Largest review to-date finds plant‑based diets can support healthy growth in children — with careful planning

A major global meta‑analysis has concluded that vegetarian and vegan diets can support healthy growth in children, provided they are well planned and include appropriate supplementation.

The review – the most comprehensive assessment to date of plant‑based eating in young people – also found that children on vegetarian and vegan diets often show improved cardiovascular health markers compared with omnivores.

The peer‑reviewed study, published in Critical Reviews in Food Science and Nutrition, analysed data from 59 studies across 18 countries, covering more than 48,000 children and adolescents. Researchers from Italy, the US and Australia compared nutrient intake, growth and health outcomes among 7,280 lacto‑ovo‑vegetarians, 1,289 vegans and 40,059 omnivores.

Higher fibre and micronutrient intake – but key gaps without supplements

The analysis found that vegetarian children typically consumed more fibre, iron, folate, vitamin C and magnesium than their omnivorous peers. However, they also had lower intakes of energy, protein, fat, vitamin B12 and zinc. Similar patterns were observed among vegan children, with calcium intake emerging as a particular concern.

“Vitamin B12 didn’t reach adequate levels without supplementation or fortified foods, and calcium, iodine and zinc intakes were often at the lower end of recommended ranges,” said co‑author Dr Jeannette Beasley of New York University. “Vegan children, in particular, had especially low calcium intake.”

Cardiovascular benefits and leaner body composition

Despite nutrient shortfalls, the study found consistent evidence of cardiovascular advantages among children on plant‑based diets. Both vegetarian and vegan groups showed lower total and LDL (“bad”) cholesterol levels than omnivores.

Body composition data indicated that plant‑based children tended to be leaner. Vegetarian and vegan children were, on average, slightly shorter and lighter, with lower BMI and fat mass. Bone mineral content was also lower, particularly among vegans — a finding the authors link to lower calcium intake.

Lead author Dr Monica Dinu of the University of Florence said the evidence supports the nutritional adequacy of plant‑based diets when properly managed. “Well‑planned and appropriately supplemented vegetarian and vegan diets can meet nutritional requirements and support healthy growth in children,” she said.

Clearer guidance needed for families

The researchers emphasised that plant‑based diets remain a viable option for families choosing them for ethical, environmental or health reasons. However, they stressed the importance of planning and professional guidance, particularly during periods of rapid growth.

They recommend that parents pay close attention to a small number of critical nutrients – especially vitamin B12, calcium, iodine, iron and zinc – and use fortified foods or supplements where needed.

Dr Dinu said the findings should help clarify the mixed messages parents often receive. “We hope these findings offer clearer guidance on both the benefits and potential risks of plant‑based diets,” she noted.

Call for more robust research

The authors also highlighted limitations in the existing evidence base. Many of the included studies were cross‑sectional, used differing methodologies, or relied on self‑reported dietary intake – all of which can affect accuracy.

Dr Wolfgang Marx of Deakin University said more rigorous research is needed to inform consistent dietary recommendations. “While well‑planned vegetarian and vegan diets are nutritionally adequate and beneficial for adults, there is far less clarity about their suitability for children,” he said. “A balanced approach is essential.”

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