Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, Cork, Ireland.
INFANT Maternal and Child Research Centre, College of Medicine and Health, University College Cork, Cork, Ireland.
Proc Nutr Soc. 2021 May;80(2):159-164. doi: 10.1017/S002966512100001X. Epub 2021 Jan 28.
In parallel with increased public awareness of the health and environmental benefits of consuming a plant-based diet, the numbers of people who identify as vegan has increased sharply. The question of whether vegetarian and vegan diets are appropriate for children is a longstanding and unresolved controversy. The more restrictive the diet and the younger the child, the greater the risk of nutritional deficiency. Nutrients of potential concern are protein quantity and quality, iron, zinc, selenium, calcium, riboflavin, vitamins A, D, B12 and essential fatty acids. Although intakes and status of some nutrients (e.g. vitamin D and iron) are low in many children, vegan children are particularly susceptible due to inadequate supply and/or excess dietary fibre as well as other components that limit bioavailability. Although position papers from North America state that well-planned vegetarian and vegan diets, supplemented appropriately, are suitable for all life stages, European statements include strong recommendations to parents that vegan diets should not be adopted by children without medical and dietetic supervision. Case histories of malnutrition and serious harm persist, including irreversible neurological damage due to vitamin B12 deficiency among un-supplemented children. The evidence available to evaluate the nutritional appropriateness of vegetarian diets for children is inadequate and dated. Although nutritionally adequate vegetarian diets are more easily achieved, successful provision of a complete vegan diet for a young child requires substantial commitment, expert guidance, planning, resources and supplementation.
随着公众对植物性饮食在健康和环境方面的益处的认识不断提高，自称为素食者的人数急剧增加。素食和纯素饮食是否适合儿童一直是一个长期存在且未解决的争议。饮食限制越严格，儿童年龄越小，营养缺乏的风险就越大。潜在需要关注的营养素是蛋白质的数量和质量、铁、锌、硒、钙、核黄素、维生素 A、D、B12 和必需脂肪酸。尽管许多儿童的某些营养素（例如维生素 D 和铁）摄入量和状况较低，但由于供应不足和/或膳食纤维过多以及其他限制生物利用度的成分，纯素食儿童尤其容易受到影响。尽管北美发表的立场声明指出，精心计划的素食和纯素饮食，适当补充，适合所有生命阶段，但欧洲的声明强烈建议家长，在没有医疗和饮食监督的情况下，儿童不应采用纯素饮食。营养不良和严重伤害的案例仍然存在，包括未经补充的儿童因维生素 B12 缺乏而导致的不可逆转的神经损伤。评估儿童素食饮食的营养适宜性的现有证据不足且陈旧。尽管营养充足的素食饮食更容易实现，但要为幼儿提供完整的纯素饮食，需要大量的承诺、专家指导、计划、资源和补充。
