Vegan Nutrition with Dina Aronson, M.S. R.D.

Dina Aronson, MS, RD is a vegan dietitian whose specialties include chronic disease prevention, vegetarian/vegan nutrition, and lifestyle management. She is the founder and director of VeganRD.com, a nutrition consulting company. Active in many vegetarian nutrition organizations, Dina was the recipient of the American Dietetic Association's Recognized Young Dietitian of the Year Award in 2002.

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I am 33 weeks pregnant and have been a vegan for over a year, I was just diagnosed with Gestational Diabetes. Do you have any suggestions to help me control this so I can have a healthy baby? - April

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Dear April,
Gestational diabetes (GD), which affects 2-4% of pregnancies, is a temporary form of diabetes that typically subsides upon delivery of the baby. However, about half the women with GD will develop type 2 diabetes later in life. Furthermore, their children are also at greater risk for the disease.

The most important goal for women with GD to do is to control their blood sugar levels. Untreated, GD can harm the heart and liver of the fetus, and may result in birth defects or stillbirth if the blood sugar remains out of control.

The good news is that with a little planning and attention, it is not very difficult to control GD and have a healthy, happy baby. The guidelines for GD among vegans and non-vegans are the same; the only difference is that your nutrients will be coming exclusively from plants.

Did your doctor show you how to test your blood sugars? Blood sugar testing provides valuable information about how your diet is affecting your blood sugar, so that you can adjust your food intake accordingly. You should be testing your sugars at least four times per day: fasting and 1 or 2 hours after each meal. The goal numbers are:

fasting: under 95 mg/dl
1 hour after a meal: under 140 mg/dl
2 hours after a meal: under 120 mg/dl

Keep a detailed diary of everything you eat (including amounts), times you eat, blood sugar levels, and times you test.

If you find that these numbers are higher than they should be, make an appointment with your doctor or other healthcare giver to see if you need to take insulin.

The number one dietary goal with GD is controlling carbohydrate intake. Carbohydrate control can be attained by eating 3 moderate meals and 3 small snacks throughout the day. The total amount of calories you need depend upon your age, height, weight, and activity level. (A visit with a dietitian will reveal your particular needs.) The carbohydrate content of your meals and snacks should be about ½ of your total calories; the remaining calories are split between protein and fat. Given that plant foods are naturally rich in carbohydrates, it is important to select your foods wisely. Choose foods that are naturally low in sugar, high in fiber, and moderate in protein and fat. Foods that fit the bill include:

Legumes (beans, nuts, nut butters, seeds)*
Soy products like tofu and tempeh
Vegetables
Whole grains (intact grains are best, as opposed to foods make from flour)
Fruits, but not too much at once

Limit the following foods:

Baked goods
Fruit juice (the whole fruit is preferred; if you have juice, limit to ½ cup)
Sweetened fruits (like canned or dried with added sugar)
Potatoes, refined grains, refined cereals

During pregnancy, try to avoid:

colas, fruit punch, and other sweetened beverages
sugar
candy

*If there is a history of peanut allergy in your family, avoid peanuts during pregnancy.

Exercise is important for a healthy pregnancy, and may also help control blood sugar levels. Ask your doctor or other healthcare professional what exercise is appropriate for you at this time.

Here is a sample vegan meal plan. This is meant as an example; it is not meant as therapy. No one diet plan suits everyone, as your plan will depend on your blood sugar readings, calorie needs, and lifestyle. Please visit with a registered dietitian to get more specific guidelines that suit your particular needs.

Breakfast:

1 cup oatmeal with 1 tablespoon ground flax seeds
1-2 ounces chopped walnuts
1/2 apple
1 cup fortified, unsweetened soy milk **

Morning Snack:

6 oz container of fruited soy yogurt

Lunch:

1 slice whole wheat bread with vegan trans-fat free tub margarine
2 cups lentil soup
raw vegetables with a vegan dip or dressing

Afternoon snack:

2 brown rice cakes and 10 baby carrots with 1/2 cup hummus

Dinner:

1 cup chopped fruit, like pineapple, melons, etc.
1 cup whole grain pilaf (like Kashi that you cook)
1 serving soy-based meatball substitute, tofu, or tempeh, seasoned to taste
1/2 cup tomato sauce
2-3 servings of vegetables (try to serve different kinds; for example, a salad with greens and other raw chopped veggies, plus a serving of steamed broccoli or other vegetable)
flax oil-based salad dressing

Evening Snack:

1 oz (22 each) almonds with 1/4 cup dried fruit OR 2 oz whole grain crackers with 2 tablespoons nut butter
1 cup fortified, unsweetened soy milk

Drink plenty of fresh water throughout the day.

If your foods do not supply added B12 and vitamin D, take a supplement with these vitamins.

**If you do not like the flavor of unsweetened soy milk, use 1/2 unsweetened and 1/2 sweetened soy milk mixed together.

Disclaimer: The advice given here is for eductional purposes only. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider.

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