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Published in: European Journal of Pediatrics 12/2011

01-12-2011 | Review

Clinical practice

Vegetarian infant and child nutrition

Authors: Myriam Van Winckel, Saskia Vande Velde, Ruth De Bruyne, Stephanie Van Biervliet

Published in: European Journal of Pediatrics | Issue 12/2011

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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.
Literature
1.
go back to reference American Dietetic Association (2009) Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc 109:1266–1282CrossRef American Dietetic Association (2009) Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc 109:1266–1282CrossRef
2.
go back to reference Amit V (2010) Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 15:303–314PubMed Amit V (2010) Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 15:303–314PubMed
3.
go back to reference Appleby P, Roddam A, Allen J, Key T (2007) Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 61:1400–1406PubMedCrossRef Appleby P, Roddam A, Allen J, Key T (2007) Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 61:1400–1406PubMedCrossRef
5.
go back to reference 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 14:340–346PubMedCrossRef 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 14:340–346PubMedCrossRef
6.
go back to reference 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 P (2003) Voeding en gezondheid - potentiële gezondheidsvoordelen en risico’s van vegetarisme en beperkte vleesconsumptie in Nederland. Ned Tijdschr Geneesk 147:1308–1313
7.
go back to reference 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–S111PubMed 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–S111PubMed
8.
go back to reference Dror DK, Allen LH (2008) Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev 66:250–255PubMedCrossRef Dror DK, Allen LH (2008) Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev 66:250–255PubMedCrossRef
9.
go back to reference Dunham L, Kollar L (2006) Vegetarian eating for children and adolescents. J Pediatr Health Care 20:27–34PubMedCrossRef Dunham L, Kollar L (2006) Vegetarian eating for children and adolescents. J Pediatr Health Care 20:27–34PubMedCrossRef
10.
go back to reference Elzerman J, Hoek A, Van Boekel M, Luning P (2011) Consumer acceptance and appropriateness of meat substitutes in a meal context. Food Qual Prefer 22:233–240CrossRef Elzerman J, Hoek A, Van Boekel M, Luning P (2011) Consumer acceptance and appropriateness of meat substitutes in a meal context. Food Qual Prefer 22:233–240CrossRef
11.
go back to reference FAO/WHO (1991) Protein quality evaluation in human diets. Food and Nutrition paper 51. FAO/WHO, Rome, pp 35–36 FAO/WHO (1991) Protein quality evaluation in human diets. Food and Nutrition paper 51. FAO/WHO, Rome, pp 35–36
12.
go back to reference 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–585SPubMed 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–585SPubMed
13.
go back to reference 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 41:1478–1488PubMedCrossRef 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 41:1478–1488PubMedCrossRef
14.
go back to reference Hunt JR (2003) Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 78:633S–639SPubMed Hunt JR (2003) Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 78:633S–639SPubMed
15.
go back to reference 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 1:33–41PubMedCrossRef 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 1:33–41PubMedCrossRef
16.
go back to reference Kirby M, Danner E (2009) Nutritional deficiencies in children on restricted diets. Pediatr Clin North Am 56:1085–1103PubMedCrossRef Kirby M, Danner E (2009) Nutritional deficiencies in children on restricted diets. Pediatr Clin North Am 56:1085–1103PubMedCrossRef
17.
go back to reference 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 103:745–747PubMedCrossRef 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 103:745–747PubMedCrossRef
18.
go back to reference 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 41:311–314PubMedCrossRef 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 41:311–314PubMedCrossRef
19.
go back to reference Larsson C, Johansson G (2002) Dietary intake and nutritional status of young vegans and omnivores in Sweden. Am J Clin Nutr 76:100–106PubMed Larsson C, Johansson G (2002) Dietary intake and nutritional status of young vegans and omnivores in Sweden. Am J Clin Nutr 76:100–106PubMed
20.
go back to reference Legius E, Proesmans W, Eggermont E, Van Damme-Lombaerts R, Bouillon R, Smet M (1989) Rickets due to dietary calcium deficiency. Eur J Pediatr 148:784–785PubMedCrossRef Legius E, Proesmans W, Eggermont E, Van Damme-Lombaerts R, Bouillon R, Smet M (1989) Rickets due to dietary calcium deficiency. Eur J Pediatr 148:784–785PubMedCrossRef
21.
go back to reference 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 37:247–253PubMedCrossRef 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 37:247–253PubMedCrossRef
22.
go back to reference 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 72:762–769PubMed 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 72:762–769PubMed
23.
go back to reference Mangels A, Messina V (2001) Considerations in planning vegan diets: infants. J Am Diet Assoc 101:670–677PubMedCrossRef Mangels A, Messina V (2001) Considerations in planning vegan diets: infants. J Am Diet Assoc 101:670–677PubMedCrossRef
24.
go back to reference Martins Y, Pliner P, O’Conner R (1999) Restrained eating among vegetarians: does a vegetarian eating style mask concerns about weight? Appetite 32:145–154PubMedCrossRef Martins Y, Pliner P, O’Conner R (1999) Restrained eating among vegetarians: does a vegetarian eating style mask concerns about weight? Appetite 32:145–154PubMedCrossRef
25.
go back to reference 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 14:467–471PubMedCrossRef 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 14:467–471PubMedCrossRef
26.
go back to reference Messina V, Mangels A (2001) Considerations in planning vegan diets: children. J Am Diet Assoc 101:661–669PubMedCrossRef Messina V, Mangels A (2001) Considerations in planning vegan diets: children. J Am Diet Assoc 101:661–669PubMedCrossRef
27.
go back to reference Messina V, Melina V, Mangels A (2003) A new food guide for North American vegetarians. J Am Diet Assoc 103:771–775PubMedCrossRef Messina V, Melina V, Mangels A (2003) A new food guide for North American vegetarians. J Am Diet Assoc 103:771–775PubMedCrossRef
28.
go back to reference 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 69:103–118PubMedCrossRef 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 69:103–118PubMedCrossRef
29.
go back to reference 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 75:533–544PubMedCrossRef 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 75:533–544PubMedCrossRef
30.
go back to reference 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 51:20–25PubMedCrossRef 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 51:20–25PubMedCrossRef
32.
go back to reference O’Connell J, Dibley M, Sierra J, Wallace B, Marks J, Yip R (1989) Growth of vegetarian children: the Farm study. Pediatrics 84:475–481PubMed O’Connell J, Dibley M, Sierra J, Wallace B, Marks J, Yip R (1989) Growth of vegetarian children: the Farm study. Pediatrics 84:475–481PubMed
33.
go back to reference O’Connor MA, Touyz SW, Dunn SM et al (1987) Vegetarianism in anorexia nervosa? A review of 116 consecutive cases. Med J Aust 147:540–542PubMed O’Connor MA, Touyz SW, Dunn SM et al (1987) Vegetarianism in anorexia nervosa? A review of 116 consecutive cases. Med J Aust 147:540–542PubMed
34.
go back to reference 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 12:1486–1494PubMedCrossRef 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 12:1486–1494PubMedCrossRef
35.
go back to reference Perry C, Mcguire M, Neumark-Sztainer D, Story M (2001) Characteristics of vegetarian adolescents in a multi-ethnic urban population. J Adolesc Health 29:406–416PubMedCrossRef Perry C, Mcguire M, Neumark-Sztainer D, Story M (2001) Characteristics of vegetarian adolescents in a multi-ethnic urban population. J Adolesc Health 29:406–416PubMedCrossRef
36.
go back to reference Rasmussen S, Fernhoff T, Scanlon K (2001) Vitamin B12 deficiency in children and adolescents. J Pediatr 138:10–17PubMedCrossRef Rasmussen S, Fernhoff T, Scanlon K (2001) Vitamin B12 deficiency in children and adolescents. J Pediatr 138:10–17PubMedCrossRef
37.
go back to reference 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 109:648–655PubMedCrossRef 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 109:648–655PubMedCrossRef
38.
go back to reference 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 82:327–334PubMed 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 82:327–334PubMed
39.
go back to reference Sabaté J (2003) The contribution of vegetarian diets to health and disease: a paradigm shift. Am J Clin Nutr 78:502S–507SPubMed Sabaté J (2003) The contribution of vegetarian diets to health and disease: a paradigm shift. Am J Clin Nutr 78:502S–507SPubMed
40.
go back to reference Sabaté J, Lindsted K, Harris R, Johnston P (1990) Anthropometric parameters of schoolchildren with different life styles. Am J Dis Child 144:1159–1163PubMed Sabaté J, Lindsted K, Harris R, Johnston P (1990) Anthropometric parameters of schoolchildren with different life styles. Am J Dis Child 144:1159–1163PubMed
41.
go back to reference Sabaté J, Lindsted KD, Harris RD, Sanchez A (1991) Attained height of lacto-ovo vegetarian children and adolescents. Eur J Clin Nutr 45:51–58PubMed Sabaté J, Lindsted KD, Harris RD, Sanchez A (1991) Attained height of lacto-ovo vegetarian children and adolescents. Eur J Clin Nutr 45:51–58PubMed
42.
go back to reference Sadler M (2004) Meat alternatives—market developments and health benefits. Trends Food Sci Technol 15:250–260CrossRef Sadler M (2004) Meat alternatives—market developments and health benefits. Trends Food Sci Technol 15:250–260CrossRef
43.
go back to reference Sanders T (1988) Growth and development of British vegan children. Am J Clin Nutr 48:822–825PubMed Sanders T (1988) Growth and development of British vegan children. Am J Clin Nutr 48:822–825PubMed
44.
go back to reference Schaafsma G (2000) The protein digestibility-corrected amino acid score. J Nutr 130:1865S–1867SPubMed Schaafsma G (2000) The protein digestibility-corrected amino acid score. J Nutr 130:1865S–1867SPubMed
45.
go back to reference Smith AM (2006) Veganism and osteoporosis: a review of the current literature. Int J Nurs Pract 12:302–306PubMedCrossRef Smith AM (2006) Veganism and osteoporosis: a review of the current literature. Int J Nurs Pract 12:302–306PubMedCrossRef
46.
go back to reference Ströhle A, Waldmann A, Wolters M, Hahn A (2006) Vegetarische Ernährung: Präventives Potenzial und mögliche Risiken. Wien Klin Wochenschr 118:580–593PubMedCrossRef Ströhle A, Waldmann A, Wolters M, Hahn A (2006) Vegetarische Ernährung: Präventives Potenzial und mögliche Risiken. Wien Klin Wochenschr 118:580–593PubMedCrossRef
47.
go back to reference Thane CW, Bates CJ (2000) Dietary intakes and nutrient status of vegetarian preschool children from a British national survey. J Hum Nutr Dietet 13:149–162CrossRef Thane CW, Bates CJ (2000) Dietary intakes and nutrient status of vegetarian preschool children from a British national survey. J Hum Nutr Dietet 13:149–162CrossRef
48.
go back to reference Tonstad S, Butler T, Yan R, Fraser GE (2009) Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 32:791–796PubMedCrossRef Tonstad S, Butler T, Yan R, Fraser GE (2009) Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 32:791–796PubMedCrossRef
49.
go back to reference 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 126:2977–2983PubMed 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 126:2977–2983PubMed
50.
go back to reference Wanatabe F (2007) Vitamin B12 sources and bioavailability. Exp Biol Med 232:1266–1274CrossRef Wanatabe F (2007) Vitamin B12 sources and bioavailability. Exp Biol Med 232:1266–1274CrossRef
51.
go back to reference WHO/FAO (2004) Vitamin B12. Vitamin and mineral requirements in human nutrition, 2nd edn. World Health Organisation, Geneva, pp 279–288 WHO/FAO (2004) Vitamin B12. Vitamin and mineral requirements in human nutrition, 2nd edn. World Health Organisation, Geneva, pp 279–288
53.
go back to reference Young V, Pellett P (1994) Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 59:1203S–1212SPubMed Young V, Pellett P (1994) Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 59:1203S–1212SPubMed
Metadata
Title
Clinical practice
Vegetarian infant and child nutrition
Authors
Myriam Van Winckel
Saskia Vande Velde
Ruth De Bruyne
Stephanie Van Biervliet
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 12/2011
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-011-1547-x

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