Textbook Problem

Ms. Lederman, a healthy 32-year-old woman entering her thirteenth week of pregnancy, asks her doctor for a referral to a dietitian to discuss her vegan diet. She receives the referral, and while making an appointment with the nutrition consulting service, she is asked to record her food intake for 3 days prior to the appointment. Ms. Lederman follows the instructions she was given and carefully completes a 3-day food record. Prior to the appointment, she sends her food record to the dietitian she will be seeing.

  During the appointment, the dietitian learns that Ms. Lederman started pregnancy at normal weight, has gained 3 lb so far in pregnancy, has no history of iron or another nutrient deficiency, and is experiencing a normal course of pregnancy. Ms. Lederman has been a vegan since the age of 16, and although she believes it is good for her health, she worries that her baby may not be getting the nutrients she or he needs. Ms. Lederman wears sunscreen whenever she goes outside, so she makes little or no vitamin D in her skin. She makes sure to combine plant sources of protein (usually dried beans and grains), so she’ll consume complete sources of protein every day.

  Results of the dietary analysis performed by the dietitian showed the following average calorie and nutrient intake levels:

  Kcal: 2237

  Protein, g: 71

  Linoleic acid (n-6 fatty acids), g: 15.2

  Alpha-linolenic acid (n-3 fatty acids), g: 0.54

  Vitamin B₁₂, mcg: 2.1

  Vitamin D, meg: 3 (120 IU)

  Zinc, mg: 15

3.    Suggest three types of food Ms. Lederman could consume to bring up her intake of the nutrients identified in question 2.