Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate®

Vegetarian diets for children

Debby Demory-Luce, PhD, RD, LD
Kathleen J Motil, MD, PhD
Section Editors
Jan E Drutz, MD
Amy B Middleman, MD, MPH, MS Ed
Deputy Editor
Alison G Hoppin, MD


Vegetarian diets are becoming increasingly popular [1-5]. A poll conducted in the United States in 2016 estimated that 3.3 percent of adult Americans (8 million) indicated that they follow a vegetarian or vegan diet, while 1.5 percent (3.7 million) follow a vegan diet [6]. In this survey, "vegetarian" was defined as no meat, fish or poultry, and "vegan" as no meat, fish, poultry, dairy products, or eggs. When eating away from home, 37 percent (91 million) reported that they "sometimes or always" eat vegetarian or vegan meals; 5 percent (12 million) "always" choose vegetarian meals; and 3 percent (7 million) "always" choose vegan meals. As a result, more food companies and restaurants are offering vegetarian options, such as a vegan burger or vegan ice cream. Approximately 8 to 10 percent of adults in Germany, Austria, Italy and the United Kingdom describe themselves as vegetarians [7,8].

An increasing number of children and adolescents maintain a vegetarian eating style [9-11]. An estimated 8 percent of adolescents in the United Kingdom [12] and 6 percent of public middle- and high-school students surveyed in the midwestern United States [13] consume a vegetarian diet. A poll conducted in 2014 estimated that 4 percent (2 million) of American youth aged 8 to 18 years are vegetarian or vegan, 3 percent (1.5 million) do not eat meat, fish, or poultry, and 1 percent (500,000) do not eat meat, fish, poultry, dairy, or eggs [14]. In addition, an estimated 32 percent (15 million) of American youth eat one or more vegetarian meals per week; 4 percent "always" have vegetarian or vegan meals and 1 percent "always" have vegan meals.

Studies of vegetarian diets are complicated by variations in definitions for the term "vegetarian." Definitions range from whether the individual considers himself or herself as vegetarian ("self-defined" vegetarians), avoids meat only, or lives by the strict definition (never consuming meat, fish, and poultry). As an example, one review of dietary patterns and nutrient intakes of self-defined vegetarians (aged six years and older) found that patterns ranged from those who consumed reduced amounts of red meat but included poultry and fish, to those who excluded all animal foods [15].

Reasons for choosing a vegetarian diet are varied and include potential health benefits and sociopolitical, ecological, and ethical issues related to allocation of resources and animal rights [2,4,5,16-22]. In some cases, and particularly among adolescents, it may be difficult to distinguish whether a choice to eat a vegetarian diet is related to health or ethical concerns, versus a desire for dietary restriction [23,24]. The types and composition of vegetarian diets also are varied and have important implications for the growth and development of children and adolescents.

The best available data regarding the nutritional quality of vegetarian diets and strategies to prevent nutritional deficiencies while consuming vegetarian diets are reviewed here. Nutrition requirements, deficiencies, and supplementation of specific nutrients are discussed separately. (See appropriate topic reviews).


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Aug 2017. | This topic last updated: Aug 30, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Craig WJ. Health effects of vegan diets. Am J Clin Nutr 2009; 89:1627S.
  2. Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet 2016; 116:1970.
  3. Schürmann S, Kersting M, Alexy U. Vegetarian diets in children: a systematic review. Eur J Nutr 2017; 56:1797.
  4. Appleby PN, Key TJ. The long-term health of vegetarians and vegans. Proc Nutr Soc 2016; 75:287.
  5. Vegetarian resource group: How many adults in the U.S. are vegetarian and vegan? Available at: http://www.vrg.org/nutshell/Polls/2016_adults_veg.htm (Accessed on July 06, 2017).
  6. Stahler C. How many adults in the US are vegetarian and vegan? How many adults eat vegetarian and vegan meals when eating out? Vegetarian Resource Group, National Harris Poll, 2016. http://www.vrg.org/nutshell/Polls/2016_adults_veg.htm (Accessed on July 16, 2017).
  7. Sawe BE. Countries with the highest rates of vegetarianism. World Atlas.com. Available on May 1, 2016. Available at: http://www.worldatlas.com/articles/countries-with-the-highest-rates-of-vegetarianism.html (Accessed on July 18, 2017).
  8. VEBU Vegetarierbund Deutschland. Anzahl der veganer und vegetarier in Deutschland, 2016. https://vebu.de/veggie-fakten/entwicklung-in-zahlen/anzahl-veganer-und-vegetarier-in-deutschland/ (Accessed on July 18, 2017).
  9. Hebbelinck M, Clarys P, De Malsche A. Growth, development, and physical fitness of Flemish vegetarian children, adolescents, and young adults. Am J Clin Nutr 1999; 70:579S.
  10. Nathan I, Hackett AF, Kirby S. A longitudinal study of the growth of matched pairs of vegetarian and omnivorous children, aged 7-11 years, in the north-west of England. Eur J Clin Nutr 1997; 51:20.
  11. Van Winckel M, Vande Velde S, De Bruyne R, Van Biervliet S. Clinical practice: vegetarian infant and child nutrition. Eur J Pediatr 2011; 170:1489.
  12. Vegetarian Society, UK. Trends in vegetarianism among adults and young people. Vegetarian Society, Altrincham, United Kingdom 1991.
  13. Perry CL, Mcguire MT, Neumark-Sztainer D, Story M. Characteristics of vegetarian adolescents in a multiethnic urban population. J Adolesc Health 2001; 29:406.
  14. Stahler C. How many teens and other youth are vegetarian and vegan? The vegetarian resource group asks in a 2014 national poll. http://www.vrg.org/blog/2014/5/30/how-many-teens-and-other-youth-are-vegetarian-and-vegan-the-vegetarian-resource-group-asks-in-a-2014-national-poll/ (Accessed on July 16, 2017).
  15. Haddad EH, Tanzman JS. What do vegetarians in the United States eat? Am J Clin Nutr 2003; 78:626S.
  16. Leitzmann C. Vegetarian diets: what are the advantages? Forum Nutr 2005:147.
  17. Johnston PK, Haddad E, Sabate J. The Vegetarian Adolescent. Adolesc Med 1992; 3:417.
  18. Johnston PK, Sabate J. Nutritional implications of vegetarian diets. In: Modern nutrition in health and disease, 10, Shils ME, Shike M, Ross AC, et al (Eds), Lippincott Williams & Wilkins, Baltimore 2006. p.1638.
  19. Fox N, Ward K. Health, ethics and environment: a qualitative study of vegetarian motivations. Appetite 2008; 50:422.
  20. Crowe FL, Appleby PN, Travis RC, Key TJ. Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. Am J Clin Nutr 2013; 97:597.
  21. Orlich MJ, Singh PN, Sabaté J, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med 2013; 173:1230.
  22. Mullee A, Vermeire L, Vanaelst B, et al. Vegetarianism and meat consumption: A comparison of attitudes and beliefs between vegetarian, semi-vegetarian, and omnivorous subjects in Belgium. Appetite 2017; 114:299.
  23. Renda M, Fischer P. Vegetarian diets in children and adolescents. Pediatr Rev 2009; 30:e1.
  24. Greene-Finestone LS, Campbell MK, Evers SE, Gutmanis IA. Attitudes and health behaviours of young adolescent omnivores and vegetarians: a school-based study. Appetite 2008; 51:104.
  25. Orlich MJ, Jaceldo-Siegl K, Sabaté J, et al. Patterns of food consumption among vegetarians and non-vegetarians. Br J Nutr 2014; 112:1644.
  26. Di Genova T, Guyda H. Infants and children consuming atypical diets: Vegetarianism and macrobiotics. Paediatr Child Health 2007; 12:185.
  27. Le LT, Sabaté J. Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients 2014; 6:2131.
  28. Dominique Ashen M. Vegetarian diets in cardiovascular prevention. Curr Treat Options Cardiovasc Med 2013; 15:735.
  29. Sabaté J, Wien M. Vegetarian diets and childhood obesity prevention. Am J Clin Nutr 2010; 91:1525S.
  30. Sabaté J, Wien M. A perspective on vegetarian dietary patterns and risk of metabolic syndrome. Br J Nutr 2015; 113 Suppl 2:S136.
  31. Appel LJ. The Effects of Dietary Factors on Blood Pressure. Cardiol Clin 2017; 35:197.
  32. Yokoyama Y, Barnard ND, Levin SM, Watanabe M. Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis. Cardiovasc Diagn Ther 2014; 4:373.
  33. Dinu M, Abbate R, Gensini GF, et al. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr 2017; 57:3640.
  34. Barnard ND, Levin SM, Yokoyama Y. A systematic review and meta-analysis of changes in body weight in clinical trials of vegetarian diets. J Acad Nutr Diet 2015; 115:954.
  35. Mihrshahi S, Ding D, Gale J, et al. Vegetarian diet and all-cause mortality: Evidence from a large population-based Australian cohort - the 45 and Up Study. Prev Med 2017; 97:1.
  36. Weaver CM. Should dairy be recommended as part of a healthy vegetarian diet? Point. Am J Clin Nutr 2009; 89:1634S.
  37. Federici E, Prete R, Lazzi C, et al. Bacterial Composition, Genotoxicity, and Cytotoxicity of Fecal Samples from Individuals Consuming Omnivorous or Vegetarian Diets. Front Microbiol 2017; 8:300.
  38. Phillips F . Vegetarian nutrition. Nutr Bull 2005; 30:132.
  39. Sanders TA, Manning J. The growth and development of vegan children. J Hum Nutr Diet 1992; 5:11.
  40. Sabaté J, Lindsted KD, Harris RD, Sanchez A. Attained height of lacto-ovo vegetarian children and adolescents. Eur J Clin Nutr 1991; 45:51.
  41. O'Connell JM, Dibley MJ, Sierra J, et al. Growth of vegetarian children: The Farm Study. Pediatrics 1989; 84:475.
  42. Dwyer JT, Andrew EM, Valadian I, Reed RB. Size, obesity, and leanness in vegetarian preschool children. J Am Diet Assoc 1980; 77:434.
  43. Shull MW, Reed RB, Valadian I, et al. Velocities of growth in vegetarian preschool children. Pediatrics 1977; 60:410.
  44. Fulton JR, Hutton CW, Stitt KR. Preschool vegetarian children. Dietary and anthropometric data. J Am Diet Assoc 1980; 76:360.
  45. Dagnelie PC, van Staveren WA, van Klaveren JD, Burema J. Do children on macrobiotic diets show catch-up growth? A population-based cross-sectional study in children aged 0-8 years. Eur J Clin Nutr 1988; 42:1007.
  46. Van Dusseldorp M, Arts IC, Bergsma JS, et al. Catch-up growth in children fed a macrobiotic diet in early childhood. J Nutr 1996; 126:2977.
  47. Gibson RS, Heath AL, Szymlek-Gay EA. Is iron and zinc nutrition a concern for vegetarian infants and young children in industrialized countries? Am J Clin Nutr 2014; 100 Suppl 1:459S.
  48. Tucker KL. Vegetarian diets and bone status. Am J Clin Nutr 2014; 100 Suppl 1:329S.
  49. Saunders AV, Davis BC, Garg ML. Omega-3 polyunsaturated fatty acids and vegetarian diets. Med J Aust 2013; 199:S22.
  50. Botero D, Wolfsdorf JI. Diabetes mellitus in children and adolescents. Arch Med Res 2005; 36:281.
  51. Franko DL, Albertson AM, Thompson DR, Barton BA. Cereal consumption and indicators of cardiovascular risk in adolescent girls. Public Health Nutr 2011; 14:584.
  52. Mikkilä V, Räsänen L, Raitakari OT, et al. Major dietary patterns and cardiovascular risk factors from childhood to adulthood. The Cardiovascular Risk in Young Finns Study. Br J Nutr 2007; 98:218.
  53. Uauy R, Solomons N. Diet, nutrition, and the life-course approach to cancer prevention. J Nutr 2005; 135:2934S.
  54. Lassi ZS, Mansoor T, Salam RA, et al. Review of nutrition guidelines relevant for adolescents in low- and middle-income countries. Ann N Y Acad Sci 2017; 1393:51.
  55. Lloyd LJ, Langley-Evans SC, McMullen S. Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obes (Lond) 2012; 36:1.
  56. Banfield EC, Liu Y, Davis JS, et al. Poor Adherence to US Dietary Guidelines for Children and Adolescents in the National Health and Nutrition Examination Survey Population. J Acad Nutr Diet 2016; 116:21.
  57. Funtikova AN, Navarro E, Bawaked RA, et al. Impact of diet on cardiometabolic health in children and adolescents. Nutr J 2015; 14:118.
  58. Appel LJ, Lichtenstein AH, Callahan EA, et al. Reducing Sodium Intake in Children: A Public Health Investment. J Clin Hypertens (Greenwich) 2015; 17:657.
  59. Venti CA, Johnston CS. Modified food guide pyramid for lactovegetarians and vegans. J Nutr 2002; 132:1050.
  60. Messina V, Melina V, Mangels AR. A new food guide for North American vegetarians. J Am Diet Assoc 2003; 103:771.
  61. Perry CL, McGuire MT, Neumark-Sztainer D, Story M. Adolescent vegetarians: how well do their dietary patterns meet the healthy people 2010 objectives? Arch Pediatr Adolesc Med 2002; 156:431.
  62. Turner-McGrievy GM, Hales SB, Baum AC. Transitioning to new child-care nutrition policies: nutrient content of preschool menus differs by presence of vegetarian main entrée. J Acad Nutr Diet 2014; 114:117.
  63. Fox N, Ward KJ. You are what you eat? Vegetarianism, health and identity. Soc Sci Med 2008; 66:2585.
  64. Robinson-O'Brien R, Perry CL, Wall MM, et al. Adolescent and young adult vegetarianism: better dietary intake and weight outcomes but increased risk of disordered eating behaviors. J Am Diet Assoc 2009; 109:648.
  65. Jacobs C, Dwyer JT. Vegetarian children: appropriate and inappropriate diets. Am J Clin Nutr 1988; 48:811.
  66. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. National Academies Press, Washington DC, 2005. Available at: http://www.nap.edu/catalog.php?record_id=10490 (Accessed on December 02, 2010).
  67. Larsson CL, Johansson GK. Young Swedish vegans have different sources of nutrients than young omnivores. J Am Diet Assoc 2005; 105:1438.
  68. Haddad EH, Sabaté J, Whitten CG. Vegetarian food guide pyramid: a conceptual framework. Am J Clin Nutr 1999; 70:615S.
  69. Stonehouse W. Does consumption of LC omega-3 PUFA enhance cognitive performance in healthy school-aged children and throughout adulthood? Evidence from clinical trials. Nutrients 2014; 6:2730.
  70. Rosell MS, Lloyd-Wright Z, Appleby PN, et al. Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men. Am J Clin Nutr 2005; 82:327.
  71. Craddock JC, Neale EP, Probst YC, Peoples GE. Algal supplementation of vegetarian eating patterns improves plasma and serum docosahexaenoic acid concentrations and omega-3 indices: a systematic literature review. J Hum Nutr Diet 2017.
  72. Koletzko B, Beblo S, Demmelmair H, Hanebutt FL. Omega-3 LC-PUFA supply and neurological outcomes in children with phenylketonuria (PKU). J Pediatr Gastroenterol Nutr 2009; 48 Suppl 1:S2.
  73. Craig WJ, Mangels AR, American Dietetic Association. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc 2009; 109:1266.
  74. Young VR. Soy protein in relation to human protein and amino acid nutrition. J Am Diet Assoc 1991; 91:828.
  75. Fomon SJ, Ziegler EE, Nelson SE, Edwards BB. Requirement for sulfur-containing amino acids in infancy. J Nutr 1986; 116:1405.
  76. Fomon SJ, Ziegler EE, Filer LJ Jr, et al. Methionine fortification of a soy protein formula fed to infants. Am J Clin Nutr 1979; 32:2460.
  77. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994; 59:1203S.
  78. Young VR, Wayler A, Garza C, et al. A long-term metabolic balance study in young men to assess the nutritional quality of an isolated soy protein and beef proteins. Am J Clin Nutr 1984; 39:8.
  79. Messina V, Mangels AR. Considerations in planning vegan diets: children. J Am Diet Assoc 2001; 101:661.
  80. Johnston PK, Sabate, J. Nutritional implications of vegetarian diets. In: Modern nutrition in health and disease, 10 Ed, Shils ME, Shike M, Ross, AC, et al (Eds), Lippincott Williams & Wilkins, Baltiomore 2006. p.1641.
  81. Thane CW, Bates CJ, Prentice A. Risk factors for low iron intake and poor iron status in a national sample of British young people aged 4-18 years. Public Health Nutr 2003; 6:485.
  82. Domellöf M, Braegger C, Campoy C, et al. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr 2014; 58:119.
  83. Clénin GE. The treatment of iron deficiency without anaemia (in otherwise healthy persons). Swiss Med Wkly 2017; 147:w14434.
  84. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Available at: http://www.nap.edu/catalog.php?record_id=10026 (Accessed on December 02, 2010).
  85. Pawlak R, Bell K. Iron Status of Vegetarian Children: A Review of Literature. Ann Nutr Metab 2017; 70:88.
  86. Ambroszkiewicz J, Klemarczyk W, Mazur J, et al. Serum Hepcidin and Soluble Transferrin Receptor in the Assessment of Iron Metabolism in Children on a Vegetarian Diet. Biol Trace Elem Res 2017.
  87. Murphy SP, Allen LH. Nutritional importance of animal source foods. J Nutr 2003; 133:3932S.
  88. Fairweather-Tait S, Hurrell RF. Bioavailability of minerals and trace elements. Nutr Res Rev 1996; 9:295.
  89. Roughead ZK, Hunt JR. Adaptation in iron absorption: iron supplementation reduces nonheme-iron but not heme-iron absorption from food. Am J Clin Nutr 2000; 72:982.
  90. Hallberg L, Hulthén L. Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron. Am J Clin Nutr 2000; 71:1147.
  91. Hunt JR. Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 2003; 78:633S.
  92. Craig WJ. Iron status of vegetarians. Am J Clin Nutr 1994; 59:1233S.
  93. Gorczyca D, Prescha A, Szeremeta K, Jankowski A. Iron status and dietary iron intake of vegetarian children from Poland. Ann Nutr Metab 2013; 62:291.
  94. Dwyer JT, Dietz WH Jr, Andrews EM, Suskind RM. Nutritional status of vegetarian children. Am J Clin Nutr 1982; 35:204.
  95. Chiplonkar SA, Tupe R. Development of a diet quality index with special reference to micronutrient adequacy for adolescent girls consuming a lacto-vegetarian diet. J Am Diet Assoc 2010; 110:926.
  96. Hallberg L, Brune M, Rossander L. Effect of ascorbic acid on iron absorption from different types of meals. Studies with ascorbic-acid-rich foods and synthetic ascorbic acid given in different amounts with different meals. Hum Nutr Appl Nutr 1986; 40:97.
  97. Siegenberg D, Baynes RD, Bothwell TH, et al. Ascorbic acid prevents the dose-dependent inhibitory effects of polyphenols and phytates on nonheme-iron absorption. Am J Clin Nutr 1991; 53:537.
  98. Sandström B. Micronutrient interactions: effects on absorption and bioavailability. Br J Nutr 2001; 85 Suppl 2:S181.
  99. Anderson GH, Zlotkin SH. Developing and implementing food-based dietary guidance for fat in the diets of children. Am J Clin Nutr 2000; 72:1404S.
  100. Harland BF, Morris ER. Phytate: a good or a bad food component? Nutr Res 1995; 15:733.
  101. Gibson RS, Hotz C. Dietary diversification/modification strategies to enhance micronutrient content and bioavailability of diets in developing countries. Br J Nutr 2001; 85 Suppl 2:S159.
  102. Hunt JR. Moving toward a plant-based diet: are iron and zinc at risk? Nutr Rev 2002; 60:127.
  103. Foster M, Samman S. Vegetarian diets across the lifecycle: impact on zinc intake and status. Adv Food Nutr Res 2015; 74:93.
  104. Haddad EH. Development of a vegetarian food guide. Am J Clin Nutr 1994; 59:1248S.
  105. Matkovic V, Fontana D, Tominac C, et al. Factors that influence peak bone mass formation: a study of calcium balance and the inheritance of bone mass in adolescent females. Am J Clin Nutr 1990; 52:878.
  106. Matkovic V, Heaney RP. Calcium balance during human growth: evidence for threshold behavior. Am J Clin Nutr 1992; 55:992.
  107. Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary calcium with a vegetarian diet. Am J Clin Nutr 1999; 70:543S.
  108. Greer FR, Krebs NF, American Academy of Pediatrics Committee on Nutrition. Optimizing bone health and calcium intakes of infants, children, and adolescents. Pediatrics 2006; 117:578.
  109. Heaney RP. Protein intake and the calcium economy. J Am Diet Assoc 1993; 93:1259.
  110. Breslau NA, Brinkley L, Hill KD, Pak CY. Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocrinol Metab 1988; 66:140.
  111. Tayter M, Stanek KL. Anthropometric and dietary assessment of omnivore and lacto-ovo-vegetarian children. J Am Diet Assoc 1989; 89:1661.
  112. Donovan UM, Gibson RS. Dietary intakes of adolescent females consuming vegetarian, semi-vegetarian, and omnivorous diets. J Adolesc Health 1996; 18:292.
  113. Mangels AR. Bone nutrients for vegetarians. Am J Clin Nutr 2014; 100 Suppl 1:469S.
  114. Movassagh EZ, Vatanparast H. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review. Adv Nutr 2017; 8:1.
  115. Sanders TA. Vegetarian diets and children. Pediatr Clin North Am 1995; 42:955.
  116. Tesar R, Notelovitz M, Shim E, et al. Axial and peripheral bone density and nutrient intakes of postmenopausal vegetarian and omnivorous women. Am J Clin Nutr 1992; 56:699.
  117. Dagnelie PC, van Dusseldorp M, van Staveren WA, Hautvast JG. Effects of macrobiotic diets on linear growth in infants and children until 10 years of age. Eur J Clin Nutr 1994; 48 Suppl 1:S103.
  118. Haddad EH. Meeting the RDAs with a vegetarian diet. Top Clin Nutr 1995; 10:7.
  119. Heaney RP, Dowell MS, Rafferty K, Bierman J. Bioavailability of the calcium in fortified soy imitation milk, with some observations on method. Am J Clin Nutr 2000; 71:1166.
  120. Bonjour JP, Carrie AL, Ferrari S, et al. Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest 1997; 99:1287.
  121. Dietary supplement fact sheet: vitamin D. Office of Dietary Supplements, National Institute of Health, Bethesda, MD, 2008 http://ods.od.nih.gov/factsheets/vitamind.asp (Accessed on October 10, 2015).
  122. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for calcium and vitamin D. National Academy Press, Washington DC, 2010. Available at: http://books.nap.edu/openbook.php?record_id=13050 (Accessed on December 02, 2010).
  123. Elsori DH, Hammoud MS. Vitamin D deficiency in mothers, neonates and children. J Steroid Biochem Mol Biol 2017.
  124. Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 2005; 135:317.
  125. Bergstrom WH. When you see rickets, consider calcium deficiency. J Pediatr 1998; 133:722.
  126. Dwyer JT, Dietz WH Jr, Hass G, Suskind R. Risk of nutritional rickets among vegetarian children. Am J Dis Child 1979; 133:134.
  127. Hellebostad M, Markestad T, Seeger Halvorsen K. Vitamin D deficiency rickets and vitamin B12 deficiency in vegetarian children. Acta Paediatr Scand 1985; 74:191.
  128. Parsons TJ, van Dusseldorp M, van der Vliet M, et al. Reduced bone mass in Dutch adolescents fed a macrobiotic diet in early life. J Bone Miner Res 1997; 12:1486.
  129. Dagnelie PC, Vergote FJ, van Staveren WA, et al. High prevalence of rickets in infants on macrobiotic diets. Am J Clin Nutr 1990; 51:202.
  130. Laskowska-Klita T, Chełchowska M, Ambroszkiewicz J, et al. The effect of vegetarian diet on selected essential nutrients in children. Med Wieku Rozwoj 2011; 15:318.
  131. Herrmann W, Geisel J. Vegetarian lifestyle and monitoring of vitamin B-12 status. Clin Chim Acta 2002; 326:47.
  132. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline, National Academy Press, Washington DC, 1998. Available at: http://www.nap.edu/catalog.php?record_id=6015 (Accessed on December 02, 2010).
  133. Allen LH. Causes of vitamin B12 and folate deficiency. Food Nutr Bull 2008; 29:S20.
  134. Pawlak R, Lester SE, Babatunde T. The prevalence of cobalamin deficiency among vegetarians assessed by serum vitamin B12: a review of literature. Eur J Clin Nutr 2014; 68:541.
  135. Haddad EH, Berk LS, Kettering JD, et al. Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians. Am J Clin Nutr 1999; 70:586S.
  136. Dong A, Scott SC. Serum vitamin B12 and blood cell values in vegetarians. Ann Nutr Metab 1982; 26:209.
  137. Dagnelie PC, van Staveren WA, van den Berg H. Vitamin B-12 from algae appears not to be bioavailable. Am J Clin Nutr 1991; 53:695.
  138. Burke KI. The use of soy foods in a vegetarian diet. Top Clin Nutr 1995; 10:37.
  139. Davies GJ, Crowder M, Dickerson JW. Dietary fibre intakes of individuals with different eating patterns. Hum Nutr Appl Nutr 1985; 39:139.
  140. Dagnelie PC, van Staveren WA, Hautvast JG. Stunting and nutrient deficiencies in children on alternative diets. Acta Paediatr Scand Suppl 1991; 374:111.
  141. Williams CL, Bollella M. Is a high-fiber diet safe for children? Pediatrics 1995; 96:1014.
  142. Agostoni C, Riva E, Giovannini M. Dietary fiber in weaning foods of young children. Pediatrics 1995; 96:1002.
  143. Davidsson L, Mackenzie J, Kastenmayer P, et al. Dietary fiber in weaning cereals: a study of the effect on stool characteristics and absorption of energy, nitrogen, and minerals in healthy infants. J Pediatr Gastroenterol Nutr 1996; 22:167.
  144. Dagnelie PC, van Staveren WA. Macrobiotic nutrition and child health: results of a population-based, mixed-longitudinal cohort study in The Netherlands. Am J Clin Nutr 1994; 59:1187S.
  145. Amit M. Vegetarian diets in children and adolescents. Paediatr Child Health 2010; 15:303.
  146. Johnston PK. Vegetarians among us: Implications for health professionals. Top Clin Nutr 1995; 10:1.