Debate intensifies over vegan diets for children, pediatric associations weigh in

By Pooja Toshniwal PahariaReviewed by Lily Ramsey, LLMNov 10 2023

In a recent study published in Nutrients, researchers examined available evidence on vegan (VN) diets for pediatric and adolescent individuals, particularly by citing position statement articles from several professional and scientific bodies, including pediatric organizations.

Study: Vegan Diets for Children: A Narrative Review of Position Papers Published by Relevant Associations. Image Credit: RONEDYA/Shutterstock.com

Background

Specialized organizations believe a well-planned vegan diet may be healthful and promote growth at critical life stages. However, due to possible risks and a lack of appropriate justification, pediatric societies contradict vegan diets for pediatric and adolescent individuals.

Critics refer to low-quality and outdated studies, as well as public health concerns concerning cardiovascular disease, obesity, prediabetes, and diabetes type 2. To test children's adherence, scientific rigor proposes comparing omnivorous and vegan diets.

About the review

In the present review, researchers evaluated T=the findings and short remarks of studies mentioned by various key position papers on vegan diets for pediatric individuals. 

Opinions of the key organizations on vegan diet adherence during childhood

Numerous professional and scientific organizations have produced position statements on the acceptability of VN meals for pediatric and adolescent individuals during the last two decades.

Most organizations feel that a well-planned vegan diet with vitamin B12 supplementation is healthful and suitable for babies, children, adolescents, adults, and elders throughout pregnancy and breastfeeding. They note, however, that a vegan diet needs more cautious planning and supplementation.

French and German physicians are more cautious or contemptuous of vegan diets for pediatric and adolescent individuals.

The German viewpoint emphasizes increased vigilance regarding the consumption and levels of particular nutrients like zinc, iron, docosahexaenoic acid (DHA), iodine, protein, and calcium, as well as energy intake, to avoid critical clinical implications such as growth impediments, anemia, or neurological damage.

Due to the perceived likelihood of nutritional deficits caused by the absence or lack of adequate supplements, the French pediatric profession does not advocate vegan diets for neonatal, pediatric, and adolescent individuals.

The Royal Academy of Medicine of Belgium issued a short and poorly cited report in 2019 claiming that VN diets offer dangers to pregnant women and children.

Belgium faces higher nutritional issues, with only three percent of young Flemish adults ingesting the necessary quantity of vegetables, and Flemish millennials, but not vegetarian (VG) individuals, consuming fewer than 150 g of the recommended 300 g of vegetables daily on average.

Since 1997, 2003, 2009, and 2016, the American Academy of Nutrition and Dietetics (AND) has advocated for a well-designed VN diet for children, as have Canadian dietitians, who emphasize proper calorie consumption, specific nutrients, and vitamin B12 supplementation.

The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) believes that VN diets with enough supplementation can maintain growth and development in children.

Studies on vegetarian, vegan, and omnivorous diets for children and adolescent individuals

The Czech Vegan Children Study (CAROTS) compared 91, 75, and 52 children in the VG, VN, and omnivorous diet (OM) groups, respectively, aged below 18.5 years concerning anthropometric, clinical, hematological, and urinary data on thyroid function and iodine levels.

Non-significant variations in thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), thyroglobulin (TG), and ATPOc levels were observed between the groups.

The highest urine iodine content (UIC) was found in OM children, followed by children in the VN and VG groups. Iodine insufficiency was more common among children in the vegan (42%) and vegetarian (35%) groups compared to those in the omnivorous group (20%).

For 2.8 years, the ‘TARGET KIDS!’ study tracked 8,907 children, of whom 248 and 25 belonged to the VG and VN groups, respectively. The researchers compared the influences of VG and OM diets on development, micronutrient reserves, and serological lipid levels among healthy youngsters.

There were no significant relationships between VG diet intake and z-scores for body mass index (BMI), height-for-age, serological vitamin D, ferritin, or lipid levels, nor were there clinically relevant variations in nutritional or growth parameters.

A Finnish study discovered that children on a VN diet consumed less vitamin B12, total fat, and calcium while consuming more fiber, folate, iron, and zinc than those on an OM diet. Both groups consumed vitamin D and iodine in equivalent amounts and insufficient amounts of DHA and eicosapentaenoic acid (EPA) without supplementation. Both groups had comparable iron stores.

An analysis of 187 children from Poland aged five to 10 years showed that B12 insufficiency incidence was increased among VN children but not among those who consumed vitamin B12. B12 was deficient in 16%, 19%, and 40% of OM, VG, and VN children, respectively. There were dietary consumption disparities between children from the OM and VN groups.

In a four-week randomized pilot trial in Cleveland, Ohio, 30 pairs of obese children with hypercholesterolemia aged 9.0 to 18 years and their parents discovered that a whole-food, plant-based (VN) diet with no added fat and American Heart Association (AHA) diet guidelines was effective in reducing BMI/fat, systolic blood pressure, total cholesterol, low-density lipoprotein (LDL)-cholesterol, high-sensitivity C-reactive protein (hs-CRP), insulin, and waist circumference.

Based on the review findings, vegan diets are fast developing, and an increasing number of children and parents are following suit. Pediatric, dietetic, and nutritional societies should work together to enhance the design and consistency of both diet types.

Position papers for the pediatric population should be revised to include the latest discoveries with VN diets. Improved information on well-designed VN diets for this age range, including supplementation recommendations, should be advantageous.

When addressing EPA and DHA nutrients in VN diets, future position statement papers should take a more scientifically balanced approach, include data on food allergies related to specific plant-based foods, and provide guidance on dietary modifications to ensure continued nutritional adequacy.