- A large global meta analysis found vegetarian and vegan diets can support healthy growth when well planned and appropriately supplemented
- Children on plant based diets often showed better cardiovascular markers, including lower total cholesterol and lower LDL cholesterol
- The main risks were predictable nutrient gaps, especially vitamin B12 and calcium, plus iodine, iron and zinc when fortified foods or supplements were not used
A major review of international research suggests vegetarian and vegan diets can be suitable for children and teenagers, and may improve some markers linked to heart health, but only when families plan carefully and address common nutrient shortfalls.
Researchers reviewed 59 studies from 18 countries, covering more than 48,000 children and adolescents under 18.
The analysis compared omnivorous diets with lacto ovo vegetarian diets, which include dairy and eggs but exclude meat and fish, and vegan diets, which exclude all animal derived foods.
Overall, the evidence supports the idea that plant based diets can meet nutritional needs during childhood when they are built properly.
The analysis also makes clear why some clinicians are cautious.
Removing animal foods without replacing the nutrients they provide is a straightforward way to create deficiencies, especially during periods of rapid growth.
Children following vegetarian diets tended to consume more fibre and higher amounts of several micronutrients such as iron, folate, vitamin C and magnesium.
- Vegan diet with unhealthy plant foods still beats Mediterranean diet for weight loss
- Plant-based eating may help some people with type 1 diabetes use less insulin
However, they often had lower intakes of energy, protein and fat, and lower intakes of vitamin B12 and zinc.
Fewer studies specifically focused on vegan children, but the same broad pattern appeared.
Vitamin B12 emerged as the most consistent problem nutrient.
Without supplementation or fortified foods, intakes did not reliably reach adequate levels. Calcium was also frequently low, particularly among vegan children. Iodine and zinc were often towards the lower end of recommended ranges, making them practical targets for planning and monitoring.
Despite nutrient concerns, children on plant based diets showed more favourable cardiovascular profiles.
The analysis reported lower total cholesterol and lower LDL cholesterol compared with omnivorous peers.
These differences are consistent with what is often seen in adults, though childhood nutrition has distinct requirements and trade offs.
The review also found that children on plant based diets tended to be leaner.
Vegetarian children were, on average, slightly shorter and lighter with lower body mass index, lower fat mass and lower bone mineral content.
Vegan children also tended to show shorter stature and lower BMI.
These are average differences across populations rather than a prediction for any individual child, and they likely reflect a mix of diet quality, energy intake, family habits and socioeconomic factors.
The practical takeaway is not that plant based diets are inherently risky, but that they are less forgiving.
- Risk of multiple long-term conditions reduced by plant-based diets
- Vegan protein sources as effective as animal protein for muscle building
Families choosing vegetarian or vegan diets for ethical, environmental or health reasons need to plan with intent. That usually means ensuring reliable vitamin B12 intake, checking calcium sources and thinking about iodine, iron and zinc, using fortified foods or supplements where needed.
The authors also note limitations in the research base.
Many studies were cross sectional, dietary assessment varies and measuring what children actually eat is hard. That uncertainty is exactly why parents often receive inconsistent advice.
The review argues for clearer evidence based guidance so families can make plant based diets work safely during childhood.
