A major review reveals that vegan diets can be safe and healthy for children if meticulously planned and supplemented. However, it stresses the need for better guidance to bridge critical knowledge gaps for parents and clinicians alike.
Review: Influence of a Vegan Diet on Child Health and Development: A Scoping Review. Image Credit: everst / Shutterstock
In a recent article published in the journal Nutrition Reviews, researchers analyzed current research on vegan diets in children, focusing on health outcomes, growth, and nutritional adequacy. They identified gaps in evidence and highlighted the need for guidance in public health and clinical contexts.
Based on the current evidence, vegan diets can support healthy growth and development in children if carefully planned and supplemented, particularly for nutrients like iron, calcium, vitamin B12, and vitamin D. However, ensuring adequacy for certain nutrients, such as zinc, selenium, and long-chain omega-3 fatty acids remains more challenging and may require additional attention, including fortified foods or specific supplements. Parents should have access to resources and support. Clinicians may need specific training to ensure that they can provide guidance on these topics.
Background
Plant-based diets are increasingly popular due to their health and environmental benefits, and many people also adopt them for ethical reasons. In adults, these diets are linked to lower risks of some cancers, metabolic disorders, obesity, and cardiovascular disease.
However, regarding children, there is limited research on the long-term effects of well-planned plant-based diets, particularly vegan ones, which exclude all animal products. Most available studies focus on vegetarian diets or the risks of poorly planned vegan diets, leading to inconsistent dietary recommendations for children.
While vegan diets are hypothesized to provide benefits beyond those of vegetarian diets by eliminating inflammatory animal products, applying adult findings to children is challenging due to their unique developmental needs.
The limited evidence, combined with inconsistent guidelines, can create confusion and concern among healthcare providers and parents.
Nutritional deficiencies and supplementation
Research suggests that children following vegan diets could be at risk for several nutrient deficiencies without proper planning. Vitamin B12 deficiency is a major concern and can cause serious neurological problems, yet it can be prevented through supplementation.
The writers noted regional differences in vitamin B12 access and intake. Vitamin D3 intake is typically low and also needs supplementation. Though vegan diets often include iron-rich foods, the iron bioavailability is low, requiring co-consumption with vitamin C or supplements to prevent anemia.
Calcium intake may be insufficient, affecting bone health and requiring fortified foods or supplements. Iodine deficiency, which affects thyroid function, can be mitigated using iodized salt.
When thoughtfully designed and supplemented, vegan diets can meet children's energy and nutrient requirements. Plant-based foods can adequately supply nutrients such as calcium, iodine, fiber, zinc, omega-3 fatty acids, and protein. However, the evidence base for some nutrients, including zinc, selenium, and long-chain omega-3s, is less robust, and more research is needed to confirm adequacy in real-world settings. Nonetheless, poorly planned vegan diets can result in serious health issues like cognitive impairments and stunted growth.
Growth and development
Most studies showed that children on a well-planned vegan diet grow and develop normally, with no significant differences in height, weight, or body mass index (BMI). However, poorly planned diets may result in lower growth indicators.
Lower bone mineral content (BMC) and bone mineral density (BMD) were observed in some cases, indicating the importance of calcium and vitamin D supplementation. High fiber intake can reduce calorie density, but when properly managed, vegan diets support healthy growth.
Children on vegan diets often exhibit healthier lipid profiles, with lower total cholesterol levels, suggesting reduced cardiovascular risk. These children also have lower rates of overweight and obesity and generally healthier body composition compared to those on omnivorous diets.
It should be noted that most studies available are cross-sectional in design, with small sample sizes, which limits the ability to draw causal or long-term conclusions about health and development.
Avenues for future research
Current evidence suggests that when carefully designed, vegan diets can be nutritionally adequate and even beneficial for children. However, numerous research gaps remain. There is insufficient data on the long-term effects of vegan diets on children’s growth, development, and chronic disease risks.
The impact of maternal vegan diets during pregnancy and breastfeeding on infants is also under-researched. Few studies examine specific micronutrient statuses such as vitamin B2, selenium, and zinc.
Furthermore, the lack of data on diet duration, fasting, supplement adherence, and accurate biomarkers impairs our understanding. Research into age-specific guidelines, optimal supplementation doses, and cultural dietary practices is also needed.
Most of the studies reviewed used cross-sectional designs, which prevented conclusions about causality and long-term outcomes. Many also had small sample sizes, self-reported data, and limited demographic diversity, which affected accuracy and generalizability.
Few studies included control groups, and many lacked adjustments for confounding variables. Methodological inconsistencies, including poor dietary tracking and outdated data, also limit the reliability of findings.
Moreover, there is not universal agreement among professional institutions regarding the safety of vegan diets for all pediatric age groups—particularly infants and very young children—due to the limited and low-quality evidence base.
Conclusions
While vegan diets can be healthy when carefully planned, the authors emphasized the need for routine supplementation, particularly for vitamin B12, vitamin D, calcium, iron, iodine, and omega-3s.
Public health campaigns should educate on the importance of prenatal and early-life nutrition in vegan families. Regular monitoring through noninvasive measures such as ultrasound screening for bone health, pediatric visits, and blood tests, is recommended.
Multidisciplinary care involving dietitians and pediatricians is essential. Tailored, age-appropriate dietary guidelines for children on vegan diets should be developed, considering regional and cultural contexts.
The review also highlights the importance of regular growth and nutritional status monitoring and notes that a lack of planning and oversight can lead to serious adverse health outcomes, as documented in several case reports.