Safely Raising a Vegetarian Child
As a way to combat the obesity epidemic in this country, Americans are encouraged to put fruits and vegetables front and center on their plates. Some take this even further, eliminating meat, fish, and/or other animal products, following some form of a vegetarian diet . While it is not necessary to remove meat or animal products from your diet to be healthy, this approach can be a healthful way for adults to eat when careful consideration is given to adequate nutrient intake. However, passing vegetarianism onto children has raised concerns. Will vegetarian children get all the nutrients they need during their years of rapid growth and development? The following discussion addresses such concerns.
Types of vegetarian diets
It is important to understand that not all vegetarians follow the exact same eating patterns. A lacto-ovo vegetarian does not eat meat, fish, or fowl, but does consume eggs and dairy products. A pescatarian eats fish, eggs, and dairy products, but not meat or fowl. Finally, a vegan, or total vegetarian, eats only plant-based foods, eliminating anything that is derived from an animal such as eggs and dairy products. Even within these patterns, considerable variations exist in the extent to which animal products are avoided.
A vegetarian diet for children requires careful planning
The American Academy of Pediatrics and the American Dietetic Association both feel that a carefully planned vegetarian diet can be nutritionally adequate for children. However, the key words here are "carefully planned," and the extent of planning required will depend on the type of vegetarianism you choose for your child. Vegetarian children who eat a small amount of dairy products and/or eggs will probably get enough of the protein and other nutrients they need. If your child is a vegan who excludes meat, poultry, seafood, dairy products, and eggs, you will want to make sure he gets adequate amounts of the following nutrients, which are found mostly in the these eliminated foods.
- Protein : It was once thought that plant proteins did not provide the correct balance of essential amino acids, which are necessary for proper growth and development. However, research now indicates that this is not true, and that an assortment of plant foods eaten over the course of the day can provide all the essential amino acids.1 However, plant proteins are not digested as easily as animal proteins, so vegetarians, especially vegans, may need more protein than non-vegetarians to meet their needs. Add beans and soy to your child's diet to help meet these increased needs.
- Calories: Your child's body will make its own complete proteins if he consumes a variety of plant foods and enough total calories throughout the day. In fact, calories are even more important than protein when it comes to his growth. Make sure he eats high-calorie, nutrient-rich foods like peanut butter, nuts, seeds, and cheese (if appropriate).
- Iron: There are 2 types of iron: heme and non-heme. Heme iron is easily absorbed, but is only found in animal products. Non-heme iron is found in plant foods and is difficult for the body to absorb. As a result, vegetarians need more iron than non-vegetarians to account for the iron that cannot be utilized. Non-meat foods that are high in iron include soy foods (soybeans, tofu, tempeh, soymilk), legumes (black beans, kidney beans, adzuki beans, great northern beans, etc), sunflower seeds, pumpkin seeds, and fortified breads and cereals. Vitamin C also helps the body absorb iron, so add a citrus fruit or a glass of orange juice to a meal that includes some of the above high-iron foods. 2, 3 (See Are you at risk of iron deficiency? )
- Calcium: If your child is a lacto-ovo vegetarian and eats dairy products daily, he probably gets enough calcium. Calcium intake of vegans, however, is often below recommended intakes.4 To ensure that he gets enough calcium, make sure he eats some of the following every day: Bok choy, broccoli, Napa cabbage, collards, kale, okra, turnip greens, and calcium-fortified foods such as soy milk, tofu, fruit juices, and breakfast cereals. To learn more read Calcium Deficiency: What you should know
- Vitamin D : There are 2 ways to get vitamin D: from sun and food. Since infants and children synthesize vitamin D less efficiently than adults and are often protected from the sun, they require more vitamin D from the foods they eat. Fortified cow or soy milk, egg yolks, and fortified breakfast cereals are among the few foods that provide vitamin D. If your child has insufficient sun exposure and intake of vitamin D-fortified foods is inadequate, vitamin D supplements are recommended.
- Vitamin B12: No plant food contains significant amounts of active vitamin B-12. Lacto-ovo vegetarians can get adequate B-12 from dairy foods and eggs if these foods are consumed regularly. However, vegans are at highest risk for B-12 deficiency.5 Therefore, it is crucial that vegans consume B-12-fortified foods, such as enriched cereals, or supplements daily (see . Vitamin B-12 deficiency is very serious, especially in developing children, as it can cause irreversible nerve damage.
- Omega-3 fatty acids: Diets that do not include fish or eggs are generally low in the omega-3 fatty acids EPA and DHA, which are essential for proper brain development and function. Most studies show vegetarians, and particularly vegans, tend to have lower blood levels of EPA and DHA than non-vegetarians.6 If your child does not eat fish or eggs, include some of the following in his diet each day: walnuts, walnut oil, ground flaxseed, flaxseed oil, canola oil, soybeans, and tofu.
Importance of a healthy diet
A vegetarian diet, like any other, has the potential to be healthful or unhealthful, depending on the food choices you make. A diet filled with junk food can easily meet the definition of a vegetarian diet, but would not be healthy. When approached correctly, vegetarian diets tend be lower in saturated fat and cholesterol and higher in fiber and many beneficial vitamins and minerals than non-vegetarian diets. If you have addressed all of the above nutrient issues, there is no cause for concern if your child is following a vegetarian diet.
- Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994;59:1203S-1212S.
- Hallberg L, Hulthen L. Prediction of dietary iron absorption: An algorithm for calculating absorption and bioavailability of dietary iron. Am J Clin Nutr 2000;71:1147-1160.
- Sandstrom B. Micronutrient interactions: Effects on absorption and bioavailability. Br J Nutr 2001;85(suppl 2):S181-S185.
- Larsson CL, Johansson GK. Dietary intake and nutritional status of young vegans and omnivores in Sweden. Am J Clin Nutr 2002;76:100-106.
- Herrmann W, Schorr H, Purschwitz K, Rassoul F, Richter V. Total homocysteine, vitamin B12, and total antioxidant status in vegetarians. Clin Chem 2001;47:1094-1101.
- Ågren JJ, Tormala ML, Nenonen MT, Hanninen OO. Fatty acid composition of erythrocyte, platelet, and serum lipids in strict vegans. Lipids 1995;30:365-369.