Children Dr Mabel Blades Parents often worry that their vegetarian or vegan offspring will not get enough nourishment from their diets. Is there cause for concern?

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Toddlers and pre-school children School-age children

Teenage years Summary

Vegetarian and vegan diets can be a healthy way of eating for all age groups - provided that enough thought is given to balance youngsters’ diets. There are potential pitfalls (getting adequate amounts of B12 and iron, for example, is likely to require planning) but provided that parents (and teenagers) understand how to balance their requirements, vegetarian and vegan diets can be healthy and adequately nutritious.

The diet of growing toddlers is vital to their well-being

The diet of growing toddlers is vital to their well-being, their ability to play and to learn, as well as to their future health. This is the age when food tastes are learned, so giving children the chance to explore a variety of tastes and textures is important to future likes and dislikes.

Milk

One of the major components of a toddler's diet will still be milk. Full-cream milk provides extra calories and vitamin A and vitamin D, which are both essential for health. Children following a vegetarian diet should be given whole milk up to the age of two years when semi-skimmed milk can be introduced. From the age of five years, fully skimmed milk can be substituted if desired.

For those following a vegan diet, soya milk provides a good substitute for cows’ milk, but be sure to choose those that are supplemented with extra calcium. Likewise, if rice, oat or potato milk is chosen as part of a vegan diet, the toddler will need to be given extra calcium and vitamins as a supplement. Be certain to discuss this with your doctor.

Food-wise, desserts such as homemade rice, tapioca and sago puddings are popular with children, as are custards to accompany fruits. These can be made with either full-cream, semi-skimmed, skimmed or soya milk. White sauces made with any of the different types of milk can be used to enhance dishes such as cauliflower cheese, macaroni cheese and chickpea and pasta bakes using a selection of vegetables such as mushrooms for flavour.

Iron

One of the deficiencies to which toddlers are more prone is iron deficiency anaemia. There are two types of iron: haem, which is the type found in meat; and non-haem, which is the type found in non-meat items such as eggs, cereals, vegetables, peas, beans and lentils. Non-haem iron is not as well absorbed by the body as haem iron is. However, the absorption of non-haem iron can be enhanced by vitamin C, which is a good reason for giving vegetables and fruit at the same time.

High-fibre foods

For toddlers with a small appetite, high-fibre foods can be too filling, so for this age group keep to white varieties of pasta, bread and rice. Breakfast cereals fortified with iron and vitamins can be a useful addition.

Nuts

Nuts are very nutritious, providing protein and vitamins A and E, as well as minerals such as phosphorous and potassium. Nuts can provide protein in meat-free diets, but in those children where there is a family history of allergy, peanut butter is best avoided until after two years of age. Whole nuts are not suitable for young children as they can cause choking.

Carbohydrates

During the school years, children need plenty of starchy carbohydrates for energy. It is recommended that young people eat wholemeal or seeded breads for extra fibre as it is more filling and is beneficial to bowel health. Seeded breads are ideal in packed lunches. For variety, include wraps, bagels and pittas. Brown rice and brown pasta also provide extra fibre.

To get extra fibre from potatoes, keep the skins on. Children are keen on jacket potatoes and chips; new potatoes and potato wedges are easy to cook and can be made with well scrubbed unpeeled potatoes.

Fruit and vegetables

Children should be encouraged to eat plenty of fruit and vegetables for important vitamins and fibre (ideally five portions per day, or 400g). Snacks of fresh or dried fruit also provide some iron. Vegetables are easy to add to all types of dishes such as curries, casseroles and stir-fries. Salad vegetables are easy to include in sandwiches and wraps. Bean salads are useful and tasty fillings for sandwiches and jacket potatoes as well as in salads.

Protein

Protein-rich foods are important for this age group as their muscles and vital organs are growing and developing. Good sources of protein include peas, beans, lentils, nuts, seeds, cheese, tofu, milk (whether soya milk or cows’ milk), eggs and special vegetable products made from textured vegetable protein (TVP). A vegan diet needs to be carefully balanced to ensure that substantial portions of these foods are provided.

School lunches

Government guidance on school meals recommends that vegetarian options be included in schools. In Scotland, the standards clearly specify that school meals should also provide vegetarian alternatives to cheese a minimum of three times per week in order to discourage an over-reliance on cheese by non-meat eaters. Most schools offer dishes based on pulses or mycoprotein (although the latter is not suitable for vegans).

Family meals

The teenage years are when many people decide to ‘go vegetarian’. For meat-eating parents, this decision can be a cause of consternation, but it needn’t be. In fact, it’s easy enough to accommodate vegetarian family members by providing a vegetable dish such as a casserole, lentil loaf or vegetable bake to replace the meat in the family meals. Vegetarian dishes such as stir-fries with tofu or nuts and chickpea curries are easy to makeand delicious enough to tempt non-vegetarians. It’s also easy enough to add some cooked meat or chicken to the dish afterwards for meat-eaters.

Calcium

Calcium-rich foods are vital to teenagers’ health

During the teenage years about 50% of the calcium in the skeleton is deposited, so calcium-rich foods are vital to teenagers’ health. Milk is an important source of calcium as is anything made from it, such as yoghurt and ice cream. Vegetarian cheese, made with vegetarian rennet, is easy to find and, for vegans, calcium-enriched soya milk, soya-based ‘cheeses’ and tofu are important sources of calcium. Others include white bread, beans, lentils and chickpeas, figs and other dried fruit, tahini (made from sesame seeds), green vegetables, nuts and seeds.

Iron

Teenage girls are starting their periods and thus have a greater requirement for iron. The symptoms of iron deficiency anaemia are tiredness and lethargy, which affects the ability to enjoy life and learn and can mar the teenage years.

Eggs are an important source of iron for vegetarians; they can be included in a number of dishes such as omelettes, quiches, savoury custards, pancakes and vegetable loaves bound together with beaten egg. Desserts such as sponges, mousses and meringues all contain eggs and are well liked by the majority of children.

Lentils, nuts, seeds and chickpeas also contain iron and these can be included in pasta dishes, risottos, bakes and flans for the basis for family meals. Seeds, such as such as linseeds, sesame seeds and sunflower seeds, provide iron and calcium and are a useful and tasty component of vegetarian and vegan diets. Not only are they useful snacks, but they can also be added to salads, stir-fries, breads and biscuits.

Specially made vegan and vegetarian dishes made with textured vegetable protein (TVP) and vegetarian sausages and grills can be useful to add variety to the diet but some products can be high in fat. Also, as some of these products are made to mimic meat, those who do not like the texture of meat may find them a turn-off.

Vitamin B12

Vitamin B12, necessary for the formation of healthy blood cells, is found in milk, eggs and cheese and is added to most brands of yeast extract. Vegetarians normally get enough B12 from dairy produce, but vegan diets can be inadequate in B12. In order to avoid deficiency, vegans should try to eat foods enriched with B12 (such as breakfast cereals) or regularly include fortified yeast extract in the diet.

So, to sum up, it is entirely possible for children and young people to get all the nutrition they need from a vegetarian diet. In some parts of the world, generations have been doing so for centuries. Parents who want to bring up children as vegans must be aware of the particular nutritional deficiencies that their children may be prone to and provide proper supplements as needed. But, with foresight, knowledge and some proper planning, eating a diet that's free from animal products needn’t be cause for worry.

Dr Mabel Blades is a freelance dietitian and nutritionist who regularly provides advice on nutrition to young people with all types of dietary needs.

DISCLAIMER: All content within BBC Food is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Always consult your own GP if you are in any way concerned about your health.