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.
This is a preview of subscription content,
to check access.
Similar content being viewed by others
References
American Dietetic Association (2009) Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc 109:1266–1282
Amit V (2010) Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 15:303–314
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
Carmel R (2000) Current concepts in cobalamin deficiency. Annu Rev Med 51:357–375
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
Dagnelie P (2003) Voeding en gezondheid - potentiële gezondheidsvoordelen en risico’s van vegetarisme en beperkte vleesconsumptie in Nederland. Ned Tijdschr Geneesk 147:1308–1313
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
Dror DK, Allen LH (2008) Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev 66:250–255
Dunham L, Kollar L (2006) Vegetarian eating for children and adolescents. J Pediatr Health Care 20:27–34
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
FAO/WHO (1991) Protein quality evaluation in human diets. Food and Nutrition paper 51. FAO/WHO, Rome, pp 35–36
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
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
Hunt JR (2003) Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 78:633S–639S
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
Kirby M, Danner E (2009) Nutritional deficiencies in children on restricted diets. Pediatr Clin North Am 56:1085–1103
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
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
Larsson C, Johansson G (2002) Dietary intake and nutritional status of young vegans and omnivores in Sweden. Am J Clin Nutr 76:100–106
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
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
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
Mangels A, Messina V (2001) Considerations in planning vegan diets: infants. J Am Diet Assoc 101:670–677
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
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
Messina V, Mangels A (2001) Considerations in planning vegan diets: children. J Am Diet Assoc 101:661–669
Messina V, Melina V, Mangels A (2003) A new food guide for North American vegetarians. J Am Diet Assoc 103:771–775
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
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
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
New S (2004) Do vegetarians have a normal bone mass? Osteoporos Int 15:679–688
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
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
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
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
Rasmussen S, Fernhoff T, Scanlon K (2001) Vitamin B12 deficiency in children and adolescents. J Pediatr 138:10–17
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
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
Sabaté J (2003) The contribution of vegetarian diets to health and disease: a paradigm shift. Am J Clin Nutr 78:502S–507S
Sabaté J, Lindsted K, Harris R, Johnston P (1990) Anthropometric parameters of schoolchildren with different life styles. Am J Dis Child 144:1159–1163
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
Sadler M (2004) Meat alternatives—market developments and health benefits. Trends Food Sci Technol 15:250–260
Sanders T (1988) Growth and development of British vegan children. Am J Clin Nutr 48:822–825
Schaafsma G (2000) The protein digestibility-corrected amino acid score. J Nutr 130:1865S–1867S
Smith AM (2006) Veganism and osteoporosis: a review of the current literature. Int J Nurs Pract 12:302–306
Ströhle A, Waldmann A, Wolters M, Hahn A (2006) Vegetarische Ernährung: Präventives Potenzial und mögliche Risiken. Wien Klin Wochenschr 118:580–593
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
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
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
Wanatabe F (2007) Vitamin B12 sources and bioavailability. Exp Biol Med 232:1266–1274
WHO/FAO (2004) Vitamin B12. Vitamin and mineral requirements in human nutrition, 2nd edn. World Health Organisation, Geneva, pp 279–288
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
Young V, Pellett P (1994) Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 59:1203S–1212S
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-011-1547-x