Clinical nutrition ESPEN · 2026
Characterization of Nutritional Intake in Vegan Pregnant Women and its Association on Birth Weight.
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Dubinsky Efrat Paz, Avnon Tomer, Shaham Sivan, Shiff Yaffa Elbaum, Yogev Yariv, Anbar Ronit
Аннотация
BACKGROUND & AIMS: Evidence regarding the nutritional characteristics of strictly vegan diets during pregnancy and their potential associations with fetal growth remains limited. We aimed to characterize nutrient intake among vegan pregnant women and to examine dietary factors associated with neonatal birth weight and small-for-gestational-age (SGA) birth.
METHODS: This secondary analysis of a prospective observational study included women with singleton pregnancies who delivered at a single medical center and adhered to a consistent diet. Participants were classified as vegan or non-vegan and reported demographic data and supplement use. During the third trimester, women completed a validated Food Frequency Questionnaire. Pregnancy outcomes were retrieved from a computerized database. SGA was defined as birthweight <10th percentile. Dietary intake was compared between vegan and non-vegan women, and associations of protein and amino acid intake with neonatal growth outcomes were examined using regression, classification and regression tree (CRT), and exploratory correlation analyses.
RESULTS: Among 230 participants, 54 followed a vegan diet. Vegan women had lower protein intake (60 vs. 82 g/day, p <0.001), as well as lower protein intake relative to pre-pregnancy body weight (1.10 vs. 1.44 g/kg/day, p<0.001). Higher protein percentage was associated with a lower risk of SGA (OR=0.80, 95% CI: 0.673-0.956, p=0.014). In CRT analysis, leucine expressed as a proportion of total protein was identified as the primary splitting variable for birth weight, with a cutoff of 5.636%; mean birth weight was 3341 g above this threshold and 3074 g at or below it (mean difference 267 g, p<0.001). Exploratory correlations showed modest positive associations of neonatal growth measures with protein percentage, absolute leucine intake, and leucine, tyrosine, and valine as proportions of total protein (ρ=0.160-0.248, q≤0.019). Vegan diets included higher carbohydrate (256 vs. 217 g), fiber (48 vs. 30 g), folate (627 vs. 416 μg), and iron (17 vs. 12 mg) intake, and lower fat (72 vs. 79 g), calcium (764 vs. 1053 mg), vitamin D (0.24 vs. 5.5 μg), vitamin B12 (1.5 vs. 4.6 μg), DHA (0 vs. 0.07 g), and choline (270 vs. 394 mg) (all p<0.05).
CONCLUSIONS: Vegan women had a higher rate of SGA than non-vegan women, and this increased risk may be partly related to differences in maternal protein intake and composition. In addition, vegan women had lower dietary intakes of calcium, vitamin B12, vitamin D, DHA, and choline, highlighting these nutrients as important considerations in the nutritional assessment and counseling of pregnant women adhering to a strictly vegan diet.
METHODS: This secondary analysis of a prospective observational study included women with singleton pregnancies who delivered at a single medical center and adhered to a consistent diet. Participants were classified as vegan or non-vegan and reported demographic data and supplement use. During the third trimester, women completed a validated Food Frequency Questionnaire. Pregnancy outcomes were retrieved from a computerized database. SGA was defined as birthweight <10th percentile. Dietary intake was compared between vegan and non-vegan women, and associations of protein and amino acid intake with neonatal growth outcomes were examined using regression, classification and regression tree (CRT), and exploratory correlation analyses.
RESULTS: Among 230 participants, 54 followed a vegan diet. Vegan women had lower protein intake (60 vs. 82 g/day, p <0.001), as well as lower protein intake relative to pre-pregnancy body weight (1.10 vs. 1.44 g/kg/day, p<0.001). Higher protein percentage was associated with a lower risk of SGA (OR=0.80, 95% CI: 0.673-0.956, p=0.014). In CRT analysis, leucine expressed as a proportion of total protein was identified as the primary splitting variable for birth weight, with a cutoff of 5.636%; mean birth weight was 3341 g above this threshold and 3074 g at or below it (mean difference 267 g, p<0.001). Exploratory correlations showed modest positive associations of neonatal growth measures with protein percentage, absolute leucine intake, and leucine, tyrosine, and valine as proportions of total protein (ρ=0.160-0.248, q≤0.019). Vegan diets included higher carbohydrate (256 vs. 217 g), fiber (48 vs. 30 g), folate (627 vs. 416 μg), and iron (17 vs. 12 mg) intake, and lower fat (72 vs. 79 g), calcium (764 vs. 1053 mg), vitamin D (0.24 vs. 5.5 μg), vitamin B12 (1.5 vs. 4.6 μg), DHA (0 vs. 0.07 g), and choline (270 vs. 394 mg) (all p<0.05).
CONCLUSIONS: Vegan women had a higher rate of SGA than non-vegan women, and this increased risk may be partly related to differences in maternal protein intake and composition. In addition, vegan women had lower dietary intakes of calcium, vitamin B12, vitamin D, DHA, and choline, highlighting these nutrients as important considerations in the nutritional assessment and counseling of pregnant women adhering to a strictly vegan diet.