Although there are no official data, it is estimated that in our world between 1 and 2% of the population opts for vegetarian diets, those that dispense with the consumption of meat, products derived from it, and fish. These diets are in turn divided into those that include the consumption of eggs and milk (ovolacteus-vegan diet), or those that completely exclude the intake of any product of animal origin, including honey (vegan diet).
As with any other type of diet, if not done correctly, restricting the consumption of animal meat and fish can have very negative consequences, especially in children and adolescents.
Nutrition Societies around the world have been making public recommendations for a correct vegetarian diet in adults, but until now there have been no guidelines for children.
The Nutrition and Breastfeeding Committee of the Spanish Association of Pediatrics (AEP) has understood the need to provide reliable information to families who follow this type of diet in order to ensure the health of minors.
According to the available studies, children and adolescents who follow vegetarian diets have normal growth and development. The only ‘but’ is that they tend to have a lower than average body mass index.
To ensure the health of minors, it is advisable to consult with your pediatrician about the best way to implement a meat-free diet.
The contribution of fiber, magnesium, ferric iron, folic acid, vitamins C and E, n-6 polyunsaturated fatty acids, carotenoids, flavonoids, and other phytochemicals and antioxidants is guaranteed with vegetarian diets. But other essential elements in child development such as fats, n-3 polyunsaturated fatty acids, cholesterol, iodine, zinc, ferrous iron, and vitamins B12 and D, can be deficient in the child if there is no planning and control by the pediatrician. The nutritional contribution of these elements is further reduced with other types of more restrictive diets, such as vegan, which can pose a risk.
That is why the Nutrition Committee of the AEP recommends paying special attention to the presence of these elements in the diet of children.
A vegetarian diet consisting of a rich variety of foods of plant origin provides enough energy for the growth and development of the child. But since the quality of the vegetable protein is inferior to that of animal protein, pediatricians advise that the child consume foods rich in protein such as legumes, nuts, or seeds and that the protein sources be combined.
For pediatricians, “the use of soy and its derivatives (tofu, tempeh, meat analogs), as well as pseudo-cereals such as quinoa and amaranth, can help to guarantee an adequate balance of amino acids”.
It is also convenient to control the contribution of iron and zinc. It is true that a large number of plant foods provide a large amount of iron to the body, what happens is that it is non-heme iron, more difficult for the body to absorb. For this reason, the AEP recommends the daily consumption of foods rich in vitamin C, which helps this process of iron absorption.
Iodized salt, vegetables of marine origin, and some cereal-based foods provide the necessary iodine. If dairy and eggs are also consumed, the intake of this element is completed. At this point, the recommendation of pediatricians focuses on the consumption of algae such as wakame, kombu, nori, which in addition to iodine have a high content of arsenic, so they should be given in moderation to both infants and young children.
Although there are still no conclusive studies on the influence of vegetarian diets on the bone structure of children, the Committee on Nutrition and Breastfeeding recommends “the consumption of foods fortified in calcium and vitamin D, along with the usual practice of physical activity of appropriate intensity ”, regardless of the type of diet they practice. Some research has revealed a “higher risk of fractures in a vegan population with low calcium intake”
Vitamin D supplements are also recommended, both in vegetarians and non-vegetarians, when the intake of foods rich in it is not enough.
Foods like fish, olive oil, sunflower oil, soybean, nuts, and seeds are rich in omega-3 fats. Pediatricians recommend that pregnant women, infants, children under 6 months who are not breastfeeding, and those over 6 months who ingest less than 50% of the calories in breast milk, receive supplements of this type of fatty acids.
The latest guideline from the Spanish Pediatric Association refers to Vitamin B12, essential for the production of red blood cells, and which is not present in any plant food.
They consider that “the oral supplement of this vitamin is essential for all vegetarians and vegans. Even in the ovolactovegetarian or in people who habitually consume fortified foods, a weekly dose of a booster is the best way to guarantee optimal levels of this vitamin ”.
EVERY AGE HAS ITS NUTRITIONAL REQUIREMENTS
The experts of the Nutrition Committee of the Spanish Association of Pediatrics (AEP) have prepared a series of indications on the best nutrition habits according to the moment of the child’s development.
Thus, they consider it essential to boost the intake of vitamin B12 and omega-3 fatty acids during pregnancy to reduce the risk of preterm birth and ensure the correct weight of the baby. These contributions will continue during breastfeeding. And if this is not possible, there are formula kinds of milk on the market made from purified soybeans. At this point, pediatricians warn about certain unsuitable plant-based drinks for infants, which are sometimes flavored with fruit and vegetable juices, and which can cause “severe malnutrition, neurological disorders, and even death.”
Families on vegetarian diets should start introducing food at the same age as omnivores. Thus, legumes will be introduced from 6 months, like soy yogurts without sugar.
It is important that children’s menus always include foods rich in vitamin C to promote the absorption of iron and vegetables rich in vitamin A.
The introduction of gluten will be done exactly the same as in non-vegetarian children. It is important to promote the use of whole grains: bread, rice, pasta, couscous, millet, corn polenta, and quinoa.
Pediatricians also recommend avoiding during the first year of life “spinach, chard, borage, beetroot, arugula and other green leaves due to their high nitrate content; honey and syrups (agave syrup, rice syrup, wheat syrup), due to the danger of contamination with botulism spores.
It is also not recommended that children consume seaweed before 12 months, due to its high iodine content, or foods such as flax seeds or chia, due to its laxative effects.
Once they are 2 years old, children should eat the same as the rest of the family, always avoiding processed products with added sugars.
In the adolescent stage the need for nutrients such as protein, iron, zinc, and calcium increases, so menu planning should include legumes daily, both in vegetarian and vegan diets. At this stage, the intake of vitamin C is also essential to absorb iron and consume products rich in calcium or enriched with this nutrient.