Preventing Gestational Diabetes During Pregnancy with Diet

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Eating well-balanced plant-based diets during pregnancy can reduce risks of gestational diabetes and hypertensive disorders like preeclampsia.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Over the past two decades, scientific and professional nutrition and pediatric associations have issued official statements and published position papers about adopting vegan diets during crucial life stages, including pregnancy and lactation, infancy, and childhood. While some of these associations firmly agree a well-designed vegan diet can be healthy and support normal growth and development, others are more reserved, and some caution against vegan diets for children. Those that are supportive include the American Dietetic Association, which has held this position for more than 25 years, as well as professional associations in Australia, Canada, Portugal, Italy, the UK, Finland, Germany and Norway, and Europe more broadly. More reserved opinions also came out of the UK and Europe, including Spain, and downright dismissive positions have come out of Slovenia, Germany, Italy, France, and Belgium. What does the evidence say about vegan diets in children?

Part of the challenge starts at the very beginning, with the exclusion of pregnant people from clinical trials in general. With such compelling needs, why are pregnant women largely excluded from clinical research? Often due to ethical concerns, dominated by fears of fetal harm. Even nonpregnant women of reproductive age often have to commit to contraception during the research period, and those who become pregnant must leave the study with their data excluded. That all adds up to a lack of clinical trial data on pregnant women. Paradoxically, these precautionary measures may not have made pregnant moms or their babies safer because of the resulting lack of evidence.

Some of the commentary around vegan diets for children includes this same concern about the lack of data. One researcher stated, “In children we do not have many good quality studies, and the studies we do have come mostly from vegetarian children—and they are of very varying quality.” But researchers are attempting to fill this void, starting with “to vegan or not to vegan when pregnant, lactating or feeding young children.”

The oldest and largest association of nutrition professionals in the world, the Academy of Nutrition and Dietetics, considers a completely plant-based diet to be suitable during pregnancy, lactation, infancy, and childhood, provided it is well-planned. What exactly does well-planned mean? First of all, a diet rich in a wide variety of plant foods—grains, legumes (such as beans, lentils, split peas, and chickpeas), fruits and veggies, nuts and seeds, herbs and spices. We want to limit vegetable fats so they don’t displace more nutrient-dense foods, and if you do use them, choosing them carefully––for example, avoiding trans fats and tropical oils. Also, taking a DHA supplement, consuming enough calcium, and ensuring sufficient vitamin D––and most importantly, not forgetting about vitamin B12, as Dr. Greger has covered extensively because it is so important to ensure a regular and reliable source of vitamin B12.

Balanced plant-based diets mean eating a wide variety of plant foods in order to sufficiently meet energy requirements, and paying attention to some nutrients that may be critical, iodine included. It’s one nutrient that should also be supplemented during pregnancy and breastfeeding.

What are the impacts on the mother’s health of following a vegetarian diet during pregnancy? Gestational diabetes affects around 14 percent of pregnancies globally, and even more in some regions of the world. It’s also at the center of the vicious cycle of diabetes begetting diabetes. Linked not only to adverse pregnancy and birth outcomes, but greater long-term risk of cardiometabolic disorders in both moms and babies. Research suggests beneficial impacts of plant-based diets on blood sugar control. What effect might that have on risk of gestational diabetes? A systematic review and meta-analysis on the plant-based dietary patterns and gestational diabetes risk found that those who ate closer to a healthy plant-based diet had a significantly lower risk of developing gestational diabetes.

Evidence from the Harvard Nurses’ Health Study II suggests these benefits extend to hypertensive disorders, like preeclampsia, with a 20 percent lower risk among those eating the most plant-based diets. And this lower risk could benefit moms’ health for years to come, as hypertensive disorders during pregnancy are associated with increased risk of stroke later in life. Note that Dr. Greger previously covered other pregnancy outcomes as well. Once the baby arrives, what do we know about plant-based diets and feeding babies and young children? I’ll cover that next.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Over the past two decades, scientific and professional nutrition and pediatric associations have issued official statements and published position papers about adopting vegan diets during crucial life stages, including pregnancy and lactation, infancy, and childhood. While some of these associations firmly agree a well-designed vegan diet can be healthy and support normal growth and development, others are more reserved, and some caution against vegan diets for children. Those that are supportive include the American Dietetic Association, which has held this position for more than 25 years, as well as professional associations in Australia, Canada, Portugal, Italy, the UK, Finland, Germany and Norway, and Europe more broadly. More reserved opinions also came out of the UK and Europe, including Spain, and downright dismissive positions have come out of Slovenia, Germany, Italy, France, and Belgium. What does the evidence say about vegan diets in children?

Part of the challenge starts at the very beginning, with the exclusion of pregnant people from clinical trials in general. With such compelling needs, why are pregnant women largely excluded from clinical research? Often due to ethical concerns, dominated by fears of fetal harm. Even nonpregnant women of reproductive age often have to commit to contraception during the research period, and those who become pregnant must leave the study with their data excluded. That all adds up to a lack of clinical trial data on pregnant women. Paradoxically, these precautionary measures may not have made pregnant moms or their babies safer because of the resulting lack of evidence.

Some of the commentary around vegan diets for children includes this same concern about the lack of data. One researcher stated, “In children we do not have many good quality studies, and the studies we do have come mostly from vegetarian children—and they are of very varying quality.” But researchers are attempting to fill this void, starting with “to vegan or not to vegan when pregnant, lactating or feeding young children.”

The oldest and largest association of nutrition professionals in the world, the Academy of Nutrition and Dietetics, considers a completely plant-based diet to be suitable during pregnancy, lactation, infancy, and childhood, provided it is well-planned. What exactly does well-planned mean? First of all, a diet rich in a wide variety of plant foods—grains, legumes (such as beans, lentils, split peas, and chickpeas), fruits and veggies, nuts and seeds, herbs and spices. We want to limit vegetable fats so they don’t displace more nutrient-dense foods, and if you do use them, choosing them carefully––for example, avoiding trans fats and tropical oils. Also, taking a DHA supplement, consuming enough calcium, and ensuring sufficient vitamin D––and most importantly, not forgetting about vitamin B12, as Dr. Greger has covered extensively because it is so important to ensure a regular and reliable source of vitamin B12.

Balanced plant-based diets mean eating a wide variety of plant foods in order to sufficiently meet energy requirements, and paying attention to some nutrients that may be critical, iodine included. It’s one nutrient that should also be supplemented during pregnancy and breastfeeding.

What are the impacts on the mother’s health of following a vegetarian diet during pregnancy? Gestational diabetes affects around 14 percent of pregnancies globally, and even more in some regions of the world. It’s also at the center of the vicious cycle of diabetes begetting diabetes. Linked not only to adverse pregnancy and birth outcomes, but greater long-term risk of cardiometabolic disorders in both moms and babies. Research suggests beneficial impacts of plant-based diets on blood sugar control. What effect might that have on risk of gestational diabetes? A systematic review and meta-analysis on the plant-based dietary patterns and gestational diabetes risk found that those who ate closer to a healthy plant-based diet had a significantly lower risk of developing gestational diabetes.

Evidence from the Harvard Nurses’ Health Study II suggests these benefits extend to hypertensive disorders, like preeclampsia, with a 20 percent lower risk among those eating the most plant-based diets. And this lower risk could benefit moms’ health for years to come, as hypertensive disorders during pregnancy are associated with increased risk of stroke later in life. Note that Dr. Greger previously covered other pregnancy outcomes as well. Once the baby arrives, what do we know about plant-based diets and feeding babies and young children? I’ll cover that next.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

A note from Dr. Greger:
I am thrilled to introduce Dr. Kristine Dennis, our Senior Research Scientist. Dr. Dennis is an experienced nutrition and public health scientist who joined NutritionFacts to expand our research capacity — diving deep into the research, writing scripts, and now, narrating her own videos! You’ll continue to see videos from both of us interspersed in no particular order. I’m so happy Kristine is with NutritionFacts to help expand our capacity and perspectives.

Stay tuned for my next video, The Growth and Nutrient Intakes of Children Raised on Plant-Based Diets.

For more on vitamin B12, download our infographic, and for more on vitamin D, calcium, omega-3 fatty acids, iodine, iron, and selenium, see our Optimum Nutrient Recommendations. 

These are the videos I mentioned:

For more on pregnancy, see the pregnancy topic page and our resources for fertility, pregnancy, breastfeeding, and early childhood.

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