title: The effect of vegetarian diet on selected essential nutrients in children.
abstract: BACKGROUND
  Vegetarian diets are considered to promote health and reduce the risk of some chronic diseases. It is also known that restriction or exclusion of animal foods may result in low intake of essential nutrients. The aim of the presented study was to assess the intake and serum status of vitamin B12, folate, vitamins A, E and D, as well as concentrations of homocysteine, total antioxidant status and iron balance in Polish vegetarian children.
  
  
  METHODS
  The study included 50 children, aged 5-11 who had been referred to the Institute of Mother and Child for dietary consultation. From those, 32 were vegetarians (aged 6.5±4.2 years) and 18 omnivores (aged 7.9±2.7 years). Dietary constituents were analyzed using the nutritional programme Dietetyk2®. Folate and vitamin B12 were determined with a chemiluminescence immunoassay, total homocysteine with a fluorescence polarization immunoassay and TAS (total antioxidant status) by colorimetric method. Vitamin A and E in serum were determined by the high-pressure liquid chromatography method (HPLC) and vitamin D by immunoenzymatic assay (ELISA). Concentrations of iron, ferritin, transferrin and total iron-binding capacity (TIBC) in serum were determined by commercially available kits.
  
  
  RESULTS
  In vegetarian children daily intake of vitamin B12 (1.6 ěg) was in the recommended range, that of folate (195 ěg) and vitamin A (1245 ěg) higher, but vitamin E slightly lower (6.6 ěg) and three-fold lower vitamin D (1.1 ěg) than references allowance. Serum concentrations of vitamin B12 (548 pg/ml), folate (12.8 ng/ml), vitamin A (1.2 ěmol/L), vitamin E (15.6 ěmol/l) were within physiological range, but that of vitamin D (13.7 ěg/L) was only half of the lowest limit of the reference value. In vegetarian children in comparison to omnivorous similar levels of homocysteine (6.13 ěmol/L vs 5.45 ěmol/L) and vitamin A (1,17 ěmol/L vs 1.32 ěmol/L) were observed. Lower (p<0.05) values of vitamin E (15.6 ěmol/L vs 18.4 ěmol/L) and TAS (1.21 mmol/L vs 1.30 mmol/L; p<0.0001) were found. Concentrations of iron markers were in physiological range.
  
  
  CONCLUSIONS
  Obtained results indicated that intakes of vitamin B12 and folic acid from vegetarian diets are sufficient to maintain serum concentrations of both homocysteine and iron in the range observed in omnivorous children. High consumption of vitamin A and low vitamin E only slightly affected their serum values. Significantly lower concentration of serum vitamin E in vegetarian children in comparison to nonvegetarians may be reflected with statistically significant lowering of total antioxidant status. Insufficient intake of vitamin D and its low serum concentration should be under close monitoring in vegetarian children. In order to prevent vitamin D deficiency appropriate age-dependent supplementation should be considered.
authors: Screening Test Department, Institute of Mother and Child, Warsaw. lipidy.imid@imid.med.pl
authors: Teresa
authors: T
authors: Laskowska-Klita
authors: Magdalena
authors: M
authors: Chełchowska
authors: Jadwiga
authors: J
authors: Ambroszkiewicz
authors: Joanna
authors: J
authors: Gajewska
authors: Witold
authors: W
authors: Klemarczyk
mesh_terms: D000975:Antioxidants / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002669:Child Welfare; D014676:Diet, Vegetarian / Q000009:adverse effects* / Q000706:statistics & numerical data; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D008297:Male; D009752:Nutritional Status; D011044:Poland; D014801:Vitamin A / Q000097:blood*; D014805:Vitamin B 12 / Q000097:blood*; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D014810:Vitamin E / Q000097:blood*
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; D005492:Folic Acid; D014805:Vitamin B 12