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Ask Dr. Bob
 

  This article orginally appeared in the Feb. 4, 2009 issue of he St. Louis Post Dispatch.

          Many parents have had to ride out their kids' food jags — periods when a son or daughter favors mac and cheese over all else or refuses to eat anything that isn't breaded and fried. Those periods usually pass, but what if a child decides to make a permanent dietary change, such as foregoing meat?

           It's a question that more and more U.S. parents are facing: A recent study by the Centers for Disease Control and Prevention (CDC) reports that some 367,000 kids — or about 1 in 200 — are vegetarians. For the government's first estimate of how many kids avoid meat, researchers interviewed about 9,000 parents on their kids' eating habits.

           These numbers might just be part of a much bigger picture: Other surveys suggest the vegetarianism rate could be four to six times higher among older teens, who have more control over what they eat and who sometimes have concerns over animal welfare.

           It certainly seems more common to me as three of our four daughters, ages 25, 18 and 16, are all vegan and seem to do quite well with careful dietary planning.  I would also advise a daily multi-vitamin that can help to provide essential vitamins and trace elements.

           Should parents be concerned if their youngster wants to give up meat? Yes and no. “While a vegetarian diet can meet all nutrient needs, it does take some careful planning,” says Rita Chrivia, a clinical dietitian at SSM Cardinal Glennon Children’s Medical Center. “Unhealthy eating, no matter how it’s done, can stop a child or teenager from growing to their full height and meeting their potential. Their developing bodies need appropriate calories and nutrients to grow fully and most healthfully.”

            Chrivia adds that bones take in the most of their calcium during the teens and early twenties. While the best sources are milk, yogurt and cheese, there are other, non-animal sources to meet the equivalent of three cups of milk daily.

            Experts agree that while vegetarian diets can be very healthy, some fall short on key nutrients such as protein, vitamins B12 and D, iron, and calcium found in meat. Growing kids need many of the nutrients found in meat, eggs, and dairy.

            It's important to note that the term "vegetarian" isn't a one-size-fits-all description of non-meat diets. The major vegetarian types are:

  • Ovo-vegetarian: eats eggs; no meat
  • Lacto-ovo vegetarian: eats dairy and egg products; no meat
  • Lacto-vegetarian: eats dairy products; no eggs or meat
  • Vegan: eats only food from plant sources (no eggs or dairy products)

            Kids who still eat eggs and dairy products will likely get all the nutrition they need. But parents of vegans need to be especially watchful for nutritional deficits.

Fortunately, most neighborhood grocery stores now carry a fair amount of veggie-friendly foods, including soy and other plant-based meat alternatives. Look for these good sources of:

  • Calcium: milk and dairy products, green leafy vegetables, calcium-enriched tofu, white beans, chickpeas, bok choy, almonds, and calcium-fortified products (orange juice, soy and rice drinks, cereals)
  • Iron: tofu, enriched grains, dried beans and peas, dried fruits, leafy green vegetables, blackstrap molasses, iron-fortified breakfast cereals, and eggs
  • Protein: beans, chickpeas, lentils, tofu, nuts, eggs, and low-fat dairy products
  • Vitamin B12: dairy products, fortified soy milk, nutritional yeast (tastes similar to cheese)
  • Vitamin D: fortified foods (soy milk, orange juice); also produced by the body when the skin is exposed to sunlight
  • Zinc: dairy products, nuts, whole grains, and fortified cereals

            Chrivia advises that parents discuss with their child why they want to be vegetarian and what foods they want to avoid. To get started, go to www.mypyramid.gov and search “vegetarian.”

            “If your child is old enough, have them help plan meals, help shop, and prepare meals,” Chrivia says. “While not all vegetarian items are low in fat and calories, working together with your child may help you find some new, less expensive and healthier meals the whole family can enjoy.”

            Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine. If you have a question about your child’s health, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at www.cardinalglennon.com.

2/4/2009