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Vegetarian Diets: A Dietitian's Guide

Vegetarian Children and Toddlers

Vegetarian children tend to have higher intakes of fiber, vitamins, and some minerals compared to children who eat meat. And their diets are lower in cholesterol and saturated fat. In short, they have better diets than children who eat meat.

That doesn't mean that there aren't some nutrients that deserve special attention. But where there is potential for nutritional shortfalls, it is easy to adjust a child's diet to make sure he or she is getting plenty of good nutrition. So, don't let well meaning family members and health professionals tell you that a vegetarian diet is "dangerous" for your little one. As long as you give some attention to food choices–just as you would do if your child was eating meat–it's not difficult to plan healthy vegetarian diets for children.

Of course planning such diets is one thing. What about getting children to eat healthfully? That's a concern of course, whether or not your child's diet includes meat. Most children do like some types of grain-based foods (bread, macaroni, rice, breakfast cereal, etc) and fruits or, especially fruit juices. Most will also eat some kind of nuts or nut better like peanut butter. Vegetables are a tough one, but all children should be eating plenty of vegetables. (Whether or not your child likes vegetables is an issue–but it's not a vegetarian issue.)

This means that the real sticking point–the hurdle that vegetarian parents are more likely to face than parents in omnivore families–is in getting kids to eat beans and soyfoods. Happily, your child can get away with fairly small amounts of these foods and still have a balanced healthy diet. Relative to adults, children have low needs for protein and their diet doesn't need to be all that protein dense. So if you can sneak a few tablespoons of beans into your child's diet every day, and if he or she eats some nuts and plenty of grains, you shouldn't have too much trouble meeting protein needs. And if children drink a protein-rich milk like fortified soymilk on a regular basis, protein needs will be met with ease.

Make sure children get plenty of calcium and be sure to think beyond cow's milk. Good choices for children include fortified orange juice, apple juice, soymilk or rice milk and calcium-set tofu. It's crucial that children get plenty of zinc and that's one nutrient that may be on the low side for vegetarian kids. Give your child's diet a zinc boost by including plenty of whole grains and nuts or nut butters. Finally, children need foods that are fortified with vitamin B12 and, depending on where you live, foods that are fortified with vitamin D. If you aren't sure that a child is getting enough of these nutrients, then do include a multivitamin and multimineral tablet in their diet. It can't take the place of a good diet but it can help to give your child some extra nutritional insurance.

The vegetarian food guide provides a suggested pattern for meal planning for vegetarian children. Guidelines for feeding vegetarian toddlers are slightly different, because serving sizes are much smaller and toddlers will more easily meet nutrient needs if they consume some type of milk–like fortified soymilk–regularly.

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Vegetarian toddlers, ages 1-3:

Children are not among the most adventurous eaters and the picky habits of some age groups makes it a big challenge to get kids to try new foods. Here are a few things to keep in mind.

• Keep an open mind. You'll hear over and over again: Oh, no three-year-old will eat asparagus! Well guess what? Some three-year-olds do. He may indeed be the rare three-year-old, but he may also be yours! So don't second guess what your child will or won't eat just based on what most kids prefer.
• Be persistent. Research shows that it takes as many as ten exposures to a new food before a young child will try it. So, if your child turns her nose up at baked beans, serve them again, in a different type of meal in another week or so. And, again. And, again.
• Keep it low-keyed. Don't make a big deal out of the new food. Just present it and don't react to your child's reaction. Some research shows that even praise for trying a new food can backfire and make a child dislike the food the next time it is served.
• Stick to the familiar. If you want your little one to give kale a try, offer a small serving along with something that your child already likes a lot.
• Be a good role model. It's important for children to see you eating and enjoying these foods.
• Be a sneak. It's nice if children actually learn to enjoy new foods, but if all else fails and you are worried that your child is not eating enough variety, it's okay to sneak some foods into the diet any way you can. Your child may turn his nose up at a glass of soymilk, but might be perfectly content to eat mashed potatoes, pancakes, or chocolate pudding made with soymilk. If he won't eat collard greens, tear the leaves up into tiny pieces and add them to spaghetti sauce or rice and tofu wrapped up in a tortilla. If he thinks tofu is too weird to eat, then puree it in a blender with fruit to make a smoothie.

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Vegetarian Teens

Teens are often attracted to vegetarianism because they are concerned about the environment and animal welfare. There are many vegetarian teenagers living in meat-eating households. In this case it is extremely important for parents to be supportive of a child's dietary choices. Parents need to become knowledgeable about vegetarian diets and give children some guidance, since most children and teens will not make the best diet decisions if left to their own devices.

The teen years include periods of very rapid growth and nutrient needs are high during this stage. Many meat-eating teens have very unbalanced diets. Both nutrient deficiencies and obesity are problems among American teenagers. Some research shows that vegetarian teens are actually likely to have healthier diets.

Use the vegetarian food guide in planning meals for teens. Help your teenager make good food choices by having appropriate foods that are easy to prepare on hand. Teenagers consume many of their meals as snacks and also often eat away from home. Stock the kitchen with healthful foods that make good quick snacks or that can be easily packed into a backpack. Some good ideas include dried fruits, trail mix, popcorn, rice cakes, frozen pizza slices, hummus on pita, muffins, calcium-fortified juice or soymilk in individual serving cartons, bagels or English muffins with nut butter, instant soups, instant cereals.

Eating Disorders

Eating disorders are a serious problem that affect teenage girls more often than other groups. There is some evidence that eating disorders are more common among vegetarians than meat eaters. This is because girls sometimes adopt a vegetarian diet as a way to manage and disguise their eating disorder.

But healthy girls who become vegetarian are no more likely than anyone else to develop an eating disorder. If your child decides to become a vegetarian it does not mean that you need to be concerned about an eating disorder. The following factors are signs that an eating disorder may be present.

• Weight loss that continues beyond three months. Initial adoption of a vegetarian diet may cause a small amount of weight loss, but it should not continue if your child is eating a healthy vegetarian diet.
• Meal skipping. If your child frequently doesn't want to eat and says she is not hungry, this could signal an eating disorder.
• Avoidance of all foods that appear to be high in calories or that have fat in them–tofu, meat substitutes, peanut butter, breads, and pastas.
• Compulsive counting of fat-grams and calories.
• Weighing themselves frequently or reports of feeling bloated when eating normal portions
• Ritualistic behavior around food–such as cutting food into tiny pieces or eating only one food at a time.
• Distorted body image. She comments that she needs to lose weight or is fat when she's at a healthy weight or thin.

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Vegetarian Babies

All infants start out as vegetarians. Typically, higher protein foods like meat are not introduced until an infant is 7 or 8 months old. So raising an infant as a vegetarian doesn't become any kind of issue until that time. Then parents may wonder what to give a rapidly growing baby to meet protein and other nutritional needs.

Breastfeeding is the best choice for all babies until at least the first birthday. For the first 4 to 6 months, babies don't need anything in addition to breast milk. The only alternative to breast milk is commercial infant formula. For those families that don't use cow's milk, soy formulas are excellent nutrition for infants. For all babies under the age of one year, the only appropriate milks are breast milk or commercial infant formula. Never give an infant homemade formula, regular cow's milk, regular soymilk or any milk made from nuts or grains.

By 4 to 6 months of age it's time to start introducing some solid foods to a baby's diet. Here is a recommended schedule for vegetarian infants.

4-6 months

• Introduce iron-fortified infant cereal.

A good choice is rice cereal since it is unlikely to cause allergies. Mix the cereal with breast milk or infant formula to make it liquid enough for first feedings, but feed it from a spoon, not a bottle. Once an infant is used to rice cereal, other cereals like barley or oats can be provided. While cereals are new, your baby will take just 1 to 2 teaspoons per feeding. But eventually, babies will be consuming 2 servings a day of about 1/4 cup each.

5-6 months

• When your baby is consuming a total of 1/3 to 1/2 cup of cereal per day, introduce mashed fruits and vegetables.

Good early choices include applesauce, mashed banana, pureed peaches or pears (that have been canned in their own juice, not syrup), strained potatoes, sweet potatoes, carrots, green beans, and avocado.

7 to 8 months

• Introduce apple juice from a cup.
• Introduce first protein-rich foods. Vegetarian infants can have thoroughly cooked and pureed legumes, well-mashed tofu, or soy yogurt.
• Introduce stronger-tasting vegetables like kale and collards. Temper their strong flavor by pureeing them and mixing with bland or sweet foods like avocado, applesauce, or tofu.

10 months

• Babies are ready to enjoy finger foods such as tofu chunks, bread, or crackers.

12 months

• Infants can have smooth nut or seed butters like almond butter or tahini (but not peanut butter), spread thinly on bread or crackers.

Here are a few practices to keep in mind as you introduce solid foods to your vegetarian baby.

• Introduce one new food every three to four days. This way, if your baby has an allergy to a food, you'll be able to identify it.
• Delay introduction of certain foods that are most likely to cause allergies. Infants should not have citrus juice before 8 months and peanut butter should be delayed until age 2 years.
• Never give babies unpasteurized juice or cider.
• Infants should also not have corn syrup or honey.
• Be careful not to overdo it with juices. Too much juice can cause a baby's diet to be poorly balanced and can also cause diarrhea. Limit your infant to 8 ounces of juice per day.

By the first birthday, your little one should be consuming a variety of foods. At this time, the rate of growth begins to slow and your baby may start to exhibit the picky eating habits of the toddler stage. It's the beginning of a challenging time at the table for all parents, vegetarian or not! Many families choose to continue with breastfeeding. Your baby will be consuming less breast milk–about 24 ounces per day. You can also switch your baby to soy infant formula or to regular, full-fat fortified soymilk at the first birthday.

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