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My child wants to be a vegetarian. Is that ok?

Natalie D. Muth, MD, MPH, RDN, FAAP

Answer

Vegetarian diets are healthy for kids, as long as they get key nutrients needed to grow healthy and strong. This can take some extra planning at mealtime, though.

About 5% of children are vegetarian and 2% are vegan, according to a national survey commissioned by the Vegetarian Resource Group.

Vegetarian diets are becoming more common. Reasons range from healthfulness to concerns about animal welfare or the environment.

It’s important your child understands that a "vegetarian" diet literally means a vegetable-based diet. Some kids who stop eating meat may just start eating more bread or pasta. This may fill them up, but won’t give them balanced nutrition they need.

Have a vegetarian eating plan

Overall, vegetarian diets tend to be low in saturated fat and animal protein and high in fiber, folate, vitamins C and E, carotenoids, and some phytochemicals. Children and adolescents who follow a vegetarian eating plan tend to consume more fruits and vegetables and less sweets, salty snacks, and saturated fat than their nonvegetarian peers. They also tend to be at lower risk for overweight and obesity. 

In the past, experts worried that following a vegetarian diet would lead to nutritional deficiencies in children. Today, we know that’s generally not the case with well planned vegetarian eating plans that include enough of the following nutrients:

  • Protein. Children who follow a vegetarian plan tend to get enough protein variety and quantity. Regularly eating legumes (such as beans, peas, lentils, peanuts and soy) helps ensure they'll get enough. Vegan children and adolescents may need to eat more of these foods than nonvegan children, because plants don't always have the same level of protein found in dairy and eggs.

  • Iron. Iron from vegetarian sources (non-heme iron) is not as high quality as that from nonvegetarian sources. Being low in iron is common in children in general, and more so in children who follow a vegetarian eating plan. Overall, vegetarians need about 1.8 times higher iron intake compared to non-vegetarians.
    Excellent vegetarian sources of iron include soy, lentils, chickpeas, black-eyed peas, beans, and seeds like sesame, and hemp. Vitamin C enhances iron absorption. Excellent sources of vitamin C include citrus fruits, cantaloupe, kiwi, mango, papaya, pineapple, strawberries, broccoli, brussels sprouts, green and red peppers, and leafy green vegetables.
  • Zinc. Zinc levels may be lower in children following a vegetarian diet, although deficiency is rare. Some great vegetarian sources of zinc include soy, legumes, grains, cheese, seeds, and nuts. Also, soaking and sprouting beans, grains, nuts and seeds and leavening bread can help the body better utilize zinc. So can leavening bread and fermenting foods.

  • Vitamin B12, which in nature is primarily found in animal products. There are very small amounts in some fermented foods, nori, spirulina, chlorella algae, and unfortified nutritional yeast. While most vegetarian plans contain sufficient vitamin B12, children who follow a vegan eating plan should take a vitamin B12 supplement or eat fortified foods, such as fortified nutritional yeast.

  • Calcium. The body's ability to use calcium from plant foods can be hampered by some other naturally occuring compounds such as oxalates and phytates. While spinach, beet greens, and swiss chard contain high a lot of calcium, for example, they also have high oxalates. This makes them a poor calcium source. On the other hand, low-oxalate greens such as kale, turnips, Chinese cabbage, and bok choy are good sources of calcium. So are fortified plant milks and soy, white beans, almonds, tahini, figs, and oranges.

  • Vitamin D. Few foods naturally contain vitamin D. Eggs yolks contain some. Mushrooms contain vitamin D if they've been exposed to sunlight or artificial ultraviolet (UC) light. Cow's milk, some nondairy milks, tofu, orange juice, breakfast cereals, and margarines often are fortified with vitamin D.

  • EPA + DHA Omega 3 Fatty Acids. These healthy fats, primarily found in cold-water fish, are generally low in vegetarian (and absent in vegan) eating plans. A small proportion of ALA (omega 3 from plants) is converted to EPA and DHA.  The best sources of ALA include seeds (flax, chia, camelina, canola, and hemp), walnuts, and their oils.

Be sure to talk with your pediatrician about your child’s diet during well-child visits. If there are concerns about your child’s nutrient status, particularly with regard to iron or vitamin B12, they may recommend doing a blood test to check levels.

Start by sampling

If your child is interested in a vegetarian diet, it helps to start slow. Consider "meatless Mondays," for example. Sampling vegetarian eating at one day a week lets them test it out and see if it is something they would like to continue. Be sure to use recipes from a vegetarian eating plan, rather than just leaving out the meat.

Using recipes you find (such as the Tofu and Black Bean Tacos with Creamy Cilantro Slaw included below), you can involve kids in meal preparation and cooking.

Healthychildren.org/recipes, Chopchopmag.org, and raddishkids.org->bonus bites -> recipes are some of my favorite places to access recipes that kids love.

Tofu and Black Bean Tacos with Creamy Cilantro Slaw

Vegetarian meat substitutes are often loaded with salt, oil and preservatives, which makes them a less healthy protein option. Try these protein packed tacos that are packed full with flavor!

  • 1 block firm tofu

  • ½ cup diced onion

  • 2 tablespoons of taco seasoning

  • 1 can black beans, drained

Remove tofu from container. Place in freezer bag and freeze overnight. (This extra freezing/defrosting step is optional, but it gives the tofu a meat like texture)

Defrost tofu and squeeze out excess liquid. Break tofu up into small bite sized pieces and place in a bowl.

Heat 2 tablespoons of olive oil in a medium sized pan. Place onions in pan and cook for 4-5 minutes, until onions are browned. Add tofu and black beans, then stir. Mix in taco seasoning and stir until well combined.

Creamy Cilantro Slaw:

  • 4 cups of shredded cabbage

  • ½ cup chopped cilantro

  • ½ lime, squeezed

  • ½ cup of Greek yogurt

  • ½ teaspoon of salt

Combine lime juice, yogurt and salt in a bowl. Add cabbage and cilantro. Mix until well combined.

Place tofu black bean crumbles on top of tortilla and top with cabbage slaw. Top with squeeze of lime and/or chopped avocado.

Recipe by Mary Tanaka, MD, MS, FAAP. Find more of Dr. Tanaka's kid-friendly recipes at healthychildren.org/recipes

More information

Natalie D. Muth, MD, MPH, RDN, FAAP

​Natalie D. Muth, MD, MPH, RDN, FAAP, is a pediatrician and registered dietitian who practices general pediatrics and is the director of the W.E.L.L. healthy living clinic at Children's Primary Care Medical Group in Carlsbad, CA.  She is author of the Family Fit Plan and co-author of Picky Eater Project, both published by the American Academy of Pediatrics (AAP). Find her on Twitter @drnataliemuth​ or IG @dr.nataliemuth

Last Updated
11/17/2021
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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