Plant-Powered Pregnancy: Vegan Nutritional Insights for Expecting Mothers

Introduction

Veganism, a lifestyle choice centered around not eating animal products, has become increasingly popular in recent years. Driven by concerns for personal health and environmental sustainability, many people have embraced veganism as a way of life. However, the decision to maintain a vegan diet during pregnancy remains controversial and requires careful consideration due to potential consequences to maternal and fetal health.

During pregnancy, nutrition plays a critical role in supporting the growth and development of the fetus. The maternal diet directly influences the health outcomes of both the mother and the baby, making dietary choices during pregnancy very important. While veganism offers numerous health benefits, including reducing the risk of type 2 diabetes and heart disease (1), adhering to a strict vegan diet during pregnancy presents unique challenges in meeting essential nutrient requirements and can become very dangerous to both mother and fetus. A study on vegan pregnant women published in 2023 found that most women included in the study were missing essential nutrients found in animal products (2).

Below, we outline the nutrients that are more difficult to obtain on a vegan diet that are particularly important during pregnancy. We also detail potential benefits of maintaining a vegan diet while pregnant and offer tips for ensuring a nutritious vegan diet.

Critical Nutrients Hard to Obtain on a Vegan Diet

Several essential nutrients crucial for a healthy pregnancy may be challenging to obtain solely from a vegan diet. Moreover, certain nutrients found in plant foods may have low bioavailability or exist in forms that the body struggles to absorb efficiently. Understanding these nutrient gaps is paramount for pregnant women adhering to a vegan lifestyle. Detailed below are some of the most common nutrients that may be difficult to obtain on a vegan diet that could have implications in pregnancy.

Protein

Protein is a macronutrient essential for the growth and repair of tissues, synthesis of enzymes and hormones, and overall cellular function (3). Protein requirements increase during pregnancy to support the growth and development of the placenta, fetus, and maternal tissues. Insufficient protein intake may impede fetal growth and increase the risk of complications such as low birth weight or preterm birth (4).

Animal products such as meat, poultry, fish, and eggs are rich sources of complete proteins, though vegan diets can also provide some protein. Legumes, tofu, seitan, nuts, and seeds are vegan sources of protein, though special attention and planning should be taken to meet daily protein needs as these sources have less protein than animal products. Pregnant women who choose to follow a vegan diet should prioritize a variety of protein-rich plant foods to meet the increased demand of protein during pregnancy.

Vitamin B12

Vitamin B12, primarily found in animal products, is critical for neurological function, red blood cell production, and energy metabolism (5). During pregnancy, vitamin B12 plays a critical role in fetal brain development, nerve function, and the prevention of birth defects. Deficiency can lead to neurological impairments, miscarriage, preterm birth, and neural tube defects (6). Since vitamin B12 is almost exclusively found in animal-derived foods, vegan pregnant women are at risk of deficiency and should ensure adequate intake through supplements or fortified foods. Regular monitoring of vitamin B12 levels during pregnancy are essential for maintaining optimal maternal and fetal health. Click here to read more about the science behind vitamin B12.

Omega-3 Fatty Acids

Omega-3 fatty acids, particularly docosahexaenoic acid (DHA), play a pivotal role in fetal brain and eye development and immune function (7). During pregnancy, omega-3 fatty acids are transferred from the mother to the fetus, emphasizing the importance of maternal dietary intake for optimal fetal development (8). Adequate omega-3 intake while pregnant may reduce the risk of preterm birth, low birth weight, and postpartum depression (9).

While plant-based sources of omega-3 fatty acids exist such as seeds and walnuts, supplementation with algae-based DHA supplements may be necessary to ensure adequate intake during pregnancy. More information about how to get enough omega-3s on a plant-based or vegan diet can be found here.

Iron

Iron is an essential mineral vital for oxygen transport and energy production (10). During pregnancy, iron requirements increase to support maternal blood volume expansion, fetal growth, and placental development (11). Iron deficiency during pregnancy can lead to maternal anemia, preterm birth, low birth weight, and impaired fetal iron stores (12).

Non-heme iron is the predominant type of iron in plant-based sources, which is less bioavailable and less easily absorbed by the body than heme iron found in animal foods (13). Non-heme iron is bound to compounds such as phytates and oxalates which can inhibit iron’s absorption. Non-heme iron is present in foods such as lentils, beans, spinach, tofu, and tempeh, but individuals must keep in mind that the iron in these foods may not be easily absorbed. Thus, pregnant women following a vegan diet need to ensure adequate intake of iron-rich plant foods and may consider strategies to enhance iron absorption, such as consuming vitamin C-rich foods alongside iron sources or considering iron supplementation (14).

Calcium

Calcium, essential for bone formation and muscle function, plays a critical role in fetal skeletal development, maternal bone health, and the prevention of pregnancy-related complications such as preeclampsia (15). Calcium deficiency during pregnancy may increase the risk of maternal bone loss, hypertension, and cause impaired fetal bone mineralization (16).  

Vegan pregnant women can obtain calcium from plant-based sources such as fortified plant milks, tofu, tempeh, and leafy green vegetables. As with other essential nutrients, meeting calcium needs during pregnancy may require careful dietary planning or calcium supplementation.

Vitamin D

Vitamin D is primarily synthesized within the body through exposure to sunlight, but can also be obtained from dietary supplements and, in lesser amounts, from food (17). Vitamin D deficiency, prevalent among the general population in the United States, poses additional concerns for pregnant women, especially those following plant-based diets. Adequate vitamin D intake is essential for optimal bone health, immune function, and fetal development (18).

Inadequate intake during pregnancy may increase the risk of gestational diabetes, preeclampsia, preterm birth, and impaired fetal bone mineralization (19). While sunlight exposure can stimulate vitamin D synthesis in the body, factors such as season, location, skin pigmentation, and sunscreen can impact vitamin D production (20). Therefore, vitamin D supplements are commonly recommended for pregnant women.

Choline

Choline is an essential nutrient critical for various physiological functions including brain development and neurotransmitter synthesis (21). During pregnancy, adequate choline intake is crucial for fetal neurodevelopment and cognitive function. Research suggests that choline plays a vital role in preventing neural tube defects and supporting optimal brain development in the fetus (22). The highest food sources of choline include animal-based products such as eggs and meat, and therefore vegan diets may pose challenges in meeting choline requirements, especially during pregnancy.

Zinc

Zinc is an essential mineral involved in numerous processes including cell growth, immune function, and DNA synthesis (23). During pregnancy, zinc plays a critical role in supporting fetal growth and development, as well as supporting maternal immune health. Zinc deficiency during pregnancy has been associated with prolonged labor and increased risk of preterm birth (24). Zinc deficiency can also compromise maternal immune function and increase susceptibility to infections (25).

Zinc is present in both animal and plant-based products, though plant-based sources of zinc are more difficult to absorb due to the presence of phytates and fiber, which can inhibit zinc absorption (26). Plant-based sources of zinc include legumes, nuts, and seeds, and employing cooking methods like soaking or sprouting can reduce phytate content and help enhance zinc bioavailability.

Iodine

Iodine is important for thyroid hormone synthesis, metabolism regulation, and fetal brain development (27). Iodine intake during pregnancy is crucial to support maternal thyroid function and prevent iodine deficiency in offspring. Deficiency during pregnancy can lead to poor infant growth, neurodevelopmental delays, and impaired cognitive function (28).

As iodine is naturally abundant in seafood and dairy products, vegan diets may lack reliable sources of iodine. Pregnant women following a vegan diet should prioritize iodine-rich plant foods such as seaweed and iodized salt to meet their daily requirements.

Potential Benefits of Veganism During Pregnancy

Despite the challenges associated with meeting nutrient requirements while plant-based, veganism during pregnancy can offer several potential benefits:

An Increased Intake of Fruits and Vegetables: Fruits and vegetables are staples of the vegan diet and can provide essential vitamins, minerals, and phytonutrients crucial for maternal and fetal health. The abundance of antioxidants and phytochemicals found in plant-based foods may confer protective benefits against oxidative stress and inflammation, potentially reducing the risk of pregnancy complications (29).

Increase in Fiber: Vegan diets are typically high in dietary fiber such as whole grains, legumes, fruits, and vegetables. During pregnancy, adequate fiber intake can alleviate issues such as constipation and hemorrhoids, which are prevalent among expectant mothers. Fiber-rich foods also support a healthy gut microbiome, which plays a crucial role in immune function and nutrient absorption (30).

Reduced Saturated Fat and Cholesterol Intake: Vegan diets inherently contain lower amounts of saturated fats and cholesterol compared to diets rich in animal products (31). Lowering intake during pregnancy may contribute to a reduced risk of gestational diabetes and hypertension (32). By prioritizing plant-based sources of fats such as nuts, seeds, and avocados, vegan pregnant women can promote cardiovascular health and optimal fetal development.

Tips To Optimize Maternal Nutrition When Vegan

To optimize maternal and fetal nutrition while adhering to a vegan lifestyle, consider the following tips:

Plan well-balanced meals that incorporate a diversity of plant-based foods, including fruits, vegetables, whole grains, legumes, nuts, and seeds. Emphasize variety to ensure adequate intake of essential nutrients, including protein, iron, calcium, and zinc.

Supplement as needed to fill nutrient gaps that may arise from the absence of animal products in the diet. Consult with a healthcare professional to determine appropriate supplementation based on individual needs and dietary preferences.

Regularly monitor nutrient levels through blood tests and identify potential deficiencies.

Consider seeking guidance from a registered dietitian or nutritionist with expertise in plant-based diets to navigate the complexities of veganism during pregnancy effectively. Collaborative efforts between healthcare professionals and pregnant women can ensure optimal maternal and fetal health outcomes throughout the pregnancy journey.

Conclusion

While veganism offers numerous health benefits and aligns with principles of sustainability and ethical consumption, maintaining a vegan diet during pregnancy requires careful attention. By adopting a well-planned approach, incorporating diverse plant-based foods, and seeking professional guidance, vegan pregnant women can navigate these unique challenges while prioritizing maternal and fetal health. Informed decision-making and proactive management of nutritional needs are fundamental for promoting a safe and healthy pregnancy.

Interested in learning more about plant-based diets? Read about a scientist's tips to a well balanced plant-based diet.

References

1. McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017 May;14(5):342-354. doi: 10.11909/j.issn.1671-5411.2017.05.009. PMID: 28630614; PMCID: PMC5466941.
2. Godfrey KM, Titcombe P, El-Heis S, Albert BB, Tham EH, Barton SJ, Kenealy T, Chong MF, Nield H, Chong YS, Chan SY, Cutfield WS; NiPPeR Study Group. Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial. PLoS Med. 2023 Dec 5;20(12):e1004260. doi: 10.1371/journal.pmed.1004260. PMID: 38051700; PMCID: PMC10697591.
3. Jäger R, Kerksick CM, Campbell BI, Cribb PJ, Wells SD, Skwiat TM, Purpura M, Ziegenfuss TN, Ferrando AA, Arent SM, Smith-Ryan AE, Stout JR, Arciero PJ, Ormsbee MJ, Taylor LW, Wilborn CD, Kalman DS, Kreider RB, Willoughby DS, Hoffman JR, Krzykowski JL, Antonio J. International Society of Sports Nutrition Position Stand: protein and exercise. J Int Soc Sports Nutr. 2017 Jun 20;14:20. doi: 10.1186/s12970-017-0177-8. PMID: 28642676; PMCID: PMC5477153.
4. Mousa A, Naqash A, Lim S. Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence. Nutrients. 2019 Feb 20;11(2):443. doi: 10.3390/nu11020443. PMID: 30791647; PMCID: PMC6413112.
5. Finkelstein JL, Layden AJ, Stover PJ. Vitamin B-12 and Perinatal Health. Adv Nutr. 2015 Sep 15;6(5):552-63. doi: 10.3945/an.115.008201. PMID: 26374177; PMCID: PMC4561829.
6. Rogne T, Tielemans MJ, Chong MF, Yajnik CS, Krishnaveni GV, Poston L, Jaddoe VW, Steegers EA, Joshi S, Chong YS, Godfrey KM, Yap F, Yahyaoui R, Thomas T, Hay G, Hogeveen M, Demir A, Saravanan P, Skovlund E, Martinussen MP, Jacobsen GW, Franco OH, Bracken MB, Risnes KR. Associations of Maternal Vitamin B12 Concentration in Pregnancy With the Risks of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis of Individual Participant Data. Am J Epidemiol. 2017 Feb 1;185(3):212-223. doi: 10.1093/aje/kww212. PMID: 28108470; PMCID: PMC5390862.
7. Devarshi PP, Grant RW, Ikonte CJ, Hazels Mitmesser S. Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain Development in Gestational Diabetes and Preeclampsia. Nutrients. 2019 May 18;11(5):1107. doi: 10.3390/nu11051107. PMID: 31109059; PMCID: PMC6567027.
8. Coletta JM, Bell SJ, Roman AS. Omega-3 Fatty acids and pregnancy. Rev Obstet Gynecol. 2010 Fall;3(4):163-71. PMID: 21364848; PMCID: PMC3046737.
9. Cetin I, Carlson SE, Burden C, da Fonseca EB, di Renzo GC, Hadjipanayis A, Harris WS, Kumar KR, Olsen SF, Mader S, McAuliffe FM, Muhlhausler B, Oken E, Poon LC, Poston L, Ramakrishnan U, Roehr CC, Savona-Ventura C, Smuts CM, Sotiriadis A, Su KP, Tribe RM, Vannice G, Koletzko B; Clinical Practice Guideline on behalf of Asia Pacific Health Association (Pediatric-Neonatology Branch), Child Health Foundation (Stiftung Kindergesundheit), European Academy of Paediatrics, European Board & College of Obstetrics and Gynaecology, European Foundation for the Care of Newborn Infants, European Society for Paediatric Research, and International Society for Developmental Origins of Health and Disease. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM. 2024 Feb;6(2):101251. doi: 10.1016/j.ajogmf.2023.101251. Epub 2023 Dec 7. PMID: 38070679.
10. Sangkhae V, Fisher AL, Wong S, Koenig MD, Tussing-Humphreys L, Chu A, Lelić M, Ganz T, Nemeth E. Effects of maternal iron status on placental and fetal iron homeostasis. J Clin Invest. 2020 Feb 3;130(2):625-640. doi: 10.1172/JCI127341. PMID: 31661462; PMCID: PMC6994143.
11. Brannon PM, Taylor CL. Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy. Nutrients. 2017 Dec 6;9(12):1327. doi: 10.3390/nu9121327. PMID: 29210994; PMCID: PMC5748777.
12. Abu-Ouf NM, Jan MM. The impact of maternal iron deficiency and iron deficiency anemia on child's health. Saudi Med J. 2015 Feb;36(2):146-9. doi: 10.15537/smj.2015.2.10289. PMID: 25719576; PMCID: PMC4375689.
13. Haider LM, Schwingshackl L, Hoffmann G, Ekmekcioglu C. The effect of vegetarian diets on iron status in adults: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2018 May 24;58(8):1359-1374. doi: 10.1080/10408398.2016.1259210. Epub 2017 Jul 5. PMID: 27880062.
14. Hunt JR. Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr. 2003 Sep;78(3 Suppl):633S-639S. doi: 10.1093/ajcn/78.3.633S. PMID: 12936958.
15. Kumar A, Kaur S. Calcium: A Nutrient in Pregnancy. J Obstet Gynaecol India. 2017 Oct;67(5):313-318. doi: 10.1007/s13224-017-1007-2. Epub 2017 May 22. PMID: 28867880; PMCID: PMC5561751.
16. Tihtonen K, Korhonen P, Isojärvi J, Ojala R, Ashorn U, Ashorn P, Tammela O. Calcium supplementation during pregnancy and maternal and offspring bone health: a systematic review and meta-analysis. Ann N Y Acad Sci. 2022 Mar;1509(1):23-36. doi: 10.1111/nyas.14705. Epub 2021 Nov 15. PMID: 34780069; PMCID: PMC9298950.
17. Holick MF, Chen TC, Lu Z, Sauter E. Vitamin D and skin physiology: a D-lightful story. J Bone Miner Res. 2007 Dec;22 Suppl 2:V28-33. doi: 10.1359/jbmr.07s211. PMID: 18290718.
18. Kaushal M, Magon N. Vitamin D in pregnancy: A metabolic outlook. Indian J Endocrinol Metab. 2013 Jan;17(1):76-82. doi: 10.4103/2230-8210.107862. PMID: 23776856; PMCID: PMC3659910.
19. Mithal A, Kalra S. Vitamin D supplementation in pregnancy. Indian J Endocrinol Metab. 2014 Sep;18(5):593-6. doi: 10.4103/2230-8210.139204. PMID: 25285272; PMCID: PMC4171878.
20. Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol. 2013 Jan 1;5(1):51-108. doi: 10.4161/derm.24494. PMID: 24494042; PMCID: PMC3897598.
21. Ueland PM. Choline and betaine in health and disease. J Inherit Metab Dis. 2011 Feb;34(1):3-15. doi: 10.1007/s10545-010-9088-4. Epub 2010 May 6. PMID: 20446114.
22. Caudill MA. Pre- and postnatal health: evidence of increased choline needs. J Am Diet Assoc. 2010 Aug;110(8):1198-206. doi: 10.1016/j.jada.2010.05.009. PMID: 20656095.
23. Saper RB, Rash R. Zinc: an essential micronutrient. Am Fam Physician. 2009 May 1;79(9):768-72. PMID: 20141096; PMCID: PMC2820120.
24. Chaffee BW, King JC. Effect of zinc supplementation on pregnancy and infant outcomes: a systematic review. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1(0 1):118-37. doi: 10.1111/j.1365-3016.2012.01289.x. PMID: 22742606; PMCID: PMC3787719.
25. Agedew E, Tsegaye B, Bante A, Zerihun E, Aklilu A, Girma M, Kerebih H, Wale MZ, Yirsaw MT. Zinc deficiency and associated factors among pregnant women's attending antenatal clinics in public health facilities of Konso Zone, Southern Ethiopia. PLoS One. 2022 Jul 7;17(7):e0270971. doi: 10.1371/journal.pone.0270971. PMID: 35797387; PMCID: PMC9262205.
26. Foster M, Chu A, Petocz P, Samman S. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J Sci Food Agric. 2013 Aug 15;93(10):2362-71. doi: 10.1002/jsfa.6179. Epub 2013 May 29. PMID: 23595983.
27. Lee SY, Pearce EN. Reproductive endocrinology: Iodine intake in pregnancy--even a little excess is too much. Nat Rev Endocrinol. 2015 May;11(5):260-1. doi: 10.1038/nrendo.2015.28. Epub 2015 Feb 24. PMID: 25707780; PMCID: PMC4590285.
28. Skeaff SA. Iodine deficiency in pregnancy: the effect on neurodevelopment in the child. Nutrients. 2011 Feb;3(2):265-73. doi: 10.3390/nu3020265. Epub 2011 Feb 18. PMID: 22254096; PMCID: PMC3257674.
29. Pistollato F, Sumalla Cano S, Elio I, Masias Vergara M, Giampieri F, Battino M. Plant-Based and Plant-Rich Diet Patterns during Gestation: Beneficial Effects and Possible Shortcomings. Adv Nutr. 2015 Sep 15;6(5):581-91. doi: 10.3945/an.115.009126. PMID: 26374180; PMCID: PMC4561836.
30. Ioniță-Mîndrican CB, Ziani K, Mititelu M, Oprea E, Neacșu SM, Moroșan E, Dumitrescu DE, Roșca AC, Drăgănescu D, Negrei C. Therapeutic Benefits and Dietary Restrictions of Fiber Intake: A State of the Art Review. Nutrients. 2022 Jun 26;14(13):2641. doi: 10.3390/nu14132641. PMID: 35807822; PMCID: PMC9268622.
31. Key TJ, Papier K, Tong TYN. Plant-based diets and long-term health: findings from the EPIC-Oxford study. Proc Nutr Soc. 2022 May;81(2):190-198. doi: 10.1017/S0029665121003748. Epub 2021 Oct 27. PMID: 35934687; PMCID: PMC7613518.
32. Khaire A, Wadhwani N, Madiwale S, Joshi S. Maternal fats and pregnancy complications: Implications for long-term health. Prostaglandins Leukot Essent Fatty Acids. 2020 Jun;157:102098. doi: 10.1016/j.plefa.2020.102098. Epub 2020 Apr 21. PMID: 32380367.