Benefits:
There have been few studies looking at the long-term health outcomes of vegetarian or macrobiotic diets in children. Adult vegetarians have lower intakes of fat, a lower body mass index and lower mean serum cholesterol levels than nonvegetarian individuals (2). Thus, these findings suggest an indirect effect on reducing the prevalence of coronary artery disease, with a potential decreased risk of mortality in the future (2). In addition, a large study of adults conducted in 1984 showed that Seventh-day Adventists, proponents of a vegetarian culture, have lower age-specific mortality rates than the non-vegetarian population (5).
Concerns:
The American Dietetic Association (2) and the American Academy of Pediatrics (6) state that a well-planned vegan diet can, in fact, support adequate nutrition in the growing child. However, as health care professionals, we should become concerned when foods within strict vegetarian diets or macrobiotic diets are not appropriately chosen and/or lack adequate supplementation.
Protein intake
Total protein in vegetable-based foods is lower than in animal sources; plant protein is less digestible than animal protein; and many vegetable proteins are deficient in one or more essential amino acids (5). Nevertheless, human physiological requirements for a well-balanced source of amino acids can be met if a variety of plant proteins are consumed, and additionally, if caloric needs are met (7).
However, diets such as the macrobiotic diet are more restrictive during infancy and are of greater concern. One study (8) of Dutch infants on a macrobiotic diet, ranging in age from six to eight months, found that 59% of infants had a protein intake of less than 80% of the Dutch recommended daily intake.
Energy intake
As a vegetarian diet becomes more restrictive, the energy intake requirements become more difficult to attain. The vegetarian diet is a bulky one that can restrict energy intake in children. Furthermore, energy intake in infants receiving macrobiotic diets compared with vegetarian diets is considerably lower than the recommended requirements (9). A major potential concern relates to the expanding knowledge of the critical window of early environmental influences on subsequent child development and health (10). Because the energy density of macrobiotic diets is lowest in infants during the weaning period of 10 to 12 months of age, this diet could adversely affect their future growth and development (11).
The growth of a child is a sensitive indicator of the potential negative effects of vegetarian, vegan and macrobiotic diets. Children younger than two years of age who were fed vegetarian or vegan diets exhibited significant lower mean weight and length velocities (12) and were overall lighter in weight and smaller in stature than reference populations (13). The Farm Study (14) analyzed 404 children from a vegetarian community in which parents were well educated about the diet and children were supplemented with the appropriate minerals and vitamins. While these vegetarian children were within the 25th and 75th percentiles for United States growth standards, height for age and weight for age were below the median when compared with reference populations for most ages. Values were statistically significant for children younger than five years of age. Thus, with the appropriate supplementation and parent education, children on vegetarian or vegan diets can attain adequate growth, but it may be somewhat less than reference populations.
In children following macrobiotic diets, weight and length were more depressed when compared with vegetarian children (15). A marked decline from the median for reference weight, and height and arm circumference, was observed between six months and two years of age, following which a partial catch-up for weight and arm circumference was reached, given no change in diet. However, no catch-up growth in height occurred in macrobiotic children, which may indicate the existence of chronic nutritional deficiencies that do not allow for adequate catch-up growth (4).
Vitamin D
Because vitamin D is most commonly found in fortified milk products, egg yolk or oily fish, it is the most likely vitamin to be deficient in vegetarian and macrobiotic diets, but not in lacto-ovo-vegetarian diets. Exposure to sunlight may be an unreliable source of vitamin D, especially in northern areas and dark-skinned infants; thus, supplementation is important to avoid an increased risk of osteoporosis or rickets (16).
Vitamin B12Plant foods are not a high-quality source of vitamin B12. Thus, it is not surprising that studies have shown low serum concentrations of vitamin B12 in children on vegan and macrobiotic diets without supplementation (4). Vitamin B12 deficiency is not a benign condition; it may lead to megaloblastic anemia and neurological disorders. Mild vitamin B12 deficiency in infancy, with or without hematological signs of deficiency, may be associated with impaired cognitive performance in adolescence, specifically, fluid intelligence (which involves reasoning, the capacity to solve complex problems, abstract thinking ability and the ability to learn), spatial ability and short-term memory (17). Moreover, lack of cobalamin may lead to long-term neurological disorders in infants and toddlers fed vegetarian diets (18). In addition, recent data indicate that the adverse effects of cobalamin deficiency in the macrobiotic community may not be restricted to just early childhood, but may also cause symptoms related to impaired cobalamin status later in life. Even a change to a lacto-ovo-vegetarian or omnivorous diet at six years of age is not sufficient to restore normal cobalamin status in previously strict macrobiotic adolescents (19). Thus, it is obvious that vitamin B12 supplementation for children consuming vegan and macrobiotic diets is essential to ensure normal growth and development.
Iron
Iron intakes in vegan preschoolers have been shown to be above the current recommended daily allowance (20); however, nonheme iron from plants is less bioavailable than heme iron from animal sources. Consequently, iron deficiency anemia has been shown in many studies to occur in vegetarian children and in a greater proportion of macrobiotic children (4). Iron deficiency is also not a benign condition, because anemic infants may have significantly lower Mental and Psychomotor Developmental Index scores compared with control infants (4). Thus, iron is another nutrient that should be monitored in children who follow atypical diets.
Calcium
Calcium intake for vegan and macrobiotic children may be below current recommendations (2), and their diets may contain substances found in plant foods that may impair calcium absorption (2). Low calcium may result in rickets (4) and reduced bone mineral content or osteoporosis (21), with important implications for future fracture risk. Therefore, foods rich in calcium, or calcium itself, should be supplemented to assure adequate intake.
Overall this study shows that the vegetarian diet might be potentially bad for a growing child. However it does state with proper planning of meals and nutrients that it can be possible to grow up very healthy on a vegan or vegetarian diet. This may put some people off cooking these meals for their children. If I am going to make a food range for children that are vegetarian or vegan I would want them to be as rich in nutrients as possible. I should focus on iron, protein and energy rich foods in order to create the healthiest meals possible.
No comments:
Post a Comment