Diet and growth of vegetarian and vegan children

Abstract

The prevalence of plant-based diets, that is, vegetarian (without meat and fish) and vegan (plant foods only) diets, is increasing also among children and adolescents, and energy and nutrient requirements are highest during this age. Hence the question emerges whether and, if so, how much animal-source food should be included in a healthy and sustainable diet. Recent studies, published 2018–2023, mostly showed comparable anthropometrics between omnivore and vegetarian children, however, fat mass was lower in vegetarians or vegans. Results on marker of iron status were inconsistent. Vitamin B12 status was lower without supplementation, but did not differ between groups when supplementation prevalence was high. Blood lipid profile seems to be more favourable in plant-based groups. Bone mineral density was lower in vegetarians and vegans, but differences attenuated after adjustment. Nevertheless, the long-term clinical relevance of these results remains unclear. Energy intake did not differ between groups and was in the recommended range, although protein intake was lower in vegetarians and vegans. Reported calcium intakes did not differ or were lower in vegetarians compared with omnivores, and were lowest in vegans. More favourable intakes in subjects on plant-based diets were found for fibre, sugar, folate, magnesium and iron. All but one study were cross-sectional, and longitudinal studies of both vegetarian and vegan children/adolescents are required to prospectively examine associations of plant-based diets with health. Professional societies should develop country-specific food-based dietary guidelines adapted to the special dietary habits for children on plant-based diets.