Can children get enough nutrients for healthy growth from a completely vegan diet? One European authority says no.
Vegans are among some of the most passionate advocates for their dietary beliefs, eating only plant-based foods for health and ethical reasons. But, health experts around the world are voicing their concerns that restrictive vegan diets can cause irreversible harm in growing children. Just two weeks ago, Belgium’s Royal Academy of Medicine issued a recommendation against a strict vegan diet for children, teens, pregnant women and nursing mothers, citing nutrient deficiencies and stunted development as their main concerns.
These are not unfounded concerns. There have been cases back to 2004 of infants and children being severely malnourished and even dying of starvation from poorly executed vegan diets. These are the extremes, but the truth is it’s a tremendous amount of work to meet the calorie, protein, and nutrient needs of growing children with a strict vegan diet.
Common Nutrient Deficiencies in Vegan Diets
In my 4 decades of nutrition practice, I’ve worked with people on every type of vegetarian diet – from broad-spectrum vegetarians who eat dairy, eggs, and fish, to strict vegans who don’t allow animal proteins of any type. While strict vegan diets have distinct health advantages, they also have unique challenges that make it difficult to eat enough fats, proteins, and calories in general – especially for growing infants and children. These research-based nutrient deficiencies are of special concern for pregnant and nursing women, infants, and children:
- Vitamin B12. Needed for healthy nerves, red blood cells, and DNA building, this vitamin is only found naturally in animal foods. Infants under 12 months old who are born to vegan mothers are especially prone to this deficiency, even if the mother shows no signs of deficiency throughout the pregnancy, because these babies lack reserves of vitamin B12 at birth.
Because vegan diets are naturally high in folate, this can mask the symptoms of vitamin B12 deficiency, putting children at risk for neurological issues as a result. Vegan children should have at least 3 servings per day of nutritional yeast, cereals, and plant-based “milks” that are fortified with vitamin B12 produced by bacteria. Infants of vegan mothers should be supplemented directly with vitamin B12.
- Fat Soluble Vitamins A and D. Preformed vitamin A is only found in animal foods. Strict vegans have to convert the carotenoids found in leafy greens and yellow and orange vegetables into vitamin A. Children need at least 3 servings per day of these foods to get enough, provided their digestive systems are functioning optimally.
Vitamin D is found in egg yolks, deep sea fatty fish, and liver. We rarely get enough sun exposure in our busy lives to synthesize enough vitamin D, especially with all of the sunscreen that we put on our children. Vegan children and women who are pregnant or breastfeeding need to supplement with vitamin D3.
- Protein. Because plant-based diets are so high in fiber, children often feel full from the sheer bulk of the food, and as a result, aren’t getting enough total calories or protein. In addition, plant-based proteins are less digestible compared to animal-based sources, with wheat protein 50% less usable than animal proteins. Each plant-based protein has different essential amino acids, protein content, and digestibility and needs to be increased in a child’s diet based on their age and specific needs.
- Essential Fats. Vegan diets are naturally lower in fats, with nuts, seeds, and sea vegetables as the primary sources of essential Omega 3 and Omega 6 fats. Without fish, seafood, grass fed meats, and pastured poultry and eggs, low blood levels of Omega 3 fats have been found in adults. Microalgae and flaxseed oil supplements are vegan sources of the Omega 3 fats that can be given to children, while nuts and seeds are excellent sources of healthy Omega 6 fats.
- Iron, Calcium, and Zinc. Phytates are plant proteins that inhibit the breakdown and absorption of nutrients, and are of special concern with iron and zinc. Legumes, nuts, and grains are primary sources of these minerals, and the phytates in these foods inhibit the absorption of iron while binding the zinc and reducing its bioavailability. Soaking, fermenting, and even sprouting are effective methods of breaking down these phytates and making the nutrients more bioavailable. Because iron deficiency is the most common nutrient deficiency in children, it is monitored during well child checks and should also be considered a red flag for zinc deficiency.
Breast milk is rich in calcium, whether the mother is vegan or not. But calcium intake in vegan children is known to be deficient, and this can worsen existing heart conditions, soften bones, and stunt growth. Low oxalate greens like kale, collards, and bok choy are good bioavailable sources of calcium for children, as are fortified juices and organic cereals. Calcium supplementation is recommended for all vegan children because of the difficulty of getting enough through the diet.
Does Your Vegan Child Have a Nutrient Deficiency?
Vegetarian diets that allow dairy, eggs, and fish are far less likely to cause nutrient deficiencies than a vegan diet is, so whenever possible, this is the better choice for children. But, if your health and ethical beliefs make it necessary for your children to be on a strict vegan diet, with no animal products at all, I strongly recommend regular monitoring of their nutrient status. Keep track of what they’re eating, their growth, and any symptoms they’re having. And whenever possible, test, don’t guess.
I recommend starting with the Tissue Mineral Analysis (TMA) through UNI KEY Health, which is a non-invasive hair test that will measure mineral levels and give you a good idea of whether their diet is meeting their nutritional needs. (Honestly, I think this test is extremely beneficial for every child going through a growth spurt.) Blood tests for iron, vitamin B12, vitamin D, and Omega essential fatty acid levels are also important to get on a regular basis or when they’re showing signs of deficiency. Special attention should be given to picky eaters, adolescents growing quickly, athletes with high calorie needs, and children with health concerns, who add a layer of complexity to an already complicated diet to maintain in infants and children.
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