Gestational diabetes, a form of diabetes that occurs during pregnancy, poses risks to both the mother and the developing infant. Emerging research suggests that plant-based diets may offer a protective effect against gestational diabetes and promote overall health during pregnancy. This article explores the benefits of plant-based diets for both mother and child, delving into nutrient needs, relevant research, and practical dietary considerations.
Benefits of Plant-Based Diets for the Mother
Diets centered around plant-based whole foods are associated with a significantly lower risk of developing gestational diabetes. The Nurses’ Health Study II found that every 10-gram increase in daily fiber was associated with a 26% reduction in risk. Research published in 2023 found that women who ate the most animal protein were almost three times more likely to develop gestational diabetes than those eating the least. Meanwhile, women eating the most plant protein were less than half as likely to develop gestational diabetes than those eating the least. Similarly, diets centered around plant-based whole foods are also associated with lower risks of gestational hypertension and pre-eclampsia, which are disorders of high blood pressure that can develop during pregnancy.
A study of Iranian adults, involving 635 pregnant women, examined the association between plant-based dietary patterns and the risk of gestational diabetes mellitus (GDM). The study, which assessed dietary intakes using a 90-item food frequency questionnaire during the first trimester of pregnancy, revealed that women with higher adherence to plant-based diets, particularly healthy plant-based diets, had a lower risk of developing GDM. Specifically, those in the third tertile of the Plant-based Diet Index (PDI) and healthy PDI (hPDI) had a significantly reduced risk compared to those in the first tertile. These findings suggest that incorporating more plant-based foods into one's diet during early pregnancy may be a beneficial strategy for reducing GDM risk.
These findings align with a systematic review and meta-analysis, which analyzed ten studies involving 32,006 participants. The analysis demonstrated that greater adherence to plant-based dietary patterns was associated with a lower risk of developing GDM. The review highlighted that healthy plant-based dietary patterns are more beneficial than unhealthy ones in mitigating GDM risk.
Benefits of Plant-Based Diets for the Infant
Maternal dietary choices also influence infant and toddler health. Children who are raised on healthful vegan diets have a reduced risk for heart disease, cancer, obesity, diabetes, and other conditions. Adolescents raised on a plant-based diet often find they have an easy time maintaining a healthy weight. They also have fewer problems with acne, allergies, and gastrointestinal problems than their peers who eat animal products.
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Children start to develop taste preferences in the womb and while breastfeeding. The more fruits, vegetables, whole grains, legumes, and plant-based foods the baby is exposed to during pregnancy and while breastfeeding, the more inclined the child will eat these foods later in life. Vegan and vegetarian diets and especially maternal consumption of certain vegetables and nutrients is associated with a lower risk of eczema in their offspring.
A study from 2023 of more than 76,000 women found that low fiber intake during pregnancy was associated with neurodevelopmental delay in their offspring, including delayed communication, delayed fine motor skills, and delayed developmental in problem solving and social skills.
Calorie Needs During Pregnancy
Calorie needs increase only modestly during pregnancy. According to the 2020-2025 Dietary Guidelines for Americans, pregnant individuals need about 340 extra calories per day in the second trimester and about 452 extra calories per day during the third.
It’s recommended to maintain a steady rate of weight gain. How much weight should be gained depends on prepregnancy weight status. Minimal weight is expected to be gained during the first trimester, amounting to 1.1-4.4 pounds. During the second and third trimesters, the Dietary Guidelines for Americans recommend a weekly weight gain of 1 pound for women who are of normal weight or are underweight and a weekly weight gain of 0.5 and 0.6 pounds for women who are obese or overweight, respectively.
Essential Nutrient Needs During Pregnancy
During pregnancy, nutrient needs increase. For example, calcium, protein, and folic acid requirements increase, despite only modest increases in caloric requirements. Limiting empty calories found in highly processed foods and sweets is beneficial to maximize nutrient intake. Discuss with your doctor the appropriate nutrients you require for a healthy pregnancy and if you should take a supplement.
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Protein
Protein needs are slightly higher during pregnancy. An adult who is not pregnant and not physically active should get about 0.36 grams of protein per pound of body weight. For an average woman this would be about 46 grams of protein per day. During pregnancy (especially the second and third trimester), women should eat an additional 25 grams of protein per day, or 70 grams of total protein per day (0.5 grams of protein per pound of body weight). This is usually an easy goal to meet by eating a variety of plant-based foods, including beans, lentils, quinoa, tempeh, tofu, whole grains, nuts, seeds, and vegetables.
A day’s menu could include oatmeal with fruit, walnuts, and chia seeds for breakfast; lentil soup and a hummus sandwich for lunch; brown rice, broccoli, and chickpea bowl for dinner; and a slice of whole-wheat bread with peanut butter for a snack.
Calcium
The recommended amount of calcium to consume is 1,000 milligrams per day. Calcium is important during pregnancy, but the amount a woman needs does not increase. It’s important to include plenty of calcium-rich plant-based foods in one’s diet, like tofu, dark green leafy vegetables, beans, figs, sunflower seeds, tahini, almond butter, and calcium-fortified soy milk, cereals, and juices.
Vitamin D
The natural source of vitamin D is sunlight. If a woman does not get regular sunlight, vitamin D is also available in vitamins and in fortified foods. Many brands of cereal and plant milks are fortified with vitamin D.
Vitamin B12
The amount of vitamin B12 a woman needs during pregnancy is 2.6 micrograms; this is a little higher than the 2.4 micrograms that nonpregnant people need. Vitamin B12 is not naturally found in plant foods, however many plant-based foods are now fortified with vitamin B12, including plant-based milk alternatives, cereals, and nutritional yeast. To ensure vitamin B12 needs are being met, pregnant women should be encouraged to take a supplement regularly. Vitamin B12 is found in all standard multivitamins and in prenatal vitamins, but a dedicated B12 supplement may be a good idea to ensure you’re getting enough. We suggest getting 100 micrograms per day or 2,500 micrograms once a week.
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Iron
During pregnancy, iron needs increase considerably, from 18 milligrams to 27 milligrams per day. Iron is abundant in plant-based diets. Beans, dark green vegetables, dried fruits, blackstrap molasses, nuts and seeds, and whole-grain or fortified breads and cereals all contain plenty of iron. Most prenatal vitamins will contain iron but check with your health care provider to discuss iron supplements based on your blood levels.
Omega-3 Fatty Acids
Omega-3 fatty acids are important to support a baby’s growth and development. Plant foods contain very little DHA and EPA, but your body can make them from ALA (a plant omega-3 source), however, conversion rates are low. The Adequate Intakes (AIs) or recommended amount of ALA per day is 1.4 milligrams during pregnancy. You can easily get this from chia seeds, ground flaxseed, or walnuts. Microalgae-based DHA and EPA supplements are also available. Discuss with your health care provider whether a DHA and EPA supplement is necessary.
Choline
Choline deficiency is rare, but pregnant women may be at higher risk. A well-balanced diet that is not deficient in other nutrients (like B12) usually provides enough choline. Certain vegetables and beans are a great source of choline, with grains, nuts, and seeds being reliable sources in general. In fact, soybeans have more choline than beef and chicken; potatoes and most beans have more than dairy and tuna.
Breastfeeding Considerations
The guidelines for breastfeeding mothers are similar to those for pregnant women. Milk production requires even more calories than pregnancy, so you will need to boost your food intake a little bit. During the first six months of breastfeeding, you need 500 calories a day more than you did before you became pregnant. This drops to 400 additional calories a day during the second six months of breastfeeding, because it is recommended that children start eating some solid foods (like infant cereals, soft fruits and vegetables, and baby foods).
Plant-Based Dietary Patterns and GDM Prevention: Exploring the Evidence
The global rise in gestational diabetes mellitus (GDM) presents a significant health challenge, necessitating the exploration of effective prevention strategies. Plant-based dietary patterns, characterized by a greater emphasis on plant-derived foods and a reduced intake of animal products, have garnered attention for their potential role in mitigating GDM risk.
Plant-Based Diet Indices and GDM Risk
Studies have utilized plant-based diet indices (PDI) to assess the relationship between adherence to plant-based diets and GDM risk. These indices typically assign positive scores to plant-based foods and negative scores to animal-based foods, providing a continuous measure of plant-based diet adherence. Higher PDI scores have been associated with reduced insulin resistance and a lower risk of developing prediabetes and type 2 diabetes.
The Role of Inflammation and Oxidative Stress
Gestational diabetes mellitus (GDM) represents a challenging pregnancy complication in which women present a state of glucose intolerance. GDM has been associated with various obstetric complications, such as polyhydramnios, preterm delivery, and increased cesarean delivery rate. Moreover, the fetus could suffer from congenital malformation, macrosomia, neonatal respiratory distress syndrome, and intrauterine death. It has been speculated that inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin (IL) 6, and C-reactive protein (CRP) impact on endothelium dysfunction and insulin resistance and contribute to the pathogenesis of GDM. Nutritional patterns enriched with plant-derived foods, such as a low glycemic or Mediterranean diet, might favorably impact on the incidence of GDM. A high intake of vegetables, fibers, and fruits seems to decrease inflammation by enhancing antioxidant compounds. This aspect contributes to improving insulin efficacy and metabolic control and could provide maternal and neonatal health benefits.
The Gut Microbiota Connection
The intestinal microbiota, a complex community of microorganisms residing in the gut, plays a crucial role in human health, including metabolic regulation. Emerging evidence suggests that the gut microbiota may influence the risk of GDM. Plant-based diets can modulate the composition and function of the gut microbiota, potentially leading to beneficial metabolic effects.
During pregnancy, hormones modulate the composition of gut microbiota: from the first to the third trimester, there is an increase in Proteobacteria and Actinobacteria and an increase in heterogeneity, also called beta diversity. A decreased richness of bacterial populations, or alpha diversity, represents the opposite condition in the last part of the pregnancy. In the third trimester, there is an increase in gut inflammation and hyperglycemia is promoted. This condition has been considered as an adaptative function in order to augment energy storage for fetus development.
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