Vegetarian diets in childhood and adolescence. Statement of the Nutrition Committee of the German Society for Pediatric and Adolescent Medicine (DGKJ)

In western countries a carefully combined vegetarian diet is associated with a lower intake of energy, saturated fatty acids and animal protein but more fibers and secondary plant products in comparison to the normal omnivorous diet. Whether the corresponding positive health benefits in vegetarians outweigh the risks of nutrient deficits, has not been fully clarified. In this context, it has to be considered that vegetarians often have a higher socioeconomic status and follow a more health-conscious life style with higher physical activity and refrain from smoking than non-vegetarians. The nutritional needs of growing children and adolescents can be generally met by a balanced, vegetable-based diet; however, due to their higher nutrient requirements per kg body weight vegetarian children have a higher risk for nutrient deficiencies compared to adults. With a vegetarian diet themean intake of some nutrients, such as the omega-3 fatty acid docosahexanoic acid (DHA) is lower compared to omnivores or those eating fish. For other nutrients, such as iron and zinc, the bioavailability from vegetable foodstuffs is reduced when the intake of phytates and fiber is high; thus, the prevalence of iron deficiency can be increased despite a high vitamin C intake. In addition, vitamin B12 is only present in appreciable amounts in animal products. Therefore, it should be supplemented in people of all age groups who follow a strictly vegetarian diet without animal products. A vegetarian diet in childhood needs well-informed parents and adolescents and requires special care by a pediatrician, if necessary in cooperation with an appropriately trained dietary specialist.