Key Takeaways:

• According to a comprehensive study, children following vegetarian diets had, on average, similar weight, height, and essential nutrient levels to meat-eating counterparts. However, they were twice as likely to be underweight, highlighting the importance of monitoring their growth more closely.
• A well-structured vegetarian diet, abundant in vegetables, fruits, high-fiber grains, beans, and possibly dairy products and eggs, is suitable and healthy for all age groups, including young children.
• Despite the benefits, vegetarian diets might struggle to meet the necessary amounts of certain nutrients including zinc, vitamin B12, protein, and calcium. These deficiencies are less concerning when children consume eggs, dairy, plant foods like beans and nuts, fortified non-dairy “milks,” cereals, and nutritional yeasts.
• Research has shown that middle-aged women who adhere to a vegetarian diet might have a higher risk for hip fractures than those who regularly eat meat and/or fish, and this has been linked to lower body mass index (BMI) and nutrient deficiencies.
• Vegetarians seeking to maintain bone health should focus on maintaining a healthy weight and consuming a balanced diet rich in bone-healthy nutrients—possibly augmenting their diets with fortified foods and supplements— alongside regular resistance exercise for building bone and muscle strength.

Analysis of a comprehensive study, that involved about 9,000 young children, found that children following vegetarian diets had, on average, comparable weight, height, and blood levels of essential nutrients such as iron and vitamin D to their meat-eating counterparts. These nutrients might be slightly more challenging to obtain from a diet without meat, fish, and sometimes, dairy products.

The one concern was that vegetarian children were twice as likely as other children to be underweight. Nevertheless, a reassuring 94% were not underweight.

Vegetarian Diets and Kids: Research Findings and Recommendations

The study findings, which were detailed in the journal Pediatrics, echo existing guidelines. The Academy of Nutrition and Dietetics, for instance, states that well-structured vegetarian diets are suited for all age groups, including young children.

Despite the recognized health benefits of such diets, only a few studies have investigated their effects on children’s growth and nutritional status. The senior researcher of the study, Dr. Jonathon Maguire, highlighted that their findings are “good news” and that the increasing number of parents choosing vegetarian diets for their children are “very thoughtful” about ensuring their kids get the nutrients they need.

Key Highlights

High quality vegetarian diets, when implemented correctly, are abundant in vegetables, fruits, high-fiber grains, beans, and often include dairy products and eggs. These diets also typically avoid processed foods high in added sugars and of low nutritional value.

As for the higher likelihood of vegetarian kids being underweight, it is critical for pediatricians to monitor such cases. Underweight children should have their growth tracked more closely, and their parents might need assistance from a nutrition specialist in formulating a balanced diet.

Selecting Foods in a Vegetarian Diet

Amy Reed, a pediatric dietitian at Cincinnati Children’s Hospital and a spokesperson for the Academy of Nutrition and Dietetics, states that for some young children following vegetarian diets, the high fiber content can be challenging as they are filling but often relatively low in calories.

According to Reed, if a child is underweight or there are concerns about possible nutritional deficiencies, parents can request a referral to a dietitian.

Diets devoid of meat might struggle to get certain nutrients in the necessary amounts, such as zinc, vitamin B12, protein, and calcium, Reed said. However, she added that this relies on what foods kids are consuming. When they are consuming eggs and dairy, these nutritional shortfalls are not a concern. Furthermore, kids can obtain these nutrients from plant foods such as beans, nuts, fortified non-dairy “milks,” cereals, and nutritional yeasts.

In general, Reed stated it is essential to “keep an open mind.” She added, “Vegetarian diets can be healthy at any age.”

A Genetic Impact on Diet?

The study findings are based on 8,907 Canadian children who were, on average, 2 years old at the outset and were monitored for an average of three years. At the study’s start, 248 children were vegetarian.

Overall, the study found that children on meat-free diets were similar to their peers in growth, weight, and blood levels of iron, vitamin D, and cholesterol. The only difference was in the risk of being underweight: roughly 6% of vegetarian kids were underweight compared to approximately 3% of their meat-consuming counterparts.

While there is an increasing ratio of vegetarian children, Reed noted an interesting pattern where children often get “fixated” on a handful of foods between the ages of 2 and 5, leading to the conclusion that many kids in this age range are “self-imposed vegetarians,” primarily not consuming meat.

Based on these findings, Reed recommended aiming for plenty of quality protein from eggs, dairy, beans, legumes, nuts, nut butter, and seeds if one choose to follow a vegetarian diet. This could assure adequate amounts of all the bone-building nutrients, including calcium. At the same time, she emphasized that eating plenty of plant-based foods does not necessarily require going meat-free.

For further information, the Nemours Foundation has more on vegetarian diets for children here.

Does a Meat-Free Diet Impact Bone Health in Middle-Aged Women?

Research has indicated that middle-aged women who constantly abstain from eating meat might be more prone to hip fractures than women who regularly consume meat and/or fish. Although more research is required to understand why vegetarians seem to be at higher risk for hip fractures, it is suspected that both low body mass index (BMI) and nutrient deficiencies could play a role.

The Potential Reason Behind Increased Hip Fracture Risk

The study author, James Webster, who is a doctoral researcher from the School of Food Science and Nutrition at the University of Leeds in England, suggested, “Whilst a lower BMI is beneficial for many health conditions, being underweight can lead to insufficient fat mass, and poor bone and muscle health, which can each increase hip fracture risk.”

“People with less fat mass have less cushioning during falls, and falls account for 90% of hip fractures,” he explained.

Webster also pointed out that meat and fish are excellent sources of several nutrients for bone health, including protein, vitamin B12, and vitamin D. Obtaining these nutrients from plant sources, eggs, and dairy products can be possible, but earlier studies have reported lower intake of these nutrients in vegetarians. In the study, vegetarians had lower consumption of protein and vitamin B12 than individuals who ate meat five or more times weekly.

Protein and Vegetarianism

The research focused on rates of hip fractures among over 26,000 women aged 35 to 69 who ate meat no more than four times a week, pescatarians who ate fish but not meat, vegetarians, and regular meat-eaters who consumed meat at least five times a week. The women filled out food frequency questionnaires, compared against hospital records to track hip fracture incidents over approximately 20 years.

Considering other known risk factors such as smoking status and physical activity level, vegetarians heightened risk for hip fracture once these factors were controlled.

The findings were published in the journal, BMC Medicine.

Maintaining Bone Health on a Vegetarian Diet

Webster suggests that vegetarians can take measures to better protect their bones while reaping the heart and other health benefits of a plant-based diet. This starts with maintaining a healthy weight, consuming a plethora of fruits and vegetables, nuts, legumes, beans, and whole grains, which provide most of the nutrients needed for bone health and fracture prevention.

He also recommended considering fortified foods and supplements as they can help avoid nutritional deficiencies, particularly vitamin B12 and omega-3 fatty acids, which can be difficult to get from plant foods directly.

Physical Activity and Bone Health

Avoiding smoking and excessive alcohol consumption, while getting regular exercise, can also help to maintain strong bones. “Resistance exercise, where you lift or pull against resistance, such as weight training, may be particularly beneficial through increasing bone and muscle strength,” said Webster.

Supporting this, new Austrian research indicated that vegans who lift weights or do strength training have stronger bones than vegans who only do other types of exercise, like biking or swimming.

Nutritional Deficiencies in Vegetarians: Dietitians’ Advice

Robin Foroutan, a New York dietitian, indicated that building strong and healthy bones involves more than just getting enough calcium. Magnesium, potassium, boron, zinc, copper, manganese, vitamin D, vitamin K2 are equally important.

“Protein is critically important to building a strong and flexible bone matrix,” she added. “Vegetarian sources of protein may be more difficult to digest and absorb for some people, which makes the protein less bioavailable.” Emphasizing on high-quality sources of vegetarian protein, as well as dark leafy greens, nuts, seeds, and other high-mineral plant foods can support healthy bones, according to Foroutan.

A Word of Caution

Marion Nestle, a retired professor of nutrition, food studies, and public health at New York University, expressed caution about jumping to conclusions about fracture risk in vegetarians. “Vegetarians who don’t eat red meat but eat other animal products should be at no higher risk for bone fractures,” she stated. However, underweight vegans might miss out on essential nutrients.

For more details, learn more about how to maintain a healthy vegetarian diet here at the Academy of Nutrition and Dietetics.