Help me upgrade my vegetarian diet for pregnancy
February 25, 2016 12:53 PM   Subscribe

I am trying to upgrade the nutritional content of my vegetarian diet for potential pregnancy. Looking for any suggestions to improve my current habits.

The background: Had a positive home test but it's early so I am not getting my hopes up. We are in treatment for some fertility issues so if this is not the time, I expect it to be soon.

I am vegetarian---egg is okay, but I am allergic to dairy. Also cannot have flax, green beans, corn or tree nuts (peanuts and seeds are fine). There are diagnosed medical allergies, not lifestyle choices. I do not care for meat and am otherwise vegetarian for health reasons.

Here is a sample of how my current week looks. I am looking for advice on areas where I can tweak and improve things in a manageable way to get more nutrition.

Breakfast: usually toast and a coffee. I have been having margarine since I can't have butter (dairy) or Earth Balance. I am happy to switch to peanut butter for extra protein, or coconut oil. I also have a half-cup of rice milk mixed with a small coffee---the rice milk is fortified with B12. I sometimes have oatmeal (plain oats mixed with a spoonful each of raisins and some kind of seed (pumpkin, hemp, sunflower) and can do that more often. I do get breakfast sandwiches (bagel with egg, no cheese) when we travel. I can budget for that once or twice a week to get the egg in. I am open to smoothies as well, but I don't tolerate banana very well so I have been reluctant.

Snacks: I pack a snack container with a fruit (usually grapes or strawberries) and a crackery thing (wheat thins, rice crackers) or dry cereal. I can add some hummus to this, or pack some sunflower or pumpkin seeds. My workplace prohibits peanuts but I am happy to eat them at home.

Lunch/Dinner: I am trying to get better about cooking ahead a little and making proper meals and not just pasta or sandwiches. Current favourites are pizza (made with goat cheese on a pita, but I guess I can't have goat cheese know?), pasta and tomato sauce with a cup of frozen veggies, jarred soup with crackers or toast, sometimes ramen soup with veggies mixed in. I also like sweet potato (I mix it into the jarred soup) and we have a rice cooker. I subscribe to a vegetarian meal plan program but have not used the recipes yet. I know I should be.

You are not my doctor/nutritionist, but is there anything the more experienced vegetarians can see in this that is obviously deficient here? Areas where I can improve? Superfoods I simply must try (other than flax, which I cannot have) or other suggestions?
posted by JoannaC to Food & Drink (24 answers total) 11 users marked this as a favorite
Best answer: Take your prenatal vitamins.

Eat what you normally eat but more as you'll get hungrier.

You may find your tastes change during pregnancy, so adjust your eating to those tastes and needs.

But the prenatal vitamin really helps make up for a lot of deficiency.

My creds: Vegetarian who has been pregnant twice.
posted by zizzle at 1:01 PM on February 25, 2016 [3 favorites]

And don't beat yourself up if for the first trimester you end up living on a horribly unbalanced diet due to food aversions. This is an issue for everyone, not just vegetarians.
posted by town of cats at 1:03 PM on February 25, 2016 [7 favorites]

IIRC now is the time to focus on boosting gut health (fermented foods, probiotics in the evening, that sorta thing) ..something something your baby will thank you in the long run.
posted by speakeasy at 1:09 PM on February 25, 2016

Best answer: For a very filling meal with a lot of good fat and protein:
Black beans (make 1-2 lbs ahead of time and freeze portions) in a tortilla (our massive bag of corn tortillas says they're good for 3-4 weeks in the fridge). Top with a fried egg, salsa (from a jar works), cilantro, chopped onion, and/or avocado (peel and slice).
posted by asphericalcow at 1:13 PM on February 25, 2016 [1 favorite]

Protein is very important during pregnancy - you really want to up it to 50-100 grams a day. That's probably the toughest piece for someone who doesn't eat dairy or meat. Can you eat more eggs? Getting enough protein really helps prevent pre-eclampsia, which is very, very serious.

There's some research showing that eating peanuts during pregnancy can reduce peanut allergies so definitely add that in.

I, and many women I know, went through a major stage of craving calcium, around when the baby's bones were forming. You might want to either look for calcium-fortified juices or non-dairy milks, or look at other sources of calcium-rich foods that you like.

You will likely develop some weird food aversions as well as starting to like foods you didn't previously. They may or may not go away afterwards.

And two relevant things that don't answer your direct question: potato chips are a miraculous cure for morning sickness. And there is real research showing that eating dark chocolate every day during pregnancy leads to a happier baby. Can't hurt to try - I have to say it worked for me.

posted by john_snow at 1:15 PM on February 25, 2016 [2 favorites]

From what I gather, people with dairy allergies are specifically allergic to cow's milk. Goat and sheep dairy products should be fine. You may also be able to have clarified butter ("ghee").

I have a super low opinion of margarine. If you cannot have ghee, I have heard that if you refrigerate olive oil, it firms up and can be used as a margarine substitute. It would be a healthier substitute.

You can enrich hot cereals, like cream of wheat, by adding tofu or wheat germ. IIRC, tofu is high in both protein and calcium. You need more of both.

Your blood supply doubles when pregnant, so you need extra iron. Broccoli is a fairly high iron vegetarian food.

Congrats and best of luck!
posted by Michele in California at 1:24 PM on February 25, 2016

Pregnancy often comes with a whole host of recommended dietary restrictions that vary in how grounded in evidence they really are. In particular, sometimes the recommendations are broader or restrict a larger swath of food in an effort to not be confusing. Given your existing food restrictions, I would think it's especially important for you to know what is actually risky versus "common knowledge" about what you shouldn't eat. Specifically: restrictions on cheese are based on the risk of listeria, which means you shouldn't eat soft cheeses that aren't pasteurized. So, raw-milk goat cheese is probably a no-no, but it's pretty difficult to find raw-milk (unpasteurized) soft cheeses for sale in most mainstream stores anyway.

When I was pregnant, the two driving considerations were: (1) eat frequently enough to keep blood sugar stable and avoid nausea; and (2) up protein levels. Do you like pulses (lentils) and beans? I found those kept me relatively full when pregnant, and had the happy effect of counter-acting some of the constipating effects of the iron in prenatal vitamins.
posted by iminurmefi at 1:26 PM on February 25, 2016

Best answer: Once I got pregnant, fruit and crackers or cereal as a snack weren't doing it for me anymore because my blood sugar went haywire, and haywire blood sugar led to a lot of puking. Plus, I was starving for protein all the damn time.

How are you with beans of the non-green variety? Chickpeas and tofu are clutch, and the fiber also helped with the pregnancy-related constipation, part of which came from the delightful hormones, and part of which came from all the additional iron I was taking through my prenatal.

Also, you can totally have goat cheese. It's just supposed to come from pasteurized milk.

(And just to reiterate what iminurmefi says, there's a lot of stuff out there about what pregnant ladies are and aren't supposed to eat. Some of it is evidence based. Some of it is. Some of it is just straight scaremongering. It all gets presented as being 100000000% SERIOUS OH GOD IF ONE BIT PASSES YOUR LIPS, YOU AND THE BABY ARE DOOMED FOREVER. I found Metafilter fave Expecting Better really helpful in parsing through stuff.)
posted by joyceanmachine at 1:34 PM on February 25, 2016

Congrats! I don't see folic acid on your list--if you're not taking a supplement, you should start immediately. (This is generally included in prenatals and one-a-days for women). It's also found in leafy green vegetables, like kale (a pseudo-superfood of the moment), and fortified into breakfast cereals. It looks like you're also a little bit low in iron, protein, and omega-3s, and a little bit high on carbs. I'd add lentils, other beans, and nut butters. Some people like chia seeds for protein and omegas. I'd skip the margarine and start with avocado or maybe nut butter. Your doctor/midwife should do your labs and if you're not anemic, you don't need extra iron--it tends to just be constipating and nauseating.

As noted by others above, the first trimester is often filled with food aversions and nausea/vomiting. Your body has everything that the baby needs, so if you can really only have saltines and 7-up, that is completely fine. (Although if you're unable to hold down water, you need to get extra help!)

Finally, the old wisdom that you're pregnant so you need to eat a lot more is not true. You really only need an extra ~200 calories (or one cup of yogurt and an apple) per day, assuming you're an average healthy woman with a healthy BMI. What works well for nausea and maintaining blood sugar levels is eating small, frequent meals throughout the day--your fruit and cracker packs are perfect for this.

And do check with your provider--they likely will be able to offer additional info based on your labs and medical history. Good luck and best wishes!
posted by stillmoving at 1:38 PM on February 25, 2016

Congratulations! Pregnant vegetarian here. One who doesn't really like dairy!

I have marmite on toast (granary bread) for breakfast, which is rich in B12 and folate. Spinach is also awesome, as are lentils and chickpeas. Tofu also a really good source of protein.

It also looks like you could maybe do with more fresh fruit. I've really loved oranges and grapes for a quick refreshing snack. I drank a lot of smoothie with nut butter and frozen fruits.

Honestly, except for the multivitamins and folic acid, don't worry too much about what you eat in the first trimester, as you may feel really nauseous and not be able to eat much. At this stage you don't have to eat more calories, and baby will get most of the nutrients they need from you (hence why people used to lose teeth in the olden days when they were pregnant as baby stole the calcium)

I also recommend stocking up on gingery things as it really helps with nausea.
posted by Dorothea_in_Rome at 1:39 PM on February 25, 2016

Does your insurance cover consultation with a registered dietitian? Mine does. I've been vegan for more than half my life, but I'd never met with an RD until a couple years ago. I live in a big progressive city, so it was no problem to find a vegan/vegetarian-specializing RD. It was a great experience, and she mentioned that RDs do telemedicine consultations pretty commonly.
posted by late afternoon dreaming hotel at 1:44 PM on February 25, 2016 [1 favorite]

You mentioned not tolerating bananas in smoothies - I can't either, and my favorite substitute is frozen mango. I buy it at Trader Joe's in the freezer section, and just swap it out for smoothie recipes (I assume about a cup of mango is about a banana).

posted by bananacabana at 1:48 PM on February 25, 2016

but I guess I can't have goat cheese know?

Sure you can. It just needs to be made from pasteurized milk, and/or aged (more than 60 days, I think). If goat and sheep milk products are dairy you can have, then you can keep having them as long as they are pasteurized.
posted by rtha at 1:56 PM on February 25, 2016

Came back to say that quinoa is another superfood du jour that has good vitamins and proteins for vegetarians. I had a friend who ate it for breakfast as an oatmeal substitute.
posted by stillmoving at 1:58 PM on February 25, 2016

Your diet sounds lower protein than what makes my body feel good, and especially in pregnancy as a vegetarian, I had major protein cravings. (Like, eating refried beans from a can with a spoon.) I would consider eating more beans, stir fries with tofu, frozen veggie burger type things if you don't want to cook.
posted by metasarah at 2:11 PM on February 25, 2016 [2 favorites]

I agree with pre-natal vitamins. My doctor has also said that I should try to up my protein just in preparation for getting pregnant (I'm not yet), so I would focus on that category as well. One of my favorite snacks is a hardboiled egg -- easy to take to work, just peel under running water and sprinkle with some salt and pepper. Plus you can cook up a bunch at once and then store them in the fridge.

Also - I am not an expert (you should double check with your doctor), but I was under the impression that goat cheese is okay as long as it is cooked. So in a pizza application I would think it would be ok. Here is a link:
posted by rainbowbrite at 2:48 PM on February 25, 2016

Avocado is a pregnancy superfood. Also spinach. I would recommend having avocado on toast for breakfast and adding spinach for the folic acid.

I had terrible morning sickness with Baby Kitty and anything sweet (like ginger ale) made it much worse. I really liked just plain seltzer water to help get me through those first four months.

Congratulations !!
posted by Suffocating Kitty at 3:04 PM on February 25, 2016

Best answer: Iron, calcium, and folate are the most important nutrients that you can make sure to incorporate into your diet now (that the baby will steal from you mercilessly).

I am a vegetarian with 9 month old twins and my levels of calcium and iron were normal before conceiving and then plummeted and I was constantly craving broccoli (which is great source of both iron and calcium btw, squeeze lemon juice on it bc the citric acid will allow you to absorb more iron).

Start taking a prenatal vitamin now if you have not already.
You need to build your folic acid up before you conceive because it does its most important job of regulating the growth of the baby's neural column in the first few weeks after conception, when you might not even know you are preggo yet. So folate now. It's in all the prenatals but you can also take extra if you want as a separate pill.
I recommend the Rainbow Lite vegetarian prenatal. It's a big honking pill but it didn't make me as nauseous as some other brands. I hated the gummy style ones but ymmv.

I don't see tofu or beans in your post but 2 meals that are great both nutrient and protein-wise would be:
1. Broccoli, tofu, carrots in peanut sauce (jarred is fine) over rice
2. Quesadilla with sauteed spinach,black beans, sweet potato, and goat cheese (yes you can eat goat cheese- in the US you really have to go out of your way to find unpasteurized dairy and that where the listeria cheese risk comes in)

Eat healthy while and if you can, and then cut yourself slack if you get crazy morning sickness and only eat crackers and chips for 3 days. (speaking from experience)
posted by rmless at 3:46 PM on February 25, 2016 [1 favorite]

Response by poster: Should have clarified, the jarred soup is usually lentil or split pea. I do keep frozen chickpeas and lentils (from a can, rinsed and flash frozen) on hand and I toss them into things when I can. I find cooking challenging, husband is a non-foodie who would happily eat cheese sandwiches for dinner every night :-)

It's so hard to separate the alarming fear-mongers from the truth. The handout my own doctor gave me said one regular but not jumbo cup of coffee was fine; then I went online (husband has banned me from doing this) and they pretty much said that coffee will Killz Yur Baybee...
posted by JoannaC at 3:51 PM on February 25, 2016

Even registered dietitians (RDs) who don't specialize in vegan/vegetarian nutrition will often repeat myths about vegetarianism (like that you need to be extra careful to get enough protein). So I agree that seeing an RD who specializes in vegetarian diets is your best move if at all possible. The second thing I'd suggest is getting a good book about vegetarian nutrition written by an RD (one possibility would be "The New Becoming Vegetarian," which has a chapter on pregnancy and lactation). Internet discussion of diet is a lot like internet discussion of religion - people have their personal beliefs and can quote chapter and verse of their own holy books. (Source: grandmother of two healthy children whose mother was vegan during pregnancy.)
posted by FencingGal at 5:24 PM on February 25, 2016

I was raised vegetarian and remain mostly vegetarian, except during both my pregnancies I craved ALL THE PROTEIN. So I'd think hard about ways to introduce additional protein into your diet and come up with portable things you can keep on hand (mine were almonds and string cheese, which obviously don't work for you, but hard boiled eggs and sunbutter might be good options).

If you're already being overwhelmed with the nutritional nonsense that's handed down to pregnant women, I really recommend Expecting Better. I don't remember how much she touches on vegetarianism, but she does break down the science behind the restrictions on caffeine, deli meat, soft cheese, alcohol, and other things.
posted by peanut_mcgillicuty at 6:21 PM on February 25, 2016

Here to nth reading Expecting Better, it's light reading and will give you a lot of peace of mind and useful info.

I usually throw up for 4 months when I'm pregnant and Flintsones chewable vitamins were the only vitamins I could tolerate. There's one kind with extra iron.
posted by CrazyLemonade at 6:50 PM on February 25, 2016

I had a very healthy vegetarian pregnancy. I wrote you a carefully referenced comment and then my phone crashed and deleted it. I'll be super brief and if you want extensive references/papers just ask me. Eating fruits and veggies is associated with marginally better outcomes but then again so is extreme nausea and those women are often subsisting on crackers. That's telling. The U.S. Is obsessed with recommending protein. The CDC calls for 70g but the WHO recommends only 45 (10g more than normal) for someone my size - such recommendations work fine for people all over the world. (And NOT with worse outcomes. This is well supported.) So don't worry you need to be eating tofu all day unless you want to in which case go right ahead. Take a prenatal with iron (I took Rainbow Light minis so I could actually swallow them) and maybe avoid the worst sources of listeria or E. coli. Don't drink. Moderate coffee is ok. If you eat what looks reasonably healthy you will be just fine.
posted by Cygnet at 6:58 PM on February 25, 2016

Protein + gut health = tempeh

Saute with veggies, or just warm it up and dunk in bbq sauce.
posted by BusyBusyBusy at 9:31 AM on February 26, 2016

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