Live Chat: How to have a healthy pregnancy while eating a plant-based diet

In this Live Chat Sharon and plant-based nutrition expert Kayli Anderson talk about everything you need to know on how to have a healthy pregnancy while eating a plant-based diet. 

I’m so excited to have Registered Dietitian and plant-based nutrition expert, Kayli Anderson on my Live Chat today. She’s a leading aficionado on plant-based nutrition, including vegan diets during pregnancy. She answers some of your top questions on how to have a healthy pregnancy while eating a plant-based diet, including what nutrients you need to get enough of, supplements to take, how to plan a balanced vegan diet during pregnancy, and more. 

Watch our Live Video Chat here, and check out the transcript from our live chat, resources, and one of Kayli’s favorite recipes below. 

Things You Will Learn in This Episode

• Macronutrient and calorie needs during pregnancy
• Important nutrients to pay attention to while eating a plant-based diet during pregnancy
• Supplements you should take in order to have a healthy plant-based pregnancy
• Tips for managing morning sickness
• Foods to avoid during pregnancy
• Benefits of eating plant-based diet during pregnancy

About Kayli

Registered Dietitian Kayli Anderson specializes in supporting women on their wellness journeys. She’s the founder of the site Plant-Based Mavens, a hub for women and the healthcare providers who care for women to get evidence-based guidance on plant-based nutrition and cooking, hormone health, fertility, pregnancy, intuitive eating, and lifestyle medicine. Plant-Based Mavens is inclusive of all types of plant eaters – from plant-curious to vegan – and provides support that is woman-centered and free from diet culture. Join the community at plantbasedmavens.com and access an array of free resources including a Plant-Based Pregnancy Checklist, an Intuitive Eating mini course, and more.

Kayli is Board Certified in Lifestyle Medicine and serves as Lead Faculty of the American College of Lifestyle Medicine’s Food as Medicine Course. She is Secretary of ACLM’s Women’s Health Member Interest Group, and Nutrition Faculty for many of ACLM’s other course offerings. She is the author of the Plant-Based Nutrition Quick Start Guide and works with many of the leading organizations in nutrition and lifestyle medicine including Blue Zones, Engine 2, and Full Plate Living to develop nutrition content, recipes, and educational programs. She frequently speaks on the topics of women’s health and plant-based nutrition and has co-authored two lifestyle medicine textbooks including the first one on women’s health Improving Women’s Health Across the Lifespan.

Kayli holds a Master’s degree in Nutrition and Physical Performance and is certified as an Exercise Physiologist and Intuitive Eating Counselor. She has completed professional training in women’s integrative & functional medicine and herbal medicine. She lives in Colorado with her husband where you’ll find her out on a trail or in her garden.

Kayli Anderson’s Resources

Interview: How to have a healthy pregnancy while eating a plant-based diet with Kayli Anderson

Q: Can you tell us a little about your background and how you got involved in plant-based nutrition?

A: Growing up I was always really interested in food, experimenting with food, and cooking. I watched the Food Network a lot when I was younger. And I would buy cookbooks and experiment with cooking. And when I was in grad school I had a professor who shared a lot of the cornerstone plant-based nutrition research with me, like the Adventist health studies and Ornish’s studies. That opened my eyes to the true power of food. 

In dietetics we learned a lot about food, but sometimes we don’t learn a lot about plant-based nutrition. That really opened my eyes. I knew from that point that that’s what I wanted to do. I started to change my own life. And after grad school I started a personal chef company. I would go into people’s homes and help them transition to a plant-based diet. I’d cook for them, teach them how to cook, and wean them off of meat cooking. And then around that time I also connected with the Plantrician Project and the American College of Lifestyle Medicine and started to work for those organizations. From there the rest is history. 

Q: Why is nutrition so important to pregnancy?

A: A lot of women enter pregnancy with nutrient deficiencies.  What mom eats during pregnancy can shape the health of the next generation. We know through epigenetic studies, that what mom is eating can set the baby up for being predisposed to certain conditions, or to be more resilient to certain conditions. Babies taste buds are developing in utero. They’re tasting what mom is eating through amniotic fluid, and through breast milk later on. So it’s really an opportunity to not only nourish yourself, but set your baby up for a healthy life.

Q: Is it safe to eat a plant-based diet during pregnancy?

A: Yes, it is safe to eat a plant-based diet, whether that’s vegetarian or a one hundred percent vegan plant-based diet. Those can all be done. We know that from the Academy of Nutrition and Dietetics position paper on vegetarian diets that is it safe for all stages of the of the life cycle, including pregnancy and lactation. 

But the key, and you always point this out as well, is that well-planned piece that they state in that position statement. We do need to pay special attention to certain nutrients and make sure that we’re meeting our needs. But it is safe as long as you are doing that.

Q: What does that healthy plant-based diet look like?

A: So we can use the plate model that’s pretty popular and people are familiar with. You really want to think about your plate in thirds during pregnancy. 

• 1/3 is the fruits and vegetables
• 1/3 is our starchy vegetables and whole grains
• 1/3 is our beans, peas, soy foods, nuts and seeds

Normally, we see half the plate being fruits and vegetables. But in this case energy needs are going up. Nutrient needs are going up. We change the structure of the plate to make sure we’re meeting those. 

And then supplements are certainly part of a healthy pregnancy. When it comes to supplements. We often see two sides of the story. People who are purists and want to get everything from whole foods, and don’t want to take supplements, and then people who have a whole regiment of supplements that they take. But in pregnancy it is important to at least take a prenatal multivitamin, and then perhaps a couple of other things, just to make sure that you’re meeting their needs.

Q: What are some of those nutrients of concern? What are the supplements that would be really important for pregnancy in a 100% plant-based diet?

A: It’s definitely important to take a prenatal multivitamin. And it’s across the board recommended that all women take a prenatal during pregnancy, and it is associated with better pregnancy outcomes. 

The thing is, as we all know, the supplement aisle can be quite confusing even to dietitians. And so prenatals are no different. So it’s really important that you’re doing your research and looking, turning over that bottle and looking at the actual amounts of the nutrients that are in there.

Some of the ones to look for:

• Folic acid. It’s really important for preventing neural tube defects, and the neural tube actually closes in the first four weeks after conception. 
• B-12 for people who are fully plant-based. Most prenatals have B-12 in them. But you might want to add a little bit extra in addition to that. And one thing to note with vitamin B-12: we have the option between daily and weekly vitamin B-12 supplements. In pregnancy it’s really important to take that daily supplement, because there is some evidence that baby might not be able to access mom’s stores of vitamin B-12, so they might need that daily intake. 
• Iron as well. That’s another important one to make sure is included in the prenatal.

Q: We are getting a lot a lot of folic acid in a healthy plant-based diet. Right?

A: You’re absolutely right. Most plant eaters consume more folic acid than other people do, and so you probably are getting enough from leafy greens and beans. But having that supplement is good insurance. 

Q: What about other things like calcium? What do you recommend there?

A: Calcium needs actually don’t increase during pregnancy, because our body is so amazing and it increases absorption of calcium. So, it starts taking in more during pregnancy. But you might have been barely meeting those needs, or maybe even not meeting those needs before pregnancy. So it’s still an important one to be aware of. A lot of prenatals do include calcium in them. So you might be getting a little bit extra that way as well. But you still want to include those calcium-rich foods every day.

Q: Are there any other nutrients that concern you? 

A: Protein is certainly an important one, and that’s really because protein needs increase by fifty percent in pregnancy. It’s important to make sure you’re including protein every day. In the world of plant-based nutrition, a lot of people will say well, all foods include protein. If you’re just eating plant foods, it’ll be okay. 

But pregnancy is a time in life when you really want to focus on those concentrated plant protein sources. Every meal should include one serving of plant protein rich foods like: beans, lentils, soy foods, soy milk tofu, nuts and seeds. If you make a smoothie, throw in some chia seeds, hemp seeds, or walnuts. You could throw some tofu or beans in there. Pack your foods with those plant proteins.

Q: Are there any other nutrients that you try to make sure your clients get enough of?

A: Another one is Omega-3 fatty acids. And you know, we talk about that in general in plant-based nutrition quite a bit, and in pregnancy it becomes even more important because DHA is really important for babies’ development. So normally, we say that the plant sources of Omega-3s are good enough if you’re eating them every day, and the body can convert them to EPA and DHA types of Omega-3s. 

But in pregnancy there is some evidence that the ALA intake does not raise the blood levels of DHA. So, the baby might not be accessing that converted DHA. DHA is really important. If you’re not eating fish, then you need to be taking a DHA supplement during pregnancy. And they make microalgae-based supplements. 

Q: What about iodine?

A: Deficiencies of iodine in pregnancy can impair fetal growth and development. So, it’s important that we’re meeting those needs. And this used to be one that we really weren’t worried about because of the use of iodine salt. But now that people are more conscious about salt use and they’re switching to sea salts, iodine intake is going down. 

We can get iodine on a plant-based diet from seaweeds. But the iodine content in seaweed can vary quite a bit. So it’s actually not recommended to rely on that as your sole iodine source and pregnancy, because it can be so variable. Most prenatals do include some iodine, so you can get it that way. If you’re not too worried about your salt intake, if you’re not eating out a lot or eating a lot of processed foods, then cooking with a little bit of iodine salt is also an option.

Q: What about zinc? Is that something that you also help clients with getting enough of?

A: That’s one where needs usually go up just a little bit in pregnancy.  But we flag that one because plant eaters tend to need more zinc because of the lower bioavailability. So, make sure that your first line, includes those zinc rich foods. There’s zinc in whole grains like wheat germ. Beyond that, a lot of prenatal multivitamins contain some zinc as well. So you’re probably covering your bases that way too. 

Q: And then what about vitamin D?

A: Vitamin D is kind of like calcium where needs don’t increase. But, I usually recommend that people get their vitamin D levels checked in pregnancy to see where they’re at, or even outside of pregnancy, just to know what their vitamin D levels are, and then supplement according to that. Getting outside in the sunshine is a great way to get that vitamin D. However, that’s not realistic for everyone depending on where they live and the time of year. They might not be getting enough. I recommend supplementing according to what your test results say.

 Q: I also want to ask you about choline. What would you advise for choline? Talking about choline and plant-based diets is very hot right now. 

A: It is, you’re right. It’s kind of a new kid on the block with plant-based nutrition and especially in pregnancy. It’s really important for brain development and plant-based diets tend to be fairly low in choline. You can eat choline rich foods and make sure that those are included every day. 

Choline rich foods include shiitake mushrooms, red potatoes, soy milk, wheat germ, kidney beans, quinoa. Because it’s so important for healthy pregnancy, it might be a good idea to add a choline supplement. Most prenatals don’t include choline right now. So even supplementing for about half of the recommendation, 225 milligrams might be a good idea during pregnancy, but there aren’t any official recommendations on that one. 

Q: What supplement do you recommend?

A: I think “Nested Naturals” is the one that I have. 

Q: I wanted to shift gears and talk about this idea of “eating for two” and what that means for weight gain. What advice do you have based on this idea, in particular for people who are eating plant-based diets? 

A: We have heard that, “eating for two”. A lot of people like to bust that myth and say, “it’s not actually true.” I have an issue with that because I don’t want to create fear in women. I don’t want them to think that they need to be eating less or need to be really careful about how much they eat because they do have to eat more. 

And frankly, if you’re eating a plant-based diet that’s very nutrient-dense, but has low calorie density then you might be at risk of not getting enough in every day. So it is important to make sure that that you’re getting enough calories. 

So here are the general guidelines: There is no real additional increase during the first trimester. During the second trimester, it’s about 340 calories per day extra. And then in the third trimester about 450 calories per day extra. I think those are the official amounts. 

In order to get in enough calories in a plant-based pregnancy it’s important to keep that thirds method of the plate in mind when you’re building your plate. And, maybe go heavier on the plant protein sources and the whole grains rather than the fruits and vegetables. 

Q: Are there any tips or tricks for morning sickness? Any plant-based foods that can help people with morning sickness? 

A: Here are some things you can try: Ginger is great for nausea, so make some ginger tea. You can just take ginger root and slice off a couple of chunks, boil that in water, and make ginger tea. Ginger chews are really good to suck on during pregnancy.

Same with mint. Mint helps to settle nausea. You can make mint tea, or even breath mints are helpful. In general, take the pressure off and eat what you can when you can. I know I ate a lot of toast in my first trimester and that’s okay. That’s why we take the prenatal. And hopefully, you’ll be able to get back on track after the nausea subsides.

Even just keeping your blood sugar steady, always having something to nibble on with you, can be helpful to kind of prevent or get ahead of the nausea.

Q: Are there any foods on a plant-based diet that we should avoid during pregnancy?

A: By being plant-based you’re already avoiding a lot of the things that are typically recommended to avoid: undercooked animal foods and pasteurized dairy. 

Of the plant-based foods, I do caution people against unpasteurized juices. They can harbor dangerous bacteria. 

Be careful with herbs, teas, and basically any adaptogens. Educate yourself on which ones are safe and which ones may not be safe during pregnancy. A lot of herbs can be really helpful in pregnancy. But a lot of them can also be pretty dangerous during pregnancy.

Q: What about caffeine and alcohol?

A: I would recommend avoiding alcohol. I know there is a little bit of controversy. But we haven’t really shown that it’s okay. So I would say, avoid alcohol completely during pregnancy. 

Caffeine is a bit more up in the air. The American College of Obstetricians and Gynecologists recommend keeping your intake below 200 milligrams per day, which is about two 6 ounce cups of coffee per day. I usually recommend no more than one cup of coffee a day, or none. 

Q: What are some of the benefits of eating plant-based during your pregnancy? I didn’t even ask you that.

A: There are a lot of benefits for eating plant-based or eating plant-based foods during pregnancy. A lot of them revolve around less complications, less risk of a lot of the pregnancy-related conditions that we see like Gestational Diabetes. There are healthier outcomes for your baby as well. Remember that you are setting up your baby for healthy food preferences, and reduced susceptibility for disease, which is a really wonderful first gift to give your child.

Kayli Anderson shares one of her favorite plant-based recipes, Homemade Energy Bites!

Homemade Energy Bites

These are great to snack on during pregnancy. They contain omega-3s from flax seeds, calcium-rich tahini, and fiber-filled oats. They also contain dates, and eating dates in late pregnancy can help with on-time, healthy labor and delivery. The general recommendation for this is about 4-6 dates per day. Make a big batch of these and freeze them for postpartum. They make a perfect one-handed snack while nursing.

Makes 36 bites 

Ingredients:

• ½ cup pitted Medjool dates, packed
• ½ cup ground flaxseed
• ¾ cup oats
• ½ cup coconut flakes
• ¼ cup cocoa powder
• ½ tsp cinnamon
• ¼ tsp cardamom
• ¼ tsp nutmeg
• ½ cup tahini
• ½ cup dark chocolate chips (optional)

Preparation:

1. Line a casserole dish with parchment paper and set aside.
2. Soak the dates in water for at least 30 minutes, or overnight in the refrigerator.
3. In a food processor, combine ground flaxseed, oats, coconut, coconut, cocoa powder, cinnamon, cardamom, and nutmeg. Pulse until the coconut and oats are broken into small pieces. Transfer to a separate bowl and set aside.
4. Drain dates and add to the food processor with the tahini. Blend until the mixture forms into a well-incorporated paste.
5. Add the dry mixture back into the food processor with the paste. Blend until fully incorporated. The mixture should easily stick together when you squeeze it between your fingers. Add optional chocolate chips, and pulse a few times to incorporate.
6. Transfer mixture into the lined dish and press it firmly and evenly into the dish. Allow it to sit in the refrigerator for 30 minutes. Cut into 36 bites. Store bites in the refrigerator or freezer.

For more resources on plant-based pregnancy, check out the following: 

5 Steps to a Balanced Plant-Based Pregnancy Diet
Pesticides May Impact Pregnancy Outcomes
Meeting Your Nutrient Needs on a Vegan Diet