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Clinical practice

Vegetarian infant and child nutrition

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Abstract

The aim of this review is to give insight on the benefits and risks of vegetarianism, with special emphasis on vegetarian child nutrition. This eating pattern excluding meat and fish is being adopted by a growing number of people. A vegetarian diet has been shown to be associated with lower mortality of ischaemic heart disease and lower prevalence of obesity. Growth in children on a vegetarian diet including dairy has been shown to be similar to omnivorous peers. Although vegetarianism in adolescents is associated with eating disorders, there is no proof of a causal relation, as the eating disorder generally precedes the exclusion of meat from the diet. A well-balanced lacto-ovo-vegetarian diet, including dairy products, can satisfy all nutritional needs of the growing child. In contrast, a vegan diet, excluding all animal food sources, has at least to be supplemented with vitamin B12, with special attention to adequate intakes of calcium and zinc and energy-dense foods containing enough high-quality protein for young children. The more restricted the diet and the younger the child, the greater the risk for deficiencies.

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References

  1. American Dietetic Association (2009) Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc 109:1266–1282

    Article  Google Scholar 

  2. Amit V (2010) Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 15:303–314

    PubMed  CAS  Google Scholar 

  3. Appleby P, Roddam A, Allen J, Key T (2007) Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 61:1400–1406

    Article  PubMed  CAS  Google Scholar 

  4. Carmel R (2000) Current concepts in cobalamin deficiency. Annu Rev Med 51:357–375

    Article  PubMed  CAS  Google Scholar 

  5. Crowe F, Steur M, Allen N, Appleby P, Travis R, Key T (2011) Plasma concentrations of 25-hydroxyvitamin D in meat eaters, fish eaters, vegetarians and vegans: results from the EPIC-Oxford study. Public Health Nutr 14:340–346

    Article  PubMed  Google Scholar 

  6. Dagnelie P (2003) Voeding en gezondheid - potentiële gezondheidsvoordelen en risico’s van vegetarisme en beperkte vleesconsumptie in Nederland. Ned Tijdschr Geneesk 147:1308–1313

    CAS  Google Scholar 

  7. Dagnelie PC, van Dusseldorp M, van Staveren W, Hautvast J (1994) Effects of macrobiotic diets on linear growth in infants and children until 10 years of age. Eur J Clin Nutr 48:S103–S111

    PubMed  Google Scholar 

  8. Dror DK, Allen LH (2008) Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev 66:250–255

    Article  PubMed  Google Scholar 

  9. Dunham L, Kollar L (2006) Vegetarian eating for children and adolescents. J Pediatr Health Care 20:27–34

    Article  PubMed  Google Scholar 

  10. Elzerman J, Hoek A, Van Boekel M, Luning P (2011) Consumer acceptance and appropriateness of meat substitutes in a meal context. Food Qual Prefer 22:233–240

    Article  Google Scholar 

  11. FAO/WHO (1991) Protein quality evaluation in human diets. Food and Nutrition paper 51. FAO/WHO, Rome, pp 35–36

    Google Scholar 

  12. Hebbelinck M, Clarys P, De Malsche A (1999) Growth, development, and physical fitness of Flemish vegetarian children, adolescents and young adults. Am J Clin Nutr 70:579S–585S

    PubMed  CAS  Google Scholar 

  13. Herrmann W, Obeid R, Schorr H, Geisel J (2003) Functional vitamin B12 deficiency and determination of holotranscobalamin in populations at risk. Clin Chem Lab Med 41:1478–1488

    Article  PubMed  CAS  Google Scholar 

  14. Hunt JR (2003) Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 78:633S–639S

    PubMed  CAS  Google Scholar 

  15. Key T, Frase G, Thorogood M (1998) Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76000 men and women in five prospective studies. Public Health Nutr 1:33–41

    Article  PubMed  CAS  Google Scholar 

  16. Kirby M, Danner E (2009) Nutritional deficiencies in children on restricted diets. Pediatr Clin North Am 56:1085–1103

    Article  PubMed  Google Scholar 

  17. Klopp S, Heiss C, Smith H (2003) Self-reported vegetarianism may be a marker for college women at risk for disordered eating. J Am Diet Assoc 103:745–747

    Article  PubMed  Google Scholar 

  18. Krajcovicová-Kudlácková M, Simoncic R, Béderová A, Grancicová E, Magálová T (1997) Influence of vegetarian and mixed nutrition on selected haematological and biochemical parameters in children. Nahrung 41:311–314

    Article  PubMed  Google Scholar 

  19. Larsson C, Johansson G (2002) Dietary intake and nutritional status of young vegans and omnivores in Sweden. Am J Clin Nutr 76:100–106

    PubMed  CAS  Google Scholar 

  20. Legius E, Proesmans W, Eggermont E, Van Damme-Lombaerts R, Bouillon R, Smet M (1989) Rickets due to dietary calcium deficiency. Eur J Pediatr 148:784–785

    Article  PubMed  CAS  Google Scholar 

  21. Leung SS, Lee RH, Sung RY, Luo HY, Kam CW, Yuen MP, Hjelm M, Lee SH (2001) Growth and nutrition of Chinese vegetarian children in Hong Kong. J Paediatr Child Health 37:247–253

    Article  PubMed  CAS  Google Scholar 

  22. Louwman M, Van Dusseldorp M, Van de Vijver F, Thomas C, Schneede J, Ueland P, Refsum H, Van Staveren W (2000) Signs of impaired cognitive function in adolescents with marginal cobalamin status. Am J Clin Nutr 72:762–769

    PubMed  CAS  Google Scholar 

  23. Mangels A, Messina V (2001) Considerations in planning vegan diets: infants. J Am Diet Assoc 101:670–677

    Article  PubMed  CAS  Google Scholar 

  24. Martins Y, Pliner P, O’Conner R (1999) Restrained eating among vegetarians: does a vegetarian eating style mask concerns about weight? Appetite 32:145–154

    Article  PubMed  CAS  Google Scholar 

  25. Mathey C, Di Marco JN, Poujol A, Coumelle MA, Brevaut V, Livet MO, Chabrol B, Michel G (2007) Stagnation pondérale et régression psychomotrice révélant une carence en vitamine B 12 chez 3 nourissons. Arch Pediatr 14:467–471

    Article  PubMed  CAS  Google Scholar 

  26. Messina V, Mangels A (2001) Considerations in planning vegan diets: children. J Am Diet Assoc 101:661–669

    Article  PubMed  CAS  Google Scholar 

  27. Messina V, Melina V, Mangels A (2003) A new food guide for North American vegetarians. J Am Diet Assoc 103:771–775

    Article  PubMed  Google Scholar 

  28. Millward DJ, Garnett T (2010) Food and the planet: nutritional dilemmas of greenhouse gas emission reductions through reduced intakes of meat and dairy foods. Proc Nutr Soc 69:103–118

    Article  PubMed  Google Scholar 

  29. Nathan I, Hackett AF, Kirby S (1996) The dietary intake of a group of vegetarian children aged 7–11 years compared with matched omnivores. Br J Nutr 75:533–544

    Article  PubMed  CAS  Google Scholar 

  30. Nathan I, Hackett AF, Kirby S (1997) A longitudinal study of the growth of matched pairs of vegetarian and omnivorous children, aged 7–11 years, in the North-West of England. Eur J Clin Nutr 51:20–25

    Article  PubMed  CAS  Google Scholar 

  31. New S (2004) Do vegetarians have a normal bone mass? Osteoporos Int 15:679–688

    Article  PubMed  Google Scholar 

  32. O’Connell J, Dibley M, Sierra J, Wallace B, Marks J, Yip R (1989) Growth of vegetarian children: the Farm study. Pediatrics 84:475–481

    PubMed  Google Scholar 

  33. O’Connor MA, Touyz SW, Dunn SM et al (1987) Vegetarianism in anorexia nervosa? A review of 116 consecutive cases. Med J Aust 147:540–542

    PubMed  Google Scholar 

  34. Parsons T, van Dusseldorp M, van der Vliet M, van de Werken K, Schaafsma G, van Staveren W (1997) Reduced bone mass in Dutch adolescents fed a macrobiotic diet in early life. J Bone Miner Res 12:1486–1494

    Article  PubMed  CAS  Google Scholar 

  35. Perry C, Mcguire M, Neumark-Sztainer D, Story M (2001) Characteristics of vegetarian adolescents in a multi-ethnic urban population. J Adolesc Health 29:406–416

    Article  PubMed  CAS  Google Scholar 

  36. Rasmussen S, Fernhoff T, Scanlon K (2001) Vitamin B12 deficiency in children and adolescents. J Pediatr 138:10–17

    Article  PubMed  CAS  Google Scholar 

  37. Robinson-O’Brien R, Perry C, Wall M, Story M, Neumark-Sztainer D (2009) Adolescent and young adult vegetarianism: better dietary intake and weight outcomes but increased risk of disordered eating behaviors. J Am Diet Assoc 109:648–655

    Article  PubMed  Google Scholar 

  38. Rosell M, Lloyd-Wright Z, Appleby P, Sanders T, Annel N, Key T (2005) Long-chain n-3 poly-unsaturated fatty acids in plasma in British meat-eating, vegetarian and vegan men. Am J Clin Nutr 82:327–334

    PubMed  CAS  Google Scholar 

  39. Sabaté J (2003) The contribution of vegetarian diets to health and disease: a paradigm shift. Am J Clin Nutr 78:502S–507S

    PubMed  Google Scholar 

  40. Sabaté J, Lindsted K, Harris R, Johnston P (1990) Anthropometric parameters of schoolchildren with different life styles. Am J Dis Child 144:1159–1163

    PubMed  Google Scholar 

  41. Sabaté J, Lindsted KD, Harris RD, Sanchez A (1991) Attained height of lacto-ovo vegetarian children and adolescents. Eur J Clin Nutr 45:51–58

    PubMed  Google Scholar 

  42. Sadler M (2004) Meat alternatives—market developments and health benefits. Trends Food Sci Technol 15:250–260

    Article  CAS  Google Scholar 

  43. Sanders T (1988) Growth and development of British vegan children. Am J Clin Nutr 48:822–825

    PubMed  CAS  Google Scholar 

  44. Schaafsma G (2000) The protein digestibility-corrected amino acid score. J Nutr 130:1865S–1867S

    PubMed  CAS  Google Scholar 

  45. Smith AM (2006) Veganism and osteoporosis: a review of the current literature. Int J Nurs Pract 12:302–306

    Article  PubMed  Google Scholar 

  46. Ströhle A, Waldmann A, Wolters M, Hahn A (2006) Vegetarische Ernährung: Präventives Potenzial und mögliche Risiken. Wien Klin Wochenschr 118:580–593

    Article  PubMed  Google Scholar 

  47. Thane CW, Bates CJ (2000) Dietary intakes and nutrient status of vegetarian preschool children from a British national survey. J Hum Nutr Dietet 13:149–162

    Article  Google Scholar 

  48. Tonstad S, Butler T, Yan R, Fraser GE (2009) Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 32:791–796

    Article  PubMed  Google Scholar 

  49. Van Dusseldorp M, Arts I, Bergsma J, De Jong N, Dagnelie P, Van Staveren M (1996) Catch-up growth in children fed a macrobiotic diet in early childhood. J Nutr 126:2977–2983

    PubMed  Google Scholar 

  50. Wanatabe F (2007) Vitamin B12 sources and bioavailability. Exp Biol Med 232:1266–1274

    Article  Google Scholar 

  51. WHO/FAO (2004) Vitamin B12. Vitamin and mineral requirements in human nutrition, 2nd edn. World Health Organisation, Geneva, pp 279–288

    Google Scholar 

  52. Woolf P, Fu L, Basu A (2011) vProtein: identifying optimal amino acid complements form plant-based foods. PLoS One 6:e18836. doi:10.1371/journal.pone.0018836

    Article  PubMed  CAS  Google Scholar 

  53. Young V, Pellett P (1994) Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 59:1203S–1212S

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatrics, Division of Paediatric Gastroenterology and Nutrition, University Hospital Ghent, 3K12D, De Pintelaan 185, 9000, Ghent, Belgium

    Myriam Van Winckel, Saskia Vande Velde, Ruth De Bruyne & Stephanie Van Biervliet

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  1. Myriam Van Winckel
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  2. Saskia Vande Velde
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  3. Ruth De Bruyne
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  4. Stephanie Van Biervliet
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Correspondence to Myriam Van Winckel.

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Van Winckel, M., Vande Velde, S., De Bruyne, R. et al. Clinical practice. Eur J Pediatr 170, 1489–1494 (2011). https://doi.org/10.1007/s00431-011-1547-x

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