0:16

The information in this podcast is provided

0:18

for education and research information

0:20

only .

0:21

It is not a substitute for professional

0:23

health advice . If

0:29

you're trying to get pregnant or you are pregnant

0:31

and you feel a little bit overwhelmed by all

0:33

you need to know , then this is the

0:35

right podcast for you . Welcome

0:37

to the show . I'm Bridget Maloney . And

0:58

. I'm obstetrician

1:00

Dr Brigid Maloney , and here

1:03

we are again with the wonderful

1:05

dietitian , steph Velarchus

1:07

. Welcome , steph . Thanks for having me back , bridget

1:09

, it's a pleasure . I'm so glad

1:11

that you said yes to this episode . We're

1:14

going to be covering being

1:16

a vegetarian and growing a baby . Okay , and

1:19

it is long overdue .

1:21

Yep , and we've been chatting about it for a few months , haven't

1:23

we ?

1:24

Yeah , that's right , yeah , yeah . Well , we've

1:26

been chatting about needing to have an episode like

1:28

this since we probably started the podcast

1:31

. Good , all

1:33

right , so what I might do is just introduce

1:36

you to our listeners . So

1:43

, people , steph Velarchus is an expert certified fertility and pregnancy dietitian and nutritionist

1:45

and she's the founder of the Dietologist . She

1:48

and her team have won numerous awards , including

1:50

Best Pregnancy and Fertility Nutrition Clinic

1:53

in 2022 , quality

1:55

in Primary Care Award by Dietitians

1:57

Australia in 2022 . That

2:00

was a big year , steph , yeah .

2:03

I gave up from the awards . After that I was like

2:05

that's okay , we won , son , that'll

2:08

do .

2:10

Steph truly believes every hopeful parent should

2:12

have access to scientifically backed nutrition

2:14

information to prepare their body prior

2:16

to conception , support them through

2:18

fertility treatments , pregnancy and ultimately

2:21

bring home a healthy and happy baby

2:23

. Steph also hosts the popular

2:25

fertility health podcast , fertility Friendly

2:28

Food , which everybody who's

2:30

trying for a baby and listening to this episode go

2:32

over and have a listen to Steph's podcast . It's

2:34

wonderful .

2:35

What a new show . That's brilliant , I know

2:37

.

2:39

There was more I could have said , but I think that

2:41

is amazing . You're a

2:43

very productive expert

2:46

.

2:46

Yes , Do try .

2:48

Yeah , do try . Yeah , so , as I said , we're

2:50

talking about vegetarian and

2:53

veganism in pregnancy , but

2:55

I thought maybe we should start with a recap

2:57

of the most important aspects of a diet

3:00

for a pregnant woman . Now

3:06

, we've had you on the podcast before , so I urge people to go back to Steph's podcasts that

3:08

we've had a couple of months ago , and I'll put the links in the show notes for all of the

3:11

podcasts that I suggest today . But just briefly

3:13

, can you just give us the top nutritional

3:15

needs that a pregnant or pre-pregnant person

3:17

needs ?

3:18

Yeah . So with pregnancy

3:21

specifically , we kind

3:23

of follow the trimester pattern , because

3:25

in trimester one it's

3:28

characterized often by nausea , food

3:30

aversions , constipation

3:33

, fatigue , bloating , and

3:35

people are often particularly first-time

3:37

pregnant . Mums are

3:39

pretty shocked about how much of an impact

3:41

this has on their diet quality

3:44

and the quality of the diet that they thought

3:46

they were going to have when they're pregnant . And

3:48

so in trimester one you don't actually

3:50

need anything extra . You don't need extra

3:52

calories or energy . You

3:55

don't need more protein or more carbs

3:57

or more fats . We do need

4:00

more micronutrients or vitamins

4:02

and minerals , which is where

4:04

that prenatal vitamin element comes

4:06

in , which is what we talked about in those last couple of

4:08

episodes that I was on . But

4:12

in trimester one , if you're symptomatic , I

4:14

have this moniker of survive

4:17

now , thrive later . You

4:19

just got to get by . Don't beat yourself up too much

4:21

about the quality of your diet . In trimester one

4:23

, bumps doesn't really need much to

4:26

kind of get by , and , particularly

4:28

for those who are very sick , you will know that

4:30

you will still pretty much grow a perfectly

4:33

happy , healthy baby in trimester

4:35

one , despite living off

4:37

crackers and water and then

4:39

spewing it up 20 minutes later . So

4:43

they're really resilient . They're

4:46

both delicate and resilient all at the same time

4:48

. In trimester two we do get an increase

4:50

in the energy , and

4:52

that energy should be coming from an

4:55

extra serving of carbohydrates or

4:57

grain foods so think brown

4:59

rice , quinoa breads , oats

5:02

, popcorn , things like that and

5:04

also protein foods so

5:07

chicken meat , fish , eggs

5:09

, tofu , legumes and

5:11

beans , all that good stuff , and

5:14

so that kind of replicates . Again

5:16

in trimester three where we get another

5:18

step up in total energy intake . So in trimester

5:20

two it's an extra 350 calories

5:23

or so compared to your pre-pregnancy . And

5:25

then in trimester three it is

5:27

an extra 450 calories compared

5:30

to pre-pregnancy , not compared to trimester

5:32

two , so it's only a little jump up . So

5:34

it is not eating for two . The average woman needs

5:36

about 2000 calories per day

5:38

, so as a percentage it's

5:40

not even a quarter . So it is an

5:42

extra amount . It is generally

5:45

not too difficult to achieve for most people

5:47

and we want more of our

5:49

protein rich foods and our grain foods

5:52

to be making up that extra energy

5:54

. And then that switches

5:56

a little bit . When it comes to breastfeeding Preconception

5:59

I think we kind of touched on a little bit last

6:01

time but we want to be thinking about our abundance

6:04

of fruits and vegetables for lots of antioxidants

6:06

. Seafood is particularly important

6:09

in pre-pregnancy and it's shown to

6:11

help support fertility outcomes . We

6:13

know that whole grains help support implantation

6:16

. Nuts and seeds can

6:19

contain vital nutrients to support reproductive

6:21

health for both female and males . Dairy

6:24

foods seem to be helpful as well , and

6:27

optimizing that calcium intake

6:29

pre-pregnancy . So certainly

6:31

like the kind of five food groups are

6:33

all come out to play all

6:35

throughout this life stage but they do modulate

6:37

at different points and then you're also

6:39

going to be kind of limited by

6:41

what you're going through . Every pregnancy

6:44

. Every person's journey is going to be different . So

6:46

it's going to be limited by your capacity

6:48

, either physically or mentally , to navigate

6:51

those particular foods and

6:53

your diet as a whole and how much energy

6:55

you have to actually eat

6:58

and prepare food and shop and

7:00

all those kinds of things . So we take a very

7:02

practical approach to the dietologist and

7:04

I think that's why people like coming to see

7:06

us , because we're not going to slap you on the wrist because you've

7:08

been living off crackers in your

7:10

pregnancy , because you've been feeling wretched . So

7:12

there's certainly lots

7:14

of intricate details and

7:17

lots of micronutrient shifts and demands

7:19

that occur over this life stage

7:21

, but that's probably

7:24

a little bit of an overview .

7:26

That's wonderful . That is an incredible

7:29

quick

7:32

snippet of basically what it is that

7:34

you're trying to achieve with

7:36

your diet . Can I just maybe

7:38

quantify what do you mean by 300

7:40

calories ? That's about two pieces

7:43

of bread , isn't it ?

7:44

Yeah , so it's pretty much a

7:46

piece of bread with some peanut butter and banana

7:48

on top is about what it looks like

7:50

.

7:51

I definitely made that mistake , but then our listeners

7:55

won't . Our listeners will know exactly

7:57

what their nutritional needs will

7:59

be . I've spoken about it before . Long-time

8:02

listeners would know that in my first pregnancy

8:04

, I thought my extra nutritional

8:06

needs was eating a Magnum every night

8:08

. Yeah , that was not good

8:10

. A delicious choice . A

8:13

delicious choice but , however , not nutritionally

8:15

sound or needed . All

8:18

right , so we're focusing mainly on only

8:20

on vegetarian , and I

8:22

wondered whether you could describe

8:25

the levels or

8:27

the types of different vegetarian

8:30

diets .

8:30

Yeah Well , we'll go from you know

8:32

, most limited , and then we'll move up

8:35

. So the most limited

8:37

mainstream

8:39

kind of version of vegetarian diet is

8:41

the vegan diet . So the vegan

8:43

diet will completely exclude

8:46

animal meats but also

8:48

animal byproducts . So that will be things

8:50

like red meat . Chicken

8:52

fish are off the menu

8:55

, but so too will be eggs and

8:57

dairy . So their

8:59

diets are mainly focused on foods

9:02

like fruits , vegetables , nuts

9:04

and seeds , whole grains , plant-based

9:07

milk alternatives , tofu

9:09

and tempeh , legumes

9:12

and beans , nuts and seeds and

9:14

healthy fats that come from plants

9:17

. So that's the vegan

9:19

diet . Then you've got kind

9:22

of different variations when it comes to vegetarianism

9:24

, and the technical terms are lacto-ovo-vegetarian

9:28

, which means you eat milk

9:30

, you eat eggs , and then it's

9:32

basically milk and eggs plus vegan

9:35

is the way that I always explain

9:37

it to people . And then you also have lacto-vegetarians

9:40

they just have dairy but no eggs . And then you

9:42

have over-vegetarians they have eggs but not

9:44

dairy . That's a very individual

9:46

kind of thing , I would say . Overarchingly

9:49

, vegetarians will limit just the

9:51

actual animal flesh . So you meet

9:54

fish , chicken and

9:56

seafood , and they will eat

9:58

eggs and dairy

10:00

products in general . Then

10:03

you've kind of got this like emergence

10:05

of this new style of vegetarianism

10:07

which I like to call flexitarian , which

10:10

is , you know , a lot of people will

10:12

be vegetarian part time , so

10:14

a lot of people will be vegetarian , you

10:16

know , up until lunchtime , and then dinner

10:19

will have some kind of meat . Other people will be vegetarian for certain

10:21

days of the week , and then dinner we'll have some kind of meat . Other people will be vegetarian for certain days of

10:23

the week , and then they might go out on the weekend

10:25

and have a piece of fish or have a steak

10:27

or have some chicken . And this is a more

10:29

flexible version of the vegetarian diet

10:31

. It's not strict and

10:34

they are able to incorporate

10:36

some meats as they

10:38

wish in the frequency that they

10:40

like . And then there's also the term plant-based

10:43

diet , which is very hard to

10:45

define . I find this really difficult

10:47

. When a client comes in to me and says , oh , I'm plant-based

10:50

, I'm like okay , what does that mean to you

10:52

? Because it doesn't mean anything specific

10:55

to me , doesn't have a definition

10:57

. So plant-based diets can sometimes

10:59

be used to describe a vegan diet . So some vegans will say , oh , I . So plant-based diets can sometimes be used to describe a vegan diet . So some

11:01

vegans will say , oh , I'm plant-based

11:04

, and then for other people it just means

11:06

that they are plant-focused

11:08

, which means that you can be omnivorous

11:11

and say you have a plant-focused

11:13

or a plant-based diet , because you're

11:15

mostly eating plants like fruits , vegetables

11:17

, whole grains , nuts and seeds , and

11:19

so , yeah

11:21

, that definition can be really loose

11:24

. So I generally try and get

11:27

people to kind of give me some sense

11:29

of it . Sometimes there's no label , and that's

11:31

okay too , but they're the key

11:33

kind of groups .

11:35

Well , that's going to make gosh , even this discussion

11:37

a little bit tricky , because , you

11:40

know , we can't really give a

11:42

panacea . This is what a vegetarian woman

11:44

should eat during her pregnancy .

11:46

Yeah .

11:47

How do you , how can we help people

11:49

to know what it is that they need to do

11:51

to meet their nutritional requirements

11:53

?

11:54

Oh , I like . I know

11:56

this is such a cop-out answer , but

11:58

every time somebody says , oh , what should

12:00

a vegetarian do , I was like see a dietician . Like

12:02

, please just see a dietician , because

12:05

you can ask

12:07

100 vegetarians how they eat and

12:09

you probably , if you're not a vegetarian , you

12:12

probably have a vision of what vegetarianism

12:14

looks like . And I will get back

12:16

100 different types of dietary reports

12:18

. It is just as diverse as

12:21

omnivorous diets in terms

12:23

of dietary quality , and

12:25

I think I'm sure that something we'll get to

12:27

in our chat today is , just

12:29

because somebody is

12:31

avoiding meats or animal

12:34

byproducts , it doesn't automatically mean

12:36

that their diet is significantly healthier

12:38

than someone who does . And I think that's

12:41

a common trap that even

12:43

people who follow a vegetarian or vegan

12:45

diet can fall into themselves . Because

12:47

they've put this label on and they shop

12:49

like that they think , oh well

12:51

, it must be . Only , you know , I must

12:53

be only eating nutritiously because I'm eating plants

12:56

. That can be true

12:58

, but a lot of the times I find it's not

13:00

the case , because coke zero

13:02

is vegetarian and vegan oreos

13:05

are vegan . Uh , you know coconut

13:07

ice , the plant-based magnums are vegan

13:10

. So there's lots of things

13:12

in the and and like ultra processed

13:15

, you know , plant-based burgers and

13:17

things like that , which have been shown to

13:19

be perhaps just as non-nutritious

13:22

as the meat versions of

13:24

them and perhaps lacking more micronutrients

13:26

. So the commercialization

13:28

of plant-based diets has caused

13:31

the diet quality

13:33

, I think , to go down . But because of this label

13:35

and this assumption , we're assuming that people

13:37

who follow a vegetarian or vegan diet are

13:40

doing a good job at baseline . So

13:43

it is hard to know what you can

13:45

and can't have . I think you know starting

13:47

at the boring Australian dietary

13:49

guidelines of what to eat in pregnancy

13:51

is a decent place to start . You have got no

13:53

place to go , like you're not going to

13:55

go see a dietician , which I'd strongly advise

13:57

, but if you're not , I think that's a

13:59

decent place to start so you can get a feel for how

14:02

many pieces of fruit you should be having a day , how

14:04

many servings of vegetables you should be having

14:06

a day , how many whole grain serves . How

14:09

the protein is going

14:11

to be an issue , because that's the group that's mainly

14:13

limited . Cool , what

14:15

are we going to do about that ? All of a

14:17

sudden , I hate eggs and I'm pregnant . All

14:19

of a sudden the smell of milk turns my stomach

14:22

. Okay , now we have more

14:24

of an issue that we're going to have to

14:26

try and navigate . It's always a workaround

14:28

, but whether you want to navigate that workaround

14:30

on your own or not is a different story . And

14:33

certainly dairy alternatives

14:35

, I should say , is another big group that I

14:37

think gets often overlooked

14:40

. Dairy is often forgotten , but calcium

14:42

is such a critical nutrient in pregnancy

14:44

and not just in pregnancy , just in

14:46

general for women . We have

14:49

this awesome opportunity when we're young to

14:51

build our bone mineral density for life

14:53

, and then our bone mineral density

14:55

takes such a knock being pregnant and breastfeeding

14:58

, and then it just declines once

15:00

that estrogen drops when we hit menopause

15:02

that you've got to really focus

15:05

on it . It's invisible , you're not going to feel

15:07

it , but one day it will catch up

15:09

to you . And so , yeah , I talk

15:12

a lot about calcium with my vegan and vegetarian

15:14

clients as well , and making sure that

15:16

we're planning the diet really well to

15:18

either be using dairy alternatives with added

15:20

calcium or , you know

15:22

, sussing out what yogurts are on the market

15:25

in terms of dairy-free

15:27

yogurts , which change

15:29

like the wind and hardly

15:31

stay on the market for very long and they're often not

15:33

a great source of calcium . And then

15:35

, like , the cheeses are made out of cashews , like

15:37

there's no calcium

15:41

in that . So it can be really , really

15:43

tricky . And then I think there's just this miseducation

15:46

that you know , like

15:48

I always hear from people oh , I'll just eat

15:51

spinach and that will give me all my calcium

15:53

and iron . I'm like no , it won't

15:55

. Like it's a drop in the ocean

15:57

, like we need a thousand milligrams of calcium

15:59

a day . Your spinach is giving you 10 . And

16:02

that's like a lot of spinach . I

16:04

was like that's a lot of spinach . It's a lot

16:06

of spinach , like it's already a lot of spinach to get

16:08

your 10 . So , like , imagine I was

16:10

just like you can't . You can't rely on those

16:12

things . So I think people misjudge

16:15

the micronutrient density

16:18

of some foods that they kind of have put

16:20

on a pedestal . And that is

16:22

the slippery slope . Like people telling me mushrooms

16:24

are full of protein on a vegan or vegetarian

16:26

diet , I'm like there's no protein in mushrooms , girl

16:29

. It's a great vegetable

16:31

, don't get me wrong . B12 . Yeah , there's

16:37

nothing protein-y about it . It's just a great textural culinary

16:40

substitute for protein . In

16:43

terms of texture , it doesn't mean it

16:45

contains a good source of

16:47

protein . So I think it's a combination

16:49

of . You

17:51

know , if you haven't been really well educated from

17:53

the jump about plant-based diets from

17:55

a healthcare professional , then it

17:58

makes it hard because you can perpetuate

18:00

those kinds of myths and that can

18:02

really compromise your nutritional intake , particularly

18:04

when you have these increased demands in pregnancy .

18:07

I've always thought a vegetarian has to be a

18:10

really good cook , or

18:12

at least interested in cooking . I

18:15

remember going through my first pregnancy

18:17

and one of my good friends she was a vegetarian

18:19

, hated cooking , actually , really didn't

18:21

love food , only ate to

18:23

survive , and so her main diet

18:25

through pregnancy was pasta

18:28

with a bit of cheese on top , and

18:30

so basically you know , morning , noon and night

18:32

that's what she ate , and I

18:35

just thought , well , it would be very

18:37

, very difficult if you weren't as

18:40

interested as it sounds as if you need to be plus

18:42

a really good cook . What do you

18:44

think about that ?

18:45

I agree , I have come to this

18:47

realisation recently that I

18:50

me personally I'm in this very

18:52

, I've had this very privileged upbringing

18:55

of being surrounded by food and

18:57

cooking and I have this skill

18:59

set where I don't need a recipe

19:01

to cook . I can think of something

19:04

and I can basically map

19:06

out how to cook it because I

19:08

have a basic repertoire of

19:10

how to cook and I

19:12

realized most people at least that I

19:14

talked to don't have that skill set . So

19:16

often people are coming to me and being like well , how

19:18

did you make that ? What's the recipe Like ? How

19:21

many meals of olive oil did

19:23

you put in the pan before you ? Spaghetti bolognese ? I'm like

19:25

I don't know , it was a dash .

19:27

I went like that with my hand and the oil came out

19:29

.

19:30

I did my yas well in the pot . I

19:32

don't know , and I've

19:34

realized as I've gotten older

19:37

and kind of further into it that that

19:39

is uncommon and that is not

19:42

the kind of the commonality that's

19:44

the norm . That's not the norm

19:46

anymore and it's kind of a little bit , I feel

19:48

like sad , because I think

19:50

that skill set lends itself so well

19:52

to flexibility and , like you

19:54

said , in the context of vegetarianism

19:57

, like you can pick up something like Otolenghi

19:59

or one of those you know more vegetarian

20:01

focused types of cookbooks

20:03

, and there's incredible , just vegetarian

20:06

restaurants all over the world that you

20:08

know have chef hats

20:10

and all these kinds of michelin stars and all

20:12

sorts of things , and certainly

20:14

you can have a delicious , nutritious

20:17

diet being vegetarian

20:19

or vegan . But if you're

20:21

not into cooking or you're a picky

20:23

eater that's

20:26

my other bug there If you're a picky

20:28

eater oh , I don't really like leggings . Oh , tofu

20:30

doesn't do it for me and you're vegan Sorry

20:32

, what proteins are we having in our diet

20:34

then ?

20:35

Have we got left ?

20:35

We're going to be in a really tricky spot

20:37

. So if you're very picky , within

20:40

that range , it's already limited or

20:43

we're layering lots of dietary restrictions

20:45

Like . Another common scenario

20:47

that I see people get themselves into

20:49

is they'll have IBS , so

20:52

irritable bowel syndrome . They

20:54

have some food sensitivities to things

20:56

like legumes and beans , which are an incredibly nutritious

20:58

addition to a vegan or vegetarian

21:01

diet . It's rich in dietary fiber and B vitamins

21:03

and zinc and plant-based iron . They're

21:05

wonderful and they're something that I wish

21:07

everybody ate more of , but

21:10

they can create

21:12

a little bit of gas and bloating for some people and

21:15

so if you have somebody who's vegan , who can't

21:17

eat that , and a selection

21:20

of some vegetables and fruits and

21:22

a selection of some grains , you have

21:24

this extreme limitation

21:26

. That is really difficult because

21:29

now we've got this long-term

21:32

potentially for some people , long-term avoidance

21:34

of a critical , you know , protein

21:36

group and it's it can be

21:38

really tricky to kind of get

21:41

ourselves out of that . So , yeah

21:44

, especially if you're a picky eater or you have other

21:46

diet-related

21:48

health conditions , that kind of layer

21:50

and start to give you more restrictions . It's just

21:52

yeah , it's just a logistical

21:55

challenge .

21:55

I do find so I'm hearing that . I

21:58

want to go right back and say firstly , I

22:00

wish we were flexitarians . Our family

22:03

could do with less meat , but

22:06

if someone's a full vegetarian

22:08

, and . I'm hearing from you that one of the main

22:10

problems is getting the right

22:13

amount of protein . Can you just

22:15

recap what is the grams of protein

22:17

that somebody needs in the first place ? And

22:20

just so people can relate that back to something

22:23

a vegetarian would eat , say tofu ?

22:25

for example . So the

22:27

average person , like

22:30

non-pregnant , needs about 0.8

22:32

to 1 gram of protein per kilogram

22:35

of their body weight . So

22:37

usually as dieticians

22:40

we trying to get about about

22:43

30 grams of protein

22:45

into a

22:47

main meal roughly sometimes

22:50

because we like to overshoot a little bit . There's

22:52

some benefits to overshooting a little bit and certainly

22:54

when you're pregnant and trimester two

22:56

and three you need quite a bit more

22:58

protein . And there's some interesting

23:00

statistics that came out of the US out of a

23:03

study of about 528

23:05

women and they showed that one in eight

23:07

women in their second and third trimester had inadequate

23:09

protein intake and that protein

23:12

inadequacy was three times more common

23:14

in trimester two than trimester one . Because

23:16

of that step up in requirements and

23:19

most people , two-thirds of that

23:21

protein intake intake was

23:23

actually coming from animal sources and the

23:25

remaining third was coming from plant-based

23:27

sources . So that gives you a snapshot of what people are currently

23:30

kind of doing and what's going on

23:32

and what's going , I guess , wrong

23:34

in a way . And then things like

23:36

tofu to get

23:38

your 30 grams you need

23:40

quite a lot of tofu or quite

23:42

a lot of legumes and beans , like you need a whole tin

23:46

of lentils or chickpeas to give you your

23:48

30 grams of protein . But

23:50

it's also going to give you a heap of fiber

23:52

, which is great . But I don't

23:54

know about you , but I would struggle to eat a whole

23:57

tin of legumes and beans

23:59

because they're really filling , and

24:01

that is one of the tricky components

24:03

, particularly on a plant-only

24:06

diet or a vegan diet is

24:09

the fiber . The fiber is excellent

24:11

for your bowels . It's excellent for our health

24:13

, we know it's protective against bowel

24:15

cancer , we know all these things and

24:18

I do not want to poo-poo fiber at

24:20

all , pun intended . But

24:24

the one downside that I see

24:26

, both preconception and in pregnancy

24:28

, is how satiating

24:30

, how feeling that fiber can be

24:32

, and so our stomach gets really full

24:35

and then we can't eat as much

24:37

density of calories

24:39

and then we're struggling to get enough

24:41

calories in and gain the right amount

24:43

of weight in pregnancy , or you know

24:46

, or eat enough food to have a period

24:48

. We know that people who follow a vegan

24:50

diet preconceptionally have a higher rate of

24:52

irregular ovulation amenorrhea

24:55

, and my hypothesis is

24:57

it's likely because their diets are

24:59

so high in fiber , they're so filling , because

25:01

it's fruits and veggies and legumes and beans

25:03

, they're so full in the fiber it's hard to actually

25:05

eat enough energy . It kind of caps

25:08

it , and so that can be a really tricky

25:10

spot to be in , but trying

25:13

to leverage the protein when you've got such limited

25:15

sources . So you can see , it's this constant juggling

25:17

act between we want to be including the sources

25:20

that we have available but simultaneously

25:22

we don't want to drive the fiber up so much

25:24

that you're getting too full that you can't eat enough

25:27

total food per day to reach

25:29

your requirements , and so that's the constant

25:31

juggle .

25:34

Is there a nice protein that doesn't have all that fiber

25:36

?

25:36

then Tofu is probably one of

25:38

the ones that I use

25:40

the most for that , and

25:42

also tempeh . They still do have some

25:44

fiber , but certainly not as much as like

25:46

yums and beans . But

25:48

a lot of people , even vegetarians , don't

25:51

love tofu or they don't , you

25:53

know , maybe they haven't learned how to prepare tofu

25:55

to the way that they like , going back to that cooking

25:57

concept , and

26:00

so that's really difficult . And then to

26:02

learn to like a new food whilst you're pregnant

26:04

and you've got some food aversions at the best of times

26:06

, it's really tough . It's a

26:08

hard sell .

26:10

Yes , but you can hide tofu Like . I love

26:12

tofu and one of my favorite dishes

26:14

is this like spicy Korean

26:17

soup that I make with tofu

26:19

in it . It is delicious and I just do

26:21

it at home . You know it's my go-to lunchtime

26:24

dish if I'm at home just

26:26

by myself and it takes I

26:28

don't know 10 minutes . It's just such

26:30

a great dish to have at hand

26:32

. All right , so

26:35

I know if there's a micronutrient missing

26:37

, like calcium you can supplement , but you can't

26:40

really supplement protein . So what the hell

26:42

are these people doing to make sure

26:44

that they can get enough protein ?

26:46

So something that I usually do

26:48

when I'm chatting to someone in pregnancy

26:50

who and look , protein is

26:53

a nutrient at risk for everybody in

26:55

pregnancy .

26:56

Yeah , that's a shocking statistic that you read out before

26:58

. Yeah .

26:59

Honestly , it's not just vegetarians

27:02

and vegans , you know . So it's

27:04

something that I'm always screening

27:06

for and kind of thinking about and talking about anyway

27:08

. So protein is something

27:11

that you know I like to call

27:13

is a negotiation . So

27:15

I go into the concert . I'm like okay , this

27:17

is where we want to be , this is where you're at . Here's

27:19

the gap . Now , here are some ways

27:22

that we can start bridging these gaps . Here's some creative

27:24

ways that we can think about this . If

27:26

all of these fail , we may need

27:28

to look at a protein powder

27:30

as an absolute backup . It's always

27:33

my last resort . It's considered

27:35

safe in pregnancy if you find the

27:37

right product without the extra ingredients

27:39

and blah , blah , blah , blah , blah , artificial sweeteners

27:42

and micronutrients and all that kind of

27:44

stuff . If you get something kind of plain Jane

27:46

that's been okayed by your healthcare team

27:48

, it's safe . But I don't like people relying

27:50

on that , because then they're missing out on the micronutrients

27:53

that are coming from the protein foods , which is actually

27:55

why we're also wanting

27:57

them to eat them . So our protein foods

27:59

are going to be richer in iron and zinc

28:01

and our demands for those nutrients really

28:03

pick up in trimesters two and three , and

28:05

they're particularly helpful preconceptionally as

28:07

well . That you

28:09

know protein powder isn't going to give you that

28:11

you know , and

28:14

protein powder is often going to be had

28:16

in a smoothie with milk and fruit

28:18

and oats and that's great . But if you

28:20

already had that for breakfast and then you're having it again

28:22

for lunch , then you're

28:24

missing out on your veg and kind

28:27

of your dietary diversity and

28:29

it becomes a little bit same same . So

28:31

it's always a little bit like last

28:33

stop if need be , maybe

28:35

not an everyday thing , as needed

28:37

if you're having a particularly rough day , but

28:40

often that's quite short lived , I find

28:42

in most people with pregnancy

28:45

. But it's just being creative

28:47

. Like , okay , we're having pumpkin

28:49

soup for dinner , great , lots of veggies

28:51

. It's always that question Where's the

28:53

protein ? Okay , can we add a tin of chickpeas

28:56

and blend that up ? Can we serve that with a piece

28:58

of toast with high protein cottage cheese

29:00

on the side ? Can we buy a higher

29:02

protein bread than what you're getting now ? Can we

29:04

switch out your regular pasta for pulse pasta

29:06

, because it gives you more protein ? Those

29:08

kinds of upgrades that we're constantly doing

29:11

to try and get that up and

29:13

then it quickly adds up and then we're already there

29:15

. But if you're not aware of

29:17

it and you're not consciously trying to make those upgrades

29:20

, then you hit kind of a wall . But

29:22

at the same time , on the other side of the

29:24

coin , I see people obsessing too much

29:26

about protein and then their

29:29

diet is lacking in other departments and I'm

29:31

like , okay , like you need

29:33

to back off with the protein bar at breakfast

29:35

and the protein shake at lunch and then the

29:37

high protein . Like

29:39

it's like what about vegetables

29:41

? What about carbs ? What about fats ? Like yeah , yeah

29:43

, like you've gone too far . So

29:45

yeah , is it ? We're kind kind of

29:47

the moderator in that regard and trying to keep

29:50

people on an even keel .

29:52

But yeah , it is tricky . It is tricky and

29:54

you know most people

29:56

, a lot of people , are still working when they're

29:58

pregnant . Good , and

30:00

I think it's really

30:02

hard to find the right sort of convenience

30:05

food . Say , you're out

30:08

and about and you need to grab

30:10

lunch , or you're starving , hungry , and it hits you really

30:12

hard when you're pregnant and you're just like , oh

30:14

my God , I need to eat something now , otherwise I'm

30:16

going to vomit . For a vegetarian

30:19

, what can they grab ?

30:21

I think a lot of the things that

30:23

work for non-vegetarians

30:26

work for vegetarians here . So you

30:28

know your nut bars

30:30

and your cheese

30:32

and crackers and your

30:34

you know roasted chickpea

30:36

snacks and I love roasted edamame

30:39

beans . They're not always in stock in the supermarkets

30:41

but they're a super high protein , savory , crunchy

30:44

snack . Those

30:46

quick things that you can kind of grab and go

30:48

can be such little

30:50

life savers when you're pregnant

30:52

and you're feeling sick and you just need like a little bit

30:55

of a snack rather than a whole meal

30:57

, and I find whole meals can be quite overwhelming

30:59

, particularly in early pregnancy

31:01

. So I think

31:03

that that is like

31:06

one of the things that you shouldn't get too bogged down

31:08

in is that you know a lot of things are still

31:10

on the menu for you as well . So , and

31:13

interestingly , a lot of my pregnant

31:16

clients who were omnivores before

31:18

, almost become vegetarian probably

31:21

the first half of their pregnancy because of meat

31:23

and fish and chicken is just too gross , and

31:25

so we get by like we just get creative

31:27

and we start introducing

31:29

different things . Like instead of having , you know , spaghetti

31:32

bolognese with mincemeat , we're having it with lentils

31:35

, and you know all those kinds of things . So

31:37

there's always ways

31:39

to get around it . But I always say lean into

31:41

, like what you're feeling

31:43

like as well , because there's no point

31:45

in me outlining a great meal plan for you and you're feeling like as well , because there's no point

31:47

me outlining a great meal plan for you and you're like ew , gross

31:50

.

31:50

I don't need any of that , yeah totally

31:53

so .

31:53

If , like , the thought of tofu makes you want to

31:55

spew , like , don't

31:57

force yourself to eat tofu , like nobody

32:00

wants to force feed . You know , particularly

32:03

in pregnancy , but I think having those

32:05

things that you know kind of work for you , that are grab and go

32:07

, are particularly helpful . And then you know , particularly in pregnancy

32:09

, but I think having those things that you know kind of work for you , that are grab and go , are particularly helpful . And then you know , once you're

32:12

feeling a little bit better , you can , you

32:14

know , put a little bit more effort into things

32:16

and you know , think more about planning

32:18

things out . But I find in those early days people

32:21

just don't have capacity to do that at

32:23

all , it's just survival load

32:25

. There's heaps

32:27

of great products that you

32:29

can definitely leverage , and it

32:31

doesn't have to be always

32:33

whole foods only . Yes , we want a whole

32:36

food-based diet , but we're time

32:38

. Poor people want convenience , and

32:41

so we can make the best out of the

32:44

packaged food category as best

32:46

as we can .

32:47

I make a really delicious , if

32:49

I say so myself . I know it's had the tick

32:52

of approval from Dr Pat this

32:54

scrambled tofu

32:56

which is kind of like scrambled eggs and

32:59

it's just so great and it's got turmeric

33:01

in it and I don't

33:04

remember the other spices . But it's

33:06

just something that I pre-prep , yeah

33:08

, and then I keep in a container and

33:10

it's a morning , it's a breakfast

33:12

for a few days in a row , like you know , if

33:15

you're feeling unwell , pick the day that you're not feeling

33:17

unwell and do

33:19

some meal prepping . Yeah , meal prepping

33:21

becomes your life later on when you

33:23

have a baby . Yeah , it's a good habit to get into . All

33:27

right , so we've talked about protein as

33:29

the macronutrient . Are there any

33:31

other macros that you're kind of

33:33

concentrating on with a

33:35

vegetarian diet ?

33:36

Yes , and it's probably not the one

33:38

that most people will be thinking of

33:40

, but it's omega-3 fats , which

33:42

isn't its own macronutrient , equally

33:45

speaking , but it sits in that fat category

33:48

. Omega-3 fats are

33:50

so , so important preconceptionally

33:53

in pregnancy , postpartum . They

33:55

help to support healthy blood flow , they

33:57

help to support baby's brain and eye development

34:00

, and recent data shows that

34:02

it may help prevent preterm

34:04

birth and labor , and so maximizing

34:07

omega-3s preconceptionally , in my opinion

34:09

, is so , so critical for people who

34:12

follow a vegetarian diet , because it does not increase

34:14

overnight . Even some people

34:16

who are vegetarian who are like , oh okay , yeah

34:18

, maybe I'd be willing to add a piece of salmon

34:21

in or something like that . I'm just like

34:23

great , still not enough . Because

34:25

you've been vegetarian for 10 years , you've

34:27

probably had very little omega-3s . It's

34:30

not going to really touch the sides at this point

34:32

, like your blood level of omega-3 would be

34:34

so low and I've seen some frightening

34:37

, because we do some omega-3

34:39

testing at the dietologist every now and then . And

34:41

the people who are vegan or vegetarian . It should be between

34:44

8% to 12% is a normal

34:46

omega-3 blood level , and people who

34:48

are vegan will be 2% or 3% , which is

34:50

extremely low . Omnivore

34:54

is like 5% to 6% , so omega-3

34:56

fats are going to mainly come from your

34:59

oily fish like salmon , ocean

35:01

trout , mackerel , sardines and anchovies

35:04

. There are plant-based omega-3s

35:06

from walnuts , flax

35:08

seeds or linseeds , chia

35:10

seeds , hemp seeds . However , the

35:12

body's ability to convert that plant-based

35:15

omega-3 called ALA into

35:17

the long-chain omega-3s called EPA

35:20

and DHA , which have the research

35:22

benefits for pregnancy specifically DHA

35:25

which are found in the marine sources , is

35:27

very , very low . So it's only 4% to

35:29

12% . So what we call the

35:31

bioavailability of that omega-3

35:33

is so , so low that it

35:36

certainly has its own independent health benefits

35:38

. But you cannot rely on that to

35:40

have a meaningful contribution to your omega-3

35:43

status and in my opinion , as

35:45

a dietitian , it's too too important to miss out on so omega-3s and in my

35:47

opinion , as a dietitian , it's too too important to miss out on so omega-3s

35:49

are something that we pretty much

35:51

supplement all the way through

35:54

, because most

35:56

people don't get enough at baseline , but

35:58

then , in addition , just without

36:00

poor omega-3 statuses and that's

36:02

where the research for the preterm

36:05

birth came from was that people

36:07

going into pregnancy with a poor omega-3

36:09

status ended up with worse-off outcomes , and

36:12

so naturally , this

36:14

group are a higher-risk group of being

36:17

in that category . So

36:19

, speaking to your healthcare provider , there are

36:22

algae oil supplements that you

36:24

can get that will provide you

36:26

with some DHA . Some of them also

36:28

have a little bit of EPA as well . They're

36:31

usually a little bit less concentrated , sometimes

36:34

a bit harder to find or a bit more expensive

36:36

, but it's definitely something

36:38

that I don't think is worth compromising

36:40

on .

36:42

If someone was willing to

36:45

put aside their veganism , their

36:47

vegetarianism , for a minute . Are

36:49

the fish sauce omega-3s better

36:51

?

36:52

Yes , in terms of bioavailability

36:54

, yes , and some people do choose to do that

36:56

. And this is the thing , like I know , talking

36:58

about vegetarianism and

37:01

veganism , it can feel really personal

37:03

, I think you know , and the reasons why

37:05

somebody has chosen to adopt

37:08

that way of eating can be tied

37:10

into culture , religion

37:12

, ethics , health

37:15

, so many reasons and

37:18

it's not . I don't want this to come

37:20

across as me poking holes in it . To

37:22

poke holes in it , I guess it's just the practicalities

37:24

. Poke holes in it , I guess it's just the practicalities

37:27

and I guess it's part of I

37:32

feel like it's part of your responsibility of adopting this way

37:34

of eating is to know about this stuff so that you can navigate it . And you know

37:36

, and also some people will be flexible

37:38

and malleable . Hey , if it's about my health and

37:40

my kids' health , like if I need to

37:42

eat a piece of fish a week , like , I'm open to

37:45

it . And other people are like I just can't do that , Like

37:47

I would like to , logically

37:50

, but I can't do it , that's okay

37:52

too , and it's not something I ask

37:54

people . People will often offer it up . They'll

37:57

be like , oh , would it be good if I did this ? I'm like

37:59

, yes , it would be good if you want to . I'm

38:02

not forcing you to , but if you would like to

38:04

offer it up , sure . I think fish

38:06

and probably eggs are the two

38:09

groups that people will sometimes

38:11

offer up as an addition to their

38:13

diet , but maybe they're not willing to add chicken

38:15

or meat or milk back in , you know , and

38:18

that's fine . So you know , I always

38:20

try and just take what's in the ginger . Yeah

38:23

, yeah , that's right , and I realize , oh , this kind of makes

38:25

my life a little bit easier to hit some of these targets

38:27

that you've outlined for me . So I would

38:29

say omega-3 fats and protein are the biggest

38:31

ones . You can certainly still get the right amount

38:33

of carbs and the right amount of fats and

38:35

certainly you can get the right amount of protein

38:37

if you plan well on a vegetarian

38:39

or vegan diet .

38:41

Moving to micronutrients now

38:43

, and

38:51

actually this is where the need for this podcast came from , because

38:53

I think we did an iron podcast ages ago , which actually

38:55

I think everybody should go back and have a listen to , and Pat

38:57

said that it's very difficult for a vegetarian to get their iron needs , and that

39:00

did cause a little furor because people

39:02

were offended by

39:04

that and it

39:07

definitely was not our intention . I think

39:09

what we're trying to do in this podcast

39:11

is what you just said is be practical

39:13

and say , okay , like everybody

39:15

has the choice of how they eat , yeah

39:17

, how can we help you do that

39:19

so you have the best outcomes ? So

39:22

, moving to micronutrients , what

39:25

does a vegetarian need to consider

39:28

and put into their

39:30

diet ?

39:31

Yeah , so iron

39:33

is one of them . However , I would

39:35

argue everybody universally struggles

39:37

with iron , whether you're vegetarian or not . It's

39:39

just probably a quicker decline with iron , particularly

39:42

in pregnancy . I recently

39:44

did a post on iron on our Instagram

39:46

page and I kind of just showed the practicality . I

39:48

was like look , if you're menstruating , good

39:51

luck to you . Unless you're eating

39:54

half a cow a day , I don't think you're

39:56

going to be Adding the red meat

39:58

once a week is really not doing anything

40:00

. So if it tortures you to do it , don't

40:02

worry about it . If you're iron , it's . If you're iron

40:04

deficient , you're iron deficient . You just got to fix the problem like

40:07

that's fine . Uh , iron is one

40:09

. Zinc can be another one , sometimes

40:11

, particularly vegans . Um

40:14

, iodine can be one as

40:16

well , although that has some very simple

40:18

workarounds , iodine mostly

40:20

coming from seafood , but there's seaweed , there's

40:23

iodized salt , there's bread with iodized salt . Vitamin

40:26

D can also be another one to think about in relation

40:28

to calcium , because they need to be friends

40:30

to be absorbed . We know vitamin D

40:32

mostly comes from the sun , though , but

40:34

also things like eggs and fish

40:36

are kind of not

40:39

well known but very high sources

40:41

of vitamin D , so

40:43

that's obviously something that can be off the menu . Veganism-wise

40:46

, we talked about omega-3s , which isn't a micronutrient

40:48

, so we won't cover that . And the last one that

40:50

nobody talks about but I'm very passionate about

40:53

is choline . So maybe

40:55

we'll walk through each of those and

40:59

talk a little bit about each . And then the

41:01

only other caveat is vitamin B12

41:04

for vegans , and I cannot

41:06

stress enough how important

41:08

that is , if you're a vegan , to

41:10

know your B12 status and

41:13

monitor your B12 status , especially

41:15

if you're new-ish to being vegan

41:17

. B12 is

41:20

a water-soluble vitamin , but it is one

41:22

of the few B vitamins that we store for quite

41:24

some time . We now live for about two years

41:26

. We have enough to kind of survive

41:28

off . So if you've gone vegan

41:30

in the last couple of years and you go and get your first few

41:33

blood tests and you're not taking any B12 or

41:35

a perinatal vitamin with B12 , it'll

41:37

come back completely normal and

41:40

then after usually the two

41:42

to three year mark , it'll just go down

41:44

all of a sudden . And B12

41:46

is super critical for your absorption

41:48

of folate , which we know is important for neural

41:51

tube defect prevention . It's

41:53

also really important for our

41:55

DNA within our

41:57

cells , our nervous system and the development

41:59

of baby's nervous system . So I cannot

42:01

stress enough if you're vegan and you're

42:03

strictly vegan , you need to take

42:05

B12 or you need to take a prenatal

42:08

that has sufficient B12 . You need to monitor your

42:10

B12 status . It is too important

42:12

not to the

42:14

reason . I stress it is . My lecturer

42:17

at university gave us

42:19

a case study from a million years

42:21

ago , before they knew this

42:23

, and the example was a pregnant

42:25

, breastfeeding woman and it stuck with me

42:27

and I'll never forget , and he did a good job because

42:30

something I'll emphasize

42:32

forever Vegetarians

42:34

will get some B12 from eggs

42:36

and dairy . I do find that

42:38

it's still a nutrient at risk for vegetarians

42:41

, even though technically speaking , and there's also

42:43

B12 added into a lot of foods

42:45

now , like soy milks and nutritional yeast

42:47

and things like that .

42:49

Can I just ask is B12 also in mushrooms

42:51

?

42:52

B12 is not generally

42:54

in mushrooms specifically

42:56

, vitamin D

42:58

sometimes is in mushrooms

43:01

because the gills you know

43:03

the brown bit of the mushrooms . If

43:05

you put them in the sun , they will

43:07

synthesize vitamin D in their skin

43:09

and when you cook them we get some of the

43:11

vitamin D . So in the coals

43:13

and woolies and stuff you'll sometimes see vitamin

43:16

D mushrooms . So they've done that process for

43:18

you . Again , the bioavailability

43:21

of dietary sources of vitamin D is not very good

43:23

, so , generally speaking , it's

43:26

not the way to get it up , but

43:28

it's a nice thing to know . And

43:30

you only got to stick the mushrooms in the sun for like 20 minutes

43:32

. But no , there's not a great deal of B12

43:34

in any major plant

43:37

food . I remember I talked about

43:39

this one time on my Instagram

43:41

and somebody said to me

43:43

time

43:48

on my Instagram and somebody said to me watercress is such a huge source of B12 . Everyone's

43:50

sleeping on it . And I remember going what are you talking about ? And you know what

43:52

I'm a humble . I will

43:54

eat my humble pie If I'm wrong . I'm

43:56

wrong , it's cool , like whatever . I

43:58

was like what Really

44:00

Am I sleeping on watercress ? I

44:02

look up watercress and I'm like and it just

44:04

comes back 0.0 milligrams

44:07

of B12 . And I was like where

44:09

have these meats come from ? Like , how Like

44:12

.

44:13

I don't know . Anyway , it's just Clever marketing

44:15

and I think that's where I've got the B12 from , because

44:17

I do remember it being marketed as

44:19

meat for vegetarians because

44:21

of the B12 . Yeah , not

44:23

necessarily the protein , and so you know . You're

44:25

saying that there's not much or no

44:28

B12 in mushrooms . That's

44:30

news to me . Yeah , I thought I was getting B12 .

44:32

Yeah , and

44:38

it's . Look , this is so , so common in nutrition at the best times

44:40

. But I find vegetarian and vegan nutrition

44:42

, especially these

44:44

myths seem to last longer

44:47

. I'm not sure if it's because I

44:49

I personally think it's probably the advent of social media

44:51

and , um , they get propagated

44:54

and kind of stay in our ecosystem

44:57

a bit longer . But , yeah , it look

44:59

all the time and , yeah , like

45:01

often I'm like I've never

45:03

heard of that and so there's always a part in my

45:05

brain , like before I say , no , let

45:07

me do a check . Yeah , yeah

45:10

, you never know . Sometimes you know people

45:12

will teach you something new every day . So

45:14

I'm never that silly to be like no

45:16

, no , I know I've

45:18

got to be confident in my no .

45:21

So tell us about choline , because I don't know

45:23

what choline is or what it does .

45:28

The forgotten nutrient . Why is that important ? The forgotten nutrient , choline . So choline

45:30

is not technically a vitamin , because we actually make a

45:33

little bit of it . So the definition of a vitamin

45:35

or a mineral is we

45:37

can't get it , we can't

45:39

make it , or we can't make enough of it to

45:41

survive . We can make enough choline

45:43

. It's not really enough for optimal health

45:45

. So it's kind of like if

45:48

you look it up it kind of says it's a vitamin but it's

45:50

kind of not . It's confusing . We're all confused

45:52

in the nutrition world about choline , but

45:54

it is a very important nutrient in relation

45:56

to pregnancy and it's got some fascinating

45:59

data behind it . So

46:01

choline helps support folate

46:04

and B12 . So I call B12

46:06

and choline the friends of folate . So

46:09

they need to work synergistically together

46:11

, which means they all need to partner together to do the

46:13

right job . So

46:15

that's part one . Part two

46:17

is another study looked at people

46:19

that took folic acid alone and

46:22

folic acid and choline and

46:24

they looked at the rate of neural tube defects

46:26

and they found that the group that also took choline

46:28

had significantly less neural tube defects

46:30

. So it seems to help to support the

46:32

role of folic acid there and

46:34

the formation of neural tube . And

46:37

then they did studies and they looked at

46:39

giving women in pregnancy

46:41

much higher amounts

46:43

of choline supplementally . So it gave

46:46

them a choline supplement at double

46:48

what our government more than double double

46:50

what our government recommends at the moment as

46:52

the target , which 23%

46:54

of women aren't are meeting this target

46:57

already . So , like , most

46:59

of us aren't , and certainly

47:01

I would say vegetarians and vegans generally don't

47:03

. And they

47:06

showed that the group that took more than double

47:08

that their babies . So they

47:10

looked at their babies and they showed that the baby's cognitive

47:12

abilities were slightly better . And

47:15

then they followed these babies to

47:17

seven years old now and

47:19

a new study just came out and they're showing that

47:21

the seven-year-olds whose mums took choline

47:23

in trimester two , trimester three and

47:26

breastfeeding up a higher amount , that they're

47:28

doing better at school .

47:29

Wow , I can just imagine everyone scrambling

47:31

to like how can I get my hands on choline ?

47:34

So choline ? One of the richest and most

47:36

efficient sources of choline is actually

47:38

egg yolks , specifically the yolk

47:41

, obviously , don't just make egg yolk omelettes

47:43

a bit gross , but if

47:46

you're just an egg white person then that's

47:48

why I emphasize it . So egg yolks

47:50

Per egg , you will get 150

47:53

milligrams of choline per egg . So

47:55

if you eat two eggs a day , that's about 300 milligrams

47:58

of choline . The government recommends 440

48:00

milligrams per day and that study was

48:02

on 930 milligrams per day

48:05

. Now if you don't eat eggs , if you're vegan

48:07

, that makes it a little bit hard . If you don't eat

48:09

eggs because you hate them when you're pregnant , it makes things

48:11

a little bit hard . You can get some from beef , chicken

48:13

, dairy things like that less

48:15

efficiently . And then the next most

48:17

efficient source from a plant-based perspective

48:20

are soybeans . So endomame

48:22

beans and whole

48:24

soybeans , specifically wheat , germ

48:26

, quinoa , peanut butter , potatoes

48:29

much , much smaller amounts , nowhere near

48:31

as concentrated as eggs . So it

48:33

becomes an efficiency problem Like how do you fit

48:35

all these foods in ? And then we also got to think about omega-3s

48:38

and we've got to think about iron-rich foods

48:40

and making sure we're putting the vitamin C with

48:42

the iron to maximize the absorption , because

48:44

we need so much iron in pregnancy . So

48:47

it's just it's . Jenga

48:49

, it's , jenga , it's like . Tetris like we're

48:51

trying to like , fit all this in . And

48:53

that's why I say

48:55

to people look more than happy to support

48:58

you to stay vegan , stay vegetarian

49:01

before , during , after pregnancy . However

49:03

, you're going to have to be a little bit

49:05

more open to the fact that we're going to

49:07

have to monitor nutrient levels a bit more frequently and

49:10

you're probably going to be on more supplements in the average

49:12

pregnancy . And that's okay

49:14

, like there's nothing wrong with that . But

49:16

if you're fighting me about it , this

49:18

is where we're going to have difficulty , because there's

49:21

going to come a time where

49:23

we're going to struggle to fit

49:26

all this in . Okay , we don't want to have

49:28

calcium-rich foods . Okay , we might need calcium supplement

49:30

. Okay , the iron's not looking too good . Which

49:33

pregnant woman's iron is good ? Most of the time , hardly

49:35

any , so we're going to

49:37

iron supplement . Okay , we can't take those two together

49:40

because they inhibit each other and cancel each other out

49:42

, so put them on either end today . Okay , we need our

49:44

prenatal vitamin . Oh , you want to take extra

49:46

choline ? Oh , your vitamin D is low . We're going

49:48

to add that . Oh , your B12 sucks . We're

49:51

going to add that , yeah , you

49:53

can see how it can become like this . You

49:56

know , cocktail of supplements

49:58

and

50:01

, yes , in an ideal world can we get this through food short . But in a practical

50:03

world where people are going to work , they're busy , they

50:05

don't love to cook , they're not sitting there

50:07

thinking about it like I am because you

50:09

know my job , so that's fair , it's

50:12

it's hard , it's hard and then , and then

50:14

the anxiety of not meeting it each day

50:16

is so high that you're like , yeah , give

50:18

me this up . Well , just

50:20

get it and deal with . Deal with the rest

50:23

later , you know . So I

50:25

think it's about having an appreciation

50:27

for what is what

50:30

the gaps may be . When

50:32

you sit , where you should be , looking

50:34

at lab work and then looking at the practicality

50:37

of it , okay , great , this

50:40

is where we should be , let's not . It's

50:42

not to make you feel bad , it's just to say

50:44

, hey , we have these gaps . Now what

50:46

are we going to do about them ? Okay , we can get half of

50:49

our calcium through our diet . Then let's just do

50:51

the other half . Supplements , that's fine

50:53

. The iron's not low yet . Let's think about

50:55

that in six weeks time . Then come

50:57

back to that . That's cool , all right . Choline

50:59

you want to add that in ? All right , let's try and do

51:02

the first . And then we might

51:04

choose a prenatal vitamin that has a lot more choline

51:06

in it than most

51:08

of them on the market . Or we may say , let's add

51:10

, tack one onto your current prenatal

51:12

and so you can start to kind of , like

51:14

I said , negotiate what's going

51:16

in , what's going out and what they're willing

51:18

to do and able to do , and

51:24

, like I said , some food aversions and nausea can really persist . It really makes it really challenging

51:26

and I think pregnant women already become really distressed about

51:28

their diet not being what they hoped and

51:31

layer other dietary restrictions

51:33

, even like vegetarian . It

51:36

can feel really anxiety inducing and it

51:38

can sometimes feel like no

51:42

one understands why you

51:44

want to keep doing that , and I

51:46

think that's often why people will come to us and be like

51:48

I want to stay vegetarian , but I also

51:50

want to do the right thing by my baby how do I do this

51:52

? And by you too , and by themselves

51:55

, yeah .

51:56

Exactly . I think you need the energy

51:58

and you need to feel like

52:01

you've got enough

52:03

for you in the tank . I think that's

52:05

really important . Steph , every time

52:07

we talk to you , I think , well

52:10

, everybody just should see a dietician

52:12

and have that kind of support

52:14

throughout their pregnancy . So

52:17

if that's the case and somebody's listened to

52:19

this and gone , well , I think I have got

52:21

a good diet . But listening to this , perhaps I

52:23

do need support . How

52:27

can they get in touch with you ?

52:28

Yeah , Thanks for having me and thanks for the

52:30

opportunity to share . So you

52:32

can come find us on Instagram the

52:35

handle is at the underscore

52:38

dietologist and our website

52:40

, thedietologistcomau

52:42

, are the main places we hang out . We

52:45

do run a virtual practice , which

52:47

means we see everyone via Zoom from all

52:49

over Australia so you don't need

52:52

to be in Sydney where I am . My

52:54

team even isn't in Sydney , so

52:56

the incredible dietitians that I work

52:58

with , georgia and Candice , are up in Queensland

53:01

. We all work virtually to support . I

53:03

think we've already helped like 400 people

53:05

this year so far . I just did the report

53:07

last week and was mind blown . So I think

53:09

we're on track for a thousand consults

53:12

by the end of the year . So

53:14

we help lots of people . There's pretty

53:16

much nothing that we haven't seen at this point

53:18

, having been in fertility

53:20

and pregnancy and postpartum nutrition

53:22

for the last five plus years

53:25

. So please don't feel

53:27

I think the other thing is like

53:30

I kind of said like don't feel um

53:32

shame about your

53:35

diet . You know um , whether

53:37

that's you're vegetarian or

53:39

vegan or you're just not

53:41

having the diet that you thought you would in pregnancy

53:44

, you know there's it's nothing to be ashamed

53:46

of at all , and particularly

53:48

when you're coming to a nutrition professional . I do find

53:50

that people feel like they're scared

53:52

of judgment . You know they're scared to tell us they're vegetarian

53:55

. They're scared to tell us they're vegan and it's

53:57

nothing to be scared about . Be upfront

53:59

, be honest , say this is what it is . Here's

54:06

what I'm eating . How to , how , where to from here . That allows us to do our job easier

54:08

. So we'll take into account your

54:10

lab work , your pregnancy

54:12

, any past medical history , any

54:14

medications you're on . We can provide

54:16

you the supplementation advice as well as

54:18

dietary guidance and take you from

54:20

preconception all the way through to pregnancy and

54:23

I think most a lot of my clients

54:25

from a few years the way through to pregnancy and I think

54:27

most a

54:29

lot of my clients from a few years ago now up to baby number three prep . So we take people through

54:31

growing their whole family until they reach their desired family size and it's

54:33

an absolute privilege to be part of their journey

54:36

. And I think you know , like

54:38

I also want to be completely transparent

54:41

in this podcast episode I'm not personally

54:43

a vegetarian or vegan and

54:46

I know sometimes hearing

54:48

about a vegetarian or vegan diet from

54:50

someone who isn't because sometimes feel

54:52

finger pointy . So I

54:54

don't want it to come across like that at all

54:57

. I think there are so many benefits

54:59

to having a plant focused

55:01

diet . However , I think a lot of

55:03

people don't get enough support with it and

55:05

that's where these big gaps and

55:07

challenges can arise . So I

55:09

just really encourage you if you can definitely

55:12

reach out to somebody like us to get

55:14

some professional advice you may

55:16

not need a whole heap of it , but at least some

55:18

to kind of get you up and going and

55:20

to have that confidence so you can feel good about

55:22

eating well in your pregnancy and

55:25

eating plant-based diet if you want to in

55:27

pregnancy . There's nothing wrong with it at all

55:29

. You just got to be clever about

55:31

it and get some professional

55:33

input . So that's what we're for .

55:36

You're amazing , Steph . Thank you

55:38

so much for this time that you've given

55:41

to us on the eve of a nice holiday

55:43

for you . I really , really do appreciate

55:45

it , and there's so much that somebody can take

55:48

away from this episode and

55:50

you know , I've learned a lot as well , which is great

55:53

.

55:53

Well , thank you for having me . I can't believe

55:55

the time has flown my gosh , I know .

55:58

Exactly , that's

56:00

fantastic . Good on you , steph . Well

56:02

, thank you everyone for listening . I

56:07

hope you enjoyed that episode with Steph just as much as I did . If you're listening

56:09

and you want some of the information that she gave about

56:12

pre-pregnancy and pregnancy in our other

56:14

episodes we did with Steph , just go back to our

56:16

back catalogue and have a little listen . I'll

56:18

put that in the show notes . Thank you for listening

56:21

and we'll see you again next week .