Vegetarian diets in children and adolescents

Question 1

What percentage of 6-17yo in US are vegetarians?

Answer 1

2%

Question 2

What percentage of 6-17yo are strict vegans?

Answer 2

0.5%

Question 3

What is a lacto-ovo-vegetarian?

Answer 3

No meat, fish, fowl or products containing these foods, but include dairy and eggs.

Question 4

What is a vegan?

Answer 4

Excludes all meat, fish, dairy and eggs – no animal products at all.

Question 5

What is a macrobiotic diet?

Answer 5

Not necessarily vegetarian, but based largely on grains, legumes and vegetables. Many also include some animal products.

Question 6

What is a rastafarian and fruitarian?

Answer 6

Extremely restrictive vegan diet

Question 7

Do vegetarian children obtain adequate energy intake and growth?

Answer 7

Yes

Question 8

Do vegan children obtain adequate energy intake and growth?

Answer 8

Can be a challenge, insufficient data to comment

Question 9

What products can increase calorie density and support growth?

Answer 9

Soy products
Nuts
Nut butters

Question 10

Do vegetarian children obtain adequate protein and essential amino acids?

Answer 10

No, require 10-15% increased recommended protein intake compared to non-vegetarians

Question 11

What are the main plant sources of protein?

Answer 11

Legumes (beans and lentils)
Cereals
Nuts and seeds
Nut and seed butters
Soy

Question 12

Do vegetarian children obtain adequate iron intake?

Answer 12

No, require 1.8 times iron intake due to poor bioavailability

Question 13

What are the main vegetarian sources of iron?

Answer 13

Iron fortified cereals
Grain products
Dried beans and peas
Iron supplementation

Question 14

Do vegetarian children obtain adequate zinc?

Answer 14

No, require 50% greater intake of zinc, but typicaly do not become truly deficient

Question 15

What are the main vegetarian sources of zinc?

Answer 15

Legumes
Nuts
Yeast leavened breads
Fermented soy products

Question 16

Do vegetarian children obtain adequate calcium?

Answer 16

Yes

Question 17

Do vegan children obtain adequate calcium?

Answer 17

No, may require supplementation

Question 18

What are the main vegan sources of calcium?

Answer 18

Fortified soy products, cereals, and juices

Leafy green vegetables, esp. bok choy, Chinese cabbage, kale, collardss

Question 19

Do vegetarian children obtain adequate fat and fatty acids?

Answer 19

Yes

Question 20

Do vegan children obtain adequate fat and fatty acids?

Answer 20

No, require additonal intake of precursor linolenic acid (as do not consume EPA or DHA)

Question 21

What are the recommendations re: omega-3 fatty acids and vegetarians?

Answer 21

1% of total caloric intake (5mL flaxseed oil, 45mL walnuts, 15mL canola oil)

Question 22

What are the recommendations re: vegans and DHA and EPA?

Answer 22

Eat food sources high in linolenic acid:
Flaxseed oil
Canola oil
Walnut products
Soy products

Preterm infants require supplementation with DHA as cannot convert precursors

Question 23

Do vegetarian children obtain adequate vitamin B12

Answer 23

Yes as its in dairy and eggs

Question 24

Do vegan children obtain adequate vitamin B12?

Answer 24

No, require supplementation (vitamin B12 5-10ug/day) or minimum of 3 servings of vitamin B12 rich foods daily including in breastfeeding infants of strict vegan mothers

Question 25

What are vegan sources of B12?

Answer 25

Appropriate: Fortified soy Other: formula and cereals

Yeasts, fortified soy and nut beverages, cereals

Question 26

What is the recommendations regarding supplementation for vitamin D?

Answer 26

Breastfed infants <1yo 400IU daily
Formula fed infants: obtain 400IU from formula
Children 1yo to teen: 200IU daily from all sources

Give 800IU PO daily from Oct to April in <2yo if:

1. > latitude 55
2. Dark skin
3. Avoiding sunlight

Question 27

Do vegetarian children obtain adequate vitamin D?

Answer 27

Yes, in fatty ocean fish, egg yolks, and fortified milk

Question 28

Do vegan children obtain adequate vitamin D?

Answer 28

No, require supplementation with ergocalciferol vitamin D2 (nonanimal product)

Question 29

Do vegetarians and vegans obtain adequate riboflavin?

Answer 29

Riboflavin should be normal

Question 30

Do vegans obtain adequate vitamin A?

Answer 30

No, need to intake beta-carotenes (three servings per day of yellow, orange, or leafy green vegetables or beta-carotene rich fruits) and convert to vitamin A

Question 31

Do vegans obtain adequate fibre?

Answer 31

May be too high an limit intake of adequate calories and interfere absorption of minerals

Question 32

What are the nutritional concerns for vegan pregnant and vegan mothers?

Answer 32

Supplement with:

1. Vitamin B12
2. Vitamin D 2000U during winter months
3. Folic acid
4. DHA or eat linolenic acid containing foods
5. Calcium content in breastmilk unaffected but mother may require Calcium supplementation
6. Zinc (inadequate zinc in breast milk >7mo)
7. Iron

Question 33

What are vegan or vegetarian adolescents often nutritionally deficient in?

Answer 33

1. Vitamin B12
2. Calcium
3. Vitamin D
4. Iron

Question 34

What are the recommendations regarding vegetarian diets in athletes?

Answer 34

Can meet all the needs but will require good supervision to ensure adequate protein, calcium iron, energy intake