Plant-Based Pregnancy: Navigating Gestational Diabetes with a Vegan Diet

What is Gestational Diabetes Mellitus

The term Gestational Diabetes Mellitus (GDM) refers to any degree of glucose

intolerance that initially appears during pregnancy. It is considered as the most

common metabolic disorder and can affect up to 25% of pregnant women. Factors

that have been shown to increase the likelihood of its occurrence include advanced

maternal age, family history of diabetes, previous gestational diabetes, previous

delivery of a larger-than-normal infant, non-Caucasian ethnicity, maternal smoking

habits, with a greater role played by the mother's body weight before the onset of

pregnancy as well as the rate of weight gain during pregnancy.

It is important to fully understand the urgent need for prevention and

management of gestational diabetes. The presence of gestational diabetes has

significant implications for both the mother and her child. Specifically, it is associated

with an increased risk of developing preeclampsia, type 2 diabetes (T2D),

cardiovascular diseases, cancer, and even kidney disease in the mother. On the

other hand, for the fetus, it is linked to large size for gestational age (LGA),

hypoglycemia or suspicion of it during pregnancy. Even in the child's later life,

obesity, T2D, hypertension, cardiovascular issues, early onset of puberty, and poor

neurological development may occur.

The first-line treatment for gestational diabetes is changes in the mother's diet

and lifestyle. In 70-85% of cases, these changes have a significant impact, while a

percentage of 15-30% may also require pharmacological therapy. One of the dietary

approaches being studied recently is the vegan diet, which is high in antioxidants,

plant-based fibers, vitamins, and minerals.

Vegan diet and its possible

The vegan diet is the most restrictive type of vegetarian diet, according to

which individuals exclude not only all animal foods (meat, fish) but also all animal

by-products (eggs, dairy, honey) from their diet. The popularity of this dietary

approach is increasing, with its prevalence estimated at around 1-10% in Europe and

approximately 3% in the United States. Apart from ethical and religious reasons that

drive the population towards plant-based diets, research suggests that such dietary

patterns may have significant health benefits. One of the benefits being studied

relates to better regulation of glucose, thus potentially aiding in the management of

diabetes.

It appears to have positive effects on addressing various metabolic diseases.

It's been observed to help regulate diabetes more effectively. The key difference here

isn’t its consistency but the fact that it's linked to lower body weight, which in turn

helps reduce insulin resistance. In the EPIC-Oxford study, vegetarians were found to

have a 35% lower risk of diabetes compared to omnivores. However, when BMI was

taken into account, the percentage decreased to 11% and was no longer statistically

significant. For vegans, the risk was 47% lower than omnivores initially, but it

decreased to just 1% when BMI was adjusted for. What’s more, in a prospective

cohort study, it was found that for every 10g increase in daily intake of dietary fiber,

the risk of developing diabetes decreased by 26%. Additionally, each 5g increase in

cereal intake reduced the risk by 23%, and fruits decreased it by 26%.

The ways in which a vegan diet may contribute to improving glycemic profiles

are diverse. Plant-based fibers delay gastric emptying and thus the absorption of

glucose, limiting peak blood sugar levels, while also enriching the gut microbiota. At

the same time, they can also reduce markers of inflammation and positively

influence fat storage in the liver, thereby limiting oxidative stress.Polyunsaturated

fatty acids are those that enhance insulin sensitivity and improve the inflammatory

response of adipose tissue. Antioxidants, on the other hand, reduce oxidative stress,

which is increased in the presence of gestational diabetes.

Challenges and considerations

Plant-based and vegan diets can be followed during pregnancy, even in the

case of gestational diabetes. However, careful planning is essential to avoid potential

deficiencies. It is also important to take appropriate supplements for the nutrients

that cannot be adequately covered by the diet. Some of the nutrients that require

monitoring include proteins, B12, iron, calcium, vitamin D, omega-3 fatty acids,

choline, and zinc. Possible deficiencies in these nutrients may be due to increased

needs during pregnancy or limited intake because of the exclusion of all

animal-derived foods.

It is significant to conduct further research to ascertain the effects and

adequacy of a vegan diet both in the general population and in pregnant women. It's

a dietary approach that has become increasingly popular, although there is still a

lack of sufficient studies. Additionally, with proper planning, theoretically, the

nutritional needs of some nutrients can be met without supplements, as in the case

of iron. Nevertheless, plant-based iron is not absorbed as efficiently as animal-based

iron. Therefore, there might be a need for different recommendations for the

population following such a diet.

Conclusion

To conclude, a vegan diet currently shows the best prognosis for weight loss. This,

along with its constituent components, makes it a potential treatment option for

diabetes. However, more studies need to be made. Despite being rich in plant fibers

and antioxidants, it lacks many other essential nutrients, making it challenging to

design for maximum nutritional needs. Adherence to such a diet is also significantly

difficult due to the limited food variety. All of these considered, until further research

is conducted, the Mediterranean diet remains the preferred dietary choice for

diabetes management.