Highly informed, yet undersupported: dietary supplement use, information sources, and perceived risks among pregnant...

Vegan diets during pregnancy are commonly discussed regarding nutritional risks, often without differentiating between heterogeneous vegan populations. Empirical evidence on clearly defined subgroups who maintain a vegan diet throughout pregnancy remains scarce.

This study characterized a highly selected subgroup of pregnant women adhering to a vegan diet, focusing on supplement use, information sources, counseling experiences, and perceived risks of micronutrient deficiency and overdosing.

An explorative, cross-sectional online survey was conducted as part of the Vegan Diet and Dietary Supplements Study (VedieS). The questionnaire was developed from a scientific literature review, pilot-tested, and distributed via vegan, nutrition-related, and health-focused organizations and social media across German-speaking regions. Individuals adhering to a vegan diet (defined as a strictly plant-based diet excluding all animal-derived products) participated. The analysis was restricted to those reporting a vegan diet during at least one pregnancy. Supplement use, information seeking, and counseling adequacy were analyzed descriptively.

In total, 801 individuals participated. Participants were highly educated and predominantly from urban areas (76.3% tertiary education; 79.6% urban). Adherence during pregnancy was largely consistent (90.5%), and supplement use was nearly universal (99.1%) with high compliance (79.1%), targeting micronutrients critical in vegan pregnancies, including vitamin B12 (77.8%), omega-3 fatty acids (76.9%), folic acid (73.8%), and vitamin D (67.8%). Scientific literature, self-identified by participants, was the primary information source (80.3%), whereas professional counseling was less frequent and often perceived as insufficient. Although 74.7% informed their gynecologist, only 16.1% reported comprehensive counseling. Despite high motivation and self-directed information seeking, considerable uncertainty persisted regarding micronutrient dosage, particularly overdosing, with 40.4% perceiving dosage guidance as insufficient. External influences, including the social environment (46.3%) and physicians (34.2%), were relevant sources of uncertainty.

Rather than a uniformly high-risk population, pregnant individuals following a vegan diet represent a highly informed and responsible subgroup whose main challenges relate less to dietary behavior than to structural gaps in professional counseling and access to consistent, evidence-based supplementation guidance. These findings underline the public health relevance of expanding nutrition training and counseling capacities among healthcare professionals and the need for clinical research using objective measures of nutritional status in vegan pregnancies.