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Beyond protein: Nutritional considerations when you

Beyond protein: Nutritional considerations when you're vegetarian or vegan and pregnant

8 min read

Vegan and vegetarian eaters, you probably already have protein on your radar. But did you know there are other nutrients that are harder to get from plant-based foods? Here, we'll dive into the food sources below that you should prioritize when you're pregnant.

Ultimately, a prenatal supplement that includes each of these nutrients can help you build up the reserves you need in your body to support a healthy vegetarian or vegan pregnancy. The Modern Fertility Prenatal Multivitamin includes all of the nutrients we talk about in this article, in doses that complement what you're already getting from what you eat.

TL;DR

From preconception through the first, second, and third trimesters, and all the way through lactation (whether or not you're breastfeeding/chestfeeding), vegans and vegetarians likely need to supplement with iron, zinc, omega-3 fatty acids, vitamin D, choline, and vitamin B12.

  • Iron: 27 mg per day during pregnancy.
  • Zinc: 11 mg per day during pregnancy.
  • Choline: 450 mg per day during pregnancy.
  • Omega-3 fatty acids: 1.4 g per day of total omega-3 fats during pregnancy, at least 200 mg of which should be DHA.
  • Vitamin B12: 450 mcg per day during pregnancy.
  • Vitamin D3: 600 IU per day from preconception through pregnancy. If deficiency is detected, higher doses, between 1,000-2,000 IU per day, are needed to replete your vitamin D stores.

Now that you've got the need-to-know bullet points for each nutrient, let's jump into the specifics.

Vegans and vegetarians need nearly 2x more iron than meat-eaters

Iron is a mineral essential to the formation of red blood cells.* During pregnancy, your blood volume expands by 50%, on average, to support the transfer of oxygen and nutrients across the placenta. Accordingly, pregnancy increases your iron needs by about 50%.

The American College of Obstetricians and Gynecologists (ACOG), the leading body of OB-GYNs, recommends adults with ovaries get at least 18 milligrams (mg) per day of iron preconception, and increase that amount to 27 mg per day when expecting.

These are some of the plant-based iron-rich foods (and the amount of iron per serving):

  • Fortified breakfast cereal (18 mg)
  • White beans (8 mg)
  • Lentils (3 mg)
  • Spinach and other green leafy vegetables (3 mg)
  • Tofu (3 mg)
  • Other beans (1-2 mg)

(Note that most wheat-based products like bread and cereal are iron-fortified foods. However, the same cannot be said for most gluten-free cereals. If you’re gluten-free, cereals are not a reliable source of iron.)

The challenge is that most of the iron in our food is not readily bioavailable — meaning it bypasses absorption and gets flushed down the toilet. For vegetarian and vegan eaters, the challenge of getting enough iron from food alone is nearly insurmountable. The reduced absorbability of non-heme iron (the form found in plant-based sources) means you need to eat nearly twice as much iron as you would with heme iron (the form found in meat sources). For many, taking an iron supplement is the easiest way to ensure you’re meeting your iron needs.*

The Modern Fertility Prenatal Multivitamin includes an easier-on-the-stomach form of iron called ferrous bisglycinate: Research shows that ferrous fumarate and ferrous sulfate lead to the most GI symptoms, while ferrous bisglycinate leads to the fewest.*

Boosting your iron absorption

Whether taking a food-first approach, supplementing, or both, there are a few key steps to boost your iron absorption:

  1. Pair iron with vitamin C.
    • If you’re taking a prenatal vitamin with iron, make sure that supplement also includes vitamin C (aka ascorbic acid).
    • Add vitamin-C rich vegetables and fruits to your meal, like tomatoes, bell peppers, strawberries, or oranges.
  2. Separate iron from calcium and caffeine.
    • Calcium, whether in a supplement or calcium-rich foods (like fortified dairy and soy products), can limit iron absorption.
    • Similarly, tannins found in coffee and tea can also block absorption of iron. If taking an iron supplement, do so at least an hour apart from calcium and caffeine.

Vegetarians and vegans need about 50% more zinc

While zinc is essential for immune function, it also has countless other roles — including support of healthy estrogen and progesterone levels.* During pregnancy, zinc’s participation in DNA synthesis and cell division makes it an invaluable player for a developing fetus.* Interestingly, zinc is also required for the formation of the sense of taste and smell.*

For people with ovaries, the daily need for zinc increases from 8 mg to 11 mg per day for pregnancy. Since zinc is found in a wide variety of foods, including some veggies, it’s not commonly listed as a nutrient of concern. Vegetarians and vegans, however, need to get in about 50% more zinc due to the limited bioavailability in plant-based sources. For many, the easiest route is to ensure you’re getting enough is to choose a prenatal vitamin that includes zinc. It's for this reason that the Modern Fertility Prenatal Multivitamin includes zinc.

Here are some of the plant-based sources of zinc (and their amount of zinc per serving):

  • Beans (2.9 mg)
  • Fortified cereals (2.8 mg)
  • Cashews (1.6 mg)
  • Chickpeas (1.3 mg)
  • Almonds (0.9 mg)

Soaking and sprouting improves the absorbability of minerals

If you have the time before hitting the kitchen, try soaking dried beans and whole grains in water before cooking. Ideally, soak them overnight, drain the water, then let them sit until they sprout. This process breaks down the phytic acid, freeing up zinc and other minerals.

Plant-based sources of omega-3s are scarce, so look for an algal DHA supplement

Omega-3s are a type of fat that comprises the outer membrane of each cell in the body, and they're the primary building block of a developing fetus’ eyes and brain.* In our food, omega-3s come in three forms: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). DHA is the primary ingredient for fetal brain and eye development.* ACOG recommends 1.4 grams (g) per day of omega-3s during pregnancy — and 200 mg of that specifically from DHA supplements.

Most of the food sources of omega-3s are fatty cold-water fish (like salmon, sardines, and mackerel), but you can meet your DHA needs by going directly to the source and taking an algal-based DHA supplement. The Modern Fertility Prenatal Multivitamin includes algal DHA instead of fish-based omega-3s to keep their formulation vegetarian. (Heads up: Modern Fertility's supplier uses soy and milk proteins to extract DHA from algae, so it's the algal DHA is not vegan.)

The following foods provide the ALA form of omega-3, but the ALA must first be converted to EPA and then to DHA before it can be utilized:

  • Walnuts
  • Chia seeds
  • Flaxseed
  • Soybean oil
  • Flaxseed oil
  • Canola oil

The conversion process for ALA is so inefficient that ALA-rich seeds and nuts are not a reliable source of the DHA — and, remember, it’s the DHA that’s most strongly associated with fetal brain and eye development.*

Prenatals with choline can bridge dietary intake gaps among vegans*

Like folate (aka folic acid), the B-vitamin choline is essential for baby-to-be’s neurological development — as well as cognitive function.* ACOG recommends 450 mg of choline per day during pregnancy.

The best food sources of choline are liver and egg yolks. Since neither of those are plant-based foods, supplementation is the way to go if you are a vegan eater. For vegetarians, you can achieve your choline intake by eating three to four eggs per day. If that’s more egg than you care to eat, supplementation is your best bet.  

Interestingly, few prenatal vitamins provide choline — one 2016 study found that out of the top 25 prenatal vitamins available, only around one-third contained the nutrient. Because of choline's importance, the Modern Fertility Prenatal Multivitamin is one of the few prenatal vitamins that does include it.

ACOG recommends all vegetarians and vegans supplement their vitamin B12 intake

Also known as cobalamin, vitamin B12 comes into play for hundreds of reactions throughout the body — everything from red blood cell formation, to nerve transmission, to DNA synthesis, to protein and fat metabolism.* ACOG suggests adults with ovaries take in 2.6 micrograms (mcg) per day of vitamin B12 during pregnancy.

Plant-based sources of B12 (and the amount per serving):

Getting your daily B12 is not a concern for most omnivorous eaters, since animal products are really good sources for the nutrient. However, for the vegetarians among us, even though eggs and dairy provide vitamin B12, deficiency is still a significant concern. An estimated 20%-40% of pregnant vegetarians do not get enough vitamin B12, and that's significantly higher among vegans. Because of this, ACOG recommends that all vegetarians and vegans take B12 supplements during pregnancy. You can get your daily dose of vitamin B12 from the Modern Fertility Prenatal Multivitamin.

Most people (vegetarian, vegan, or omnivore) are vitamin D deficient

Vitamin D is essential for calcium absorption, bone health, immune response, blood sugar regulation, and more.* ACOG recommends 600 international units (IUs) of vitamin D during pregnancy. That said, it's widely established that vitamin D deficiency is rampant in the northern hemisphere: By some estimates, far more than half of the adults in the US are low in vitamin D. In a committee opinion (reaffirmed in 2017), ACOG upped their recommendation for pregnant women with vitamin D deficiency to 1,000-2,000 IU per day in order to reverse that.

The best foods for vitamin D are fatty fish (conveniently, the same fish rich in omega-3 fats, like salmon), egg yolks, cheese, and fortified dairy products. For vegans and vegetarians, some mushrooms also provide vitamin D, although how much varies wildly. (Some mushrooms are treated with UV light to increase their vitamin D levels.)

When selecting a supplement, D3 (aka cholecalciferol) is the way to go because it's the ready-to-absorb form of vitamin D. D3 — versus D2 (aka ergocalciferol) — bypasses a cumbersome conversion process in your liver and kidneys. The Modern Fertility Prenatal Multivitamin has you covered with a dose of vitamin D3 packed into each capsule.

Vitamin D and fat-solubility

Another important consideration is that vitamin D is fat-soluble, meaning some fat in your meal is required for absorption. In practical terms, this means you’ll absorb less vitamin D in nonfat yogurt than you would from the whole milk variety. For the vegans among us, this means cooking your mushrooms in olive oil or avocado oil to reap those vitamin D benefits.

Summing it all up

If you primarily eat plant foods, it'll be trickier to get certain nutrients recommended for a healthy pregnancy — iron, zinc, omega-3 fatty acids, vitamin D, choline, and vitamin B12 — from what you eat. A prenatal supplement with these nutrients (like the Modern Fertility Prenatal Multivitamin) can help you bridge that nutritional gap between what you're getting from food and the levels you need during pregnancy. If you're wondering about the nutritional intake of your regular meal plan, you can always talk to your healthcare provider or dietitian (if you have one).

The Modern Fertility Prenatal Multivitamin

If you're prepping your body for pregnancy or you're already pregnant, the Modern Fertility Prenatal Multivitamin is a science-backed way to get those essential nutrients (including ones that are most important for vegetarians and vegans) on board.

The Prenatal Multi:

  • Is packed with 12 essential nutrients recommended by OB-GYNs
  • Was designed for before, during, and after pregnancy
  • Is easy to digest to keep your tummy happy
  • Comes with a reusable glass jar to keep your subscription sustainable
  • Is vegetarian, gluten-free, and has zero preservatives

Start prepping your body now for pregnancy whenever with the Modern Fertility Prenatal Multivitamin.

P.S. Here's a sample one-day meal plan to help you meet your nutritional needs during pregnancy:

For vegetarians:


Breakfast: Spinach, mushroom, and cheese omelet with a side of fruit and whole-grain toast


Snacks: 

  • Nuts (like walnuts and cashews)
  • Nut butter with fruit and toast
  • Crunchy edamame

Lunch: Black bean/quinoa burger with greens and sweet potatoes


Dinner: Spinach lasagna with a side salad

For vegans:


Breakfast: Tofu, spinach, and mushroom scramble with a side of fruit and whole-grain toast


Snacks: 

  • Nuts (like walnuts and cashews)
  • Nut butter with fruit and toast
  • Crunchy edamame

Lunch: Tofu and nori salad with a side of miso-noodle soup


Dinner: Spaghetti with vegan cheese sauce (from nutritional yeast), mushrooms, and a side of veggies

Plus, a prenatal vitamin to help you fill in your nutritional gaps.*



*This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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Anna Bohnengel, MS, RD, LD

Anna, MS, RD, LD is co-founder of Alavita Nutrition. With clinical training from the NIH, she teaches women how to nourish themselves so they can take control of their health. alavitanutrition.com

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