NUTR 360/490: Life Cycle Nutrition
Spring 2014
Project 1: Keeping Current to Provide Guidance
A:
With the ever-changing culture of Americans- trying to “go green” and get healthy, vegetarianism and veganism are becoming more and more prevalent. It is necessary for us, the nutrition professionals; to ensure all ages of the population at all stages of life meet dietary reference intakes. The issue is whether or not eliminating animal products from growing children’s diets is beneficial or harmful. From the research that I have conducted, it appears that a child brought up on a vegan diet can meet recommendations and grow healthily with the use of supplements and fortified foods to meet nutrient needs. Although I will also be pointing out what research has shown about the effects of a plant based diet later in life, the population group that I focus on is from pre-conception until puberty, of all ethnicities, economic statuses, and regions. More research should be conducted on the growth rates of vegan babies in comparison to omnivorous children; as well as the bioavailability of different sources of certain nutrients.
There have been studies in the past relating to vegan children having lower growth rates than omnivore children as well as press about vegan babies dying from malnourishment. In 1982, a study was done in a vegan religious community. Twenty-five infants of this community who were seen at the hospital showed evidence of protein-calorie malnutrition, iron and vitamin B12-deficient anemia, rickets, zinc deficiency, and multiple recurrent infections. Evidence of growth retardation was also found in 47 infants seen at the local mother-child health clinic1. It is clear from an anthropometric and dietary assessment of the nutritional status of vegan preschool children2 that deficiencies may occur on macrobiotic diets (more strict vegan diet often not including fortified foods) if the use of fortified foods is prohibited, macrobiotic children may suffer deficiencies of vitamin B12 and vitamin D. However, the article concludes that studies of growth and development of vegetarian children show that when vegetarian children are fed well-balanced diets that follow appropriate guidelines, they grow well. Often, their diets come closer to recommendations by nutrition experts.2 Health parameters in well-nourished vegetarian children may be closer to optimal than children following more standard American patterns.2 In 2002, a vegan couple from New Zealand was accused of child abuse after ‘failing to provide the necessities of life’ for their six-month-old child. Their son died of medical complications due to vitamin B12 deficiency after the parents left the hospital against medical advice to treat their son with herbal remedies. Second Opinions. Vegan Child Abuse.3 Also in 2005, despite the significant available literature on the potential risks of alternate diets, strict vegan parents were taken to court and charged with neglect after one of their children died of malnutrition. 4 My findings may make it seem like a vegetarian or vegan diet in early childhood is a bad idea. However, these studies are based on vegans who have very low calorie or very limited diets. Also, growth charts vary- especially comparing breast-fed infants to bottle-fed babies. Most vegan parents begin with breast-feeding. Growth charts based on formula-fed infants may make it seem that breastfed infants are not growing well because formula-fed infants grow faster than breastfed infants do.5 More research needs to be conducted on comparisons of adaptation of a vegan diet in early childhood comparing standard American diets with well-planned vegan diets. I could not find any recent studies that show that vegan children can have growth rates, which do not differ from those of omnivorous children of the same age. An area of concern for vegans is getting adequate amounts of vitamin B12. One study 6, examined the role of maternal vitamin B12 on fetal growth. Vitamin B12 is the only vitamin that is only bioavailable through consumption of animal products and supplements (the vegan supplements are made by the B12-producing bacteria, not animal products.)7 It is still confusing to me why fermented foods like miso and kombucha that contain the bacteria that B12 grow from, and have B12 on their nutrition labels, are not considered a bioavailable source of B12 given that the claim this article makes is that they do not contain the active forms of the vitamin. Another suggestion for a recommendation for the future would be to study bioavailability further and have that coincide with what is written on nutrition labels. Low maternal vitamin B12 status and protein intake are associated with increased risk of neural tube defects, low lean mass and excess adiposity, increased insulin resistance, impaired neurodevelopment and altered risk of cancer in the offspring.8 We can conclude that B12 supplementation is necessary for a healthy baby and adaptation of a vegan diet early in childhood. Although there is need for supplementation, vegetarian diets often contain more fruits, vegetables, and fiber, with less fat and cholesterol, and people who consume them are likely to have reduced risk of chronic disease, weight gain, and weight related illnesses.9 With this in mind, it is necessary that recommendations provide information about healthy vegetarian diets to further promote foods that need to be increased to increase overall health. It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, child- hood, and adolescence, and for athletes.10
In trying to find a natural cure, beneficial effects of fasting followed by a vegetarian diet in rheumatoid arthritis are confirmed by randomized controlled trials.11 The anti-inflammatory, antioxidant rich benefits of vegetarian and vegan diets may not only be able to prevent chronic disease and weight gain for children later in life, but they can even reverse and lessen the symptoms of these chronic diseases for older adults who already have them if they switch to a more plant based diet.
Vegetarian and vegan diets are appropriate for people of all ages and all stages in life, including pregnancy, lactation, infancy, childhood, and adolescents, and for athletes.16
References Cited:
- Shinwell, ED, and R. Gorodischer. “Totally Vegetarian Diets and Infant Nutrition.” National Center for Biotechnology Information. U.S. National Library of Medicine, Oct. 1982. Web. 01 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/6812012>.
- Mangels, Reed, PhD, RD, LDN, FADA, and Julia Driggers, RD, CNSC, LDN. “The Youngest Vegetarians- Vegetarian Infants and Toddlers.” Can.sagepub.com. ICAN: Infant, Child & Adolescent Nutrition, 28 Nov. 2012. Web. 30 Jan. 2014. <http://can.sagepub.com.ezproxy.lib.purdue.edu/content/4/1/8>.
- Groves, Barry, PhD, RD, FADA. “Child Abuse by Vegan Parents.” Child Abuse by Vegan Parents. Second Opinions, 9 June 2002. Web. 30 Jan. 2014. <http://www.second-opinions.co.uk/child_abuse.html#.Uu7h5SjpbHM>.
- Grinberg, Emanuella. “Child Abuse by Vegan Parents.” Child Abuse by Vegan Parents. Court TV Online, 18 Oct. 2005. Web. 30 Jan. 2014. <http://www.second-opinions.co.uk/child_abuse.html#.Uu7h5SjpbHM>.
- Mangels, Reed, PhD, RD, FADA. “Feeding Vegan Kids.” — The Vegetarian Resource Group. The Vegetarian Resource Group, 2 May 2013. Web. 01 Feb. 2014. <http://www.vrg.org/nutshell/kids.php>.
- Rush, EC, P. Katre, and CS Yajnik. “Vitamin B12: One carbon metabolism, fetal growth and programming for chronic disease.” National Center for Biotechnology Information. U.S. National Library of Medicine, 13 Nov. 2013. Web. 31 Jan. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/24219896>.
- Board of Trustees at the University of Illinois. “Vitamin B12: What Vegans Need to Know.” – McKinley Health Center. University of Illinois at Urbana-Champaign, 2008. Web. 02 Feb. 2014. <http://www.mckinley.illinois.edu/handouts/vitamin_b12/vitamin_b12.htm>.
- Rush, EC, P. Katre, and CS Yajnik. “Vitamin B12: One carbon metabolism, fetal growth and programming for chronic disease.” National Center for Biotechnology Information. U.S. National Library of Medicine, 13 Nov. 2013. Web. 31 Jan. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/24219896>.
- RD Resources for Consumers. “Vegan Nutrition for School-Age Children.” Eat Right. Academy of Nutrition and Dietetics, July 2010. Web. 30 Jan. 2014. <http://www.eatright.org/WorkArea/DownloadAsset.aspx?id=6442471778>.
10. “Balancing a Healthy Vegetarian Diet.” Student Health. Student Health Services UC San Diego, 2007. Web. 2 Feb. 2014. <http://studenthealth.ucsd.edu/pdfdocs/balancehealthyvegediet.pdf>.
- Michalsen, Li C A. “Fasting Therapy For Treating and Preventing Disease- Current State of Evidence.” National Center for Biotechnology Information. U.S. National Library of Medicine, 16 Dec. 2013. Web. 01 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/24434759>.
15. King, Debbie, MS, RD, LD. “Raising Vegetarian Infants.” Vegetarian Nutrition. Academy of Nutrition and Dietetics, 16 Oct. 2013. Web. 20 Feb. 2014. <http://vegetariannutrition.net/vegetarian-kids/raising-vegetarian-infants/>.
16. Craig, W. J., and A. R. Mangles. “Position of the American Dietetic Association: Vegetarian Diets.” National Center for Biotechnology Information. U.S. National Library of Medicine, July 2009. Web. 26 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/19562864>.
17. Mangles, Reed, PhD, RD, FADA. “Pregnancy and the Vegan Diet.” VRG Health, Environment, Ethics. The Vegetarian Resource Group, 2005. Web. 26 Feb. 2014. <http://www.vrg.org/nutrition/veganpregnancy.php>.
List of Articles for Step 1B:
12. Rush, EC, P. Katre, and CS Yajnik. “Vitamin B12: One Carbon Metabolism, Fetal Growth and Programming for Chronic Disease.” National Center for Biotechnology Information. U.S. National Library of Medicine, 14 Nov. 2013. Web. 02 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/24219896>.
13. Turner-McGrievy, Gabrielle M., PhD, MS, RD, Sarah B. Hales, MSW, and Angela C. Baum, PhD. “Transitioning to New Child-Care Nutrition Policies: Nutrient Content of Preschool Menus Differs by Presence of Vegetarian Main Entree.” Www.eatright.org. Journal of the Academy of Nutrition and Dietetics, 19 Oct. 2013. Web. 13 Feb. 2014. <http://download.journals.elsevierhealth.com/pdfs/journals/2212-2672/PIIS2212267213012501.pdf>.
Mangels, Reed, PhD, RD, LDN, FADA, and Julia Driggers, RD, CNSC, LDN. “The Youngest Vegetarians- Vegetarian Infants and Toddlers.” Can.sagepub.com. ICAN: Infant, Child & Adolescent Nutrition, 28 Nov. 2012. Web. 30 Jan. 2014. <http://can.sagepub.com.ezproxy.lib.purdue.edu/content/4/1/8>.
This section will be turned in for review separately, then corrected for inclusion in the final project with the list of articles becoming the References Cited section of Step 1B.
B: Review of the Literature
(insert text here as described page 3)
According to research so far, vegetarian diet patterns are likely to cause good health and if recommendations are met using supplements or animal products, it is possible to raise healthy vegetarian and vegan children. These three articles go over vegetarian diet recommendations and the necessity for nutrients found in animal products or supplements early in life. The first article, “Vitamin B12: one carbon metabolism, fetal growth, and programming for chronic disease,” goes into the necessity of vitamin B12 in the diet. The other two articles, “Transitioning to New Child-Care Nutrition…” and “The Youngest Vegetarians; Vegetarian Infants and Toddlers,” go more in depth about the plant-based nutrition. The “Transitioning…” article suggests how vegetarian diets provide optimal nutrient content while “The Youngest Vegetarians..” describes nutrient recommendations for meeting the needs of vegetarian infants at different stages of growth. The articles show that it is possible to raise a vegetarian or vegan child healthily. However, there isn’t much recent research with data that proves that vegan children meet the same height and growth averages as vegetarian or omnivorous children; there are only alternate suggestions of obtaining nutrients. Also, these alternate suggestions of obtaining nutrients are from supplements- there isn’t much research out there on the bioavailability of various plant super foods and fermented foods that could potentially be used for vegans. As benefits of plant-based diets are becoming better known, more research should be done on the topic.
The article, “Vitamin B12: one carbon metabolism, fetal growth, and programming for chronic disease,” is a selective literature retrospective cohort review article that goes into how vitamin B12 is not only important for growth and development of the infant, but maternal vitamin B12 is also very important. The purpose of the study was to examine the possible role of maternal vitamin B12 on fetal growth and its programming for susceptibility to chronic disease. Research was reviewed using human and animal studies particularly in the context of a vegetarian diet that may be low in B12. “Low maternal vitamin B12 status is associated with a slew of problems for the baby.”12 The review points out that vegan diets are often low in protein and vitamin B12 and high in carbohydrate- suggesting a necessity for supplementation.
The second research article, “Transitioning to New Child-Care Nutrition Policies” was an observational study with the goal to examine changes that occurred at a large, child-care center during the implementation of new nutrition standards. These changes observed were those in the nutrition content of menus before and after implementation of the new standards, as well as the influence of vegetarian meals on the nutrient content of menus. Also, parent opinions and support for these changes were examined as well as parent support for adding more vegetarian entrees. took place at a large, university-based child-care center serving 200 children at 6 weeks and older in Columbia, SC between June and December 2012. This observational study involved a survey to parents and analysis of nutrient changes of menus before and after the nutrition policy change. The study concluded “adding more vegetarian menu items improve the nutrient content of menus while keeping energy intake, saturated fat, sodium, and cholesterol levels at a more optimum level.”2 Also, there is high parent support for meeting nutrition needs by adding more vegetarian menu items. 13
The third article, “The Youngest Vegetarians”, was designed to examine key nutritional issues for the youngest vegetarians, from birth to 2 years; which is the time period of rapid growth when nutrient needs are high. It includes recommendations and research from credible sources in a collective manner that shows clearly the nutritional needs of infants at this age and how these needs are best met without the use of animal products.
There is still little research following the growth of vegan children whose nutrient needs are definitely met. Still, the combination of these articles shows that babies can grow and develop normally if they are given a well balanced vegan or vegetarian diet. There would be less confusion if more available primary prevention tools were available describing how to prevent malnutrition in vegetarian or vegan babies. The articles did a good job showing scientific evidence of the need for supplements and what nutrients to increase, as well as a growing interest in plant based diets. Healthy vegetarian and vegan diets may benefit the high prevalence of chronic disease in America. However, more research needs to be conducted on how early in life adopting a plant-based diet will be beneficial.
References Cited:
1. Rush, EC, P. Katre, and CS Yajnik. “Vitamin B12: One Carbon Metabolism, Fetal Growth and Programming for Chronic Disease.” National Center for Biotechnology Information. U.S. National Library of Medicine, 14 Nov. 2013. Web. 02 Feb. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/24219896>.
2. Turner-McGrievy, Gabrielle M., PhD, MS, RD, Sarah B. Hales, MSW, and Angela C. Baum, PhD. “Transitioning to New Child-Care Nutrition Policies: Nutrient Content of Preschool Menus Differs by Presence of Vegetarian Main Entree.” Www.eatright.org. Journal of the Academy of Nutrition and Dietetics, 19 Oct. 2013. Web. 13 Feb. 2014. <http://download.journals.elsevierhealth.com/pdfs/journals/2212-2672/PIIS2212267213012501.pdf>.
Mangels, Reed, PhD, RD, LDN, FADA, and Julia Driggers, RD, CNSC, LDN. “The Youngest Vegetarians- Vegetarian Infants and Toddlers.” Can.sagepub.com. ICAN: Infant, Child & Adolescent Nutrition, 28 Nov. 2012. Web. 30 Jan. 2014. <http://can.sagepub.com.ezproxy.lib.purdue.edu/content/4/1/8>.
C: Credible Sources of Information for Populations Affected
#1 – Title: Raising Vegetarian Infants
URL: http://vegetariannutrition.net/vegetarian-kids/raising-vegetarian-infants/
Date: October 16, 2013
Sponsor/Author: Academy of Nutrition and Dietetics
Information provided:
This pdf file shows how to raise a vegetarian baby, what foods a mother can feed a vegan baby, and how to make sure that a vegan or vegetarian baby is healthy. This is a primary prevention paper educating the public about how babies can grow and develop normally if they are given a well-balanced vegetarian diet. The pamphlet even provides a sample menu for an 11-month old vegan infant, as well as a table of dietary reference intakes for key nutrients for infants.
Evaluation:
This information is all quite credible since it comes from a reputable source. It also provides some easy to understand guidance and recommendations. However, it is not easily accessible, and the majority of mothers out there might not understand how to meet the dietary reference intakes.
#2 – Title: Pregnancy and the Vegan Diet
URL: http://www.vrg.org/nutrition/veganpregnancy.php
Date: 1999
Sponsor/Author: The Vegetarian Resource Group
Information provided:
This webpage goes in depth about nutrient needs for a pregnant women. It educates about weight gain, nutrients of concern, and how to obtain nutrients and have a healthy pregnancy with a vegan diet.
Evaluation:
This article is taken from a book written in 2005, so it is quite outdated. However, the more recent “Raising Vegetarian Infants” from the Academy of Nutrition and Dietetics, uses this article as a reference. If such a credible source as the Academy of Nutrition and Dietetics is still using this outdated information for its own articles, I think it is safe to say that it is still credible.
#3 – Title: Vegetarian Diets For Pregnancy
URL: http://pcrm.org/pdfs/health/pregnancy_factsheet.pdf
Date: Feb 2005
Sponsor/Author: Physicians Committee for Responsible Medicine
Information provided:
This article provides charts to help a pregnant women plan balanced vegan meals. It goes over guidelines for good health during pregnancy, with menu ideas, breast-feeding information, as well as all of the nutrients of concern during pregnancy and how to meet those needs.
Evaluation:
The sponsor, “Physicians Committee for Responsible Medicine” seems quite credible. However, this article (as is every other article I could find on this subject) is quite outdated. I do think it has good information, but new research should be done and new guidelines should be made accordingly.
D: Providing Guidance – Option # 2
Seeker:
A questionable health conscious mother might ask this question. Parents want to do whatever they can to provide the most quality care to their children. If there is evidence out there that a vegan or vegetarian diet will help their child be healthy in the long run, they will do what they can to provide that for them.
Question:
- Are there any notable benefits to raising a child vegetarian or vegan?
Answer:
It is clear that later in life, well-balanced vegan and vegetarian diets may not only prevent, but help to reverse the chronic diseases are a problem in America.13 More studies definitely need to done to provide current advice on whether or not vegetarian and vegan children have normal growth patterns during their most rapid stages of growth.14 Increased phytonutrients, fiber, and antioxidants of concern do appear to be beneficial during pregnancy and child birth, helping them go smoothly as well as decreased incidences of preeclampsia and gestational diabetes in vegetarian and vegan mothers. 2 One can conclude that a vegan pregnancy and a baby-raised vegan can be healthy, but it is still unknown whether or not this baby is necessarily healthier than omnivorous babies. However, vegan mothers are much more concerned about meeting their nutritional needs than omnivorous mothers, so often the help and guidance ends up making them meeting their nutrient needs better than omnivorous mothers who wouldn’t look to intensely at their diet pattern.1
Seeker:
A vegan or humane mother who is considering how to meet her needs without the use of animal products would ask this question. She is looking for what nutrients are of extra concern if she isn’t consuming animal products during her pregnancy and how those needs might be met. If the information is easily accessible and sounds easy to accomplish, she is likely to go forth with trying a plant-based pregnancy and upbringing.
Question:
- What are the nutrients of concern for vegan babies and mothers, and how should those nutrient needs met?
Answer:
It is still recommended that the first food babies consume is breast milk. 15 Vegan mothers need to consider their nutrient intake prior to conception. “Low maternal vitamin B12 status and protein intake are associated with increased risk of neural tube defect, low lean mass and excess adiposity, increased insulin resistance, impaired neurodevelopment, and altered risk of cancer in the offspring.” 1 “Breast milk levels of vitamin B12 have been postulated to be proportional to maternal dietary intake rather than maternal vitamin B12 stores.”2 Key nutrients of concern are protein, vitamin C, vitamin D, vitamin B12, calcium, iron, and zinc. After 4-6 months, or when babies begin to show that they are ready for solid foods, the first solid food for vegan infants should be baby cereal fortified with iron and zinc, mixed with breast milk. It should be thin in the beginning of introduction, made thicker over time. As cereal is accepted, one new food can be started every 3-4 days. When baby is 7-8 months old, or is ready, add foods like well-cooked and mashed or pureed dried beans, mashed tofu, and soy yogurt. A mix of iron and zinc fortified infant cereal, breast milk, whole grains, soy and soy products, as well as other beans and legumes, vegetables, and fruits in the diet, prepared in a fashion that is easily digested by the infant (chopped, steamed, mashed, pureed, etc) would meet the needs of a typical 11-month old vegan infant. 14
Seeker:
A vegan woman who would like to have a child in the near future who is concerned about her nutrient status would ask this. It is good that she is aware of the concerns about nutrient stores prior to pregnancy, and she is preparing to take action in the right direction to seek advice to ensure her child will not be malnourished.
Question:
- What supplements should I start taking to ensure I have my nutrient needs met prior to, and throughout my pregnancy?
Answer:
Before thinking about individual nutrients, it is important to know how much weight the mother will need to gain and how many calories to take in throughout her pregnancy. This can be figured out by using the pre-pregnant BMI. If the potential mother is underweight, she will have to gain 28-30 pounds, whereas an obese potential mother, will be recommended to gain 11-20 pounds.17 Fortified beverages and cereals may provide the necessary vitamin B12 prior to pregnancy. It would be a good idea to have blood tested for levels of iron to ensure there is no iron deficiency anemia prior to pregnancy. Iron supplements during pregnancy are commonly recommended along with iron-rich foods because iron needs increase. Vitamin B12 definitely needs to be supplemented because as far as research shows now, there is no plant food that produces naturally bioavailable vitamin B12. Levels of protein, calcium, vitamin D, folate, DHA, and iodine in the diet should also be checked prior to supplementing, and work with a professional to get supplements necessary or to change your dietary habits to meet your needs better.6
😉 ) I eat juices and smoothies and fruit all day and (well i have a giant salad at night) but totally with some steamed sweet potato! Yum yum!
VITAMIN KATIE 