The Best Vegan Diet and Nutrition Pregnancy Resources

The Importance of Diet During Pregnancy

While there is a lot of pressure on vegan mothers to eat well during pregnancy, this pressure is not unique to vegan women. All women need to reevaluate their diets when pregnant to make sure that they are getting enough of what they need. Both pregnancy and breastfeeding are very physically taxing on the body. You can imaging that if you were going to begin an intense muscle-building program you would probably need to change your diet. Well, you are going to begin an intense muscle-building program…along with building bones, ligaments, organs, and all the other tissues that make up a human being!

Talking to your Prenatal Medical Provider

It is important to find a medical practitioner who is supportive of your vegan diet. I would definitely look for someone who knows or is willing to learn what a vegan is and is comfortable with it. Sometimes I explain that “I am a strict vegetarian and eat no animal products” to doctors who are unfamiliar with the term “vegan.” Anyone can understand what a strict vegetarian is, and vegetarianism is generally more known and accepted than veganism.

I wouldn’t necessarily expect your medical practitioner to understand the ins and outs of vegan nutrition. For instance, he or she may not be aware that B12 deficiency is a concern to vegans or that omega 3 fatty acids are rare in a vegan diet and that vegans must take care to supplement with both. If you become anemic during your pregnancy, which is relatively common, your practitioner may not test to see whether it stems from iron deficiency or B vitamin deficiency. You may need to do some research on your own and remind your doctor to request appropriate tests.

My experience with doctors is that they are generally neutral or supportive of veganism, as long as I have presented my choice with confidence backed up by information. Showing a lack of confidence in one’s diet, while completely normal for any pregnant woman, encourages doctors to give you their standard advice to eat according to the FDA food guide, which is not appropriate for vegetarians. Having information from a reliable source like the American Dietetic Association – a source that doctors and nutritionists trust – can be invaluable when talking to your doctor. You could also make a copy of the chapter on pregnancy from Becoming Vegan and bring it in to an appointment to discuss.

I recommend asking specific rather than open-ended questions. For instance, rather than the very open-ended “What should I eat?”, instead ask “How can I get enough protein from plant foods?” or “I am having trouble including enough sources of calcium in my diet. What are some high-calcium vegan foods I can eat?” or “I lead a very busy life and rarely have time to make myself a lunch. Do you have any tips on buying a healthy lunch?”

I’ve read about other vegan women online who recommend not bringing up your diet with your doctor. I do not recommend this. Since your fetus/baby is living entirely off of your body’s resources, a healthy diet and exercise are probably the two most important factors in any pregnancy. Lies by omission to your medical provider prevent him or her from offering you the best care possible.

It Can Be Difficult to Make Dietary Changes

I have been a vegan for about 10 years now, and I tend to eat a very low-fat, low-sugar, high-fiber diet. I was very surprised when I started looking closely at my average intake of specific nutrients after I became pregnant. I had no idea that my diet was so low in protein and iron! Like most people, my husband and I have 5-10 standard dinners that we make 95% of the time. When I realized that many of our standards, while tasty, were not supplying enough nutrition during pregnancy, it was quite a hassle to find new recipes we both liked and wanted to eat regularly.

Food aversions can make this process even harder. I was very averse to garlic and onions until about 20 weeks into my pregnancy, and those formed the base for most of the dishes we usually made.

Despite being being vegan and so looking more closely at ingredients than most people, my husband and I had not before looked closely at the nutritional value of our food, believing the vegan community hype that vegan diets are ideal and combat cancer, heart disease, obesity, diabetes, and other diseases. It was hard for me to get support from friends and family about changing my diet because it meant admitting that the vegan diet I had promoted as very healthy was actually not as healthy as I had thought. I certainly don’t want to give people the idea that it is very difficult to be vegan, but now I also realize that the vegan diet holds more challenges than I had thought.

It is important to make sure that your vegan meal is “balanced.” An easy rule of thumb for lunch and dinner is that your plate should be approximately 1/4 protein such as beans, legumes, seitan, or tofu (containing at least 14g), 1/4 green and yellow vegetables, and 1/2 grains such as brown rice or pasta.

Do Not Assume That Taste Substitutes Are Also Nutritional Substitutes

I think the biggest lie that vegan perpetuate is the idea of meat and dairy “substitutes.” Unfortunately, many vegan meat and dairy substitutes do not contain an equivalent amount of nutrients as the item they are substituting for, and are really only tasty placeholders that can be quite nutritionally empty. For example, what follows is a list of protein values in meat and dairy products (found at the USDA National Nutrient Database) and in the equivalent vegan substitute (found at the various manufacturer websites using the nutrition facts information).

• 79 grams of hard-boiled egg contains 10 g of protein but the same quantity of refrigerated Nasoya organic firm tofu contains just 7 g.
• 14 grams of cheddar cheese contains 4 g of protein but the same quantity of Follow Your Heart Vegan Gourmet cheddar cheese alternative contains no protein at all.
• 2 tablespoons of cream cheese contains 2 g of protein but the same quantity of Tofutti Plain Better Than Cream Cheese imitation cream cheese contains just 1 g.
• 71 grams of broiled frozen ground beef patty contains 16 g of protein but the same quantity of Gardenburger Flame Grilled veggie burger contains just 11 g.
• 1 8-ounce cup of 2% milk contains 8 g of protein but the same quantity of Soy Dream original enriched soymilk has only 7 g and Rice Dream original enriched ricemilk has just 1 g.
• 100 grams of Breyers all natural light vanilla ice cream contains 5 g of protein but the same quantity of It’s So Delicious Purely Decadent Purely Vanilla non-dairy frozen dessert contains just 1 g.
• 1 6-ounce container of lowfat fruit-flavored yogurt contains 7 g of protein while Silk Live! fruit-flavored soy yogurt contains just 4 g.

In other words, you need to eat a larger amount of soy products than meat or dairy products to get the same amount of protein. This doesn’t mean that you can’t get enough protein from a vegan diet, but it does mean that you can’t assume that taste substitutes are also nutritional substitutes and that you pay attention to the protein content of foods to make sure you are getting an adequate intake.

I compared protein values above, but the same comparison can easily be done with iron and calcium. Vegan foods are just not as rich in minerals as meat and dairy foods. Again, that is not a problem if you pay attention to the nutrients in what you eat and/or supplement.

It was sooo frustrating to go through my kitchen and realize that the soy cheese I was piling on added little more than fat and salt to my diet, whereas if I were piling on dairy cheese I would be getting more protein and calcium as well. As an ethical vegan, I would not go back to eating cheese, but I have to say that I was pissed off to find out that all these supposedly vegan-friendly companies and products were giving vegans flavor but stiffing us on the nutrients.

Dietary Areas to Focus On

Pregnant women should eat 3-4 servings of protein a day (at least 1 serving with each meal), with a single serving being 14g. It can be challenging to get that 14g in one meal, but including high-protein vegan foods like seitan and some brands of vegan soy crumbles or strips with each dinner have made it easier. In addition to protein, I have had to focus on getting enough calcium (I started taking a calcium supplement with vitamin D), iron and B12 (now supplied by my Floradix supplement), and omega-3 fatty acids (still figuring out how to integrate this one into my diet consistently).

The other area to focus on is caloric intake. Since most vegan foods are not very calorically dense, it’s important to include some fatty and high-calorie foods like nuts, dried fruits, and avocados, and to make sure that you are getting lots of beans, grains, and root vegetables and a variety of oils. Shakes and smoothies with banana, soy protein powder, flax or canola oil, and fresh or frozen fruit are a great way to bump up the calories and nutrients.

It Can Be Done

A vegan pregnancy can be done, and successfully, but it may take some lifestyle changes. While I went into my pregnancy feeling confident that I could remain vegan and healthy, I was discouraged to find it would take more work than I had originally thought. Now that I have learned a bit more about nutrition and my husband and I have adjusted the way we eat together, it has become easy again. It’s routine now to take our supplements with breakfast and to think about combining calcium with vitamin D or iron with vitamin C to improve absorption. When we talk about what’s for dinner or shop for our lunches, we make sure that each meal includes enough protein.

I feel that the time I have spent researching vegan nutrition and changing my diet during pregnancy will reward me in the long term when I breastfeed and plan meals for my family in the future.

WEB RESOURCES

The American Dietetic Association has a new food guide for North American vegetarians that includes a vegan food guide pyramid. A great resource to print out and give to your prenatal medical provider.
http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/governance_5105_ENU_HTML.htm

The Vegetarian Nutrition Dietetic Practice Group of the American Dietetic Association has a web article on vegetarian diets during pregnancy. Another great resource to print out and give to your prenatal medical provider.
http://www.vegetariannutrition.net/articles/Vegetarian-Diets-During-Pregnancy.php

The Vegetarian Resource Group is the next place to go. They have articles on the vegan diet during pregnancy and lactation and vegan nutrition in pregnancy and childhood, as well as specific articles on getting protein, iron, calcium, and B12 in a vegan diet. They also have the ADA’s food guide in PDF format, which is unavailable through the ADA website unless you are a member.
http://www.vrg.org/nutrition

A great article on high-calorie vegetarian foods is available on the Toronto Vegetarian Association website.
http://veg.ca/content/view/170/112/

VegFamily, the magazine for vegan family living, has an archive of articles on Vegan Pregnancy.
http://www.vegfamily.com/vegan-pregnancy/index.htm

DEVA Nutrition makes a prenatal vitamin formulated specifically for vegans. The website lists online retailers under the distribution link.
http://www.devanutrition.com/vegan_prenatal_multivitamin.html

PRINT RESOURCES

Becoming Vegan: The Complete Guide to Adopting a Healthy Plant-Based Diet by Brenda Davis and Vesanto Melina is the absolute best book on the topic of vegan nutrition, and the only one you will truly need. There is an entire chapter on diet needs during pregnancy, perfect for copying and discussing with your prenatal medical provider. There is also a helpful chart showing how to achieve a high-calorie vegan diet.

Vegetarian Pregnancy by Sharon Yntema has reliable nutrition information, and specifically includes vegan diets.

The Vegetarian Mother’s Cookbook by Cathe Olson has a lot of easy, nutritious recipes if you are looking to eat healthier. Not all are vegan, but most are easily adaptable or include vegan versions.

Note: You do not need Pregnancy Children and the Vegan Diet by Michael Klaper. The information is way out of date and much less useful than that in Becoming Vegan.

VIDEO RESOURCE

Bellydance: Prenatal Fitness & Dance Instruction Program DVD with Naia is a fun way to keep in shape throughout your pregnancy. Unlike most prenatal videos, you do not need any accessories – no weights, balls, blocks, ropes, chairs, or floor mats. Any time I experienced physical discomfort during pregnancy, doing this video helped immensely. Bellydance works on the muscles you need most for pregnancy and delivery.

May Midwife Appointment

Kelly and I went to see Tiffany (my midwife) on Wednesday, and had a good appointment.  I brought a copy of the birth plan that I wrote up, and she looked it over and then added it to my medical files.  I had to take the routine gestational diabetes test, which involves drinking this horrible sugary drink and then having your blood drawn an hour later.  The results were back yesterday morning – I do not have diabetes, but I am anemic.  I have been sporadically taking an iron supplement, but now I will get more serious about it.

Kelly did laundry last night, so first the first time since we bought it last weekend I could use my body pillow (we had to wash the pillowcase).  It was great!  I slept much better than the previous couple of nights.  However, the pillow we got was cheap ($9 at Target) and I can tell that with a few months of use it will get flatter where I wrap my legs around it.  My plan is to fluff it every day and hope that it survives until August, when I will finally be able to sleep on my back again (after giving birth).

Here is the best news: I have gained 16 pounds so far!  Since I was of an average weight prior to pregnancy, I should gain somewhere in the range of 25-35 pounds.  I’ve never been a real gainer and a vegan diet is not that calorically dense, so I was a bit worried about putting on the pounds.  No need to fear, apparently.  My weight gain curve is very encouraging.

Lots of strong moving and kicking from the belly.

Allergy season has begun in force.  I had an allergy attack that was so bad yesterday that I got a nosebleed after sneezing uncontrollably.  Kelly ran out last night to get me the antihistamine recommended by the ACAAI and the AAFP, chlorpheniramine (Chlor-Trimeton).  Taking this before bed is the other reason that I slept so well.  Like Benadryl, it has a sedative effect.  I could take Zyrtec or Claratin, which are both Category B, but obviously they are new enough to the market that effects on fetal health are unknown (there is no controlled human pregnancy drug testing for obvious reasons).  I unfortunately cannot take Patanol eye drops, which I am usually all about (they are Category C), so I will have to clean my eyes with baby shampoo and use hot compresses liberally until the season ends.

I bellydanced again last night.

Allergies to food?

So, I’m vegan, and I am trying to eat as healthily as possible. Kelly and I have actually changed our diet substantially since I became pregnant. For instance, we buy all this whole-grain stuff now instead of more processed grains (whole wheat flour, whole wheat pasta, soba noodles, brown rice). We are also experimenting with more high-protein foods. Last night we cooked with seitan for the first time, and it was a success.

But, I have also been having more heartburn. Pregnancy leads to more heartburn, but if you have a wheat allergy or something, so does eating more whole-wheat foods (I think). Does anyone know how I can go get tested for food allergies? Or should I wait until I am not pregnant any more?

EDIT:

I called the allergist’s office in my medical practice, and they said that they don’t test for food allergies during pregnancy.  This makes sense, because if you end up having a major reaction it might affect the baby or something, or even just lower your general health for a while.  But this also sucks, because what if I am having smallish reactions all the time?  The eight most common food allergies are milk, eggs, fish, shellfish, peanuts, tree nuts, soy, and wheat.  I already don’t eat milk, eggs, fish, or shellfish, and have stopped eating peanut butter since I got pregnant.  I seem to eat tree nuts with impunity, but I have noticed mild reactions to both soy and wheat lately.  But I need those things to be vegan!

Diet plans

It’s been a while, and I have lots to say. The nausea and vomiting have gotten worse in the last few weeks, which is one of the reasons I have not been sending my daily missives out to the world. The other reason is that I have decided to be way more chill about this whole pregnancy thing. I am going to stick with my midwife, Tiffany, and go ahead with thinking about giving birth at the Cambridge Birth Center at least until later in the pregnancy (like, summer).

The biggest concern for me right now is making sure that I am getting enough nutrients. I found this handy chart:

Meal Planning Guidelines for Pregnant Vegetarians

Food Group	Serving size	No of Servings	Comments
Grains	1 slice of bread;1/2 cup cooked cereal, grain or pasta; 3/4 to 1 cup ready-to-eat cereal	7 or more	Choose whole or enriched
Legumes, nuts, seeds, milks	1/2 cup cooked beans, tofu, tempeh; 3 oz of meat analogue; or 2 Tbsp nuts, seeds, nut or seed butter; 1 cup fortified soy milk; 1 cup cow’s milk, 1 cup yogurt) (1 serving protein = 14 g)	5 or more	Calcium-rich foods such as dried beans, calcium-precipitated tofu, calcium-fortified soymilk, cow’s milk, and yogurt should be chosen often. A regular source of vitamin B-12 should be used.
Vegetables	1/2 cup cooked or 1 cup raw	4 or more	Calcium-rich foods such as kale, collard greens, mustard greens, broccoli, and bok choy, should be chosen often.
Fruits	1/2 cup canned fruit or juice or 1 medium fruit	4 or more	Choose calcium rich figs, and fortified juices often.

I have posted before about how disillusioning it can be to actually read the labels of the meat and dairy “substitutes” in one’s vegan kitchen. I have since realized that in order to eat well, I am going to have to make some major changes in eating habits. It is hard to introduce food items into a daily diet when right now I don’t use them at all. Like, 2 Tblsp of flax oil a day seem pretty important, but because most people eat so much fat, social messages about eating tend to say that you should reduce the amount of oil you just pour on your food. Even though the reasons for that restriction in the general obese American population don’t really apply to me as a skinny vegan, I have still paid attention to that message, resulting in less–not better–health. It seems gross and unhealthy to just add oil or nutritional yeast to whatever I’m eating, but it seems that is to be my new, delicious, healthy habit.

I also need to figure out an easy way to cook more than one vegetable at a meal. Like, if I use a lot of pots and we don’t do all the dishes, then the pots are dirty the next day and I don’t make the vegetables. This was the downfall of the “a smoothie a day” plan – we didn’t clean the blender every night, and then the next morning I wouldn’t have time to clean it and make the smoothie as I ran out the door. I also want to retain the most nutrients in the vegetables – I think steaming is more nutritious than boiling, but I don’t have a lot of experience on how you can steam stuff, especially together. Does anyone have a good resource on this or easy ideas about how to get lots of veggies in their diet?

It’s kind of embarrassing to admit, but changing your diet is difficult. My goal this week is to actually make a chart for each day and then fill in what I eat on it. And carry around a half-cup measure for serving size approximations.

Nutrition and acupressure

First, thank God for my girlfriend A. She came over last night and gave me some anti-nausea acupressure wrist bands, and they are really really helping. A lot. I am still nauseous, but only a little bit as opposed to omfg I wanna die. Also, it was just nice of her to come over, since she had to walk.

I am calling all my peeps by a single letter on my blog because I want to preserve their and my anonymity, but on the other hand who cares? I can’t decide on this issue. Input, loyal readers?

I didn’t blog yesterday about my visit with the nutritionist, so I will do it today. First of all, I brought with me the book Becoming Vegan by Davis and Melina, and the nutritionist said that it was a great book and she used it to help me figure out what I should be eating. When I described my typical diet, she said that I am a healthy vegetarian – I guess she sees a lot of people who just eat junk food. She emphasized the following for my diet:

1. I need to be getting 3-4 servings of protein a day, with a single serving being 14 g of protein. She suggested that I eat at least one serving at each meal. For instance, for breakfast I could have a smoothie with protein powder, or some soy yogurt and toast with peanut butter. For lunch I could have some veggie meat, and for dinner I could have beans or legumes.

   Since becoming vegan, I always read the ingredient labels on my food, but I don’t usually read the nutrition facts. This suggestion has focused me on reading the protein content and serving size of my food, and I have found some surprising things. First of all, most dairy substitutes in my kitchen (soy cheese, tofu cream cheese, silken tofu, and soy ice cream) do not have comparable levels of protein as what they are substituting for. You have to eat a lot more tofu than cheddar cheese to get the same amount of protein. Even more disappointing is that the soy cheese (Follow Your Heart brand), tofu cream cheese (Tofutti brand), and soy ice cream (So Delicious brand) have effectively no protein content at all – they are not protein-rich foods. In other words, while these substitutes may fill a hole in my diet in terms of flavor, they do not actually serve as substitutes in terms of nutritional content. Bummer! Soy meat substitutes can have similar drawbacks: for instance, one vegan Flame-Grilled Gardenburger patty has 11 g of protein, but one ground beef patty of comparable size has almost twice as much protein. This doesn’t mean that I can’t get enough protein from a vegan diet, but it does mean that I can’t assume that taste substitutes are also nutritional substitutes. I need to be a lot more careful so I can make sure I get at least 14 g of protein 3 times a day.

2. I need to get enough calcium every day, and it needs to be paired with Vitamin D in order to be absorbed. The nutritionist suggested I eat foods fortified with Vitamins A, D, and calcium, and that I take a calcium supplement that contains Vitamin D. I have been taking Tums, but apparently that is not a good source of calcium because it contains no Vitamin D. She suggested that I eat calcium-rich dark green vegetables, and gave me a list.
3. I should be eating a higher-than-normal calorie diet, which because of the nausea means I need to eat a number of small meals throughout the day. I have always been a little confused by serving sizes – if I am supposed to eat 3 or more servings of fruit a day, how much fruit is that? The nutritionist gave me a list of serving sizes that I can stick on the fridge, and I am hoping to start a food diary so I can see what I am getting and what I am not (Becoming Vegan has a really good example of this). She also gave me a couple of tips about how to figure serving sizes. If I generally use the same bowls at home, I can measure out a serving of fruit or beans or whatever using measuring cups, and then put it in the bowl. After a couple of times, I should be able to know how full the bowl has to be to contain one or two servings of food. Like any system, once I get used to thinking about portions of food in terms of servings, I should be able to calculate how many servings of different food groups I have eaten at a particular meal.
4. The nutritionist also suggested I add more oils such as canola oil, corn oil, and peanut oil to my diet, and said that olive oil alone does not supply what I need in order to maintain digestive health. She suggested I eat avocados, nuts, and other oil-rich foods.
5. We talked about iron and she said that with my prenatal vitamin I should be getting enough iron for the first two trimesters, and might want to consider a supplement in the third trimester.

Anyway, the wrist bands don’t work completely, but a can of ginger ale and a couple of handfuls of oyster crackers later, and somehow I managed not to hurl.

That lemon bar

So, how vegan is vegan?

Food

I believe, along with PETA, that if you eliminate the obvious animal products in your diet (animal flesh, milk, and eggs), you are eliminating 99% of the animal suffering from your diet. Although I do read ingredient labels for animal-derived ingredients such as glycerin, I try not to stress about that last 1%. My rule of thumb for food has always been that if I am really craving something, I can have it. This rule works for me because what inevitably happens is that I try to eat that hamburger, piece of pie, et cetera, and it completely grosses me out.

Prime example: yesterday I went to Diesel, a local cafe that carries some vegan baked goods and makes vegan sandwiches and salads. I got a fantastic sandwich with tofu, hummus, sprouts, tomato, and cucumber on a thick 7-grain bread (it was great!), and then was tempted by the baked goods. Unfortunately, all they happened to have that was vegan was the muffins, which did not sound good. They had a wonderful looking lemon bar, and I decided to “cheat” and go for it – I haven’t been eating a lot of fat or protein lately due to nausea, and figured that a bit of egg couldn’t hurt me. I had a bit of my lemon bar while waiting for my sandwich, and it was horrible! I forgot that the crust would have milk or butter in it, and to my vegan taste buds it tasted spoiled. The eggy smell of the lemon custard was a complete turn-off. I had a second bite to make sure (wishful thinking), and surrendered the rest of the lemon bar to the office piranhas when I got back to work. What a bummer! It’s that kind of thing that keeps me an honest vegan.

Fortunately, K and I went to Grasshopper for our anniversary dinner and had the No Name, a protein-packed wheat gluten dish.

Medicine

I am taking a prenatal vitamin, which I suspect is not even vegetarian, much less vegan. On the other hand, taking the pill daily is part of what gives me the confidence to eat a balanced vegan diet during pregnancy.

I was prescribed a flu shot by the doctor when I became pregnant. They are recommended to all pregnant women, since pregnancy changes the immune system and makes dangerous complications from the flu, such as pneumonia, more likely. When I was given the shot, I was asked if I had any egg allergies because the vaccine is incubated in eggs. Knowing this, I still took the shot.

Or how about my recent intravaginal ultrasound? The lube the technician used may have contained glycerin derived from a vegetable or an animal source, which was not disclosed. I didn’t even ask.

The whole medical industry is based on animal testing and vivisection, and I am sure that pregnancy medicine is no different. Even the statistics and recommendations I read, and the various screenings and tests that are available to me, I have to assume have been at least partially developed as a result of animal exploitation. And at the same time, I don’t want to reject all contact with Western medicine.

Destruction of the Environment

I drive a gas-powered car. I eat prepacked convenience foods and rarely shop in the bulk aisle, and my waste goes directly to the landfill. Much of the produce I buy at the grocery store is not organic and has been shipped across continents by plane, train, and automobile. Our whole society–human society–is based around the assumption that humans can and should use the rest of the natural world and its inhabitant for human uses, and that non-human animals and the environment have no intrinsic value. To really escape living with the consequences of this assumption, you would have to drop out of much of human society.

A Life of Compromise

As a result, most city-dwelling, non-crunchy vegans live lives of compromise. We’ll buy a car, but not one with leather seats. Or, we’ll have the salad, please, even if it comes in a styrofoam container. Or we won’t eat honey but we’ll kill spiders that wander into our houses.

Knowing that being vegan is a compromise, I am occasionally willing to bend the rules dictated by my conscience.

It’s a thorny ethical problem to consider, though, the line between my health and the health of the unnamed animal, especially when it comes to modern medicine.