Eating vegetarian or vegan: Do children need meat?
The day came when the child said: «Yuck, is that meat on the plate? I'm not eating that.» The child was barely four years old at the time and decided not to eat meat from then on. We had previously been on holiday on a farm and the child was probably afraid that the cow he had waved to every day in the meadow was now on his plate. That was four years ago now. The child broke off his meat-free phase a few weeks after the farm holiday and has been eating meat and fish once or twice a week ever since, just like the rest of our family.
My loved ones belong to the so-called flexitarians, i.e. people who only eat meat and other animal products once or twice a week. And we are in good company: according to a survey conducted by the Demoscope opinion research institute on behalf of Swissveg, the organisation representing the interests of vegetarians and vegans in Switzerland, around 17% of the Swiss population follow a low-meat diet. According to this survey, 11 per cent of Swiss people follow a vegetarian diet and 3 per cent even follow a vegan diet. In total, therefore, almost a third of the Swiss population has a low-meat or meat-free diet.
A vegetarian diet with a focus on the «critical» nutrients can be healthy at any age - even in infancy.
Swissveg says that the number of vegetarians and vegans has increased steadily in recent years. It is therefore not wrong to speak of a «veggie boom». Wholesalers have also expanded their range of plant-based foods. Between 2016 and 2018, the number of vegan products at Coop doubled. Migros also claims to have increased the number of vegan products by more than 30 per cent.
The main target group includes flexitarians, as they want to add something new to their meat-free diet from time to time. Are vegetarians healthier? Paediatricians Henrik Köhler and Andreas Bieri from Aarau Cantonal Hospital have summarised various studies on the topic of «vegetarian/vegan diets» in a review article. They conclude that a vegetarian diet has health benefits.
Adult vegetarians generally have a lower body mass index (BMI), and other risk factors such as smoking, alcohol consumption or lack of exercise are also less frequently observed in vegetarians, explains Andreas Bieri.
Vegetarians thrive equally well
For children and meat-free diets, the data is sparse and/or not sufficiently conclusive. However, there are trends that can be derived from it. One result is particularly interesting, as it somewhat invalidates the main accusation that parents hear when their child eats vegetarian food.
This reads: «A child needs meat!» I was more than satisfied with the indignation expressed with the deepest conviction. Wrongly, as I now know. Bieri says that several studies have shown that vegetarian children and adolescents grow and thrive in the same way as omnivorous children, i.e. those fed on meat and fish.
Children are more likely to have nutrient deficiencies
The situation is clearly different for children on a vegan diet. According to Bieri, they may be slightly slimmer overall and also smaller than their normal-fed peers. But here, too, the data is not very precise. However, it is undisputed that the diet of vegans is significantly restricted due to the avoidance of all animal products, including honey.
Due to their growth and development process, children are generally at a higher risk of nutrient deficiencies than adults - even with a vegetarian diet. «To ensure an adequate supply of nutrients for mothers, infants, children and adolescents, nutrient supplements are sometimes necessary,» says Andreas Bieri.
However, a vegetarian diet with a specific focus on the «critical» nutrients can be a fundamentally adequate, healthy form of nutrition at any age, even in infancy, childhood and adolescence, explains Andreas Bieri. It can also be considered unproblematic in the long term, as long as a wide range of foods are offered and consumed despite a meat-free diet.
This is because the need for the additional nutrients can usually be easily covered by plant-based products as well as milk and eggs. «For children to develop fully both physically and mentally, they should get enough vitamin B12 from their diet,» says Bieri. Overall, the diet should be balanced and varied. It is important that eggs and/or dairy products are also on the menu, supplemented with vitamin B12 supplements.
According to Bieri - who himself has a daughter who decided in favour of a vegetarian diet of her own accord - it is worth asking about her diet in detail. Especially in phases of strong growth (infancy, between the ages of four and six and during puberty), additional iron intake may be necessary.
Where vitamin B12 comes from
In vegans, the natural intake of vitamin B12 is virtually zero. The highest concentration of vitamin B12 is found in meat and dairy products. This decreases from offal to muscle meat to milk and eggs. If dairy products and eggs are not consumed, it is not possible to absorb the vitamin sufficiently without supplementation. This is why doctors do not recommend a vegan diet for children.
Why vitamin B12 is so important
Vitamin B12 has a major influence on a person's physical and emotional state. It is vital for cell division, the formation of red blood cells and for the nervous system. It is the only vitamin stored in the liver. So if adults decide at some point to give up animal products, they are at an advantage because they can usually count on a full store and their vitamin B12 requirement is covered for three to five years.
Doctors and professional organisations generally advise against feeding babies and children a vegan diet.
Children cannot do this. If their bodies have too little vitamin B12, this leads to impaired growth, concentration and other functional impairments or disorders that can be irreversible. This is why doctors emphasise that a vegan diet is generally not suitable for the general population. The Swiss Society for Nutrition (SGE) advises against feeding babies and children a vegan diet. The German Nutrition Society (DGE) also advises pregnant women, breastfeeding mothers, infants, children and adolescents against a vegan diet.
How a deficiency manifests itself
Signs of a vitamin B12 deficiency in children can include failure to thrive, growth retardation, circulatory disorders or apathy. Fatigue, pale skin or concentration problems also indicate a possible deficiency. Recognising this in practice is not easy, even in the laboratory. This is because it is not only necessary to analyse the intake of certain nutrients, but also how they are absorbed. This requires a blood count, for example.
Nutrition is complicated
A vitamin B12 deficiency is the most common nutrient deficiency found in practice. Vegans know this. To top up their vitamin B12 stores, they therefore have a wealth of alternatives to conventional vitamin B12 supplement drops or tablets: for example seaweed, spirulina or chlorella, shiitake mushrooms or sauerkraut, chewable tablets or toothpaste with added vitamin B12. However, experts urge caution.
This is because the stated amount of vitamin B12 can vary greatly and the bioavailability (i.e. the extent and speed at which an active ingredient enters the bloodstream) is usually unsuitable, as the consumer organisation Foodwatch explains. In addition to vitamin B12, amino acids, long-chain omega-3 fatty acids and other vitamins such as riboflavin and vitamin D, as well as calcium, iron, iodine, zinc and selenium are often critical in vegan diets.
The most important facts in brief
- A well-planned vegetarian diet can, with the appropriate expertise and the necessary care, provide adequate nutrition without deficiencies at any age.
- A vegan diet for children or adolescents should only be followed under medical supervision or under the supervision of a nutritional counsellor and should include regular clinical and laboratory tests. The German Nutrition Society, for example, is fundamentally opposed to a vegan diet for children.
- A vegan diet is not sufficient for children and adolescents without additional nutritional supplements. At the very least, vitamin B12 must be taken in the form of tablets.
- Parents and doctors should always bear in mind the possibility of an eating disorder if female adolescents in particular are increasingly restricting their food choices and thus also their calorie intake.
- A vegan diet should generally be avoided in childhood or adolescence if the illness is long-lasting or severe.
«Vegan children need to be fed like children with a metabolic protein disorder,» emphasises Mathilde Kersting, the former director of the German Research Institute of Child Nutrition (FKE). Because the right diet is so complicated, she recommends seeking advice from a nutritionist and having the supply of critical nutrients checked regularly.
These clinical checks should primarily include testing the child's ability to thrive, growth and pubertal development. Bieri advises tact and sensitivity. «The appropriate counselling of families or adolescents should take into account and respect the individual reasons for the meat-free diet.» He strongly recommends qualified nutritional counselling for vegan diets.
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