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  • Denise Scott

Is Vegetarian or Entirely Plant-Based Eating Appropriate for Children?


Child with a plate of plant-based foods


Since I ran this post last October, I am publishing it again as it reviews vegetarian eating for children.


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 animals or a vegetarian diet.


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 (such as beans and rice) or legumes with dairy. (See blog post on protein for further information, https://www.feedfuturehealth.com/post/macronutrients ).

As long as you are mindful of adding protein sources to meals and combine foods, over the course of the day, 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 (many plant-based milks do not have as much vitamin D, calcium, or protein as dairy)


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 for iron deficiency 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. Of the four diets reviewed, this is the safest for a child, if not following MyPlate recommendations. Deficiencies can occur, and your child should be monitored for these and supplemented if indicated.


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