Plant-Based Diets in Children Can Support Healthy Growth but Require Careful Planning, Says Largest Study to Date

A major new scientific review is shedding fresh light on one of the most debated topics in modern nutrition: whether vegetarian and vegan diets are suitable for children. According to the largest and most comprehensive analysis conducted so far, plant-based diets can support healthy growth and development in children and adolescents, but only when they are carefully planned and properly supplemented.

The findings come from a large systematic review and meta-analysis published in the journal Critical Reviews in Food Science and Nutrition. The research team, made up of scientists from Italy, the United States, and Australia, examined data from 59 individual studies across 18 countries, involving more than 48,000 children and adolescents under the age of 18. The goal was to compare the nutritional intake, growth patterns, and health outcomes of children following lacto-ovo-vegetarian diets, vegan diets, and omnivorous diets.

What the Study Looked At

The researchers divided participants into three dietary groups:

• 7,280 lacto-ovo-vegetarians, who consumed dairy products and eggs but avoided meat, fish, and poultry
• 1,289 vegans, who excluded all animal-derived foods
• 40,059 omnivores, who consumed meat and other animal products

Across these groups, the researchers analyzed nutrient intake, blood biomarkers, growth measurements, body composition, and cardiovascular risk markers. This wide scope is what makes the study the most detailed assessment of plant-based diets in children to date.

Nutritional Strengths of Vegetarian and Vegan Diets

One of the clearest findings was that children following vegetarian diets tended to consume higher amounts of several beneficial nutrients. Compared with omnivorous children, vegetarian children had higher intakes of dietary fiber, iron, folate, vitamin C, and magnesium. These nutrients are commonly found in fruits, vegetables, legumes, whole grains, and nuts—foods that are central to plant-based eating patterns.

Vegan children showed similar trends, although the available data on vegan diets was more limited due to fewer studies focusing specifically on this group.

Higher fiber intake, in particular, stood out as a potential long-term benefit, as fiber is associated with better gut health and improved metabolic outcomes later in life.

Nutrients That Need Special Attention

Despite these positives, the study also identified important nutritional gaps. Vegetarian children were found to consume lower amounts of energy, protein, total fat, vitamin B12, and zinc compared with omnivores. While protein needs can often be met through plant sources, doing so requires intentional food choices, especially during periods of rapid growth.

Vitamin B12 emerged as one of the most critical nutrients of concern. Since B12 is found almost exclusively in animal-derived foods, the study found that adequate levels were not achieved without supplementation or fortified foods. This issue was especially pronounced among vegan children.

The researchers also noted that calcium, iodine, and zinc intakes were often at the lower end of recommended ranges, with vegan children showing particularly low calcium intake. This raises concerns about bone health, especially during childhood and adolescence when bone mass is still developing.

Growth, Height, and Body Composition Findings

When it came to physical growth, the results were nuanced. Children following vegetarian diets tended to be slightly shorter and lighter than omnivorous children. They also had lower body mass index (BMI), lower fat mass, and lower bone mineral content. Vegan children showed similar trends, including shorter stature and lower BMI scores.

Importantly, the authors emphasized that these differences did not necessarily indicate poor health. Rather, they suggest that plant-based diets are associated with a leaner body composition. Still, lower bone mineral content highlights why nutrients like calcium and vitamin D are so important for children on these diets.

Cardiovascular Health Benefits

One of the more encouraging findings involved heart health markers. Both vegetarian and vegan children displayed lower total cholesterol and lower LDL cholesterol, often referred to as the “bad” cholesterol. These differences suggest that plant-based diets may offer early cardiovascular advantages, potentially reducing the risk of heart disease later in life.

While cardiovascular disease typically develops in adulthood, childhood risk factors can track into later years, making these findings particularly noteworthy.

Iron Status and Anemia Risk

Iron intake presented an interesting contradiction. Although vegetarian children consumed more iron overall, they were also found to have a higher risk of iron deficiency and anemia. This is likely due to the lower bioavailability of non-heme iron, the form of iron found in plant foods, compared with the heme iron found in meat.

This finding reinforces the importance of iron absorption strategies, such as pairing iron-rich plant foods with vitamin C and minimizing inhibitors like phytates when possible.

What the Researchers Recommend

The authors of the study were clear in their conclusions: vegetarian and vegan diets can meet children’s nutritional needs, but they require careful planning, education, and appropriate supplementation. They strongly advise that families choosing these diets seek guidance from dietitians, pediatricians, or other qualified health professionals.

Key nutrients that deserve close attention include vitamin B12, calcium, iodine, iron, and zinc. With the right approach, the researchers stress that families should not be discouraged from choosing plant-based diets for ethical, environmental, or health reasons.

Why the Evidence Still Has Limits

While this study is the most comprehensive so far, it does have limitations. Most of the included studies were cross-sectional, meaning they provide a snapshot in time rather than tracking children over many years. There was also wide variation in study methods, populations, and how dietary intake was measured.

Because of these factors, the researchers caution against drawing overly strong conclusions and emphasize the need for more long-term, high-quality research focused specifically on children.

Broader Context on Plant-Based Diets in Childhood

Interest in plant-based diets continues to grow worldwide, driven by concerns about climate change, animal welfare, and chronic disease prevention. For children, these diets can offer valuable lessons in food diversity and sustainability, but they also demand greater nutritional awareness than conventional eating patterns.

This study helps clarify a landscape that has often been filled with conflicting advice, offering evidence-based guidance rather than extremes of endorsement or warning.

The Bottom Line

The takeaway from this large analysis is balanced and practical. Plant-based diets are not inherently unsafe for children, but they are not “hands-off” either. With thoughtful planning, fortified foods, and supplements where needed, vegetarian and vegan diets can support healthy growth while offering some potential health advantages. Without that attention, however, nutritional shortfalls are a real risk.

As more families explore plant-based eating, research like this plays a crucial role in helping parents make informed, confident decisions about their children’s health.

Research paper: https://doi.org/10.1080/10408398.2025.2572983