A new study has been published which compared the health of children on vegan, vegetarian, and omnivore diets. It attracted a lot of media attention this week and you may have seen some of the headlines which raised concern over vegan children being shorter and having poorer bone health than meat eaters.
More research on the health impacts of vegan diets in children is certainly needed and welcome. However the findings need to be considered within the context of the research, and with regard to our existing knowledge. Drawing generalised conclusions based on specific research is often incorrect and unhelpful.
The information provided here is an overview of this particular study and what we can take from the results.
The main message is: it is important that children following a vegan diet (or any diet for that matter) be provided with nutrition that meets their nutritional requirements, in order to ensure appropriate growth and development, and reduce their risk of nutrient deficiencies and chronic diseases.
This study does not show that a vegan diet is nutritionally inadequate, nor does it demonstrate that children following a nutritionally balanced vegan diet leads to stunted growth.
It does indicate that children across all diet groups (vegan, vegetarian, and omnivores) had inadequate calcium intakes, and that some children from all diet groups were likely vitamin B12 deficient. Both of these nutritional issues were more pronounced among the vegan children. These are issues that can be corrected with diet and/or supplement changes.
This was a cross-sectional study of healthy Polish children aged 5–10 years. It was conducted by the Great Ormond Street Institute of Child Health in London, and The Children’s Memorial Health Institute in Poland, with funding awarded to the NIHR Great Ormond Street Hospital Biomedical Research Centre.
There were 187 children: 72 omnivores, 63 vegetarians, and 52 vegans, with each group having about equal numbers of girls and boys.
The majority (85%) of the vegetarians and vegans had followed their diets for ≥3 years, with the remaining 15% following their diet for 2-3 years.
Diets were analysed for nutritional intake, and assessments of body composition, bone mineral content (BMC), and cardiometabolic health were conducted.
Height, bone health, and calcium
Dietary calcium intake was inadequate for children across all diet groups, but was lowest among vegans.
On average, compared with omnivores, vegans were about 3cm shorter, and had lower BMC. Parental height was accounted for in this analysis. However, despite being shorter than omnivores, the height of vegans was within the normal range.
It is not clear from the study whether the BMC of vegans, despite being lower than omnivores, was still within the normal range.
Vegans who did not have vitamin B12 supplements had lower blood levels of vitamin B12 than omnivores. Almost a third of children on either vegetarian or vegan diets did not have any vitamin B12 supplements or vitamin B12 fortified foods.
Among the vegan children, blood results showed 13% as having probable vitamin B12 deficiency and 40% having possible vitamin B12 deficiency. This assessment did not separate the vegan children based on whether they were supplemented with vitamin B12.
Vitamin B12 deficiency was also noted among children on the other diets. For vegetarian children, 4% had probable vitamin B12 deficiency and 19% had possible vitamin B12 deficiency. For omnivore children, 3% had probable vitamin B12 deficiency and 16% had possible vitamin B12 deficiency.
About a third of children on vegan or vegetarian diets took vitamin D supplements.
Vegetarians and vegans who did not have supplements had lower blood levels of vitamin D than omnivores. However, it was not stated whether these lower vitamin D levels were still within the normal range or not.
Cholesterol and cardiometabolic health
In omnivore children, 13% had high LDL (or bad) cholesterol and 17% had borderline high LDL cholesterol. For vegetarians, 6% had high LDL cholesterol, and 10% borderline high, while no vegans had high LDL cholesterol and only 1% had borderline high.
HDL (or good) cholesterol was low in 7% and borderline low in 12% of omnivores. Among vegetarians, 15% had low and 19% borderline low HDL cholesterol, while vegans had 26% low and 24% borderline low HDL cholesterol.
The authors noted that vegan children had more favourable values for several cardiometabolic risk factors and had lower fat mass, while vegetarians unexpectedly showed a less favourable cardiometabolic risk factor profile.
So what can we take from this study? This research will add to current evidence of children’s nutrition and meat-free diets, though it’s limitations including the small number of participants should be noted.
This study does show that some of the vegan children (as well as some vegetarians and omnivores) were probably or possibly vitamin B12 deficient, and a third of the vegan children did not take vitamin B12 supplements. In order to meet vitamin B12 requirements on a vegan diet and avoid deficiency, supplementation is needed.
Calcium intake was inadequate across all diet groups, but particularly so for the vegan children, who also had a lower BMC. It is important to pay attention to calcium intakes on a vegan diet to ensure the recommended dietary intake can be met and bone health is maximised. It has been shown in adult studies of vegans (and indeed in all diets) that adequate calcium intake is important for good bone health.
This study demonstrated the positive cardiometabolic profile of the children on a vegan diet. Significant cardiac benefits have also been shown in adults following a vegan diet.
With regard to height, the vegan children in this study were shorter than those following an omnivore diet. However they were still of normal height. Due to the nature of this study it cannot be concluded from this research that following a vegan diet as a child causes stunted growth.
Additionally, in a separate study involving vegan children aged 1-3 years, no differences were found in height between children following a vegan, vegetarian, or omnivore diet.
Following from this study, further research would be beneficial to expand the knowledge base of the health of vegan children.
What this study confirms is the importance of children obtaining adequate nutrition, whether following a vegan or non-vegan diet. With nutrition of vegan diets not being widely known, it is important to access credible information on how to achieve a nutritious vegan diet, especially for growing children. A specialist health professional can provide assistance with this and help children to thrive on a vegan diet.
Desmond M, Sobiecki J, Jaworski M, Płudowski P, Antoniewicz J, Shirley M, Eaton S, Ksią˙zyk J, Cortina-Borja M, De Stavola B, Fewtrell M, and Wells J. Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets. Am J Clin Nutr 2021;113:1565–1577.
Zeuschner, C, Hokin B, Marsh K, Saunders A, Reid M, Ramsay M. Vitamin B12 and vegetarian diets. MJA Open 2012;
1 Suppl 2: 27–32.
Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet 2016;116:1970-1980.
Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 2007;61:1400–6.
Benatar JR, Stewart RAH (2018). Cardiometabolic risk factors in vegans; A metaanalysis of observational studies. PLoS ONE 13 (12): e0209086.
Weder S, Hoffmann M, Becker K, Alexy U, Keller M. Energy, Macronutrient Intake, and Anthropometrics of Vegetarian, Vegan, and Omnivorous Children (1–3 Years) in Germany (VeChi Diet Study). Nutrients 2019, 11, 832