Special planning is needed for young children and adolescents on a vegetarian diet. Here are tips on how to get it right.

Yashna Harjani

The "Vegetarian Diet" - a new way of living for some and a religious or spiritual path for others, includes mainly plant sources of foods - grains, legumes, nuts, vegetables and fruits. Foods of animal origin viz., meat, fish or poultry are excluded. Eggs or dairy products may be included depending on the type of vegetarian diet that has been adopted.

Whatever the type of vegetarian diet, a major concern always, is getting adequate nutrients. This is of even greater importance in growing children and adolescents, since diet influences not only growth and development, but impacts long-term health too.

Growing up on a vegetarian diet
Childhood and adolescence, a period of rapid growth and development, makes excessive nutrient demands on the body. A well-balanced vegetarian diet can provide all these nutrients in quantities needed by the body. However, careful planning of the diet is of utmost importance along with emphasis on some nutrients viz., protein, vitamin B12, vitamin D, calcium, iron and zinc.

Nutrient risks
Nutritional risk depends on the type of vegetarian diet consumed:

a. The Lacto-ovo Vegetarian Diet
The diet includes eggs and dairy products, but excludes meat, poultry and fish. Most vegetarians fit into this group.
Nutrients to watch out for: iron, zinc and vitamin B12.

b. The Lacto-vegetarian Diet
The diet excludes meat, poultry, fish and eggs and includes dairy products.
Nutrients to watch out for: protein, iron, zinc and vitamin B12.

c. The Strict Vegetarian or Vegan diet
The diet excludes all animal products viz., dairy products, meat, fish, poultry and eggs.
Nutrients to watch out for: protein, iron, zinc, calcium, vitamin D and vitamin B12.

Getting the balance right
A good balance of all nutrients is important for normal growth and development. Each nutrient plays an important independent role in the body, but is dependent on others for effective utilisation. So, missing even one nutrient in the diet can affect growth. To help you avoid this situation, here are practical tips for you to get the right balance from a vegetarian diet:

a. Protein
Sources: eggs; dairy products; dried beans; bean products like soymilk; tempeh; tofu; taukwa; tauhuay; dried peas; lentils and nuts.

Deficiency: a deficiency can impair growth and development. In teenagers, it may also affect muscle development.

For adequate protein: eat a variety of protein foods. Provide two servings* of protein foods for growing children and three servings* of protein foods for adolescents. Provide adequate grain foods too. Grain foods provide enough carbohydrates for energy (calories) needed for a rapid growth spurt, hence protein foods can be solely used for building and maintenance of the body.

b. Iron
Sources: legumes; iron-fortified cereals and breads; tofu; dark green leafy vegetables; prune juice and dried fruit.

Deficiency: iron is part of the haemoglobin in blood which carries oxygen to body cells. Once there, oxygen helps cells produce energy. When iron is in short supply, there's less haemoglobin and so less oxygen available to produce energy - hence, a feeling of fatigue.

*Females need more iron to replace iron losses during menstruation.

For adequate iron: consume a variety of foods rich in iron daily. Non-heme iron (the form of iron) found in plant foods is not as efficiently absorbed by the body. To make non-heme iron available to the body, consume vitamin C-rich fruits and vegetables at each meal. Vitamin C-rich sources include guava, kiwi, orange, broccoli, green pepper, strawberries, grapefruit, cantaloupe, tomato juice, mango, potato, cabbage and green leafy vegetables.

c. Zinc
Sources: small amounts of zinc are found in eggs and dairy products. Whole-grain products, wheat germ, black-eyed peas, fermented soybean paste (miso), tofu and nuts also contain zinc, but it is present in a form that is not as easily available to the body.

Deficiency: zinc promotes cell reproduction and tissue growth and repair. A deficiency during a growth spurt can therefore cause retarded growth. Other symptoms include appetite loss, skin changes, and reduced resistance to infections.

For adequate zinc: include eggs, dairy products and other sources of zinc in your child's diet whenever possible.

d. Calcium
Sources: milk and milk products, calcium-fortified soymilk, calcium-fortified orange juice, soybean curd (taukwa), tempeh and green leafy vegetables.

Deficiency: calcium's prime role in the body is development and maintenance of bone mass. Half of an adult's bone mass is formed during the teen years. A deficiency of calcium in these growing years could therefore affect bone strength and predispose the individual to brittle or weak bones and osteoporosis later in life.

For adequate calcium: calcium from milk and milk products is well absorbed by the body. So, provide milk and milk products daily in your child's diet. Two cups of a high-calcium milk (each cup providing about 400mg daily), along with half a bowl (rice bowl) of cooked green leafy vegetables should provide the necessary calcium. If your child cannot drink milk, offer calcium-fortified soymilk or orange juice as an alternative or even consider a supplement.

e. Vitamin D
Sources: exposure to sunlight (the body makes enough vitamin D in the presence of sunlight.); egg yolk and fortified milk.

Daily vitamin D needs: aim for about 5mcg of vitamin D for all age groups.

Deficiency: vitamin D helps deposit calcium in the bones. Hence, a deficiency could stunt bone growth and development.

For adequate vitamin D: A daily exposure to sunlight, of just the hands and the face for 20 to 30 minutes, two to three times a week is enough to produce the quantity of vitamin D needed by the body. Growing children or adolescents with limited milk intake or exposure to sunlight may need a vitamin D supplement.

f. Vitamin B12
Sources: eggs; dairy product and fortified breakfast cereals.

Deficiency: this vitamin helps your body make red blood cells, serves as an important component of body chemicals and is found in every cell of the body. It also helps the body utilise fats and proteins. A deficiency may result in anaemia, fatigue, severe nerve damage, a smooth tongue or very sensitive skin.

For adequate vitamin B12: provide eggs or dairy products daily. A cup of milk or an egg daily can provide enough vitamin B12 for the day. Those not consuming either eggs or dairy products should consider taking a daily supplement of vitamin B12.

The bottom-line
With food, there is no one magic formula for the "Right Diet". As long as you include a variety of foods in moderation, your child should have no problem with achieving normal growth and staying healthy for life. If for some reason however, intake of some nutrient is a problem, just provide a supplement which provides about 100% RDA (Recommended Dietary Allowance) of a nutrient.

Note: All "aim for" values have been obtained from the US RDA (Recommended Dietary Allowance) or DRI (Dietary Reference Intakes) - 199 -1998

Yashna Harjani is a consultant dietitian with Food + Nutrition Specialists.

Date reviewed: 02 March 2000