My child wants to be a vegetarian …now what?

It’s not uncommon for children to be picky eaters – but what happens when your child decides they don’t want to eat meat?

First and foremost: don’t panic. It may just be a phase, or maybe not, but in any case the best thing you can do initially is to have a conversation with your child about why they want to be a vegetarian and what this decision entails, do your research, and talk to your child’s pediatrician.

According to Carol Robey, MD, FAAP, a board-certified pediatrician with Merrimack Valley Pediatrics in Nashua, vegetarian diets are becoming increasingly common, even in children and young adults.

“In one study, seven percent of children age eight to 18 years of age followed some sort of vegetarian diet,” Dr. Robey said. “Teenagers are often attracted to these diets and a parent should have a serious discussion with their teen if they wish to become vegetarian. It is important to stress the need for balanced nutritional intake that includes essential nutrients such as calcium, iron, zinc, vitamins, protein and fat.”

Dr. Robey stresses that good nutrition is thought to reduce the likelihood of chronic disease, and parents should contact their child’s doctor if they have concerns that their child is using a vegetarian diet as a way of controlling their weight. Children who are underweight can have other special concerns when their weight is very low, and infants and young children can have serious medical problems with restrictive diets.

Older children, however, can do quite well if there is adequate supplementation with essential nutrients, especially during periods of growth. Small studies indicate that healthy children who choose a vegetarian diet later in childhood are equal in growth to their non-vegetarian peers.

Tara I. Efstathiou, MS, RD, LD, a clinical dietitian at Dartmouth-Hitchcock Medical Center, cites the American Dietetic Association on the safety of adopting a vegetarian diet in childhood and adolescence.

“It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian diets or vegan diets are healthful, nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals across all stages of the lifecycle.”

“There are absolutely health benefits of vegetarian diets. In general, a vegetarian diet is associated with a lower risk of death from ischemic heart disease and vegetarians tend lower levels of LDL (Low-Density Lipoprotein cholesterol), lower blood pressure, and lower rates of hypertension and type 2 diabetes than non-vegetarians. Vegetarians also tend to maintain a healthier body weight and lower overall cancer rates. The reason behind all of these health benefits may be the features of a vegetarian diet which is higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber and phytochemicals.”

Nutrition counseling can be helpful when trying to make dietary changes, Efstathiou said. “A food and nutrition professional can provide assistance in meal planning to help avoid deficiencies.”

According to Robey, it is possible to get complete balanced nutrition from a variety of vegetarian diets – but particular attention is needed for vegan or similar diets, as well as with children who are underweight. Vegetarians who avoid all animal protein (including eggs and dairy), she said, will miss out on essential amino acids needed for growth and repair. Other necessary nutrients can be inadequate, especially in the most restrictive types of vegetarian diets such as veganism.

The protein needs for most children are approximately two grams of protein per pound, per day. Dairy products and eggs are great non-animal sources of protein. Other sources include nuts, soybean products, and other beans such as lentils and garbanzos. Protein and other nutrients that come from a vegetarian diet, however, are less well absorbed, as is also the case with iron and zinc.

Generally, 1,000 to 1,300 milligrams per day of calcium is needed, depending on age. Those who don’t consume milk can obtain calcium from fortified foods such as soy or almond milk, soy yogurt, and soy cheese, as well as calcium precipitated tofu and calcium-fortified cereals, breakfast bars, pastas, waffles and juices.

“Vitamin D is primarily obtained from fortified milk, and the deficiency of this vitamin is now implicated as an associated factor in many chronic diseases,” Dr. Robey said. “Vitamin D supplementation should be at least 600 international units per day. Vegans, whose diets are based entirely on plant food, are at considerable risk for vitamin B12 deficiency. Only animal protein contains this nutrient that is essential for the nervous system.” Oral B12 supplementation is generally recommended, and fish will also provide this essential vitamin.

Efstathiou echoes the concern of vitamin B12 deficiency, as this vitamin is only found in animal-derived foods. Adequate amounts of B12 can be obtained from dairy food, eggs, or other reliable B12-fortified sources such as soy milk or breakfast cereals. A daily vitamin B12 supplement can also be taken.

Lastly, vegetarian diets are generally rich in omega-6 fatty acids, but inadequate in omega-3 fatty acids. These nutrients are important for cardiovascular health as well as eye and brain development. Vegetarians should include good sources of alpha-linolenic acid (ALA), a plant-based omega-3 fatty acid, in their diet, by consuming flaxseed, walnuts, canola oil and soy.

 “The good news is vegetarian children and adolescents have lower intakes of saturated fat, cholesterol, and total fat and higher intakes of fruits, vegetables and fiber than non-vegetarians,” Efstathiou said. “Conversely, both vegetarian and non-vegetarian diets can be detrimental to health when overloaded with fat. Vegetarians whose diets are centered on processed foods and deep-fat fried foods rich in saturated fat and sodium are at the same health risk for disease as a meat-eater.”

For more information and help with meal planning, there are resources on vegetarian diets, including The Vegetarian Resource Group at vrg.org and Vegetarian Nutrition Practice Group at http://vegetariannutrition.net .

Julia K. Agresto is a freelance writer based in Nashua.

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