Vegan Children and Nutritional Deficiencies
The vegan diet is growing in popularity, motivated by ecological, ethical, health-related, or religious reasons. In fact, many children are choosing this type of diet of their own volition (often influenced by peers or celebrities). And, to be sure, there are positive health benefits to the vegan diet which have been scientifically established, including lower body mass index (BMI), reduced non‐HDL cholesterol, and improved blood glucose levels.
As well, “adults following a vegan diet have been reported to have a reduced risk for ischemic heart disease, type‐2 diabetes, and all cancers combined (but an increased risk for bone fractures and brain hemorrhages)”. However, the benefits of the vegan diet have been determined by studying adults, whereas there have been limited studies on how the vegan diet affects the growing bodies of children.
Limited studies on vegan children suggest “diminished average growth, yet still within normal range”, and occasional cases are reported “of life‐threatening micronutrient deficiencies from poorly planned vegan diets”.
Children have higher requirements for energy and nutrients (per body weight unit) than adults, to ensure healthy development of their hormonal, neurological, and immune systems. Therefore, we cannot extrapolate dietary recommendations for children from studies done on vegan adults. So, a group of Finnish scientists decided to do a more detailed examination of vegan children to see if they had nutritional deficiencies that could cause problems with their normal, healthy development.
The Finnish Study
Our scientists decided their homeland was a perfect place to run such a study for the following reasons: “Finland is a high‐income country with public daycares of excellent quality, available for the families for the six first years of life of children. Up to 75% of Finnish children attend public daycares, which offer standardized nutritionist‐planned daily meals free of charge. Such a uniform system offers an excellent opportunity to study effects of vegan diet in young children.”
They examined 40 healthy children (on average, 3.5 years old), a mix of vegans and omnivores from the same daycare centers. “Their nutritional intake, metabolic biomarkers and micronutrient statuses were extensively studied.”
As mentioned above, studies have been done on the nutritional status of adults. These studies have established that some vegans (those who do not pay close attention to how they design their diet, and do not supplement to make up for deficiencies) can be critically low in certain nutrients. These include, “protein, vitamin B12, iodine, vitamin D, calcium, iron, zinc, long‐chain n‐3 fatty acids (omega 3 fatty acids), riboflavin, and vitamin A”.
The vegan children in our study were ideal subjects because their parents already supplemented them with iodine, vitamin D, and vitamin B12, indicating they were familiar with the previously established nutritional requirements of a vegan diet. But, these perceived nutritional requirements of a vegan diet were based on studies done on adults, so, let’s have a look at what was discovered about children on a vegan diet.
“The children on a fully vegan diet were found to have significantly lower vitamin D levels compared to children without a special diet, despite having regular vitamin D supplementation, and blood samples being collected in late summer (when their vitamin D levels should have been highest). Surprisingly, also their vitamin A status was lowered. Levels for LDL and HDL cholesterol, essential amino acids in general, and docosahexaenoic acid, a fatty acid with a central role in development of visual function, were low while folate levels were remarkably high in vegan children.”
According to the authors of this study, these new findings should motivate further, and larger, studies on the health consequences of a vegan diet in young children. (Study)
Breaking it Down
The folate levels of these children was particularly high because plant foods are high in this form of folic acid. That is a positive thing for general health. But, of particular concern to the researchers, was that low vitamin A and DHA (docosahexaenoic acid) status can lead to poor development in the area of visual health.
As indicated in a recent newsletter, Beta Carotene is No Substitute for Vitamin A, and given the importance of vitamin A to the body (for many more functions that just vision), parents of vegan children should consider supplementing them with vitamin A. Since preformed vitamin A occurs exclusively in the animal foods (liver, dairy products, fish), and natural vitamin A supplements are derived from fish liver oil, the only vegan option is to use synthetic vitamin A. Fortunately, unlike with synthetic beta carotene, this form works just fine to fulfill our vitamin A requirements.
Omega 3 fatty acids (DHA and EPA) are necessary for good health, and are mostly obtained in the diet from fish and other seafoods. The best vegan source of omega 3s is flax oil, which most healthy people will convert into DHA and EPA, especially women (and likely, girls), who convert it four times more effectively than males do. (This is because Nature knows that the brains of fetuses require omega 3s for healthy development.)
Essential Amino Acids and Cholesterol
Both the essential amino acids and cholesterol found to be deficient in these children, are derived from animal proteins. Cholesterol is necessary for brain function and the production of hormones, among other things. Since the body requires some saturated fat, and saturated fats of animal origin contain cholesterol, one solution to low cholesterol levels in vegan children is to use coconut oil in their diet. Coconut oil is a saturated fat, and while it contains no cholesterol per se, it has been shown to elevate cholesterol levels in the body. (Source). This study did not define the amino acids that were found to be low in vegan children, but further research gives us a clue.
The amino acid taurine is a sulfur compound found in various body tissues, including the brain, heart, and kidneys. It plays a role in muscle function, bile salt formation, and antioxidant defense, and is only found in animal foods. “Subsequently, studies have shown that vegans have lower levels of taurine than meat eaters.” (Source)
Another amino found only in animal foods is carnosine, an antioxidant that is concentrated in the muscles and brain of humans. Carnosine is required for muscle function, and high levels are linked to reduced muscle fatigue and improved performance. “Studies have shown that vegetarians have less carnosine in their muscles than meat eaters.” (Source)
Any vegan, child or otherwise, should consider supplementing with taurine if they have anxiety disorders (as it is required for the production of the inhibitory neurotransmitter GABA), or heart problems. Carnosine should be used by those engaging in athletic endeavors.
These amino acids can be provided in supplemental form, and these days it is now possible to find vegan source amino acids, though I am not sure if these two aminos are to be found in such a form. (Amino acids are usually made from feathers from ducks or chickens.)
Vitamin D Cofactors
The most unusual discovery in this study was that the children were supplemented with vitamin D, and their D test was done in the summer, yet they were still borderline deficient. This leads me to think about cofactors required for vitamin D absorption that may be missing from the vegan diet.
First, let’s look at vitamin K. “Vitamin K helps to control the amount of vitamin D made by the body and keep it in homeostasis (this means keeping the amount stable so that the body has enough vitamin D, without making too much). Vitamin K activates a protein which moves calcium from the blood and into the bones and teeth. Once the level of calcium in the blood drops, the body makes more vitamin D.” (Source)
But, if there is not enough vitamin K present to move the calcium from the blood into the skeletal structure, the body will not make (or activate) more vitamin D. While a vegan diet is high in vitamin K1, very little of this is turned into vitamin K2, which is the form required for this regulation of vitamin D. And, of course, vitamin K2 is found in grass-fed meat and dairy products. Fortunately, vitamin K2 supplements are vegan in nature.
There are also other nutrients required to act as cofactors for vitamin D. These include magnesium, boron, zinc, and vitamin A. Both magnesium and boron can be found readily available in a plant-based diet, especially when the majority of the foods are organically grown.
I have already addressed vitamin A, but it becomes more relevant here since “vitamin A increases the number of vitamin D receptors”. Thus, vitamin A deficiency alone may be the reason these children have a problem absorbing vitamin D. (Source)
With regards to zinc, red meat, poultry, and seafood are the primary sources of zinc in the omnivore diet. Though zinc is also found in beans, nuts, and whole grains, the presence of phytic acid in these foods can inhibit full absorption, and so one should probably ensure that vegan children are supplemented with some zinc. (Remember that white spots on the fingernails indicate a severe zinc deficiency.)
B12 was not found to be a deficiency among the children in this study, but it was mentioned that the parents were aware that their children should receive a B12 supplement. It is critical that all vegans supplement with vitamin B12, as it is only available from animal foods (some believe that it can be obtained from tempeh and spirulina, but these are analogs and do not serve the function of B12 in the body). Vitamin B12 supplements are almost always synthetic, and thus suitable for vegans.
(For more on the subject of Vitamin B12 check out this blog of mine, as well as this one.)
Our sublingual methylcobalamin liquid is a tasty, easily absorbed form of vitamin B12, and is not derived from animal sources.
Truly vegan vitamin D3 is derived from lichen (do not use D2 derived from mushrooms), while most D3 is made from irradiating lanolin from sheep’s wool. While NutriStart’s Quick D is from lanolin, we are one of the few companies whose product is endorsed by the American Vegetarian Society. They endorse the source of our vitamin D because the sheep used are tracked to ensure they receive humane treatment.
As with our B12, our vitamin K2 is also synthetic (clinically proven to be as effective as K2 derived from soybean/natto), and thus suitable for a vegan diet.