32 - Vegetarian and Plant-Based Diets in Pregnancy

Abstract

A healthy diet during pregnancy has been recognized for centuries as key for the well-being of the mother and the fetus. Over time, the definition of an ideal diet has progressively switched from a diet at a low-risk of nutritional deficiencies to a diet that reduced the risk of diseases that relates to overeating. The rediscovery of the Mediterranean diet and vegetarian diets has gained a growing interest, mainly because they may protect from the most commonly encountered chronic diseases linked to “overeating” in the developed and developing world, including the array of cardiovascular diseases, diabetes, and obesity. The evidence on advantages and drawbacks of plant-based diets in pregnancy is scant, and heterogeneous also on the account of the link with higher education and health awareness in Western countries, and with poverty in the developing world. However, well-balanced plant-based diets are theoretically welcomed in both settings: they are rarely “too rich” and may protect from overnutrition in high resourced countries, and they are often more affordable in low-resourced countries. The present review contextualizes vegetarian/vegan diets in four situations: the “healthy and wealthy,” who choose them in the Western words, the “poor and obliged” in low-resourced settings, the “nutritionally disturbed,” on the account of the link between nutritional disturbances and plant-based diets in the Western world, and the “sick and controlled,” i.e., the specific experience on protein-restricted diets in patients with chronic kidney diseases. Overall, well-balanced, varied, and controlled, plant-based diets in pregnancy are nutritionally safe, and they are not associated with clinical problems in either mother nor child, in health and disease, provided they are varied and balanced enough and attention is paid to cover the nutritional requirements (in particular, vitamin B12, vitamin D, iron, and zinc).