... but they should make sure to get enough calcium and iodine. ➜ New results from the “VeChi Youth Study” in Germany, whose participants were children and teenagers (6–18 years old), found that most (but not all) of the vegan children and teenagers consumed enough vitamin B12. Most vegans were also getting enough vitamin D. Most vegans were NOT consuming enough calcium. And iodine, selenium, and omega-3 intakes were not assessed.
You can see vegan nutrient recommendations for adults here. Children should consume about the same amount (or 3/4 the amount) of iodine than adults and about 1/4 to 1/2 the amount of selenium compared to adults.
Note: on average, these vegan children and
teenagers in this study (VeChi Youth Study) had been vegan for more than four
years.
Authors’ conclusions first:
These are the main conclusions from the authors:
“[..] the Vechi Youth Study did not
indicate specific nutritional risks among vegetarian and vegan children and
adolescents compared to omnivores.”
“The results of the VeChi Youth Study
confirm[.] the position [...] that a vegetarian, including a vegan, diet can
meet the recommended nutrient requirements in childhood and adolescence.”
“[Continuing this study/more studies] are
desirable to examine the long-term health impacts of vegetarian and vegan diets
in children and adolescents, in particular with respect to bone health.”
“[.] other [..] nutrients should be
examined, e.g., intake and status of [..] iodine and selenium. The results are
not readily transferable to [..] infants […].”
What the study found out about
nutrient intakes of vegan children and teenagers:
Vitamin B12
B12 supplements 👇
88% of vegans took a vitamin B12
supplement, compared to 39% of vegetarians and 10% of non-vegetarians.
B12 Intake
The vitamin B12 intake of vegan participants
from diet – without supplements – was very low. But this doesn’t matter as long
as the vegans compensate this by taking a vitamin B12 supplement.
Blood B12 status
High MMA (methylmalonic acid) concentrations
– if these are high, this indicates “B12 deficiency” – were found in 14% of
vegetarian participants, 11% of vegan participants and 7% of omnivore
participants.
Considering both holoTC (another indicator
of B12 status) and MMA concentrations, 13% of vegetarian, 8% of vegan and 4% of
omnivore participants were categorized as likely deficient.
So, this indicates that these vegans (about
10% of vegans) did not get enough vitamin B12 (from supplements and/or B12
fortified foods). This is a very important finding for the “vegan movement” and
vegan organizations. The conclusion should be that there should be information
campaigns for vegans with information about vitamin B12.
Vitamin D
A high prevalence (>30%) of 25-OH
vitamin D3 …concentrations below reference values were found irrespective of the
diet group.
Vitamin D supplements
In Germany taking a vitamin D supplement (~800–1000
IU/day) in winter and getting lots of sunshine in spring, summer, and autumn is
a good idea. 54% of vegans, 27% of vegetarian, and 54% of non-vegetarians took
a vitamin D supplement. But this information doesn’t tell us too much because it
depends on whether it’s summer or winter, if taking a vitamin D supplement is
necessary.
Blood vitamin D status
27% of vegans, 26% of vegetarians, and 28%
of non-vegetarians had low-ish 25-OH-D3 blood concentrations (a marker of
vitamin D status; “low-ish” here means: below 20 ng/mL).
5% of vegans, 10% of vegetarians, and 4% of
non-vegetarians had very low 25-OH-D3 values (less than 12 ng/mL).
That means vegans did NOT have vitamin D deficiency
or “semi-deficiency” any more often than other dietary groups. Still, the
recommendations of taking a vitamin D supplement in winter remains relatively
important (same recommendation as for adults: ~800–1000 IU/day).
Vitamin B2 (riboflavin)
Vitamin B2 (also called riboflavin) is
probably not a concern. Even though intakes may be a little bit lower in some
vegans, it may just be that the reference values for vitamin B2 blood concentrations
are higher than necessary.
Anyway, it’s easy to consume enough vitamin
B2 from vegan foods. Good sources of vitamin B2 are (for example): almonds,
sesame seeds/tahini, mushrooms, tempeh, spinach beetroot leaves, artichokes,
asparagus, avocado, bread, durian fruit, bananas, plantains, edamame, oats,
barley, rye, durum wheat (spaghetti etc.), quinoa, whole grain rice, nuts, peanuts,
tofu, soy milk, sweet potatoes, pumpkin, tomato sauce, cherimoya, passion
fruit, dried peaches, raisins, dried plums, foods fortified with vitamin B2 (for
example, some soya milks and soya yogurts), and yeast flakes.
Vitamin B2 supplements
The intake from supplements was not
mentioned, but, for example, the Vegan Society VEG1 supplement (which I do not
sell – and I have no connection to the Vegan Society) does contain vitamin B2.
Blood vitamin B2 status
54% of vegans, 50% of vegetarians, and 37%
of non-vegetarians had “low” concentrations of vitamin B2 (FAD) in blood.
The authors write: “[.] the biochemical
thresholds for deficiency may be inappropriate[,] and the clinical relevance of
the low vitamin B2 (FAD) concentrations observed in the VeChi Youth Study is
still unclear.”
“[…] there are several plant sources for
this vitamin, e.g., nuts, mushrooms, legumes, textured vegetable protein (TVP)
or fortified plant-based dairy alternatives.”
Folate/folic acid
These results are not surprising:
“Vegan participants had higher folate [folic
acid] concentrations than vegetarian participants.”
“Intake of [folate/folic acid] was highest
in the vegan group.”
“Vegan participants had the highest intake
compared to the reference values of […] folate […].”
Vitamin B1 (thiamine)
“Vegan participants had the highest intake
compared to the reference values of [..] vitamin B1 […].” This is great – but vitamin B1 intake
is usually adequate for most people.
Vitamin A
There was no difference in vitamin A (retinol-equivalents) intake between the different dietary groups. It’s important that vegans regularly consume foods rich in beta-carotene (see here under point 9). Vitamin E
“Vegan participants had the highest intake
compared to the reference values of vitamin E […].” This is great.
Vitamin C
“Vegan participants had the highest intake
compared to the reference values of […] vitamin C […].” This is great.
Calcium
“[.] the intake of calcium was […] lowest in vegans.” This is an important – and unfortunately unsurprising – finding. Vegan children and teenagers should consume calcium-fortified soya milk or calcium-fortified soya yogurt (more or less) daily or consume other good vegan sources of calcium (see here under point 2).
Iodine
Iodine intake or status was not assessed.
Iodine intake is a bit low in the general population in Germany and even lower
in vegans. In fact, many studies have shown that vegans who do not pay
attention to iodine (iodized salt, seaweeds like nori, or a supplement) very
often have iodine deficiency or “semi-deficiency”. The Vegan Society VEG1
supplement (which I do not sell – and I have no connection to the Vegan
Society) does contain iodine (VEG1: children should take half a tablet/day). Note:
iodine excess can be dangerous. More info on iodine in general: here.
Iron
Iron supplements
15% of vegans, 20% of vegetarians, and 2%
of non-vegetarians took an iron supplement.
Iron intake from food
“Vegan participants had the highest intake
of […] iron, whereas omnivore participants had the lowest intake […].”
Iron status in blood
“Ferritin concentration [a marker of iron
status] was significantly higher in omnivores than in vegetarians [.] and
vegans [.].”
It’s controversial if this is good or bad
(or both). High ferritin is associated with higher risk of chronic diseases in
the long term. But if ferritin is too low, this is considered iron deficiency.
There was no significant difference between
the dietary groups in terms of haemoglobin (another marker of iron status and a
marker of iron deficiency anaemia).
“[…] there was no elevated risk for iron
deficiency in the vegetarian or vegan subgroup. [.] the higher iron intake observed
in the vegan participants […] could compensate for the lower bioavailability of
non-haem iron in plant-based diets.”
“Median ferritin concentrations were lower
in vegan than in vegetarian and omnivore participants of the VeChi Youth Study.
However, the prevalence of concentrations below the cut-off was small. Hence,
the observed diet group differences appear to be of minor importance.”
Zinc
“The median calcium intake of vegan
participants was <50% of the reference value [recommended daily intake]” and
less than 56% in vegetarians and less than 67% in non-vegetarians.
It’s important the vegan children and
teenagers consume enough zinc-rich foods: nuts, seeds, and legumes (and whole
grains).
Selenium
Selenium intake or selenium blood status (for
example, plasma/whole blood selenium, GPX, or SePP) was not assessed. Selenium
intake is likely a bit low in the general population in Germany and even lower
in vegetarians and vegans. The Vegan Society VEG1 supplement (which I do not sell
– and I have no connection to the Vegan Society) does contain selenium (VEG1: children
should take half a tablet/day). Note: selenium excess can be very dangerous. More info on selenium in general: here.
Magnesium
“Vegan participants had the highest intake
of […] magnesium [..], whereas omnivore participants had the lowest intake […].”
A high intake is great.
Potassium
Potassium intake was not assessed. Potassium
intake is usually higher in vegans – which is great.
Protein intake and status
The median protein intake of vegetarian and
vegan participants was adequate.
“[…] a blend of plant food proteins [legumes
and grains] is consumed in a vegan diet. Hence, the concern of inadequate
protein or amino acid intake seems not to be relevant in practice.”
Vegans should consume legumes daily (see
here under point 10).
Fat intake
“The median fat intake [percentage of calories]
was below 30%[.] among vegan participant; the fat intake of vegetarians and
omnivores was significantly higher [.]” That means that for the vegan participants
fat intake was OK, but a little higher would also be OK.
“The intake of SFA [saturated fatty acids –
these are considered unhealthy for our arteries] was highest among omnivores [non-vegetarians]
and lowest among vegans.” This is great.
“[..] vegan participants had the highest
intake of PUFA [polyunsaturated fatty acids – these are considered healthy for
our arteries, unless it’s from fried or highly processed foods].”
Vegans should consume adequate amounts of omega-3 fatty acids (flax seed oil, chia seeds, rapeseed oil, etc.; see here, under point 5; children should consume about half of these amounts, under point 5).
Carbohydrate intake
Healthy carb foods: fruit and whole grains
(but for children some refined grains are good too because they are less “bulky”
and don’t fill up the stomach so quickly).
Less healthy carb foods: foods with lots of
added sugars (candy, cakes, highly sweetened foods, etc.).
“Vegan participants reported a lower mean
intake of free sugar than [vegetarians and non-vegetarians].”
“Dietary fibre intake was highest among
vegans and lowest among omnivore [non-vegetarian] participants […].” A high
fibre intake is a good thing. But for children, fibre intake should not be too
high – because this could result in consuming too few calories or too little
protein. And the children and teenagers in this study did consume enough
calories and protein.
These vegan children and teenagers were
doing well in terms of carbohydrate intake.
Calorie intake
“The total energy [calorie] intake did not
differ between groups […].” These vegan children and teenagers were doing well
in terms of calorie intake.
Healthful effects of vegan
diets in the long term:
“Vegans had the lowest non-HDL-C and LDL-C [bad
cholesterol] concentrations […]”. This is great, because these types of
cholesterol damage our arteries, which increases the risk of heart attack and
stroke (and other cardiovascular diseases).
“TC [total cholesterol] was lowe[st] among
vegan[s] […].” That’s also great (see above).
93% of vegans, 89% of vegetarians, and 79%
of non-vegetarians had “acceptable concentrations” of LDL cholesterol (the most
commonly measured type of bad cholesterol).
95% of vegans, 93% of vegetarians, and 85%
of non-vegetarians had “acceptable concentrations” of non-HDL cholesterol (all
or practically all types of bad cholesterol combined).
“Since the focus of many statements on
vegan diets is on potential health risks, it should be emphasized that vegan
participants in our study had the highest intakes of vitamin E, vitamin B1,
folate, vitamin C, magnesium, iron and zinc. Intake of free sugars was lowest
in this group […]. […] The mean fibre intake was highest among vegan compared
to vegetarian and omnivore participants. The latter did not reach the dietary
reference value [daily recommended intake] of 14 g/1000 kcal.”
“[…] vegan participants […] showed the best
dietary fat quality indicated by the lowest intake of SFA and the highest
intake of PUFA. Accordingly, vegan participants had the lowest serum TC, LDL-C
and non-HDL-C concentrations. This result is in accordance with the
abovementioned recent German study on vegan and omnivore adults.”
“The VeChi Youth Study provides the first
evidence of reduced cardiovascular risk factors already in childhood and
adolescence, only with a vegan diet.”
However, vegan parents should make sure that their vegan children have adequate intakes of certain key nutrients.
Reference:
Alexy et al. (2021): Nutrient Intake andStatus of German Children and Adolescents Consuming Vegetarian, Vegan orOmnivore Diets: Results of the VeChi Youth Study. Nutrients; 2021 May
18;13(5):1707; doi: 10.3390/nu13051707.
