Pregnancy brings with it unique physical symptoms and increased nutritional requirements.

  • Overview
  • Action Plan
  • Ask The Doctor
  • Related Info


The best way to approach pregnancy is to be well prepared physically and nutritionally months in advance of conception.

Many critical nutrients that a young, growing fetus needs are initially drawn from stored amounts in the mother, which means that what the mother eats before conception matters significantly and may mean the difference between the baby having a disease down the road or not. Nutrients such as folate, iron, calcium, omega-3 fatty acids, and many others have been shown to be very important prior to conception and during pregnancy. Taking in a sufficient amount of these important nutrients is not only important in order to provide enough for the growing fetus, but also to make sure the mother does not become deficient as her body automatically prioritizes the nutritional needs of the fetus during pregnancy.

A balanced Nutritarian eating style implemented before, during, and even after being pregnant accounts for all of these nutrient requirements at each stage and is ideal as long as the mother is eating enough to satisfy her hunger. Avoiding toxic substances and environmental contaminants is also critical before, during, and after pregnancy (if breast-feeding) as the child is much more susceptible to physical damage being so small and growing so fast. Also, staying fit physically is important throughout pregnancy and afterwards.


Action Plan


Preconception eating should be accounting for sufficient nutrients such as:

  • Folate
  • Iron
  • Calcium
  • Omega-3 fatty acids
  • Many others

A balanced Nutritarian eating style promotes regular intake of foods high in all of the nutrients required for a healthy pregnancy.


  • Taking a multivitamin with a low dose of iron is generally recommended and is best initiated at least one month before conception. Iron is essential for the baby’s developing brain, but excess iron promotes oxidative stress and is associated with low birthweight; too little or too much iron can be problematic. Iron supplementation should be tailored to individual needs aiming to achieve the “sweet spot” of adequacy for the baby’s development without excess, based on monitoring the mother’s iron status during pregnancy. It is wise to learn your iron status starting early in pregnancy and use this information to decide the appropriate level of supplementation to complement a health-promoting diet.1
  • Choosing a multivitamin that does not contain synthetic folic acid is preferable, as considerable evidence suggests that synthetic folic acid increases risk of cancer2 (particularly breast cancer), asthma,3 and birth defects.4 Natural folate from whole plant foods is different than synthetic folic acid found in fortified processed foods and conventional multivitamins, which may explain these observed associated risks. To reduce the risk of other complications, such as neural tube defects in the fetus, it is essential that the mother eats folate-rich foods, such as green vegetables, legumes, and other plant foods as part of a Nutritarian eating style before and during pregnancy in order to insure folate adequacy. Those who follow a Nutritarian diet generally have high levels of folate when their blood is tested, and these levels remain high even through periods of little food intake in early pregnancy. Folate-rich green vegetables are not optional, they are essential to the health of both mother and child, and the complex beneficial nutrients contained in greens cannot be duplicated with a folic acid supplement. I have designed a prenatal vitamin without folic acid to accommodate these critical findings.
  • Taking extra iron beyond the low doses found in a multivitamin may be recommended by your doctor based on blood testing during pregnancy.
  • Omega-3 fatty acids, taken as a supplement in the form of vegan DHA and EPA, help to assure adequacy for the baby and mother during preconception, pregnancy, and breast-feeding stages.

Other Considerations

  • Stay physically active before, during, and after pregnancy with regular, moderate exercise.
  • Avoid toxic substances and environmental contaminants as much as possible during both pregnancy and breast-feeding stages. This includes:
    • Medications
    • Non-organically grown foods
    • Tobacco
    • Alcohol
    • Commercial and processed meats and fast foods
    • Refined carbohydrates
    • Mercury and Dioxin from fish
  1. Pregnancy: Does every pregnant woman need daily iron supplements, and what are the possible adverse effects? PubMed Health 2010.
  2. Baggott JE, Oster RA, Tamura T. Meta-analysis of cancer risk in folic acid supplementation trials. Cancer Epidemiol 2012, 36:78-81.
  3. Haberg SE, London SJ, Stigum H, et al. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child 2009, 94:180-184.
  4. Kallen B. Congenital malformations in infants whose mothers reported the use of folic acid in early pregnancy in Sweden. A prospective population study. Congenit Anom (Kyoto) 2007, 47:119-124.

Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


I have been mostly following your diet (about 90% I think). I haven’t lost weight, which from your other responses means that I must be overeating, though I don’t eat a lot.

I am two months pregnant, 30 years old, 5’5", and 195 lbs. I took the one hour glucose tolerance test, and the result was 142. They recommended that since my value was over 135 I should take the three hour test where I have to consume twice as much glucose. I’m hesitant to do this partly because consuming 100g of glucose sounds bad for me and my baby and partly because I follow a very healthy diet without added sugar or almost any bread anyway. I am interested in hearing what you recommend.


If you weigh that much and are not losing and your glucose tolerance test is high, then you do not follow the proper diet for you. Ninety percent, or whatever you really are doing, is not sufficient. Since this is serious, I think you should post everything you eat here and follow your routine fasting glucose and a 2-hour post prandial. I think the 100 gram test is irrelevant because your body weight and the 50 gram glucose test already determines that you are at high risk and need intervention with your diet and exercise.

Here is a Sample Phase One Diabetic Reversal Diet for newly diagnosed Gestational Diabetes:

This menu includes options, so do not attempt to consume all the food or dishes suggested; choose only one or two options at each meal. You can eat the same dish for more than one meal and even use as leftovers for a few days. Breakfast is only listed for those who are doing lots of exercise and hungry in the morning. If not hungry, eat two meals a day. You do NOT have to eat all the food listed.

Please note that carbohydrates (even beans) are not fed with breakfast because insulin resistance is highest in mornings.

The most important advice here is to STOP, do not make choices and decisions about what to eat and what not to eat. Let me make all these decisions for you.

Remember, you developed this condition based on the choices you made. In order to give this method a chance to see what it can do, you must do it exactly as prescribed, without modifications.

Just follow this plan until your blood sugars are relatively favorable. Then, once your condition is in the safe, non-diabetic range, we can advance the diet to the next phase and we can discuss.

Breakfast – (use one or both of below suggestions)

  1. A green (salad) with lettuce, thin sliced red onion, tomatoes, and roasted red peppers with a creamy hemp seed herbal dressing made from hemp milk, seeds, and a fruit flavored vinegar. Or, use a roasted tomato basil dressing made from tomato paste, soaked sundried tomatoes, raw and roasted garlic, vinegar, roasted red pepper, chopped scallions, basal, cumin, and cinnamon.
  2. A roasted eggplant casserole made with sliced zucchini, mushrooms, onions, tomato, garlic, and spices, such as cinnamon or cumin, sprinkled with lightly toasted and chopped pumpkin seeds.

Lunch – (use two of the following)

  1. A vegetable-beans soup or stew served over or with a bowl of shredded lettuce and shredded raw spinach. The soup should be made with a low salt tomato/celery juice base and lots of leafy greens, leaks, zucchini, and onion.
  2. Roasted tofu slices, or one ounce sliced turkey, chopped with avocado, dill, and roasted garlic wrapped in raw collard green leaves.
  3. Zucchini-cauliflower casserole baked with chopped onion and mung bean or other sprouts and sprinkled with nutritional yeast.
  4. Or, the roasted eggplant/mushroom dish can be eaten here instead of breakfast instead.
  5. Spicy beans or lentils (one cup) served hot over a bed of finely shredded lettuce and cabbage.

Dinner – (include all three options below)

  1. A steamed green vegetable dish made with steamed or water sautéed mushroom and onions. Steamed green vegetables (string beans, artichokes or asparagus), crushed raw walnuts, and lightly toasted almonds slivers.
  2. Raw vegetables, such as raw broccoli, snow peas, cauliflower, kohlrabi, cucumber, radish, peppers, tomatoes, and celery served with a humus dip or salsa dip. A half ounce of sunflower seeds mixed with a half-ounce of your nut of choice or a sunflower-mushroom burger, served with lettuce, tomato, raw onion, and tomato sauce (without bread). One fruit such as kiwi or berries.
  3. One fresh fruit for dessert or two kiwi or box of berries.



Is there a certain amount of protein that a woman needs on a daily basis during pregnancy? Is there a supplement that provides protein that you would recommend for smoothies?


Although everybody is a little different as far as protein requirements go, for a pregnant or lactating woman, one could strive for around 50-70 grams of protein per day. This isn’t as difficult as it sounds because by just being pregnant, you end up being more hungry so you eat more throughout the day. As long as you are eating a balance of the foods I recommend, including beans, seeds, nuts, and other protein-dense foods along with everything else, you’ll meet your goals. The diet is essentially the same as long as you eat more. You should also take extra low dose iron as part of your multivitamin.


I discovered the Nutritarian diet halfway through my last pregnancy, and now, being newly pregnant, I am trying to do everything right, including taking Gentle Prenatal so as to avoid folic acid and other harmful additives of regular prenatals.

I was reading Dr. Fuhrman’s Position Paper on Folic Acid vs. Folate and am finding the recommended 600 mcg/day of folate in pregnancy quite difficult to achieve, as I am just not hungry enough. I make a large green smoothie every morning for breakfast, but I don’t get hungry again until late afternoon, which means I’m not hungry at dinner. At that point, I’m usually panicking, as I feel like I have to eat at least one cup of beans as well as another 1 1/2 cups of romaine lettuce (which is plenty to make me full). All in all, I feel as though I have to eat only folate containing foods all day long, and if I do want to enjoy any other foods, I would have to overeat. I know that folate stores in the body over time but am confused by this recommended daily amount of folate.


Stop worrying about folate and trying to eat to get enough. You cannot and will not get a folate deficiency on a Nutritarian diet, and you do not have to take in 600 mcg a day. Your needs are proportional to your calorie needs as your body also stores folate. Eat all natural foods contain folate, and I promise you, your blood levels of folate will be stellar without counting, measuring, or having to eat more than you feel comfortable with.

The reason my women’s prenatal has no folic acid and no folate is because it is impossible for a women eating healthfully to not get enough folate.