Vegetarian Diets for Children: Understanding the Essentials

By Deidra Holcomb, R.D.; Renee Wieman, R.D.; and Samuel A. Kocoshis, M.D.Vegetarian diets are gaining fans among families with children. One reason: scientific proof that diets low in animal fat help lower blood cholesterol and lipid levels. Many experts also believe that vegetarian diets reduce the risk of heart disease and diabetes. And in spite of some recent studies to the contrary, a few experts say that a vegetarian diet lowers the risk of bowel cancer.

While some families turn away from meat for health reasons, others have different motivations. Some vegetarians argue that they use fewer natural resources than meat eaters and are thereby preserving more of the natural environment. Some are against slaughtering animals for moral reasons. And some Hindus and Buddhists do not eat meat because their faith prohibits it.

 What Is a Vegetarian Diet?

 The Right Formula for Growing Children

 Counting Calories

 Protein: Quality and Quantity

 Keeping Up With Calcium

 Avoiding Iron Deficiency

 The Importance of Vitamin B12 and Biotin

 The Good News About Zinc

 Parents: Keep These Things in Mind

 Suggested Serving Sizes for Preschoolers

 Suggested Serving Sizes for 5- and 6-Year-Olds

What Is a Vegetarian Diet?

A vegetarian diet excludes all or most foods obtained from animal products. But there are many variations on this theme:

•  A vegan diet excludes all animal products. Vegans eat only foods of plant origin.

•  A lacto-vegetarian diet consists of plant foods plus some or all dairy products.

•  A lacto-ovo-vegetarian diet consists of plant foods, dairy products, and eggs.

•  A semi- or partial vegetarian diet is not a true vegetarian diet. This category has a lot of variety, depending on personal preference. Some partial vegetarians limit their use of one or more animal products, some exclude only red meat, and others eat only fish and exclude chicken and red meat.

The Right Formula for Growing Children

Parents of children eating vegetarian diets should be most concerned about their children's growth and development. Growing children need about twice as many calories and three times as much protein per pound of body weight as adults do. This is because children's diets have a dual purpose: to maintain bodily functions and to support growth. In contrast, adult diets need to provide only enough calories and protein to maintain bodily functions.

The American Dietetic Association confirms that a well-planned vegetarian and semi-vegetarian diet can meet all the nutrient requirements for growth and development in infants, children, and adolescents. Vegetarians who eat eggs, drink milk, or eat dairy products have no special problems obtaining adequate nutrients if the diet is carefully thought out. Children must eat large amounts of vegetarian foods to get the same benefit they would get from smaller amounts of a diet containing meat. The types of vegetables offered are also important to supplying the best quality of protein possible. Nutrients that may be lacking in a poorly planned vegetarian diet are protein, calcium, iron, vitamin B12, and zinc.

Counting Calories

High-fiber vegetarian diets, primarily vegan, may not provide enough calories for children. A diet high in fresh fruits, vegetables, and whole grains is usually higher in fiber. Offering some refined grain products such as crackers or bleached flour products, fruit juices, and peeled fruits or vegetables can reduce the fiber content of a vegan child's diet. Avocado, nut and seed butters, dried fruit, and soy products pack a lot of calories into small quantities, which is great for promoting growth.

Protein: Quality and Quantity

Both the quantity and quality of protein in a vegetarian diet are important. Children can meet their protein needs by eating a variety of plant foods while their parents monitor their calorie intake. Children should eat grains, vegetables, soy products, nut butters, meat alternatives, and beans every day to get enough total protein.

The type of amino acids-the molecules that make up food proteins-determines the quality of protein the child receives from the food. Our bodies can produce many amino acids, but 10 of them, known as the "essential amino acids," must come from our diet. For example, beans, peas, and other legumes are deficient in methionine, an amino acid. Corn and other cereals are deficient in another, lysine. So a healthy vegetarian diet will contain both legumes and cereals daily to make up for the lacking amino acids, something that ancient societies already understood by their mixing of rice and beans or corn and beans.

Keeping Up With Calcium

Calcium is very important for growing bones and teeth. Vegans or ovo-vegetarians who do not include dairy foods in their diets may not get enough of this mineral. Good alternative sources of calcium are:

Avoiding Iron Deficiency

Iron keeps our red blood cell count within the normal range. Iron-deficiency anemia is a common nutritional problem in children with all sorts of diets. As iron is most plentiful in red meats, which are excluded from all vegetarian diets, eating other iron-rich foods is important. These include:

•  dark green leafy vegetables (spinach, collard greens, kale, Swiss chard)
•  iron-fortified cereals
•  legumes
•  whole or enriched grains and grain products
•  dried legumes (garbanzo beans, lentils, pinto beans)
•  raisins
•  figs
•  prune juice
•  watermelon
•  pumpkin and sesame seeds
•  soy nuts
•  blackstrap molasses

Foods rich in vitamin C, such as citrus fruits and juices, enhance absorption of this important mineral.

The Importance of Vitamin B12 and Biotin

Most plant-based foods are rich in vitamins. Vitamin B12 and biotin are the only vitamins of major concern for vegetarians and ovo-vegetarians. All vegans should obtain a regular, reliable source of vitamin B12, which prevents anemia and promotes normal functioning of the nervous system. This may come from fortified foods-some cereals, meat alternatives, soy or vegetable milks, or nutritional yeast-or may be taken as a supplement. Many sea vegetables, often thought to be rich in B12, are not really good sources of this vitamin, despite package claims. Many vegetables contain biotin, and most vegetarians receive enough of it. One exception is when an ovo-vegetarian eats too many eggs daily. Then, avidin, a protein in eggs, may make biotin unavailable for absorption. This deficiency can lead to loss of hair, dry skin, and loss of sensation.

The Good News About Zinc

Zinc deficiency seldom occurs among vegetarians. The best vegetable sources of zinc are legumes, whole-grain pasta, wheat germ, fortified cereal, tofu, nut butters, and miso (soybean paste).

Parents: Keep These Things in Mind

If a family desires to follow a vegetarian diet, children can participate fully. But because it is essential to keep them growing satisfactorily, they should be weighed and measured frequently to make sure they remain on track. Children on a vegetarian diet may have looser stools than normal, more frequent stools than normal, and more gas than normal. Consistent growth and well being are the focus for careful evaluation with a health care provider.

It's also helpful to consult with a registered dietician. This way, parents can be sure that their children will receive adequate calories, protein, vitamins, and minerals. Children should receive cow's milk products or one of the soy milk substitutes to increase the likelihood that they will grow and develop properly. Remember: Many types of soy milk have no more calories than skim. If parents follow the simple practices we have outlined, there is every reason to believe that their children will thrive on a vegetarian diet.

Suggested Serving Sizes for Preschoolers

Food Group

Number of Servings

Grains

6 or more servings. A serving is equal to 1/2 to 1 slice of bread; 1/2 to 3/4 cup of cooked cereal, grain, or pasta; 1/2 to 1 cup of dry cereal.

Legumes, Nuts, Seeds

2 or more servings. A serving is 1/2 to 1 cup cooked beans, tofu, tempeh (fermented soybeans, or textured vegetable protein; 1-1/2 to 3 ounces of meat alternative; 1 to 2 tablespoons of nuts, seeds, or nut/seed butter.

Fortified Soy or Rice Milk

3 servings. A serving is 1 cup fortified soy milk, rice milk, or infant formula.

Vegetables

2 or more servings. A serving is 1/2 to3/4 cup cooked or 2/3 to 1 cup raw vegetables.

Fruits

3 or more servings. A serving is 1/2 to 1 cup canned fruit, 1/2 cup juice, 1/2 medium fruit.

Fats

3 to 4 servings. A serving is 1 teaspoon of margarine or oil.

Suggested Serving Sizes for 5- and 6-Year-Olds

Food Group

Number of Servings

Grains

6 or more servings. A serving is equal to 1 slice of bread; 3/4 cup of cooked cereal, grain or pasta; 1/2 to 1 cup of dry cereal.

Legumes, Nuts, Seeds

1-1/2 to 3 servings. A serving is 1/2 cup cooked beans, tofu, tempeh, or textured vegetable protein; 3 ounces of meat alternative; 2 tablespoons of nuts, seeds, or nut/seed butter.

Fortified Soy or Rice Milk

3 servings. A serving is 1-cup fortified soy milk or rice milk.

Vegetables

2 or more servings. A serving is 3/4 cup cooked or 1 cup raw vegetables.

Fruits

2 to 4 servings. A serving is 1/2 cup canned fruit, 1/2 cup juice, 1 medium fruit.

Fats

4 servings. A serving is 1 teaspoon of margarine or oil.

"Click here" for sample menus for 8- to 12-month-olds, toddlers, and preschoolers.