Objective:

Vegetarianism is increasingly common and transversal to all ages; however, a vegetarian diet in children requires special attention to meet the nutritional requirements necessary for their development and growth. The aim of this paper is to review the evidence on a vegetarian diet for children, particularly from food diversification to the first years of life.

Data sources:

National Guideline Clearinghouse, NICE, Canadian Medical Association Infobase, The Cochrane Library, DARE, MEDLINE, TRIP Database, UpToDate, Index of Portuguese Medical Journals, and Directorate-General for Health.

Methods:

Research of clinical guidelines, classic reviews, systematic reviews, meta-analyses, and original articles, using the MeSH terms ‘diet, vegetarian’, ‘child’, and ‘infant’, published in English or Portuguese up to June 2020.

Results:

Exclusive breastfeeding is recommended for infants up to six months of age. In vegetarian infants, it is advised until two years of age. If necessary, an infant formula derived from soy protein or rice protein should be used for healthy infants on a vegan diet. Fresh natural tofu can be started at six to seven months. The availability of protein, essential fatty acids, vitamin B12 and D, iodine, iron, calcium, zinc, fiber, and the energy intake of the diet should be considered. Vegetarian children with an adjusted diet have a lower risk of obesity, lower exposure to antibiotics present in animal origin products, and a better anti-inflammatory adipokine profile. Proper development is a predictor of a healthy diet.

Conclusions:

A balanced diet is central to nutritional adequacy and future harmonious growth. Although the ovolactovegetarian diet should be preferred over other vegetarian diets, the key point is to pay attention to the bioavailability of key nutrients and energy supply. Thus, a well-structured vegetarian diet can respond to nutritional requirements at the pediatric age. An adequate development is a predictor of a healthy diet.

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