In recent years the number of people who opt for a vegetarian diet and who include their children in this food option has increased. In Europe, it is estimated that the follow-up of a vegetarian diet ranges between 1.2 and 1.5% of the population in Spain and Portugal, rising to 7% in the United Kingdom and 10% in Germany. «The role of pediatrics is to ensure the good health of children, a follow-up that must always be done in line with the respect for the socio-cultural identity of the parents, provided that this does not pose a risk to the health of children . Its adequate growth and development are obvious signs of a good state of health, ”says Dr. María José Mellado, president of the Spanish Association of Pediatrics (AEP). Aware of the demand for reliable information on vegetarian diets by the population, the Committee on Nutrition and Breastfeeding of the AEP, has developed a series of recommendations, whose objective is “to avoid the nutritional deficiencies that this type of diets They can assume in childhood and youth. Parents should know the nutrients that must be supplemented if they opt for a vegetarian diet for their children, ”says Dr. José Manuel Moreno Villares, coordinator of the committee.
«The more varied the diet, the greater the possibility of achieving an optimal nutritional status. On the contrary, restrictive diets require greater attention and care to ensure an adequate dietary strategy and the correct use of nutritional supplements, ”explains the doctor. “A vegetarian or vegan diet, like any other type of diet, must be well planned. The increase in the number of vegetarian families in our country should motivate pediatricians to know the main characteristics and composition of the most common foods of these diets, ”explains Dr. Moreno Villares.
Studies in vegetarian children and adolescents show that their growth and development is within the normal range , although there is a tendency to present a lower body mass index. “A poorly planned vegetarian diet, like any other type of unbalanced diet, can have negative consequences on health and growth, so it is important and advisable that, before including children in a restrictive diet, they go to the Pediatrician consultation to assess whether it meets the nutritional standards necessary for good development and, if necessary, supplement it correctly, ”explains Dr. Moreno Villares.
Vegetarian diets are rich in fiber, magnesium, ferric iron, folic acid, vitamins C and E, n-6 polyunsaturated fatty acids, carotenoids, flavonoids and other phytochemicals and antioxidants. On the contrary, they are lower in total fat, n-3 polyunsaturated fatty acids, cholesterol, iodine, zinc, ferrous iron and vitamins B12 and D. « The risk of deficiencies is higher in the most restrictive diets, especially in the diet vegan as this excludes any product of animal origin , ”qualifies the doctor.
According to the article published in Annals of Pediatrics, vegetarian children tend to consume more fruits and vegetables, less sweets, salty snacks and saturated fats, but there is a risk of consuming some foods with low nutritional density. “It is for this reason that it is necessary to plan these types of diets and supplement them correctly,” explains the coordinator of the Committee on Nutrition and Breastfeeding.
What aspect to supplement
Protein needs may be sufficient if the diet includes a wide variety of plant-based foods and energy requirements are met. As, in general, the protein quality of plant foods is lower than that of animal products (especially milk and eggs), it is advisable to ensure that protein-rich foods (legumes, nuts and seeds are consumed daily) ) and that protein sources are combined. The use of soybeans and their derivatives (tofu, tempeh, meat analogues), as well as pseudocereals such as quinoa and amaranth, can contribute to ensuring an adequate balance of amino acids.
In relation to iron and zinc, the article indicates that, although it is true that in some plant products its content may be high, since it is iron in its non-heme form, whose absorption is more difficult, its bioavailability is lower . “That is why it is recommended to consume foods rich in vitamin C in each meal to promote iron absorption,” advises Dr. Moreno Villares. Iodized salt, vegetables of marine origin and some cereal-based foods are the best source of iodine for vegan people. Dairy products and egg yolk are also sources of iodine. «Algae (wakame, kombu, alaria, nori, etc.) with great prominence in these diets can be an important source of iodine. However, they are also arsenic, so they should be used with caution in infants and young children »,
Vitamin B12 is not found in plant foods. Fermented foods or marine seeds cannot be considered a reliable source of vitamin B12. «The oral vitamin B12 supplement is essential for all vegetarian and vegan people. Even in ovolac-tovegetarians or in people who regularly consume fortified foods, a weekly booster dose is the best way to guarantee optimal levels of this vitamin, ”says the doctor.
Complementary feeding in these children
In the light of the available scientific evidence and, despite the fact that following a vegetarian diet at any stage of childhood does not necessarily mean that it is unsafe, the doctor emphasizes that “it is preferable to advise that during the infant period and in the child’s at an early age, an omnivorous or, at least, ovo or lactovegetarian diet is followed ». The age of introduction of other foods should be the same as for non-vegetarians. It is advisable to introduce legumes from 6 months, as they are the natural substitute for meat in vegetarian diets. After 6 months, you can also offer unsweetened soy yogurt occasionally, for breakfast or snack, with or without fruit. It is important to choose varieties enriched with calcium.
In addition, regular consumption of vegetables rich in vitamin A (sweet potato, broccoli, carrot, squash) is also recommended. Gluten should be introduced at the same age as in infants without a special diet. It is important to promote the use of whole grains: bread, rice, pasta, couscous, millet, corn polenta and quinoa. Occasionally also, you can use vegetable drinks enriched with calcium to prepare a dish, but they should never be used as a main drink. Until the year, spinach, chard, borage, beet, arugula and other green leaves should be avoided because of their high nitrate content; honey and syrups, due to the danger of contamination with botulism spores; seaweed, because of its high iodine content; and foods with a laxative effect, such as flax and chia seeds. From the age of 2, the children ‘s diet must be the same as that of the rest of the family, taking care of the supply of fresh food against processed products or fruit juices with added sugars.
The Committee on Nutrition and Breastfeeding places special emphasis on the adolescent, a stage in which the nutrient requirement is higher, in particular protein, iron, zinc and calcium. “It is important to ensure that vegetarian and vegan adolescents consume legumes and their derivatives on a daily basis, since they are the group of foods that will contribute most to the contribution of these four nutrients,” says the doctor.