By Sarah Smith of Bayside Dietetics
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There has been a strong media reaction to a recent study that looked at the impact of vegan and vegetarian diets in children. I have written a response to address the concerns raised. While I try to keep most of my blogs a balance between information and an enjoyable read, this blog is more professional. I hope to keep you informed of the big picture around diets in children, and where this study fits in.
“Children raised on a vegan diet may have healthier hearts and less body fat than omnivores, but they grow up shorter and with weaker bones, a study has revealed.” This is a direct quote from a recent news.com.au article reporting on a European study.
There are a couple of important outcomes from this study and news reporting.
Diets that leave out whole food groups CAN put your child at nutritional risk of outcomes like reduced growth and weaker bones.
The vegan diet avoids animal products, including fish, meat, chicken, eggs, and dairy foods.
Despite this, vegan diets CAN be adequate to provide the nutrients needed to support growth in infants.
The Academy of Nutrition and Dietetics has concluded that when vegetarian and/or vegan diets are well planned to provide all the nutrients required, they are appropriate for all stages of the life cycle, from infancy to older adulthood (https://pubmed.ncbi.nlm.nih.gov/27886704/). A well planned vegan diet contains vegetables, fruit, whole grains, legumes, nuts and seeds.
Breastmilk should be the sole food for the first 4-6 months of life, with soy-based infant formula as the alternative. Commercial soy milk should not be the primary beverage until after 1 year of age.
Timing of solid introduction is the same for infants irrespective of whether they are vegan, vegetarian or omnivores. Tofu, beans, chickpeas, nut pastes and lentils are all options to replace the use of meat. Dairy products and eggs can be included in the vegetarian diet.
Supplements may be required and best advised by tailored advice from a Dietitian or Paediatrician. Vegan diets will need fortified foods and/or supplements for B12, while the most recent study indicated a need for vitamin D supplements. Other key nutrients at risk that may require supplementation are iron, zinc and omega 3.
Nutritional risk is relevant to vegan eating, but is relevant for any infant that avoids a whole food group.
For example, the current practise of avoiding dairy foods places any child at risk of not getting enough calcium, which risks reduced bone strength, whether their diet is vegan or not. Suitable alternatives to ensure calcium intake is met are lactose-free milk (if the reason to avoid milk is around suspected lactose intolerance) and soy milk that is fortified with calcium.
The nutrition risks in the study were relevant to vegan diets and relevant, but less so, to vegetarian diets.
A difference between the two outcomes is likely to do with the inclusion of the couple of extra foods available in the vegetarian diet, such as eggs and dairy products. These foods provide some of the key nutrients at risk in the vegan diet and thus, reduce the nutritional risk.
The behaviour associated with the improved health profiles in the study appeared to be for children who ate less processed foods, irrespective of the type of diet.
The children following a vegetarian diet in the study were not found to have the improved cardiac profile seen by the vegan group. The study linked this to the fact that data showed children following a vegetarian diet continued to have high levels of processed foods in their diet. The study concluded that following a plant-based diet was not the key to improve health, but instead the reduction of processed foods.
Advice for healthy eating in Australia (as well as other countries like Canada and America) does not recommend a change to plant-based eating but rather focus on healthy habits such as planning meals and snacks, trusting your child’s appetite and having family meals.
The study gives us some information but doesn’t tell us everything.
The study is a type of study called an observational study. That means, the children were assessed through questionnaires and 4 days of monitoring, without changing anything that they did around food. What was observed is limited to what the study was focussing on, which in this case was the diet. While researchers may work hard to identify any factors that are likely to have a significant impact on the outcomes, there are many potential influences that haven’t been reported on. For example, bone density is improved through physical activity. Were the vegan children in the study more or less active than the other children, which may impact their bone density? Would children on the omnivore diet with a high fibre intake have the same improvement in heart health profile?
Finally, the study was relatively small, and just adds to our pool of information on eating in children, rather than being a sole source of information in itself. Dietitians and Medical Practitioners draw their advice from a large pool of these types of studies, to make sure advice is accurate and consistent.
What does all this mean for your child?
If you are helping your child to follow a vegan or vegetarian diet, then careful planning and use of fortified foods and/or supplements are important. Professional support from a Paediatric Dietitian will tailor advice to your child to ensure nutritional risk is minimised.
If you are looking out for the best advice to help optimise your child’s health and potential then, whether you provide a vegan, vegetarian or omnivore diet for your child, this study indicates that getting enough of the key nutrients is important to meet full growth potential and bone health.
Thanks to all those scientists who continue to supply us with “food” for thought.
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