A newly published meta-analysis of nearly 50,000 children and adolescents is offering vital insights into the growing trend of plant-based diets for young people. The extensive study, appearing in Critical Reviews in Food Science and Nutrition, confirms vegetarian and vegan diets can be nutritionally sound during advancement – comparable to diets including meat – but stresses the critical need for careful planning and supplementation to avoid deficiencies. Researchers found particular attention must be paid to intake of vitamins D and B12, calcium, iron, and zinc to support optimal growth.
Vegetarian and vegan diets can be healthy and sustainable for children and adolescents, and may even offer health advantages over diets that include meat, such as lower cholesterol levels and a reduced risk of being overweight. However, a comprehensive new study highlights the importance of careful planning to avoid potential nutritional deficiencies beyond simply supplementing with vitamin B12. Understanding the nuances of plant-based nutrition is crucial for supporting optimal growth and development in young people.
The conclusions stem from a large-scale study, the most extensive of its kind to date, published this week in Critical Reviews in Food Science and Nutrition. The research thoroughly examines the benefits and risks of vegetarian and vegan diets in minors. The study analyzed data from 59 different studies, encompassing information on the diets of more than 48,000 children and adolescents from various countries, comparing nutritional profiles and several health parameters.
Researchers found that plant-based diets can support healthy growth comparable to that seen with omnivorous diets. However, without careful planning and monitoring, these diets may lead to inadequate levels of vitamins D and B12, calcium, iron, or zinc, potentially impacting a child’s development.
Experts consulted by Science Media Centre praised the study’s breadth and methodological quality. They also cautioned that, as a systematic review and meta-analysis, it has inherent limitations that could influence some conclusions. For example, the data included countries with vastly different socioeconomic levels, meaning nutritional disparities may be linked to family income and overall access to food, rather than the vegetarian or vegan dietary pattern itself.
Eduard Baladia, a researcher at the Center for Evidence Analysis of the Spanish Academy of Nutrition and Dietetics (CAEC-AEND), noted that the study aligns with the latest scientific evidence, confirming that these diets can be appropriate even for young children, but require careful planning and ongoing clinical monitoring to prevent serious deficiencies.
The study also found adequate total protein intake even in vegan diets, but raised concerns about its quality due to the difficulty of obtaining all essential amino acids solely from plant sources. Baladia pointed out that this limitation is more likely due to a lack of dietary variety, and isn’t an inherent risk of vegetarian or vegan diets. With basic planning, he said, “the risk of suboptimal protein intake is practically nonexistent.”
The researchers emphasized the critical need to supplement vitamin B12 in all vegetarian and vegan diets – a well-established recommendation. Properly supplemented individuals, both children and adults, achieve adequate levels of this essential vitamin. The risks associated with B12 deficiency stem not from plant-based diets themselves, but from a lack of supplementation, which can lead to severe and irreversible neurological damage.
The study’s observations regarding iron intake were also of interest. While vegetarian and vegan children often consume as much iron as their omnivorous peers, they tend to have lower ferritin levels, potentially leading to iron deficiency and anemia. This is because plant-based foods provide non-heme iron, which is less readily absorbed than iron from animal sources.
Baladia approached these findings with caution, noting that the study’s methodology doesn’t allow for establishing a cause-and-effect relationship. He also pointed out that the data on iron intake and ferritin levels may not have been collected from the same individuals. “It’s possible that children with low ferritin were advised to increase their iron intake, which would produce the pattern we see: higher intakes combined with lower ferritin levels,” he explained.
However, with potential nutritional deficiencies addressed, the study highlighted several additional health benefits of plant-based diets for children compared to omnivorous patterns. These included lower total and LDL cholesterol concentrations, as well as a lower overall body weight, reducing the risk of overweight and associated heart problems.
“A vegetarian or vegan diet in childhood can be healthy, but it’s not ‘automatically’ healthy,” summarized José M. Ordovás, director of Nutrition and Genomics at Tufts University in Boston, in a statement to SMC Spain. He emphasized that these diets require knowledge, supervision, variety, and supplementation, but that children can indeed grow up healthy and even adopt lifelong healthy eating habits. In addition to mandatory B12 supplementation, he recommended supplementing with vitamin D and, for vegans, paying special attention to calcium, zinc, and iron levels.
Javier Sánchez Perona, a scientist at the Institute of Fat-CSIC, agreed with the study’s conclusions but criticized some of its limitations, particularly the lack of controlled, randomized clinical trials to establish causal inferences. “While this is a very valuable study, it would be necessary to supplement it with prospective studies and clinical trials to evaluate the long-term effects of these diets on pediatric development.”
Reference
Lotti, S., Panizza, G., Martini, D., Marx, W., Beasley, J. M., Colombini, B., & Dinu, M. (2025). Lacto-ovo-vegetarian and vegan diets in children and adolescents: a systematic review and meta-analysis of nutritional and health outcomes. Critical Reviews in Food Science and Nutrition, 1–21.
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