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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.
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:
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.
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.
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.
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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