Vegetarian diets during pregnancy: ovo-vegetarian, lacto-vegetarian, vegan, and pescatarian adaptations of USDA food patterns

Authors: Hess, Julie; Comeau, Madeline; LANKES, JANE - Texas A&M University; SWANSON, KYLIE - University Of North Dakota; ANDERSON, CINDY - The Ohio State University

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/7/2024
Publication Date: N/A
Citation: N/A

Interpretive Summary: This study assessed the quality and nutrient adequacy of vegan, ovo-vegetarian, lacto-vegetarian, and pescatarian diets during pregnancy developed based on adaptations of the 1800, 2000, 2200, 2400, and 2600 kcal vegetarian dietary patterns from the 2020 Dietary Guidelines for Americans. We assessed these diets both with and without the addition of a sample, “average” prenatal multivitamin and mineral supplement. We found that our models contained enough servings of fruits, vegetables, grains, protein foods, dairy, and oils, as well as adequate amounts of calcium, phosphorus, copper, selenium, vitamin C, thiamin, riboflavin, niacin, vitamins B6 and B12, and folate. These models however did not provide adequate amounts of certain nutrients including vitamin D, vitamin E, sodium, and choline. With the addition of the prenatal supplement, the only nutrients that remained below 100% of nutrient recommendations were vitamin D, choline, and sodium. These results indicate that diets that align with the Dietary Guidelines, even if they do not contain meat, eggs, dairy, and/or seafood, can be nutritionally adequate for pregnant women with some micronutrient challenges similar to those diets that include meat and other animal products.

Technical Abstract: Background The 2020 Dietary Guidelines for Americans (DGA) includes a lacto-ovo vegetarian pattern (the Healthy Vegetarian Dietary Pattern; HVDP) as one of its 3 recommended dietary patterns during pregnancy. Objective The objective of our study was to determine whether the HVDP could be adapted for vegan, ovo-vegetarian, lacto-vegetarian, and pescatarian diets during pregnancy using foods and beverages recommended in the DGA. Design Using food pattern modeling, we developed four adaptations of the HVDP at all of the calorie levels that may be appropriate during pregnancy, according to the DGA (1800, 2000, 2200, 2400, and 2600kcal) and ran these models both with and without the addition of an approximate average prenatal supplement. Participants/setting n/a Intervention n/a Main Outcome Measures Main outcome measures were macro- and micronutrient adequacy, as measured by adherence of our modeled dietary patterns with Acceptable Macronutrient Distribution Ranges and Dietary Reference Intakes for micronutrients without exceeding recommendations for saturated fat and added sugar. Statistical Analysis Performed n/a Results Across all examined calorie levels (1800, 2000, 2200, 2400, and 2600 kcal per day), modeled dietary patterns provided sufficient macronutrients. Without prenatal supplements, each dietary pattern and calorie level met most, but not all, micronutrient recommendations. Some micronutrients that were below recommendations in dietary patterns without supplements included vitamin D, iron, vitamin E, sodium, and choline. With the addition of an “average” prenatal supplement to these dietary patterns (at all energy levels and for all age ranges), the only nutrients below 100% of recommendations were vitamin D, choline, and sodium. Conclusions Overall, these results show that a HVDP and similar diets without meat, eggs, dairy, and/or seafood can be nutritionally adequate for pregnant women, albeit with some micronutrient challenges, similar to those diets that include meat and other animal products.