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Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets.
Am J Clin Nutr. 2021 06 01; 113(6):1565-1577.AJ

Abstract

BACKGROUND

Plant-based diets (PBDs) are increasingly recommended for human and planetary health. However, comprehensive evidence on the health effects of PBDs in children remains incomplete, particularly in vegans.

OBJECTIVES

To quantify differences in body composition, cardiovascular risk, and micronutrient status of vegetarian and vegan children relative to omnivores and to estimate prevalence of abnormal micronutrient and cholesterol status in each group.

METHODS

In a cross-sectional study, Polish children aged 5-10 y (63 vegetarian, 52 vegan, 72 matched omnivores) were assessed using anthropometry, deuterium dilution, DXA, and carotid ultrasound. Fasting blood samples, dietary intake, and accelerometry data were collected.

RESULTS

All results are reported relative to omnivores. Vegetarians had lower gluteofemoral adiposity but similar total fat and lean mass. Vegans had lower fat indices in all regions but similar lean mass. Both groups had lower bone mineral content (BMC). The difference for vegetarians attenuated after accounting for body size but remained in vegans (total body minus the head: -3.7%; 95% CI: -7.0, -0.4; lumbar spine: -5.6%; 95% CI: -10.6, -0.5). Vegetarians had lower total cholesterol, HDL, and serum B-12 and 25-hydroxyvitamin D [25(OH)D] without supplementation but higher glucose, VLDL, and triglycerides. Vegans were shorter and had lower total LDL (-24 mg/dL; 95% CI: -35.2, -12.9) and HDL (-12.2 mg/dL; 95% CI: -17.3, -7.1), high-sensitivity C-reactive protein, iron status, and serum B-12 (-217.6 pmol/L; 95% CI: -305.7, -129.5) and 25(OH)D without supplementation but higher homocysteine and mean corpuscular volume. Vitamin B-12 deficiency, iron-deficiency anemia, low ferritin, and low HDL were more prevalent in vegans, who also had the lowest prevalence of high LDL. Supplementation resolved low B-12 and 25(OH)D concentrations.

CONCLUSIONS

Vegan diets were associated with a healthier cardiovascular risk profile but also with increased risk of nutritional deficiencies and lower BMC and height. Vegetarians showed less pronounced nutritional deficiencies but, unexpectedly, a less favorable cardiometabolic risk profile. Further research may help maximize the benefits of PBDs in children.

Authors+Show Affiliations

Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK. Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland.Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.Department of Biochemistry, Radioimmunology, and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.Department of Biochemistry, Radioimmunology, and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.Department of Nephrology, Kidney Transplantation, & Hypertension, The Children's Memorial Health Institute, Warsaw, Poland.Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland.Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33740036

Citation

Desmond, Małgorzata A., et al. "Growth, Body Composition, and Cardiovascular and Nutritional Risk of 5- to 10-y-old Children Consuming Vegetarian, Vegan, or Omnivore Diets." The American Journal of Clinical Nutrition, vol. 113, no. 6, 2021, pp. 1565-1577.
Desmond MA, Sobiecki JG, Jaworski M, et al. Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets. Am J Clin Nutr. 2021;113(6):1565-1577.
Desmond, M. A., Sobiecki, J. G., Jaworski, M., Płudowski, P., Antoniewicz, J., Shirley, M. K., Eaton, S., Książyk, J., Cortina-Borja, M., De Stavola, B., Fewtrell, M., & Wells, J. C. K. (2021). Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets. The American Journal of Clinical Nutrition, 113(6), 1565-1577. https://doi.org/10.1093/ajcn/nqaa445
Desmond MA, et al. Growth, Body Composition, and Cardiovascular and Nutritional Risk of 5- to 10-y-old Children Consuming Vegetarian, Vegan, or Omnivore Diets. Am J Clin Nutr. 2021 06 1;113(6):1565-1577. PubMed PMID: 33740036.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets. AU - Desmond,Małgorzata A, AU - Sobiecki,Jakub G, AU - Jaworski,Maciej, AU - Płudowski,Paweł, AU - Antoniewicz,Jolanta, AU - Shirley,Meghan K, AU - Eaton,Simon, AU - Książyk,Janusz, AU - Cortina-Borja,Mario, AU - De Stavola,Bianca, AU - Fewtrell,Mary, AU - Wells,Jonathan C K, PY - 2020/05/14/received PY - 2020/12/23/accepted PY - 2021/3/20/pubmed PY - 2021/6/29/medline PY - 2021/3/19/entrez KW - bone mineral content KW - cardiovascular risk KW - iron deficiency KW - stature KW - vegan children KW - vegetarian children KW - vitamin B-12 deficiency KW - vitamin D deficiency SP - 1565 EP - 1577 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 113 IS - 6 N2 - BACKGROUND: Plant-based diets (PBDs) are increasingly recommended for human and planetary health. However, comprehensive evidence on the health effects of PBDs in children remains incomplete, particularly in vegans. OBJECTIVES: To quantify differences in body composition, cardiovascular risk, and micronutrient status of vegetarian and vegan children relative to omnivores and to estimate prevalence of abnormal micronutrient and cholesterol status in each group. METHODS: In a cross-sectional study, Polish children aged 5-10 y (63 vegetarian, 52 vegan, 72 matched omnivores) were assessed using anthropometry, deuterium dilution, DXA, and carotid ultrasound. Fasting blood samples, dietary intake, and accelerometry data were collected. RESULTS: All results are reported relative to omnivores. Vegetarians had lower gluteofemoral adiposity but similar total fat and lean mass. Vegans had lower fat indices in all regions but similar lean mass. Both groups had lower bone mineral content (BMC). The difference for vegetarians attenuated after accounting for body size but remained in vegans (total body minus the head: -3.7%; 95% CI: -7.0, -0.4; lumbar spine: -5.6%; 95% CI: -10.6, -0.5). Vegetarians had lower total cholesterol, HDL, and serum B-12 and 25-hydroxyvitamin D [25(OH)D] without supplementation but higher glucose, VLDL, and triglycerides. Vegans were shorter and had lower total LDL (-24 mg/dL; 95% CI: -35.2, -12.9) and HDL (-12.2 mg/dL; 95% CI: -17.3, -7.1), high-sensitivity C-reactive protein, iron status, and serum B-12 (-217.6 pmol/L; 95% CI: -305.7, -129.5) and 25(OH)D without supplementation but higher homocysteine and mean corpuscular volume. Vitamin B-12 deficiency, iron-deficiency anemia, low ferritin, and low HDL were more prevalent in vegans, who also had the lowest prevalence of high LDL. Supplementation resolved low B-12 and 25(OH)D concentrations. CONCLUSIONS: Vegan diets were associated with a healthier cardiovascular risk profile but also with increased risk of nutritional deficiencies and lower BMC and height. Vegetarians showed less pronounced nutritional deficiencies but, unexpectedly, a less favorable cardiometabolic risk profile. Further research may help maximize the benefits of PBDs in children. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/33740036/Growth_body_composition_and_cardiovascular_and_nutritional_risk_of_5__to_10_y_old_children_consuming_vegetarian_vegan_or_omnivore_diets_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqaa445 DB - PRIME DP - Unbound Medicine ER -