Are vegan and vegetarian diets safe during pregnancy?
Though they may still be in the minority, people are increasingly turning to vegan or vegetarian diets, whether they don't want to eat animals or animal products, are concerned about the environment, want to improve their health, or all of the above.
But can this diet-choice still be safely adhered to during pregnancy?
Here we consult nutritional therapists Dr Anna Sanniti (previously a geneticist and currently heavily pregnant herself!) and Alexa Mullane, both nutritional advisors to Wiley's Finest.
Are vegan and vegetarian diets during pregnancy safe?
Dr Sanniti says vegetarian and vegan diets can be safe and healthy, if planned for and carried out correctly.
"However, everyone is different and it’s important to take note of how you feel during your pregnancy," she adds.
While Mullane acknowledges the decision to eat meat in pregnancy is a personal choice and there are many reasons why a woman would choose not to, she adds, "In my opinion, it can be a good idea to eat meat and fish in pregnancy because they are so nutrient-dense. Meat and fish contain complete protein and many vitamins and minerals that are essential to the growing baby's health.
"Meat and fish also contain some nutrients that are lacking in a lot of plant-based foods, like Omega 3, pre-formed vitamin A, vitamin B12 and haem iron." That said, as Sanniti indicates, if planned for properly, nutritional deficiencies can likely be combated in vegan and veggie diets. But how?
Important nutritional factors for pregnant vegans and vegetarians
Multivitamins and nutrients
Sanniti says there are several key vitamins and minerals that may be more difficult to obtain through a vegan diet, including vitamin B12, vitamin D, calcium, iron, choline, and omega-3.
"Vegetarians may also find it hard to obtain adequate levels of omega-3 fatty acids," she continues. "Although it’s always best to try and consume these nutrients through food, a good quality pregnancy multivitamin can help to cover any gaps in your nutrition. It’s a good idea to supplement vitamin B12 and vitamin D, along with the recommended levels of folate. I would always recommend a blood test to understand levels of iron, vitamin D, and vitamin B12 before supplementing."
Omega-3 fatty acids
Digging into omega-3 a little deeper, the geneticist-turned-nutritional therapist adds, "The plant-based source of omega-3 is called ALA, which can be obtained through sources such as flaxseed and hemp seed.
"ALA can be converted to EPA and DHA, DHA being essential for foetal and infant brain development. EPA and DHA are found in oily fish such as salmon, mackerel, sardines, and herring. Some people are better at this conversion based on their genetics, but during pregnancy this is likely not adequate.
"Therefore, it is recommended to source a good quality omega-3 supplement [which can be derived from algae oil, the same DHA as found in oily fish, as the fish eat the algae] to meet this need, making sure that is safe during pregnancy."
Look to a high standard of manufacturing and check supplements are from trusted high-quality brands to ensure the oils contain no contaminants, says Dr Sanniti, adding that a suggested amount of DHA is at least 300 mg per day.
Protein
Dr Sanniti also explains vegan and vegetarian women need to ensure they are consuming enough protein for healthy foetal growth. First, it's best to try and achieve this through food.
"It’s easy to obtain enough protein on a well-planned vegan diet," she explains. "Each meal should contain a plant-based source of protein, such as 150g of tofu, tempeh, lentils and other legumes, a handful of nuts and seeds, nut butters, and substituting white rice or pasta for quinoa or brown rice."
However, in some cases, the expert adds, "Pregnant women who may struggle to obtain enough protein due to nausea or food aversions may benefit from a clean good quality protein powder added, for example, to a smoothie or within porridge oats for breakfast. But this is not a substitute for whole-food sources of protein." Both powders and supplements should not be used instead of a well-balanced diet.
Choline, iron, calcium and iodine
To help with deficiencies in choline Dr Sanniti recommends legumes and peanuts as well as cruciferous vegetables such as broccoli and cauliflower. For deficiencies in iron, which isn't just unique to vegan and vegetarian pregnant women, she recommends leafy greens, lentils, and tofu with a source of vitamin C like lemon juice or peppers, which can increase iron absorption.
Plus, she advises, vegans should pay attention to calcium intake, ensuring adequate intake of tofu, legumes, sesame seeds and leafy green veg. Vegans in particular may also be deficient in iodine, primarily found in dairy and eggs. "It is found in seaweed, but in varying amounts therefore is not a reliable source. Vegans and vegetarians should talk to their healthcare provider or nutritional therapist and consider supplementing with iodine," she adds.
Choosing what's best for you and your baby
For Dr Sanniti herself, she says during her time as a strict vegan, she experienced signs of omega-3 deficiency, causing brain fog, anxiety and poor skin health. "Even as a scientist, I was not aware that a vegan diet could cause deficiencies in omega-3 as I was eating plenty of ALA (plant-based) sources of omega-3 such as flaxseeds. However, my conversion to EPA and DHA may have been low."
She now takes omega-3 supplements, either algae or fish-based, and occasionally enjoys a less restrictive plant-based diet to ensure that she "sometimes eats good quality, sustainable sources of fish rich in omega 3 (SMASH fish)".
However, she still believes others who want to can remain entirely vegan if they correct any nutritional problems. "In conclusion, vegan and vegetarian diets can be safe, but more care should be taken to plan and assess the food consumed. Any gaps in nutrition should be supplemented appropriately, with good quality supplements that do not contain fillers, binders, and unnecessary ingredients."
Mullane adds, "If eating meat in pregnancy, it's important to thoroughly cook all meat, fish and shellfish and avoid cured meat. Also avoid eating liver and foods containing liver (like pâté) as too much vitamin A can be harmful to unborn babies."
Always consult a healthcare professional before making any changes to your diet and deciding what's best for you and your baby when pregnant, as everyone is different.
Read more about vegan and vegetarian diets
Is a vegan diet good for your gut health? Experts weigh in (Yahoo Life UK, 6-min read)
Should you go vegan for your health? (Yahoo Life UK, 6-min read)
'I'm an Olympian, pregnancy, periods and body shaming are still barriers we face' (Yahoo Life UK, 9-min read)
Watch: Eight things you need to know about veganism