Children eating a vegetarian diet do not appear to have any greater likelihood of being at risk for nutritional deficiencies than children eating omnivore diets, according to research presented at the Pediatric Academic Societies(PAS) 2026 Meeting in Boston.

“Vegetarian diets are increasing in popularity, and early childhood is an important time to establish healthy eating habits,” Joseph Jamnik, MD, PhD, a clinical fellow at The Hospital for Sick Children in Toronto, Ontario, Canada, and his colleagues wrote. “These findings support a better understanding of the nutritional adequacy of vegetarian diets for children.”

They cautioned, however, that less is understood about vegan diets, which require more research since the sample in this study had too few children eating a vegan diet to assess their nutrition risk.

“These findings are reassuring and help to underscore the benefits of choosing a vegetarian diet,” Sophie J. Balk, MD, an attending pediatrician at the Children’s Hospital at Montefiore Einstein in New York City, told Medscape Medical News.

“Vegetarian diets and plant-based diets — which emphasize eating plants but can include foods like fish and chicken — have health benefits such as lowering the risk of heart disease, diabetes, and high blood pressure,” said Balk, who was not involved in this research. Families who choose vegetarian diets also can positively affect the environment because meat and dairy production contribute to greenhouse gas emissions that lead to climate change, she said.

The researchers conducted a longitudinal study with 7887 healthy children, aged 1-6 years, who were participating in The Applied Research Group for Kids primary care research network from June 2008 to December 2020. Their parents completed a 3-day food recall questionnaire to determine whether the children followed a vegetarian diet, including vegan diets.

The Nutrition Screening Tool for Toddlers and Preschoolers (NutriSTEP) was used to determine the nutrition risk for the children, with a total score < 21 deemed low nutrition risk and a score ≥ 21 deemed high nutrition risk.

The participants were an average of 31 months old, and just over half (52%) were boys. A large majority of mothers had a college/university level of education (90%), 60% had European ethnicity, and 39% had an annual family income greater than $150,000.

At baseline, 2.7% of the children were eating vegetarian diets, which included 0.3% overall (23 children) eating a vegan diet. Comparison of nutrition scores with children’s diets revealed no association between NutriSTEP scores and eating a vegetarian diet (P = .99) after adjusting for age, sex, birthweight, family income, and maternal age at birth, education, and ethnicity.

The researchers also identified no association between eating a vegetarian diet and nutrition risk (P = .9) or the subscores for dietary intake (P = .44) and eating behavior (P = .62). The researchers noted that children aged 2-4 years old who had vegetarian diets had a more favorable total NutriSTEP score than those eating nonvegetarian diets. There were too few children eating vegan diets to establish whether any associations existed with nutrition risk or NutriSTEP scores.

The poster did not report how many of the children overall were at high risk for nutritional deficits, which is important to know, particularly since physicians often see nonvegetarian children who do not seem to be eating a healthy diet, said Balk.

“Pediatricians often hear about pickiness, few fruits and vegetables, excessive sweet drinks and junk food,” she said. “We are seeing more food insecurity when parents can’t feed their families well enough because of financial issues. Sometimes families live in neighborhoods where fresh produce isn’t available. It is our job as pediatricians to assess every kid’s diet — vegetarian or not -— and to offer ways to make sure all kids are eating as well as possible.”

While pediatricians carefully review what all their patients are eating, she noted an example of the sort of nutritional deficiencies that might arise from a child eating a vegan diet if it does not contain enough plant-based protein. A patient from a vegan family that she saw several years ago had only been eating rice milk, which contains very little protein, and three vegetables. The child was eventually diagnosed and hospitalized with kwashiorkor, severe protein malnutrition.

“This situation emphasizes that we need to make sure that each of our young patients is getting enough protein, calcium, and needed vitamins and minerals,” Balk said.

Jamnik did not report any disclosures. Balk reported receiving funding from NYSCHECK, the NY State Children’s Environmental Health Centers. The study was supported by the University of Toronto, St. Michael’s Hospital, The Hospital for Sick Children, and Canadian Institutes for Health Research.

Tara Haelle is a science/health journalist based in Dallas.