You have a patient who is very health-conscious and regularly ingests a large number of vitamins in mega doses and herbal therapies on a daily basis. She is a strict vegetarian as well. She is going to attempt pregnancy and wants your advice regarding her diet and nutrition intake. Which of the following is true regarding diet recommendations in pregnancy?

The use of herbal remedies is not recommended during pregnancy because such products are classified as dietary supplements and therefore are not FDA-regulated for purity, safety, and efficacy. In fact, the actual ingredients of many herbal substances are not even known. There is almost no data regarding the teratogenic potential of herbal medications in humans. It is not recommended that women assume a vegetarian diet during pregnancy because animal sources of protein such as meat, poultry, fish, and eggs contain amino acids in the most desirable combinations. In addition, strict vegetarians can give birth to infants who are low in vitamin B12 stores because vitamin B12 occurs naturally only in foods of animal origin. Pregnant women do not need to take vitamin A supplements because adequate amounts can be obtained in the diet; in addition, a very high intake of vitamin A has been associated with the type of congenital malformations seen with oral Accutane use. Adequate vitamin C levels needed for pregnancy can be provided in a reasonable diet. No known fetal anomalies have been reported with vitamin C supplementation in pregnancy.