Pediatric Nutrition in Practice

Vegetarian Diets 135

2

counselling to ensure the child’s nutritional needs
for growth and development are met. A referral to
a qualified dietitian and supplementation of the
diet may be indicated for vegan children. This
chapter will outline the most common nutritional
considerations for vegetarian children.

Growth and Development

Breastfed infants obtain nutrients exclusively
from breast milk, and its composition will be de-
termined by the maternal diet. For non-breastfed
vegetarian infants, soy-based infant formula is

available. This tends to be higher in phyto-oestro-

gens than human breast milk, but there is cur-

rently no conclusive evidence of any adverse ef-

fects of increased phyto-oestrogen intake on hu-

man development, reproduction or endocrine

function, and soy formula appears safe for use,

when clinically indicated, in term babies with

normal renal function [4]. Clinicians should be

aware that most commercial soy formula will

contain vitamin D 3 from animal sources, which

can be unacceptable for vegans but may represent

the best option if breastfeeding is contraindicat-

ed. Homemade milk preparations (soy milk, rice

milk and nut milk) are not suitable in the first

Ta b l e 1. Types of vegetarian diets practiced as well as associated nutrients of concern for children

Vegetarian diet Description Main nutritional

concerns in children

Semi- or demi- Excludes red meat; may exclude poultry; fish is

usually eaten

Iron

Pescatarian Excludes red meat and poultry but eats fish

and possibly shellfish

Iron, zinc

Lacto-ovo- Excludes all meat, fish and poultry; milk, milk

products and eggs are usually eaten

Iron, zinc, n–3 fatty acids

Vegan Consumes no foods of animal origin;

emphasis on plant foods, grains, legumes, nuts,

seeds and vegetable oils

Energy, protein,

vitamin B 12 , zinc,

vitamin D, calcium,

n–3 fatty acids

Raw food An extreme form of veganism with the

emphasis on organic, home-grown or wild

foods in their raw or natural state; usually

comprises 80% by weight raw plants

Not suitable for

children

Fruitarian An extreme form of veganism which

excludes all foods of animal origin and also

living plants; the diet is mainly raw: 70 – 80%

fruit with small amounts of beans, bread, tofu,

nuts and seeds

Not suitable for

children

Macrobiotic Extreme diet progressing through 10

levels becoming increasingly restrictive;

foods are gradually eliminated through the 10

levels; at the final level, only cereal (brown rice)

is eaten

Not suitable for

children

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 134–138
DOI: 10.1159/000367873