Child with a plate of plant-based foods
There are many variations of eating:
Vegetarian: excludes animals
Vegan: excludes animals, dairy, and eggs
Lacto-vegetarian: excludes meat, poultry, and fish but includes milk and milk products
Ovo-vegetarian: excludes meat, poultry, and fish but includes eggs
Lacto-ovo-vegetarian: excludes meat, poultry, and fish but includes milk, milk products, and eggs
Pescatarian: excludes meat and poultry but includes fish, milk, milk products, and eggs
Semi-vegetarian or flexitarian: mostly vegetarian that occasionally consume meat, meat products, poultry, and fish
I will focus on those eating patterns that avoid animal products.
Plant-based eating has become very popular due to its many health benefits. Veganism and vegetarianism are not necessarily the same as plant-based eating since many processed foods are considered plant-based. Ultra-processed foods are the foods to avoid in any type of eating pattern. I will specifically discuss plant-based eating and the pros and cons for children.
Plant-based eating can be very healthy if the focus is on whole natural foods - fruits, vegetables, whole grains, legumes, nuts, and seeds. This dietary pattern can prevent numerous diseases: type 2 diabetes, cardiovascular disease, fatty liver disease, hypertension, and some cancers.
Being entirely plant-based can put children at risk for specific nutritional deficiencies that should be monitored. I will review these potential deficiencies and reiterate some information from previous posts that are worth repeating.
Potential deficiencies include:
Calcium
Vitamin D
Vitamin B12
Iron
Zinc
Protein
Let’s start with the only macronutrient on the list: PROTEIN.
There are numerous sources of plant-based protein. You can get enough protein on a plant-based diet if you serve these sources daily. Children need approximately 0.8 grams of protein per kilogram of body weight, or about 0.4 grams per pound, more for athletes.
Protein sources from plants:
Beans -all varieties
Lentils
Peas
Soy products - edamame, tofu, tempeh,
Nuts and Seeds
Grains - quinoa, spelt, Kamut, teff, amaranth, oats, buckwheat, wild rice, brown rice, barley, whole wheat pasta and bread, millet, cornmeal, couscous, and sorghum
Vegetables - potatoes, mushrooms, broccoli, spinach, kale, collards, sprouts, brussels sprouts, artichokes, asparagus, avocado, sweet corn, and winter squash
Seitan
Plant-based proteins are not typically complete proteins, meaning these proteins do not contain all 9 essential amino acids. Plant-based complementary proteins can be combined to make a complete protein. Examples are: legumes with grains or legumes with nuts or seeds. (See blog post on protein for further information).
As long as you are mindful of adding protein sources to meals and combine foods to make a complete protein, adequate protein intake should not be an issue.
Calcium
Before puberty, children need about 800 mg of calcium daily. Calcium requirements during puberty are 1300-1500 mg daily. This amount can be hard to obtain if milk and dairy are not part of the diet. Plant-based milk, fortified with calcium and vitamin D, is an option, as is calcium-fortified orange juice.
Plant-based sources of calcium include:
Collard greens, turnip greens, mustard greens
Soy products - soybeans, tofu, tempeh, yogurt
Calcium-fortified orange juice
Calcium-fortified plant milk
Oatmeal
Blackstrap molasses
Dried figs
Tahini
Kale
Bok choy
Okra
Navy beans
Chickpeas
Almonds and almond butter
Oranges
Broccoli
Papaya
Vitamin D
Like calcium, adequate vitamin D can be hard to obtain if on no milk or dairy, although you can find vitamin D fortified foods.
Vitamin D needs by age:
Infants 400 IU
Children 1-13 600 IU
Teens 14-19 600-800 IU
Vitamin D deficiency has become very common, especially in Black and Latino populations. I was surprised that most patients I tested for this vitamin were deficient. Vitamin D2 (ergocalciferol) is from plant sources; vitamin D3 (cholecalciferol) is from animal sources. Vitamin D3 is the form that is more effective at raising vitamin D levels in the blood. Some of the best vitamin D sources are cod liver oil, fish oil, and fatty fish. Plant products that are fortified with vitamin D may have D2 or D3.
Plant foods with vitamin D include:
Mushrooms (D2) - the only naturally occurring plant source of vitamin D
Fortified cereals
Fortified soy products
Fortified plant milk
Vitamin B12
Vitamin B12 is needed for blood and nerve cells, helps make DNA, and prevents a specific anemia. The foods richest in B12 are various types of seafood. Even though we only need a small amount, about 1-2.5 micrograms a day in children, many vegans and vegetarians are deficient in this nutrient since it occurs primarily in animal sources.
Plant sources include:
Nutritional yeast
Seaweed
Shiitake mushrooms
Fortified cereals
Fortified plant milks
Iron
Iron deficiency can also be seen, especially in menstruating girls. A blood test can check this and a child should be monitored if entirely plant-based.
Heme iron comes from animal sources and is better absorbed than non-heme iron from plants. Adding vitamin C-rich foods in combination with plant sources of iron helps to increase absorption. Calcium-rich foods decrease absorption.
Plant sources of iron include:
Legumes - beans, peas, lentils
Soybean products
Nuts and seeds
Leafy greens
Potatoes
Mushrooms
Tomato paste
Dried apricots, prunes, raisins, dates
Olives
Whole grains - amaranth, spelt, oats, quinoa
Fortified cereals
Zinc
Zinc is a trace mineral required in only small amounts but is very important in the many enzymatic processes in the body. Zinc also benefits the immune system and tissue repair.
Zinc is found in the following plant foods:
Legumes
Nutritional yeast
Wheat germ
Nuts and seeds
Soy products
Fortified cereals
Oats
Quinoa
Brown and wild rice
These are the nutrients to be mindful of for a growing, developing child when on a plant-based diet. The food lists are not exhaustive. Following a plant-based diet can be very healthy and helpful in preventing a multitude of diseases. Deficiencies can occur, and your child should be monitored for these and supplemented if indicated.