Young Children: Essential Nutrition

By Kara Rienzo, R.D.N.

Not only do vegan and vegetarian diets adequately meet the nutritional needs of children, but choosing a well-planned vegan or vegetarian diet for your child can give them the opportunity to enjoy a variety of delicious and nutritious foods [1]. Since eating habits are formed in childhood, including foods like fruits and vegetables and whole grains in your child’s diet can help form healthy eating habits for life. It is much simpler to plan a healthy diet based on plant-based foods than using animal products, which can be high in saturated fat and cholesterol. Plants are high in fiber, vitamins, minerals, and phytochemicals, and they contain plenty of energy and protein to support healthy growth and development of preschool and school-aged children.

Energy Needs

Preschool-aged children from 2 to 4 years old may have a lower food intake due to a slower growth rate, which is also seen in toddlers. While this is the case, it is still important for the child to have an adequate diet necessary for healthy growth and development. A good indicator of growth is that the child remains at a normal percentile on the Centers for Disease Control and Prevention’s growth charts between the ages of 2 and 5. The child’s healthcare provider will be able to tell you where your child stands, based on these pediatric growth charts.

Vegetarian or vegan diets are also able to support the growth of school-aged children, ages 5 to 12 years old [1]. Children’s caloric and nutrient needs are high, and they should be monitored to insure adequate growth and development during this time. Vegetarian or vegan diets tend to be high in fiber and low in fat, and, because of this, it is likely that a child will feel full before they have met their needs. To reduce the fiber content of a child’s diet, it may be necessary to include refined grain products, peeling the skin from fruits and vegetables before serving, or including fruit juices. It is easy to increase caloric intake, if necessary, to support rapid growth or for children who are more physically active, by adding calorically dense foods like avocado, full-fat soy products, nuts, seeds, nut and seed butters, dried fruits, vegetable oils, and bean spreads. Feeding children frequently and including healthy snacks can help to make sure the child is reaching their nutrition goals. Soy milk is the more nutritious option compared with other plant-based milks, as it is higher in calories and protein.

Protein

Children can easily meet their protein requirements by eating a variety of plant-based foods, which can provide all of the essential amino acids. It was previously believed that “protein complimenting” or intentionally combining of specific foods was necessary, but as long as children are eating an adequate amount of calories from different sources, it’s likely their protein intake will be sufficient as well. Good sources of protein include legumes, grains, tofu, meat alternatives, and nut butters.

Omega-3 Fatty Acids

Essential fatty acids are vital for children for optimal neurological function, brain development, and psychomotor development [2]. The human body does not make omega-3 fatty acids on its own; therefore, it is important to include foods containing DHA or take a supplement. Lacto-ovo vegetarians consume little DHA, and vegan diets contain virtually no DHA. This can be taken in a microalgae-based supplement, and it is recommended that young children take130mg per day; there are several vegan DHA supplements on the market. Foods containing DHA, from algal oil, include Silk DHA Omega-3 soymilk and fortified olive and canola oils.

Calcium

Adequate calcium intake is necessary for proper bone growth and healthy teeth. It also plays a role in healthy nerve and muscle function. Calcium recommendations for vegetarian and vegan children ages 1 to 3 is 500mg daily, ages 4 to 8 is 800mg daily, and 9 to 12 is 1100mg daily [3]. Good sources of calcium for children include fortified soymilk, fortified fruit juices, soy yogurt, green leafy vegetables, tofu, and almond butter. Calcium absorption from these foods has been shown to be adequate in meeting calcium needs [4].

Vitamin D

Vitamin D works with calcium for bone growth and development. Exposing the skin to sunlight normally produces vitamin D, which can then be used by the body, but many factors come into play, including the use of sunscreen, skin pigmentation, and location in which a child is living [5]. Children who are dark-skinned, live in regions with little sun, or who have no dietary source of vitamin D are recommended to take supplements [5]. The American Academy of Pediatrics recommends children should have a Vitamin D intake of at least 400 IU a day [5]. Dietary sources of vitamin D include fortified soymilk and fortified ready to eat cereals. Vitamin D3, or cholecalciferol, is derived from animals and can be found in fortified foods or supplements. Vitamin D2, or ergocalciferol, is derived from plants and is the ideal source of vitamin D for vegetarians or vegan.

Iron

One of the most common nutritional problems in childhood is iron deficiency anemia. However, it is no more likely to occur in vegetarian or vegan children than it is in non-vegetarian children [6]. The best way to ensure the child is consuming enough iron is to include foods such as whole or enriched whole grains, dried fruits, fortified cereals, beans and legumes, and green leafy vegetables. Including a source of vitamin C (citrus fruits and juices, bell peppers, tomatoes, and melon) with iron rich foods can help increase iron absorption by the body.

Vitamin B₁₂

Parents should ensure that their child’s diet contains an adequate amount of vitamin B12, as it is necessary for healthy blood and nerve function. Vegan children should consume foods fortified with vitamin B₁₂ since it is only found naturally in foods that come from animals. However, there are plenty of foods that are fortified with vitamin B₁₂, including fortified plant-based milks, some meat alternatives, vitamin B₁₂ fortified nutritional yeast, and some fortified ready-to-eat cereals. It is recommended that vegan children take a vitamin B₁₂ supplement either in a multivitamin or as an individual supplement in the dose of 0.9 mcg/day for children ages 1 to 3 years, 1.2 mcg/day for children ages 4 to 8 years, and 1.8 mcg/day for children ages 9 to 12 years [7].

Zinc

Zinc is necessary for growth and sexual maturation. Plant foods are typically low in zinc bioavailability, meaning the degree the nutrients from food can be absorbed and utilized by the body. Highlighting foods that are good sources of both zinc and protein, such as legumes and nut products, can help to increase absorption by the body [8]. Other good sources of zinc include whole grains, wheat germ, and fortified cereals.

Preschool Aged Children (2 – 4 years)

(Adapted from [9])

School Aged Children

(Adapted from [9])

Meal Ideas for Young Children

Tips for Parents & Caregivers

Picky Eaters

It is not uncommon for children to be particular about what they eat. Remember, it is the parent or caretaker’s job to offer the child a variety of healthy foods, and it is the child’s job to decide how much and what they want to eat. Sometimes a child may eat broccoli one day and decide that they do not like it the next day or vice versa. Some tips to get the child to eat certain foods are:

• Include children in choosing the food at the grocery store or farmer’s market and have them help with meal preparation. Letting the child make decisions will help to increase food acceptance.
• Be a good food role model. Children are more likely to eat healthy foods if they see their parent or caregiver is eating them as well.
• Keep foods simple. Piling food on a plate can make a child feel overwhelmed. Use a small plate and offer small portions. Remember that children have smaller stomachs compared to adults!
• Make food fun! Cutting food into fun shapes or adding dips can help to make eating an enjoyable experience for the child.
• Avoid fights at mealtime and make it a pleasant time. Never force a child to eat a certain food or finish everything on his or her plate. This can lead to unhealthy eating habits that can last through their lifetime.
• Make sure the child is not filling up on beverages between meals. Allowing children to constantly sip on juice or milk between meals can lead to a decreased appetite. Only offer water when children request it between meals. At mealtime, offering food first and the beverage when they have finished eating a majority of their plate will help insure the child is meeting their nutritional needs.

Choking Hazards

Even if your child seems to have mastered the ability to chew and swallow, remember that children under the age of 5 are the most at risk for choking injury and death [10]. Food should still be cut into small pieces, especially things like grapes or veggie hot dogs, which could easily block the child’s airway if inhaled. Continuing to avoid foods like popcorn and whole nuts until after age 5 is recommended, too.

Physical Activity

Children need 60 minutes of moderate to vigorous physical activity, at least 5 days a week [11]. Physical activity is an essential part of a healthy lifestyle. Starting a habit of being active every day can last throughout the child’s lifetime. Physical activity contributes to controlling weight by reducing fat and building lean muscle, promoting strong bones and healthy muscle and joint development [11]. Find something fun for you and your family to do. Playing active games together, dancing to music, biking, or running can be a great way for your family to spend time together and stay healthy!

Thinking about changing a child’s diet to vegetarian or vegan?

While some children have been vegan or vegetarian since birth, it is not uncommon for families to make the change
later in life. Explaining to your child the reason your family has decided to adapt to a vegetarian or vegan diet is
a good start. There are plenty of children’s books you can either buy or borrow from your local library that can
help you have this conversation! Gradually introducing different foods and continuing to offer familiar foods or
cruelty-free versions of your child’s favorite meals will help make for an easier transition. If significant
unintentional weight loss occurs, the child’s diet may need to be include less fiber or more concentrated sources of
calories as described in the “Energy Needs” section above. A Registered Dietitian may be able to help assess a
child’s diet to ensure it is providing adequate energy and nutrients and offer suggestions to plan healthy meals and
snacks to support adequate child growth and development.

Resources

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   1997;97:1317-1321.
2. Byrd-Bredbenner, C., Moe, G., Beshgetoor, D., Berning, J. Wardlaw’s Perspectives in Nutrition, 8^th
   ed. New York: McGraw-Hill, 2009
3. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium,
   Vitamin D, and Fluoride. Washington, D.C.: National Academies Press,1997.
4. Weaver CM, Plawecki KL. Dietary calcium: adequacy of a vegetarian diet. Am J Clin Nutr
   1994;59(suppl):1238S-41S.
5. Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics
   Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents.
   Pediatrics. 2008;122:1142-1152.
6. Craig WJ, Mangels AR. Position of the American Dietetic Association: Vegetarian diets. J Am Diet Assoc.
   2009;109:1266-1282.
7. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for thiamin, riboflavin, niacin,
   vitamin B6, folate, vitamin B₁₂, pantothenic acid, biotin, and choline. Washington, DC: National
   Academy Press; 1998.
8. Sandstrom B. (1992) Dose dependence of zinc and manganese absorption in man. Proc. Nutr. Soc. 51:211-218.
9. Mangels R, Messina V, Messina M. The Dietitian’s Guide to Vege-tarian Diets, 3rd ed. Sudbury, MA: Jones and
   Bartlett Learning, 2011
10. New York State Department of Health (March 2015). Choking Prevention for Children. Retrieved from
    https://www.health.ny.gov/prevention/injury_prevention/choking_prevention_for_children.htm
11. Let’s Move! (2015). Get Active. Retrieved from http://www.letsmove.gov/get-active.