title: Vegetarian diets in children: a systematic review.
abstract: OBJECTIVE
  While the prevalence of children on vegetarian diets is assumed to be on the rise in industrialized countries, there are hardly any representative data available. In general, vegetarian diets are presumed to be healthy; nevertheless, there are concerns as to whether the dietary specifications required during infancy, childhood, and adolescence can be met. Therefore, the objective of this systematic review was to evaluate studies on the dietary intake and the nutritional or health status of vegetarian infants, children, and adolescents.
  
  
  METHODS
  The database MEDLINE was used for literature search. In addition, references of reviews and expert opinions were considered. Inclusion criteria were (1) sufficient dietary information to define vegetarian type diet and (2) characteristics of nutritional or health status. Case reports and studies from non-industrialized countries were excluded.
  
  
  RESULTS
  24 publications from 16 studies published from 1988 to 2013 met our criteria. Study samples covered the age range from 0 to 18 years, and median sample size was 35. Five studies did not include a control group. With regard to biomarkers, anthropometry, and dietary or nutritional intake, the outcomes were diverse. Growth and body weight were generally found within the lower reference range. The intakes of folate, vitamin C, and dietary fiber were relatively high compared to reference values and/or control groups. Low status of vitamin B12was reported in one study and low status of vitamin D in two studies.
  
  
  CONCLUSIONS
  Due to the study heterogeneity, the small samples, the bias towards upper social classes, and the scarcity of recent studies, the existing data do not allow us to draw firm conclusions on health benefits or risks of present-day vegetarian type diets on the nutritional or health status of children and adolescents in industrialized countries.
authors.affiliation: Research Institute of Child Nutrition, Pediatric University Clinic Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schürmann
authors.affiliation: Research Institute of Child Nutrition, Pediatric University Clinic Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kersting
authors.affiliation: IEL-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany. alexy@uni-bonn.de.
authors.forename: U
authors.initials: U
authors.lastname: Alexy
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D001835:Body Weight; D001846:Bone Development; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D000067269:Diet, Vegan; D014676:Diet, Vegetarian; D004043:Dietary Fiber / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018977:Micronutrients / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency; D064887:Observational Studies as Topic
chemical_list: D004043:Dietary Fiber; D018977:Micronutrients
keywords: Adolescents; Children; Dietary intake; Health; Infants; Vegetarian diet