Nutrient Intake and Status in Children and Adolescents Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review

Abstract

Health authorities increasingly recommend sustainable and healthy diets rich in plant foods and with moderate amounts of animal foods. However, there are concerns about whether such diets can meet all nutrient requirements, especially in children and adolescents, who have relatively high nutrient needs for growth and development. Therefore, we aimed to evaluate the nutrient intake and status of children and adolescents (2–18 y) consuming plant-based (i.e., vegetarian and vegan) diets compared to those of meat-eating children following a systematic literature review of studies published between 2000 and 2022. Mean intake and status data of nutrients were calculated across studies and benchmarked to dietary reference values and cut-off values for nutrient deficiencies. A total of 30 studies were included (15 in children 2–5 y, 24 in children 6–12 y, and 11 in adolescents 13–18 y). In all diets, there were risks of inadequate intakes of vitamin D and calcium. Children consuming meat had a risk of inadequate folate and vitamin E intake; and mean fiber, SAFA, and PUFA intakes were not in line with the recommendations. Children consuming plant-based diets risked inadequate vitamin B12, iron, and zinc intakes. In contrast to vegans, vegetarian children may not meet the recommended intakes of fiber, SAFA, and possibly PUFA, but their mean intakes were more favorable than in meat-eating children. Although the data are limited and need further validation, our findings indicate that there are risks of nutritional inadequacies in all diet groups. Therefore, increasing consumption of a variety of plant-based foods, in combination with food fortification and supplementation where needed, is recommended for children and adolescents to have sustainable and nutritionally adequate diets.

Human Nutrition Research in the Data Era: Results of 11 Reports on the Effects of a Multiple-Micronutrient-Intervention Study

“…FFQ proved to be a valid tool for ranking the dietary intake of several nutrients and food groups in children and adolescents aged 9–13 years living in southeast Brazil and will be useful in further studies analyzing diet and health outcomes in Brazil. Biomarkers have been found for plants in adults [ 48 ] and children/adolescents [ 49 ], and for meat and seafood [ 50 ], fermented products [ 51 ], spices [ 52 ], cereals [ 53 ], and allium vegetables [ 54 ]. Collectively these biomarkers will enable the development of diagnostics for determining adherence to personalized diets.…”

Comment on Jakše et al. Vegan Diets for Children: A Narrative Review of Position Papers Published by Relevant Associations. Nutrients 2023, 15, 4715

“…The Professional Expert Panel of Paediatrics, the highest professional body in Slovenia under the Ministry of Health, does not endorse the vegan diet in the paediatric population, as there is no convincing evidence for this type of diet in the most vulnerable population in our society—infants, toddlers, children, adolescents and young adults. In fact, most recent guidelines recommend dietary supplementation in children eating a vegan diet [ 2 , 3 , 4 , 5 , 6 , 7 ], and two recently published meta-analyses raise concerns about the certainty of the evidence and call for more and better-designed studies given the lack of high-quality data [ 8 , 9 ].…”

“…Consequently, the literature included in the narrative review may lead to a biased view of the vegan diet, particularly in the paediatric population, for whom there is no clear evidence to support this diet [ 5 , 6 , 7 , 8 , 9 ]. New high-quality research in this area in paediatric populations is needed, particularly because of the potential impact of a vegan diet on long-term outcomes related to nutritional programming and effects on the gut microbiota.…”

Reply to Benedik et al. Comment on “Jakše et al. Vegan Diets for Children: A Narrative Review of Position Papers Published by Relevant Associations. Nutrients 2023, 15, 4715”

“…“The Professional Expert Panel of Paediatrics, the highest professional body in Slovenia under the Ministry of Health, does not endorse vegan diet in the paediatric population, as there is no convincing evidence for this type of diet in the most vulnerable population of our society—infants, toddlers, children, adolescents and young adults. In fact, most recent guidelines recommend dietary supplementation in children eating a vegan diet [ 2 , 3 , 4 , 5 , 6 , 7 ], and two recently published meta-analyzes raise concerns about the certainty of the evidence and call for more and better-designed studies given the lack of high-quality data [ 8 , 9 ]”.…”

“…The inclusion of “the most recent guidelines ([ 2 , 3 , 4 , 5 , 6 , 7 ])” in the comment [ 1 ] is beyond the scope of our narrative review [ 2 ]. In addition, the reference “5: Müller, P. Vegan Diet in Young Children.…”