Plant-based diets for children

The number of people adopting a plant based diet has increased enormously over the past few years. According to the Vegan Society the number of vegans in the UK has quadrupled from 2014 to 2019. It follows then that there could be many parents who may be thinking of adopting a plant-based diet for their children too. In this blog post I will discuss the nutritional considerations for different plant-based diets for children and how to manage this. 

Are plant-based diets safe for children? 

Plant-based diets CAN be nutritious and safe for young children if they are planned carefully. However, it is important to point out that an UNsupplemented and/or UNfortified vegan diet is not safe for babies, young children and breastfeeding mums. At the very minimum, vitamin B12 should be supplemented for all those following a fully plant based or vegan diet (see below for further details). 

The term ‘plant-based’ can mean different things to different people as there are many variations of plant-based diets, including:

Vegans – Don’t eat any animal products at all, including honey, dairy and eggs.

Lacto-ovo-vegetarians – Eat dairy foods and eggs but not meat, poultry or seafood. 

Lacto-vegetarians – Eat dairy foods but exclude eggs, meat, poultry and seafood. 

Ovo-vegetarians – Include eggs but avoid all other animal foods including dairy. 

Pescatarians – eat fish and/or shellfish but no meat or poultry. 

Semi-vegetarians or flexitarians – occasionally eat meat or poultry. 

PLEASE NOTE: 

The more restrictive a diet is, the higher the chance of nutritional deficiencies. I would advise all parents thinking of adopting a fully or predominantly plant-based diet for their children, to work with a Paediatric Dietitian or Registered Nutritionist, to make sure that their child’s diet is providing the ideal balance of all nutrients to promote optimal growth and development. 

What about the growth of children on vegetarian or vegan diets?

Studies have shown that the growth of vegetarian children is comparable to children who include meat in their diets. Some studies have shown that vegan children are slightly shorter and lighter than meat-eating children but their growth is still within normal ranges. 

It is important to provide sufficient calories (energy), healthy fats, as well as protein, for vegan children in order to promote healthy growth and development.Vegan diets can be bulky and high in fibre, which can make toddlers tummies full up without obtaining sufficient calories. Including energy and nutrient-dense foods such as avocados, vegetable oils, seeds, nut butters or ground nuts, tofu and pulses (beans, lentils, soya beans, chickpeas, hummus) can help increase the nutrient and energy density of vegan diets for children. 

For vegetarian children, full fat dairy products (milk, yoghurt and cheese) can be offered as well as eggs, to provide nutrient-dense sources of protein, fats and energy. 

Nutrients that require special consideration for fully and predominantly plant-based children and breastfeeding mums: 

Vitamin B12

This vitamin is ONLY found in animal products and an unsupplemented vegan diet will be deficient in vitamin B12. Vitamin B12 is vital for the healthy functioning of your nervous system, formation of red blood cells and for your body’s metabolism to function properly.

Vegan children should use foods fortified with vitamin B12 or take vitamin B12 supplements. Fortified foods include some meat substitutes, some non-dairy milks (eg. All M&S plant-based drinks, Alpro soya growing up milk, Oatly oat-based drinks, Koko ‘super’ coconut drink and The Mighty Society pea-based drink), nutritional yeast (check as not all are fortified) and some breakfast cereals.

Iodine 

Iodine is an essential micronutrient that plays a role in helping our bodies to make thyroid hormones. Iodine is also essential in pregnant women to support baby’s brain development.

Iodine is found in dairy products, eggs and also in (white) sea fish and shell fish. For this reason, vegan diets can be very low in iodine (dairy-free diets can also be low in iodine). Check with your healthcare professional, as some children may need to take an iodine supplement, but be careful as very high intakes of iodine can be harmful. You can read more about iodine here. 

Omega-3 fats 

Omega-3 fats are what we call ‘essential fatty acids’ as they cannot be made by the body and must be taken in via the diet. Omega3-fats are particularly important for babies and young children – there is plenty of strong evidence that omega-3 fats play a very important role in the development of your baby’s brain and retina in the eye. Omega-3 fats also have anti-inflammatory properties and are involved in the messages sent between the brain and the rest of the body.

There are 3 different types of omega-3 fats:

  1. Alpha-linolenic acid (ALA)
  2. Docosahexanoic acid (DHA)
  3. Eicosapentanoic acid (EPA

The best source of DHA is oily fish. Some eggs are also a good source of omega-3 fats if the hens have been fed a diet rich in omega-3 fats. There are many plant-based sources of omega-3 fats, such as chia seeds, linseeds, soya and tofu, hemp seeds, rapeseed oil, ground hazelnuts, ground walnuts, ground pecans or pecan butter and green leafy vegetables. However, these food sources contain the precursor ALA, which needs to be converted into DHA and EPA to be most beneficial. The conversion of ALA to DHA and EPA is not very efficient. It is unlikely that vegan children will get enough of these fats through their diet alone, so I would suggest a supplement of algal oil.

Iron 

Iron intakes of vegetarian and vegan children have been found to be similar to meat-eating children. However, the iron that is found in plant foods is non-haem iron, which is not as well absorbed as the iron you find in meat (called haem iron). Phytates found in wholegrain cereals, substances called tannins in tea and drinking too much cow’s milk (more than 600ml/day for a toddler) can all  inhibit the absorption of iron.

To improve the absorption of non-haem iron, include plenty of sources of vitamin C such as fresh fruits and vegetables, particularly kiwi fruit, strawberries, tomatoes, peppers, potatoes, broccoli and citrus fruits.

Good vegetarian and vegan sources of iron include tofu and soya beans, whole or enriched grains, fortified breakfast cereals, legumes (beans and lentils), hummus, green leafy vegetables, dried fruits, particularly dried apricots, figs and raisins, ground linseed, chia seeds and hempseed as well as ground nuts and nut butters.

Calcium 

As we all know calcium (and vitamin D) are both important for growing bones and teeth. This mineral is not usually a problem in vegetarian diets as milk and milk products are included. However, studies have shown that this nutrient can be insufficient in vegan diets.

Care should be taken to offer a variety of non-dairy calcium sources such as fortified non-dairy milks (see this previous post), calcium-set tofu, calcium-fortified soya yoghurts, dried figs, baked beans, hummus and some nuts such as almonds, brazil nuts and hazelnuts (as nut butters or ground nuts). 

Green leafy vegetables can also be a non-dairy source of calcium but they can contain a substance called oxalate, which inhibits the absorption of calcium. Low oxalate vegetables include kale, broccoli spring greens and okra. You can learn more about ‘non-dairy calcium sources’ in my ebook. 

Vitamin D 

Vitamin D has many important roles within the body such as maintaining a healthy immune system and it also helps with the absorption of calcium. The only significant (non-fortified) dietary source of vitamin D is oily fish. We obtain most of our vitamin D from the action of sunlight on our skins, but as young children’s skin is usually covered up or protected with sunscreen, it is felt that they are not getting enough vitamin D. 

The Department of Health in the UK recommends that ALL (not only vegetarian/ vegan) breastfed babies are supplemented with 8.5 – 10 micrograms (340 – 400 IU) of vitamin D from birth, even if mum is taking a vitamin D supplement.
Formula fed babies do not need a vitamin D supplement until they are drinking less than 500ml of formula per day as formula milk is supplemented.
The Department of Health also recommends that all children aged 1 to 4 years of age be given a daily supplement containing 10 micrograms of vitamin D all year round (as well as vitamins A and C from 6 months of age to 5 years). 

Children over the age of 5 years and adults should consider taking a supplement during the winter months from October through to April, as sunlight alone is insufficient to provide enough vitamin D. 

Protein

Protein needs can easily be met if children eat a variety of plant based protein foods such as pulses (peas, beans, lentils, soya), grains (quinoa, wheat, oats, rice, barley, pasta, bread, millet, buckwheat, etc), ground nuts, nut butters and meat substitutes such as quorn or soya products. Variety is the key! For vegetarian children, dairy products and eggs can also provide a significant source of protein. 

I hope this blog post has been helpful to you! 

If you have any questions about plant-based nutrition for children, please get in touch with me: paula@tinytotsnutrition.co.uk 

USEFUL RESOURCES: 

  1. The Vegan Society
  2. The Vegetarian Society
  3. Eating well for vegan under 5s (First Steps Nutrition Trust) 
  4. My ‘Supplements for plant-based kids and breastfeeding mums’ FREE DOWNLOAD HERE

References:

  1. The Vegan Society www.vegansociety.com
  2. Position statement of the American Dietetic Association: Vegetarian Diets. July 2009 ● Journal of the AMERICAN DIETETIC ASSOCIATION
  3. The British Dietetic Association: Plant based diets 2019 https://www.bda.uk.com/resource/plant-based-diet.html 
  4. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vegetarian-vegan-children.aspx#close
  5. Mangels AR, Messina V. Considerations in planning vegan diets. J Am Diet Assoc. 2001;101:670-677.
    16.
  6. Sanders TAB. Growth and development of British vegan children. Am J Clin Nutr. 1988;48:822-825.
  7. Gorczyca D, Prescha A, Szeremet K, Jankowska A. Iron status and dietary iron intake in vegetarian children from Poland. Annals of Nutrition and Metabolism 2013; 62: 291-7
  8. First Steps Nutrition Trust – Eating well: vegan infants and under 5’s https://www.firststepsnutrition.org/eating-well-infants-new-mums 

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