The Evidence Supporting Plant-Based Diets for Kids

Dr. Qadira Ali Huff is a plant-based pediatrician and lifestyle medicine physician with over a decade of training and experience. She is the founder of Sprouting Wellness and promotes a plant-based diet and lifestyle for parents in order to build healthy habits and futures for the entire family.

As the popularity of plant-based eating grows, conversations about associated health benefits tend to focus on adult health - from reduced risk of diet-related chronic diseases to living longer. At the same time, children also benefit from a healthful, plant-based diet in both similar and unique ways. Rather than racing the clock to slow progression of chronic disease later in life, children can start out ahead when they’re introduced to a wholesome, plant-based diet in childhood. 

Most children eat diets high in processed, dairy and other animal foods - also known as the standard American diet. Around 60% of calories come from processed foods, around 25% calories from dairy and less than 6% from whole plant foods (1). By high school, less than one out of ten teenagers eat the recommended amounts of fruits and vegetables (2).  Inadequate consumption of fruit, vegetables, whole grains and legumes means most kids are fiber-deficient. This troubling pattern manifests in earlier diagnosis of conditions previously seen almost exclusively in adults, like type two diabetes (3). 

Many common childhood diseases improve on a plant-based diet. One example is chronic constipation, which accounts for 1 in every 20 pediatric clinic visits. Two dietary risk factors have been identified as common culprits of the condition: dairy consumption and inadequate fiber intake. Studies have shown that eliminating cow’s milk can be more effective than standard therapy, like stool softeners - even among children who’ve struggled with constipation for months (4). Children that eat a plant-based diet skip the dairy and eat foods high in fiber (also known as plants - since dairy and meat do not contain any fiber). As a result, plant-based kids rarely have chronic constipation and poop like champions! Asthma, another common childhood disease, has also been shown to improve with increasing amounts of fruits and vegetables in the diet(5).

The very same dietary changes that protect against common childhood diseases also protect against the top cause of death in adulthood: cardiovascular disease. While adults experience heart attacks and stroke later on in life, early stages of the disease typically begin in the first few years of life and progress from there (6; 7). Notable studies examining the connection between lifestyle factors in childhood and heart disease later in life, including the Bogalusa Heart Study and PDAY Study, have found that elevated LDL cholesterol levels pose the strongest risk for development of atherosclerosis (8). By the time most children reach grade school, they’re already consuming higher than the recommended levels of saturated fat, which raises their LDL cholesterol and sets the stage for fatty streaks in childhood that progress into symptomatic heart disease decades later (9). Heart disease prevention needs to start in childhood by limiting foods high in saturated fat, which is almost exclusively found in animal foods,  like red meat and dairy (10; 11). 

Despite how compelling these health benefits and consequences seem, parents still worry about the safety of a plant-based diet for their children. Here’s the bottom line: an intentionally-planned plant-based diet is not only safe, but incredibly nutritious for children at all stages of life. Respected pediatric health and nutrition organizations have endorsed plant-based diets, including the American Academy of Pediatrics and Academy of Nutrition and Dietetics (12). Once parents learn more about appropriate supplementation, like vitamins B-12 and D, and how to prepare meals that cover the important nutritional bases, the advantages of a plant-based diet quickly add up.

A healthy, plant-based diet is one of the most effective disease-fighting lifestyle habits around. Children stand to gain a lifetime of personal health benefits and influence future generations by passing this eating approach down to their own children. The ripple effects of the movement towards plant-based eating are massive - better health for children, adults, and our planet.  

Sources

1. Martínez Steele E, Baraldi LG, Louzada MLDC, et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional studyBMJ Open 2016;6:e009892. doi: 10.1136/bmjopen-2015-009892 
2. Lange SJ, Moore LV, Harris DM, Merlo CL, Lee SH, Demissie Z, Galuska DA. Percentage of Adolescents Meeting Federal Fruit and Vegetable Intake Recommendations - Youth Risk Behavior Surveillance System, United States, 2017. MMWR Morb Mortal Wkly Rep. 2021 Jan 22;70(3):69-74. doi: 10.15585/mmwr.mm7003a1.
3. Divers J, Mayer-Davis EJ, Lawrence JM, et al. Trends in Incidence of Type 1 and Type 2 Diabetes Among Youths — Selected Counties and Indian Reservations, United States, 2002–2015. MMWR Morb Mortal Wkly Rep 2020;69:161–165. DOI: http://dx.doi.org/10.15585/mmwr.mm6906a3
4. Mohammadi Bourkheili A, Mehrabani S, Esmaeili Dooki M, et al. Effect of cow's-milk-free diet on chronic constipation in children; A randomized clinical trial. Caspian J Intern Med. 2021 Winter;12(1):91-96. doi: 10.22088/cjim.12.1.91. PMID: 33680404..https://pubmed.ncbi.nlm.nih.gov/33680404/ 
5. Wood LG, Garg ML, Smart JM, Scott HA, Barker D, Gibson PG. Manipulating antioxidant intake in asthma: a randomized controlled trial. Am J Clin Nutr. 2012 Sep;96(3):534-43. doi: 10.3945/ajcn.111.032623. Epub 2012 Aug 1. PMID: 22854412.
6. Enos WF, Holmes RH, Beyer J. Coronary disease among United States soldiers killed in action in Korea preliminary report. J Am Med Assoc. 1953;152:1090–1093. 
7. Holman RL, McGill HC, Strong JP, et al. The natural history of atherosclerosis. Am J Pathol. 1958;34:209–235. 
8. McMahan CA, Gidding SS, Malcom GT, et al. Pathobiological determinants of atherosclerosis in youth risk scores are associated with early and advanced atherosclerosis. Pediatrics. 2006;118:1447–1455 
9. Yu Wang, Dana Guglielmo, Jean A Welsh, Consumption of sugars, saturated fat, and sodium among US children from infancy through preschool age, NHANES 2009–2014, The American Journal of Clinical Nutrition, Volume 108, Issue 4, October 2018, Pages 868–877, https://doi.org/10.1093/ajcn/nqy168
10. Ference BA, Yoo W, Alesh I, et al. Effect of long-term exposure to lower lowdensity lipoprotein cholesterol beginning early in life on the risk of coronary heart disease. A Mendelian randomization analysis. J Am Coll Cardiol. 2012;60:2631–2639
11. Saturated Fats. American Heart Association. Accessed online at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/saturated-fats.
12. Melina V, Craig W, Levin S. Position of the academy of nutrition and dietetics: vegetarian diets. J Acad Nutr Diet. 2016;116:1970–1980.