When managed properly, vegetarian diets for children a healthy option

The potential benefits of a plant-based diet have become increasingly recognized in recent years. In addition to addressing individual health concerns and belief systems, vegetarian and/or vegan diets also play a role in combating global warming and promoting sustainable food production.

As the number of vegetarians and vegan adults increase worldwide, there is likewise an increase in the number of children adhering to plant-based diets. However, in children, an important distinction must be made between a vegetarian and vegan diet. A vegetarian diet, which excludes meat and fish consumption, can be nutritionally varied like an omnivorous diet. The most common type of vegetarian diet is lacto-ovo vegetarianism, which permits milk, cheese and eggs. These foods provide key sources of protein to growing children and, when managed under the supervision of a health care provider, do not pose health risks to children.

Conversely, because a vegan diet does not permit any animal-derived food, adherents to this diet do not consume milk, eggs or cheese. Although this level of restriction may be healthily maintained in adults, it becomes much more difficult for children to get the nutrients they need.

“When children are vegetarian but regularly eat dairy products, there is not a high risk for deficiency,” Myriam Van Winckel, MD, PhD, from the department of pediatric and medical genetics at Ghent University in Belgium, told Healio Family Medicine. “However, when you give a vegan diet to little children, you surely need vitamin supplements. It’s dangerous without supplements.”

Winckel spoke with Healio Family Medicine about the advantages and disadvantages of these diets for children, as well as the importance of implementing them safely.

Question: What is the nutritional difference in a vegetarian vs. vegan diet?

Answer: Vegetarians don’t ban all animal food; they just don’t eat meat, and most of them don’t eat fish, either. They are drinking milk and consuming dairy products and eggs. Then you have pesco-vegetarians, who eat fish, but no meat. On the other hand, vegans take no food from animal origin, and there are some key nutrients that are only found in animal products. For example, vitamin B12 is only present in animal food; it’s less present in eggs and dairy products than in meat or fish. However, a person doesn’t really need a lot of that vitamin, and the need for that nutrient can likely be met through eating dairy products and eggs regularly.

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If parents want to raise their children on a vegan diet, they need to consult someone who is knowledgeable about it. There are specialized dieticians who can help parents with this. As humans, we developed as omnivores, and we have been able to adapt to very different circumstances. For example, people living in the north, like Eskimos, can’t possibly be vegetarian, because the only food available to them for long periods in the year is fish and meat. Comparing this to other regions, people are adaptable and can adapt to a very diverse diet. But we do need vitamin B12 — children especially, but adults also.

Q: What can happen if a child becomes deficient in vitamin B12?

A: A person who is B12 deficient can develop permanent neurological damage — that’s why it’s so important to prevent it. Children, and especially infants, are more vulnerable to this damage because they and their brain are still in development.

I’ve seen the children with neurological damage; they were breastfed by a vegan mother. The child had signs of deficiency while the mother had not yet shown signs of deficiency, but serum levels showed that she was also deficient. The neurological damage is regressive — children don’t develop anymore, and they become less responsive to what is happening around them. They lose the ability to keep their balance.

Q: As far as infant nutrition, what are some of the potential deficiency risks?

A: There are many products labeled “milks,” such as almond milk, rice milk or soy milk, which some parents might think are safe to give to infants instead of breast milk. In fact, almond milk is an almond drink, not milk, and these drinks are not the same as breast milk or infant formula. Soy has a rather high quality as a vegetarian protein food, but the protein quality of soy milk is not sufficient for an infant. It is not a good calcium or zinc source.

So, if a parent chooses a soy product, it needs to be adapted for infants or young children. These products are what we call the growth milks or soy formula. The right growth milks can be suitable. Even if “nut milks” are supplemented with vitamins and minerals (B12, calcium, vitamin D), they remain poor sources of protein compared to cow’s milk or breast milk..

Q: Is there a lack of awareness regarding the potential dangers of these diets?

A: It’s dangerous if the child doesn’t take supplements, and if it’s not done in a reasonable way. I do think that in general, we’re eating too much meat. Speaking for myself, I eat vegetarian most of the time, but I don’t ban dairy and eggs, and from time to time I do eat meat. It depends on where the meat comes from; if it’s comes from cattle raised in a way that is in harmony with nature, I don’t have a problem.
However, a vegetarian diet can be very balanced and healthy, and provide many advantages, such as fewer cardiovascular problems, and less diabetes and obesity. Vegetarianism also has less ecological impact. You just have to be sure to get enough vitamin B12. This is especially important for young kids.

Additionally, it’s also important that parents get advice from a dietician when raising children on a vegetarian diet. Vegetarian food is less calorie-dense, and young kids are growing fast. They’re expending a lot of energy, so they need energy.

I see a lot of children being raised vegetarian, and I’ve seen quite a lot of parents who implement the advice given. With these parents, there’s no problem.
As all parents, they very much want their children to be healthy and thrive. – by Jennifer Byrne

For more information:

Myriam Van Winckel , MD, can be reached at De Pintelaan 185, 3K12D, 9000 Gent; email: myriam.vanwinckel@ughent.be.

Disclosure: Van Winckel reports no relevant disclosures.