Vegan diets present nutritional challenges for children | Feature Story

Susan S. Johnson

Eat healthy, be physically active, make sure you and your children have clean hands and mask up with the right sized face covering.

Q My daughter-in-law is visiting and asked us to provide them vegan food. Is it OK for me to feed the children a vegan diet? — G.G. Winterville.

A It takes planning to ensure infants, children and teens get the right nutrients for growth and development while following a vegan plan. The parents I work with think it’s easier and safer to follow a vegetarian rather than vegan eating plan for their children.

It would be helpful to have a guide. One resource I like, written by colleagues of mine, Dr. Mark and Virginia Messina is “The Vegetarian Way: Total Health for You and Your Family.” My go-to website for information and recipes is the Vegetarian Resource Group. It has resources for vegans, too. Jayati S. Vyas, a fourth-year Brody medical student has more information to share. Here is what she wants you to know.

Alternative diets have been embraced by some people for centuries, with vegetarianism and veganism being among the most popular approaches. Experts from the Academy of Nutrition and Dietetics and the American Academy of Pediatrics acknowledge that a well-balanced vegetarian diet can provide for the needs of a growing child and an adolescent.

However, diets that vary from the mainstream omnivore way of eating may cause problems of malnutrition in children since they have some greater nutrient requirements than adults. Here are a few tips on how to ensure your grandchildren get the right nutrition to grow and develop in a healthy way. If they are going vegan it would be important to have a visit with a registered dietitian nutritionist (RDN) to be sure you plan is adequate.

Let’s start with some definitions. Broadly, vegetarians consume a plant-based diet and refrain from eating any animal flesh. People can be lacto-ovo-vegetarians meaning they include eggs, milk and dairy products and plant-based foods in their diet. Lacto-vegetarians don’t eat eggs but use dairy products. Vegans refrain from eating all foods and drinks of animal origin.

Since dairy foods are a major source of important nutrients including protein, calcium, vitamin D and potassium for most children in the USA, it takes less effort to ensure a healthy diet if dairy is included. Planned well, however, adults and children following a vegetarian diet have healthier intakes of total fat, saturated fat, servings of vegetables and fruits, and lower intakes of fast foods, salt, sugary and fruit drinks than those who eat the traditional American diet.

The Dietary Guidelines for Americans has meal planning advice for vegetarian toddlers 12-23 months and also for those over the age of 2 years ( The guidelines do not have a plan for vegans of any age. Dairy typically provides protein for children, but your grandchildren’s protein needs, and concentrated sources of energy can be met with soy products, nuts and nut butters. Other plant food sources of protein include legumes like beans and lentils, and cereals.

High intake of dairy products and infant formula by lacto-vegetarians makes calcium and vitamin D and A deficiencies unlikely. Vegans should ask their doctor if they need supplemental vitamins and minerals or if they get enough by consuming fortified soy products, cereals and juices. Be sure to read the Nutrition Facts labels on plant based “milks” like almond, oat, coconut, cashew or hemp — they are not all the same. Low-oxalate greens including Bok choy, Chinese cabbage, kale and collards provide highly bioavailable calcium for adolescents.

I can’t cover all the nutritional needs of a vegan toddler, child, or teen in this column but a few other essential nutrients to plan for include iron, zinc, fat and fatty acids, and vitamin B12. For example, vegans need almost twice as much iron as omnivores. Options to help increase your grandchild’s iron intake include iron-fortified cereals, grain products, dried beans, and peas.

We have seen children in our clinic, following a vegan diet, that often lacks the essential fatty acids including DHA and EPA, the long-chain omega-3 fatty acid important for many bodily functions and brain development. One way to meet at least part of the need is to incorporate sources of the precursor linolenic acid which is found in flaxseed, canola oils, walnuts, and soy products. They can then be converted to DHA and EPA.

Vitamin B12, a nutrient only found in animal products, is a concern. While vegetarians have less risk of a deficiency because they can get it from dairy products and eggs, strict vegans are at a higher risk of vitamin B12 deficiency. It is important to plan to get B12 through fortified foods like fortified soy formula and beverages, cereals, yeasts or dietary supplements. As we stated, depending on the age of your grandchildren, unless you have the time and knowledge to provide a vegan eating plan, we would advise providing a lacto-vegetarian foods and drinks.

Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an affiliate professor in the Brody School of Medicine at ECU.

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