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Vegetarian and vegan diets
Abstract
Abstract Body
The influence of vegetarian and vegan diet on children’s health has been discussed not only by pediatricians but also by other professionals who take care of children. Vegetarian, and especially vegan diet, is not only the omission of meat and other food of animal origin, but has to represent balanced nutrition adjusted for children. Such a child requires continuous supervision not only by primary health physician but also by pediatric nutritionist, who both have to be specially educated in the field. As restrictions in diet significantly increase the risk for nutritional deficiencies, parents who decide to follow such a diet, and all professionals who take care of such children, have to be aware of possible nutritional risks that are much bigger than in adulthood.
Which children should get nutritional supplements?
Abstract
Abstract Body
Vitamin D plays a key role in calcium and phosphate metabolism and is essential for bone health. Even though many other health benefits of vitamin D have been suggested, there is still insufficient evidence from interventional studies to support vitamin D supplementation for other health benefits than bone health in infants, children, and adolescents. Vitamin D deficiency occurs commonly among healthy European infants, children, and adolescents, especially in certain risk groups, including breastfed infants, not adhering to the present recommendation for vitamin D supplementation, children without adequate sun exposure, and obese children. All infants should receive vitamin D supplements. For children in risk groups, vitamin D supplementation must be considered beyond 1 year of age. Children are at high risk of nutritional anemia with a global prevalence of 42% in children < 5 years. Iron deficiency anemia is the most common cause of anemia and is associated with poor neurodevelopmental outcomes. There are large, physiological changes in biomarkers of iron status during early childhood, so age-specific reference intervals are needed. In order to prevent nutritional anemias, delayed umbilical cord clamping should be practiced, infant formula should be fortified with iron and other micronturients, low birth weight infants should receive iron supplements, infants from 6 months of age and toddlers should receive an iron-rich diet, and adolescent girls should be screened for iron deficiency. Excessive iron intakes in young children may cause adverse effects, so iron interventions should be targeted to risk groups.