Transcript Meeting the Nutritional Needs of Children with a Vegetarian Diet

Meeting the Nutritional Needs of
Children with a Vegetarian Diet
By Susan M. Parlato
Types of Vegetarian Diets and Foods
Excluded
Type of Vegetarian Diet
Foods Excluded
Semi- or partial-vegetarian
Red meat
Lacto-ovo-vegetarian
Meat, poultry, fish, seafood
Lacto-vegetarian
Meat, poultry, fish, seafood, eggs
Vegan (total vegetarian)
Meat, poultry, fish, seafood, eggs,
dairy products (may exclude
honey)
Macrobiotic
Meat, poultry, eggs, dairy, seafood,
fish (fish may be included in the
diets of some macrobiotic
vegetarians
Vegetarianism During Childhood
Young children usually follow their
parents’ eating practices
 Preadolescents may choose to follow a
vegetarian diet for the following reasons:

animal welfare
ecology
the environment
Vegetarianism During Adolescence
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About 4% of adolescents report following a
vegetarian diet
Reasons why adolescents adopt a vegetarian
lifestyle include:
cultural or religious beliefs
moral or environmental concerns
health beliefs
a means to restrict calories and/or fat intake
means of exerting independence by adopting
eating behaviors that differ from those of the
family
Benefits of a Well-Planned
Vegetarian Diet
A vegetarian diet is nutritionally adequate and
appropriate for all stages of life
 Decreased risk for:

coronary heart disease
obesity
hypertension
type-2 diabetes
osteoporosis
Vegetarians consume fewer overall calories, a lower
proportion of calories from fat (particularly saturated
fat) and cholesterol
 Vegetarian have higher intakes of fruits, vegetables,
whole grains, nuts, soy products, fiber, and
phytochemicals than non-vegetarians

Negative Effects of a Poorly Planned
Vegetarian Diet
Stunted growth
 Impaired immune function
 Effects on energy metabolism
 Osteoporosis
 Iron-deficiency anemia
 Impaired brain function
 Vision impairment

Possible Deficiencies in a Vegetarian
and Vegan Diet
Energy
 Protein
 Essential fatty acids
 Vitamins B12 and D
 Minerals:

Calcium
Iron
Zinc
Energy
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
 Appropriate energy intake may be a
concern in adolescents who practice
vegetarianism as a means of losing weight

Getting Adequate Daily Energy through
Concentrated Sources of Energy
Soy products
 Nuts and seeds
 Nut butters
 Grain products
 Protein powders

Protein
Total protein in vegetable-based foods is
lower than in animal sources
 Plant protein is less digestible than animal
protein
 Many vegetable proteins are deficient in
one or more essential amino acids

Vegetarian and Vegan Sources of
Protein
Whole grains
 Quinoa
 Tofu and other soy products
 Legumes, lentils, beans
 Nuts, seeds and nut butters
 Seitan, veggie burgers and meat substitutes
 Eggs and dairy products are excellent
protein sources for lacto-ovo vegetarians
and lacto-vegetarians respectively

Essential Fatty Acids (EFAs)
There are two EFAs
Linoleic acid (LA)
Alpha linolenic acid (ALA)

Humans can convert LA and ALA to more
physiologically active fatty acids
LA to arachidonic acid (AA)
ALA to EPA and DHA

Arachidonic acid, EPA and DHA are necessary
for:
Cell membrane function
Proper development and functioning of the brain and
nervous system
Daily Recommended Intakes of LA
and APA
LA (g)
ALA (g)
9-13 years
21
1.2
14-18 years
16
1.6
9-13 years
10
1.0
14-18 years
11
1.1
Males
Females
Good Sources of EPAs

To maximize production of EPA and DHA,
include good sources of ALA such as:
Flaxseed and flaxseed oil
Walnuts and walnut oil
Canola oil
Soybeans and soybean oil
Tofu
• DHA can be obtained in the diet through:
Foods fortified with DHA from microalgae
Supplements containing DHA from microalgae
Vitamin B12
Vitamin B12 is primarily found in animal products
It is necessary for red blood cell formation and
nerve function
 The body needs only small amounts and it can be
stored in large amounts
 Deficiency can take a long time to develop,
however once developed, it results in irreversible
nerve damage
 Deficiency may be associated with:


impaired cognitive performance in adolescence
spatial ability
short-term memory
Sources of Vitamin B12


Vegetarians can obtain enough vitamin B12
from dairy products and eggs, if they include
these in their diet
Vegans can obtain vitamin B12 from:
Nutritional yeast
Fortified soy milk
Fortified meat analogues
Fortified energy bars
Vitamin B12 supplements (children 9-13 years,
1.8mg/day; children 14-18 years, 2.4mg.day
Vitamin D
Why is it important?
 Required to absorb calcium from the digestive tract
 Incorporates calcium into bones and teeth
Why are vegetarians and vegans at risk for deficiency?
 The best sources–fortified milk, egg yolks and liver–are all of animal
origin
 The body makes vitamin D from sunlight on the skin
 People regularly exposed to sunlight can get enough vitamin D
without having any come from food
 Sun exposure can be limited by several factors including
 dark skin
 pollution
 northern latitudes.
• If sun exposure is limited and there are no animal products in the
diet a vitamin D supplement is needed
Vegetarian and Vegan Sources of
Vitamin D
Vegans:
 Fortified vegan milks
 Fortified vegan margarine
 Direct sunlight (if possible)
 Supplementation (5mg/day for males and
females age 9-18)
Some vegetarians can consume these sources
of Vitamin D:
 Fortified dairy milk
 Egg yolks
Calcium
Calcium is needed for:
 strong bones and teeth
 normal blood clotting
 normal muscle and nerve function
Adolescence is a critical period for bone development
 Calcium retention is higher at this point in life than any other
time
 Failure to consume adequate calcium can result in increased
risk for the development of osteoporosis later in life.
 Recommended intake for children 9-18 years of age is
1300mg

Vegetarian and Vegan Sources of
Calcium
Vegan sources of Calcium:
 Blackstrap molasses
 Leafy greens
 Calcium-fortified orange juice
 Calcium-fortified vegan milks
 Commercial soy yogurt, plain
 Tofu processed with calcium sulfate
 Beans
Vegetarians:
 dairy products
Iron

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Iron combines with protein to form hemoglobin, the
substance in the blood that carries oxygen and carbon
dioxide
Adequate intake of iron is necessary to prevent anemia
Iron is found in animal and plant foods, but the iron in animal
foods (heme iron) is more easily absorbed by the body then
non-heme iron found in plants
Dietary fiber, phytates and tannins found in plants may inhibit
absorption
For these reasons, vegetarians may be at a higher risk for
developing iron deficiency
Recommended iron intake for males 12-19 years is
19.6mg/day; females 12-19 years, 13.3mg/day
Sources of Iron for Vegetarians and
Vegans
Blackstrap molasses
 Soybeans, cooked
 Legumes, such as lentils, black beans, and kidney beans
 Leafy greens such as spinach, Swiss chard, turnip greens and beet
greens
 Bulgur
 Quinoa
 Dried fruits such as apricots and raisins
Important Fact!
Eat plant sources of iron at the same meal as foods high in vitamin C
Vitamin C increases the availability of iron in the intestinal tract
When vitamin C and iron are eaten together, more iron is absorbed
into the body

Zinc
Zinc is important for optimal growth and
sexual maturation during adolescence
 The recommended intake for adolescents is
8-11 mg/day
 Zinc is a mineral that is present in plant
foods but better absorbed from animal
sources
 Like iron, zinc can be better absorbed when
eaten in combination with vitamin C-rich
foods.

Vegetarian and Vegan Sources of
Zinc
Cheese
 Eggs
Some sources for Vegans include:
 Soy products
 Legumes
 Grains
 Nuts and seeds
 Wheat germ
 Eggs

Recommended Intakes of Macronutrients Based on the Institute
of Medicine Daily Recommended Intakes (DRI)
Estimated
Energy
Requirements
(Kcals)
Carbohydrate
(g)
% of Daily
Energy
from
Carbohydrate
Fiber (g)
% of Daily
Energy
from Fat
Protein
(g)
% of Daily
Energy
from
Protein
9-13
2279
130
45-65
31
25-35
34
10-30
14-18
3152
130
45-65
38
25-35
52
10-30
9-13
2071
130
45-65
26
25-35
34
10-30
14-18
2368
130
45-65
26
25-35
46
10-30
Males
Females
How can you meet your DRI on a
vegetarian or vegan diet?
Eat a variety of foods and the right amount of
foods to meet your energy and nutrient needs
 Be conscious of protein-rich foods - protein can
easily be met by eating a variety of plant foods,
such as beans, peas, soy products, nuts, and
seeds
 Include whole grains and other fiber-rich foods
 Eat good sources of vitamins D and B12 as well
as minerals including calcium, iron and zinc to
prevent deficiencies

Suggested Daily Food Guide (in servings) for Lacto-ovovegetarians and vegans 11 years and older requiring 22002800 Kcals per day
Food Groups
Lacto-OvoVegetarians
Vegan
Breads. grains,
cereal
9-11
10-12
Legumes
2-3
3 or more
Vegetables
4-5
5 or more
Fruits
4
4 or more
Nuts, seeds
1
4-6
Milk, yogurt
cheese
4
-
Soy, almond or
rice milk (fortified
with calcium and
vitamin D)
-
4
½-1
-
Eggs
Vegetarian Diet for the Athlete
Vegetarian diets can meet all the needs of
competitive athletes
 Protein requirements may be increased for
endurance training (1.2 g/kg to 1.4 g/kg) and
weight training (1.6 g/kg to 1.7g/kg)
 Energy, calcium and iron needs also require
educated supervision to ensure adequate intake
 Female athletes, particularly those presenting with
recent changes in diet, a stress fracture or
amenorrhea, should be screened for eating
disorders

Vegetarian diets and Eating
Disorders
Eating disorders are a serious problem
that affect teenage girls more often than
other groups
 There is some evidence that eating
disorders are more common among
vegetarians than meat eaters
 Girls sometimes adopt a vegetarian diet
as a way to manage and disguise their
eating disorder

Vegetarian diets and Eating
Disorders

If your child decides to become a vegetarian it does not
mean that you need to be concerned about an eating
disorder

The following factors are signs that an eating disorder may be
present:
 Weight loss that continues beyond three months
 Meal skipping
 Avoidance of all foods that appear to be high in calories or that
have fat in them–tofu, meat substitutes, peanut butter, breads,
and pastas.
 Compulsive counting of fat-grams and calories.
 Weighing themselves frequently or reports of feeling bloated
when eating normal portions
 Ritualistic behavior around food–such as cutting food into tiny
pieces or eating only one food at a time.
 Distorted body image
The Role of Parents
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Teens are often attracted to vegetarianism because they are
concerned about the environment and animal welfare
It is extremely important for parents to be supportive of a
child's dietary choices
Parents need to become knowledgeable about vegetarian
diets and give children some guidance, since most children
and teens will not make the best diet decisions if left to their
own devices
Help your children make good food choices by having
appropriate foods that are easy to prepare on hand
Stock the kitchen with healthful foods that make good quick
snacks or that can be easily packed into a backpack
Summary
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A vegetarian diet can be a healthy way to eat for
children and teens
Deficiencies in major nutrients are possible when
vegetarian and vegan diets are not planned out
properly
The key is to consume a variety of foods and the
right amount of foods to meet your energy and
nutrient needs
Getting educated about vegetarian and vegan diets
from reliable sources can help ensure your child’s
nutrient needs are being adequately met
Be supportive of your kids’ choices and get involved
in meal planning
References
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Amit, M. (2010).Vegetarian diets in children and adolescents. Paediatrics & Child
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Bellows, L. (2013, April 19). Vegetarian diets. Retrieved from
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Brown, J. (2011). Nutrition through the life cycle. (4th ed., p. 165). Belmont, CA:
Wadswoth Cengage Learning.
Davis, B., & Kris-Etherton, P. (2003). Achieving optimal essential fatty acid status in
vegetarians: current knowledge and practical implications. American Journal of Clinical
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Di Genova, T., & Guyda, H. (2007). Infants and children consuming atypical diets:
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