
Pregnant women who have regular sunlight exposure do not need any extra vitamin D 7,8. However, if there is any question as to whether or not your sun exposure is adequate, 5 micrograms (200 IU) of dietary and/or supplemental vitamin D is recommended 7. Supplements of vitamin D should only be used with the approval of your health care provider since high doses of vitamin D can be toxic. Fortified foods like some brands of soy milk and orange juice and some cereals are another way to meet vitamin D needs.
Docosahexaenoic Acid (DHA)
All of this advice to eat a plant-based whole foods diet sounds wonderful to many pregnant women. What are the barriers to eating a healthful vegan diet?
Nausea and Vomiting
Coping with nausea and vomiting:
Try eating low fat, high carbohydrate foods. These are digested more quickly and stay in the stomach for less time giving less time for queasiness.
Eat often. Sometimes nausea is really due to hunger.
Avoid foods that have strong smells. Sometimes cold foods are better tolerated because they don't smell as much. Have someone else do the cooking if possible and go away from the house while cooking is being done.
Be sure to drink juice, water, soy milk, or miso broth if you can't eat solid food. Keep trying to eat whatever you can.
Contact your health care provider if you are unable to eat or drink adequate amounts of fluids for 24 hours.
Lack of Time
Your Health Care Provider
Keeping a record of what you eat for several days may help convince your health care provider that what you're doing is fine or may highlight areas needing improvement. If you have specific concerns and questions, you may choose to consult a registered dietitian (RD) with expertise in vegetarian nutrition. Remember, a varied vegan diet can meet your needs and the needs of your baby during this exciting time.
It is also important to think about alcohol and smoking. Moderate to large amounts of alcohol during pregnancy can cause fetal alcohol syndrome, which impairs mental and physical development. Even one or two drinks of alcohol daily are associated with greater risk of health and development problems for the baby 10. Based on what we know, women should avoid alcohol during pregnancy 10. Cigarette smoking has been clearly linked to low birth weight, which increases the infant's chance of having a variety of health problems. Smoking should also be avoided during pregnancy.
If you eat too little while breast-feeding, you may not produce as much milk. Although the recommended calorie intake is 330 calories above your usual intake for the first six months 1, you still may lose weight because of a loss of calories in breast milk. It is safe to lose about 1/2 to 1 pound a week while breast-feeding but more rigorous dieting is not recommended. As in pregnancy, small frequent meals are the best way to be sure that you are getting enough calories. Since you do need extra fluid while breast-feeding, use nutritious beverages like juices, soy milk, soups, and vegan smoothies to provide calories.
The recommendation for protein is the same as in pregnancy 1 and can be obtained easily from the extra food you are eating. You should still eat good quality food because you are providing all nutrients to your infant. You will need to be careful to get enough vitamin B12, vitamin D, iodine, and DHA in order to be sure that these nutrients are present in your milk in adequate amounts. Requirements for most other nutrients are similar to those in pregnancy and should be obtained from a varied, healthy vegan diet.
This article originally appeared in the book Simply Vegan: Quick Vegetarian Meals by Debra Wasserman. Nutrition section by Reed Mangels Ph.D., R.D. (ISBN 0-931411-30-0)
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