By Chelsea Fuchs MS, Dietetic Intern at Teachers College, Columbia University.

If you have a little one on the way and you’re following a vegan diet, you might want to listen up. All vegans are at a very high risk for calcium deficiency, and pregnant women need to be particularly mindful of their intake of this vital mineral.  While vegetarians can include calcium-rich foods in the diet like eggs, milk, yogurt, and cheese, vegans are much more limited since milk and dairy products are off limits.  Calcium is an essential mineral to promote the healthy development of a baby’s teeth, bones, heart, nerves and muscles.  If a pregnant woman does not consume enough calcium, it will be extracted from her bones to nourish the baby.  The Dietary Reference Intake (DRI) for calcium during pregnancy is the same as pre-pregnancy, about 1000 mg/day.  The reason the calcium guidelines do not change is because when a woman is pregnant, the body is able to absorb calcium more effectively.  That being said, most women are deficient in calcium by the time they become pregnant, and getting enough calcium on a vegan diet can be somewhat challenging.  This challenge is made even more complicated by the fact that calcium absorption is usually less efficient when an individual is following a plant-based diet.

Food sources of calcium

Unfortunately, multivitamin and prescription prenatal supplements are not enough to meet a pregnant woman’s calcium needs, and additional calcium must be consumed through the diet and supplements.  Vegans should plan on making fortified plant foods staples in their prenatal diet, like calcium fortified soy, fortified almond and rice milks, 100% orange juice, and calcium fortified cereals.  Additional plant-based sources of calcium that vegans should make an effort to incorporate into the diet include: tofu, soy beans, dark green leafy vegetables (ie: spinach and kale), bok choy, broccoli, beans, figs, sunflower seeds, tahini, and almond butter.  Incorporating these foods into the diet on a daily basis will certainly help a vegan expectant mother meet her calcium needs, but she will also need to rely on supplementation to ensure adequate nutrition.

Calcium supplements    

When it comes to supplements, it is important to be aware that taking too many supplements has no added benefit, and can potentially be harmful.  In fact, studies show that taking too much calcium can increase the risk of developing heart disease, certain types of cancers, and kidney stones.  Before turning to supplements, consider the amount of calcium you consume from dietary sources.  For example, ¼ a block of tofu supplies nearly 160 mg of calcium, while 1 cup of calcium fortified orange juice provides 300 mg of calcium.  If you consume dark leafy greens and calcium fortified foods on a regular basis, it is quite likely that you are meeting your calcium needs through the diet.  However, if you are worried you are not getting enough calcium from food, speak with your healthcare provider about supplementation and the proper dosage.  The two most common forms of supplemental calcium are calcium citrate and calcium carbonate.  Calcium citrate is the type most easily absorbed by the body, since it does not require stomach acid for absorption.  Be sure that any calcium supplement you take is lead free.

Vitamin D is also important

It is also extremely important to keep in mind that your body cannot effectively use calcium without vitamin D.  It is vitamin D that is responsible for overseeing the absorption of calcium from food and supplements, by directing the movement of calcium in and out of bones.  Plus, recent studies show that women with more vitamin D in their bodies have a lower risk of preeclampsia during pregnancy, a lower risk of emergency C-section delivery, and give birth to babies with stronger bones.  Exposure to strong sunshine triggers the production of vitamin D, but many women do not get adequate sunlight exposure, especially if using sunscreen or living in northern latitudes.  Few foods naturally supply vitamin D, but certain fortified foods, like orange juice, ready-to-eat cereals, and cooked mushrooms contain adequate amounts of vitamin D, so aim to include these foods in your diet on a regular basis.  Your prenatal vitamin will contain vitamin D, but if you suspect that you are not getting the recommended 600 IU per day, speak to your health care provider about supplementation.

It is perfectly safe to follow a vegan diet while pregnant, but expectant mothers must be extra vigilant about making sure they get enough calcium and vitamin D from fortified plant-based foods, or through supplementation.  Choose meals wisely, eat a rainbow of nutrient-rich; wholesome foods, and make sure you are taking the right prenatal vitamin and you will be well equipped for a healthy pregnancy!

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Expect the Best, Your Guide to Healthy Eating Before, During & After Pregnancy by Elizabeth M. Ward, M.S., R.D.

Pregnancy: Overview and Nutrient Requirements, Lecture Notes by Dr. Lora A. Sporny