Should a Vegan Diet be Considered Child Neglect?

Occasionally, it happens. Loving parents who've read the research on the advantages of a plant-based diet are accused of neglecting their children by refusing to give them animal products. Currently in Italy, there is proposed legislation that would send parents to prison for providing their children with a vegan diet. But even here in the United States, a disgruntled spouse might accuse the other parent of neglect for basing their children's diet on plants. I recently discussed this subject with a family who not only fed their children a vegan diet, but who also did not serve their children snacks between meals. Were they neglecting their children as some family members had suggested? I assured them that they were making the absolute best choice for their children and gave them some solid ground to stand on as they defend their position to concerned relatives.

Why Might You Be Interested in My Opinion?

For the past 10 years, in addition to maintaining a general family practice, I have been active in the plant-based medical community both locally and nationally. I write the featured column “Well Woman Way” for VegWorld Magazine, available at www.VegWorldMag.com. I present multi-day health seminars in churches both in Canada and in the U.S., and I give lectures to plant-based groups in the Austin, TX, area as well as in venues such as HealthFest in Marshall, TX. I have created a series of DVDs on various health topics and maintain four websites (listed below) related to a plant-based lifestyle. Within the last year, I have been interviewed by Dr. Howard Jacobson for his podcast at www.PlantYourself.com, and appeared on the 2016 PlantPure Summit, discussing the superiority of an oil-free, low-fat, whole-foods plant-based diet.

One of my favorite contributions to the plant-based community started in 2009 when I was hired as the Medical Director for the first seven Engine 2 Immersion Programs. Rip Esselstyn, who was featured in the acclaimed documentary Forks Over Knives, conducted the week-long sessions for employees of Austin-based Whole Foods Market. My duties included lecturing on topics related to how the body responds to different sources of food and how a low-fat, whole-food, plant-based diet reduces medication needs. As the medical director, I was responsible for monitoring the health of the participants and lowering their medications as their medical conditions dramatically began to reverse due to their change in the diet during the six-day program.

My general medical office is located just south of Austin, TX, where I practice full time to help pediatric and adult patients prevent and reverse disease using unprocessed, whole, plant-based foods in addition to traditional medications and procedures, if needed. Some of my patients’ success stories were presented in the documentary Ancient Health. Appearing in the film alongside well-known physicians like John McDougall, M.D., I spoke about the medical advantages of using food as medicine.

So What Do I Really Think?

With these credentials as my background, it is my professional opinion that raising a child from infancy to adulthood on a plant-based (vegan) diet is in no way detrimental to a child’s growth or development. Children raised on a plant-based diet generally enjoy better health during childhood and adolescence, and they continue to benefit from the results of their early vegan diet well into adulthood. Further, based on medical science, I encourage parents to help their children avoid between meal snacking. And since some families who eat a well-balanced, whole-food plant-based diet find that a two-meal a day plan is sufficient for both parents and children, I explain that there is medical science indicating benefits from fewer meals per day.

A plant-based diet is a diet which includes no foods of animal origin. Persons following such a diet eat no meat, no fowl, no fish or other seafood, no eggs, nor any milk or dairy products. All calories are derived from plant sources. A vegan diet consists of vegetables, legumes, fruit, grains, nuts, and seeds. These foods are adequate for providing all the nutrition necessary for growing children, with the exception of vitamin B12. This nutrient should be provided in the form of an oral supplement or in fortified foods such as breakfast cereal or a plant-based milk.

What Do Others Think?

Because of the concern that children whose diets are restricted to only plant foods will not receive adequate nutrition for growth and development, research is done to evaluate the effect of a plant-based diet on children. Although acknowledging that vegan children may have increased caloric needs and must have reliable sources for certain nutrients, researchers repeatedly conclude that a diet free from animal products can provide sufficient calories and nutrition for growth and development.^{1, 2, 3} Mainstream medical and nutritional experts reach the same conclusion and go on to note that a properly designed vegan diet is not only adequate, but can be beneficial for children. The American Academy of Pediatrics states:

Some people believe that patients following vegan or vegetarian diets suffer from nutritional deficiencies. Although there have been case reports of children failing to thrive or developing cobalamin [vitamin B12] deficiency on vegan diets, these are rare exceptions. Multiple experts have concluded independently that vegan diets can be followed safely by infants and children without compromise of nutrition or growth and with some notable health benefits.⁴

The American Dietetic Association takes a similar position:

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 life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.⁵

The professional organization Dietitians of Canada and the American Dietetics Association published a joint position paper on the adequacy of diets which exclude animal products. Published in the Journal of the Academy of Nutrition and Dietetics and in a similar article in the Canadian Journal of Dietetic Practice and Research, and the two groups cite multiple studies and conclude that:

Well-planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian diets are appropriate for all stages of the life cycle, including pregnancy and lactation. Appropriately planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian diets satisfy nutrient needs of infants, children, and adolescents and promote normal growth. Vegetarian diets in childhood and adolescence can aid in the establishment of lifelong healthy eating patterns and can offer some important nutritional advantages. Vegetarian children and adolescents have lower intakes of cholesterol, saturated fat, and total fat and higher intakes of fruits, vegetables, and fiber than nonvegetarians. Vegetarian children have also been reported to be leaner and to have lower serum cholesterol levels.⁶

What About Nutritional Deficiency?

Although the medical and nutritional community are satisfied regarding the adequacy of a well-planned, plant-based diet, there are many individuals who remain unconvinced. This lack of confidence in plant foods is, I believe, a prejudice based more on tradition than on established science. Since veganism is not the norm in American society and by contrast appears restrictive, the diet is singled out for scrutiny. Due in part to this added attention, a vegan diet is often erroneously assumed to be more risky for children than a standard omnivore diet. However, regardless of whether children eat an omnivore diet, a lacto-ovo vegetarian diet, or a vegan diet, all children can be at risk nutritionally. Our national system of fortifying foods such as salt (iodine), milk (vitamin D), and grain products (various vitamins and minerals)⁷ testifies to the concerns of public health officials regarding the adequacy of the average American diet, which is, of course, an omnivore diet. Feeding a child a diet that includes animal-based foods in no way guarantees that the child will receive ideal nutrition for growth and development. Parents must always be vigilant to provide all the nutrients required for a child to grow strong and healthy no matter which eating style the family practices.

How About Nutritional Excess?

While there may be public concern about potential nutritional deficits in certain diets, the medical community in the U.S. and other westernized countries is facing a much more pressing nutritional concern. Health care professionals around the world are increasingly alarmed by the rapid increase of diseases brought on by too much nutrition.^{8, 9} This trend is particularly worrisome because children are beginning to suffer from the same lifestyle-induced diseases as adults. Stephen K. Galson, MD, who served for two years as the Acting Surgeon General of the United States, states that “Between 1980 and 2002, the number of overweight children has tripled in the United States, making this a very serious public health epidemic.” He explains that childhood obesity, like adult obesity, increases the risk of heart disease, diabetes, high blood pressure, and high cholesterol.¹⁰ Physicians have identified not only an increased need for physical activity to combat the rising rate of lifestyle-induced illness, but a need to change the food environment.¹¹ As a physician practicing in the United States, I commonly see children and adolescents at risk of disease due to the nutritional excesses inherent in a diet rich in animal products and processed foods. Many fellow physicians see this trend and are speaking out, offering plant-foods as a proven solution to the growing national health crisis.^{12, 13, 14}

Are Laws Needed to Protect Children?

John McDougall, MD, has gone so far as to suggest that children should be protected by law from foods such as pepperoni pizza, just as they are protected by law from alcohol and tobacco products. The products turned out by the food industries which work directly with branches of the U.S. government, says Dr. McDougall, routinely result in childhood obesity, disfigurement (acne), pain (severe constipation), and precocious puberty. Offering these foods to children and adolescents is, in Dr. McDougall’s opinion, tantamount to child abuse. As a society, he says, we have become so enured to diet-induced illness that we no longer recognize the cause of our diseases. Dr. McDougall states:

Teachers, bankers, ministers, doctors, and police feed the Western diet [meat, dairy products, eggs, refined and processed foods] to their children thinking that the meat and cheese are good for their muscles and bones, and the junk is inconsequential. Ignorance of the cause does not diminish the suffering.

Instead of protecting children from these foods, says Dr. McDougall, society protects the rights of the food industry to market unhealthy food. He writes, “. . . the dairy industries' right to advertise the purported benefits of calcium in their products, while hiding the seriousness of the artery-clogging fats, outweighs the rights of children to basic good health.”¹⁵

What Makes Our Eating So SAD?

It is because the typical Western diet which includes dairy and other animal products is so clearly tied to disease that I believe a vegan diet is preferable for children. Many people educated in the effects of processed and animal-derived foods refer to the Standard American Diet by the acronym “SAD.” The moniker fits because it is truly heartbreaking to see friends and family members suffering from diseases assumed to be genetic and therefore inevitable but which are simply the result of dietary choices.

Is Our Health Determined by Genes?

We know that obesity and many diseases like high blood pressure, elevated cholesterol levels, type 2 diabetes, cardiovascular disease, and some types of cancer are not primarily genetic diseases; we see these diseases improve and often reverse when patients change their eating habits. The story of a set of twins is illustrative of the relationship of genetics to disease. Rosane Oliveira, DVM, PhD is an identical twin. As an adult, Rosane became vegan while her sister ate a semi-vegetarian diet which included dairy products and a small amount of fish or chicken. Rosane maintained a healthy weight and low cholesterol while her sister struggled with weight gain and high cholesterol like all the other women in their family. Not until Rosane’s sister joined her on a vegan diet did her sister’s cholesterol levels drop, demonstrating that eating habits rather than genetics were responsible for blood cholesterol levels.¹⁶ Formal research conducted on twins in Scandinavia bears out that environmental factors outweigh genetics in many forms of cancer as well.¹⁷

Neal Barnard, M.D., of the Physicians Committee for Responsible Medicine (PCRM) explains that genetics are not destiny. People may have a genetic tendency toward diseases like Alzheimer’s, but the expression of the genes is determined by lifestyle choices.¹⁸ His research indicates that “vegetables, legumes (beans, peas, and lentils), fruits, and whole grains should replace meats and dairy products as primary staples of the diet.” Barnard notes that these foods provide both macro and micronutrients but contain little to no saturated fat or trans fat. Citing two large studies, the Chicago Health and Aging Project and the Nurses’ Health Study, among other research, Barnard states that plant-based foods are associated with reduced risk for cognitive decline, cardiovascular disease, weight gain, and type 2 diabetes.¹⁹ Avoiding animal foods and centering the diet on plant foods eliminates disease risk factors while providing for nutritional needs.²⁰

Are Any Major Players on Board?

It is because of the health-inducing effect of plant foods that Kaiser-Permanente, the largest managed care organization in the U.S., is suggesting that patients and physicians explore a vegan diet as an alternative to prescription medication.^{21, 22}

The medical literature supports the link between animal products and increased risk of disease. Here are a few examples:

• Egg consumption increases risk of diabetes, lethal prostate cancer, ovarian cancer, colon and rectal cancer, and cardiovascular disease.^{23, 24, 25, 26, 27}
• Dairy consumption is linked to risk of inflammatory diseases of the bowel such as Crohn’s disease; the hormones in milk have been linked linked to cancer; and dairy has not been shown to promote child and adolescent bone mineralization.^{28, 29, 30}

It’s due to the preponderance of literature that shows a vegan diet to be a healthier choice that Kim Allen Williams, M.D., immediate past president of the American College of Cardiologists has adopted a vegan diet and recommends that his patients eat less meat and more plant-based foods.³¹

What About Snacking Graze-fully?

But even while veganism is gaining recognition in the medical community as a healthy lifestyle and as an alternative to medication for preventing and reversing disease, discouraging snacking is less commonly suggested. There is, however, evidence that the extra calories which snacking provides are not as healthy as many believe them to be. It is my medical opinion that better health in children is achieved when not snacking in between meals. Further, I believe that limiting the amount of food intake by eating two large meals per day will not harm growing children as long as they are taking in sufficient calories at those two meals.

Frequent calorie intake causes the body to expend energies (in making saliva, producing digestive juices, and contracting muscles of the jaws, esophagus, and stomach). Michael Klaper, M.D., an expert on fasting for health, states that 80 percent of the body’s energies are freed up during the fasting period between meals.³² What can the body do with that extra energy? In Fasting and Eating for Health: A Medical Doctor's Program For Conquering Disease, Joel Fuhrman, M.D., writes:

When the diet is without deficiencies, minimum caloric intake greatly increases resistance to infectious diseases. There are a host of mechanisms that strengthen our immune system and make the “soil” unwelcome for microbes when the body is not overfed. After studying various population groups, including underfed wartime prisoners, researchers have concluded that resistance to disease is highest on what would generally be considered an inadequate diet.³³

When between meal snacking is restricted, the body can take the energy it would have otherwise expended on digestion and instead use it to boost the immune system and for repair of damage at the cellular level. For growing children who are naturally exposed to many types of viruses and bacteria during social interactions and who often have little cuts and scrapes from the playground, a strong immune system such as is fostered by between-meal fasts is a benefit that parents can offer.

My Professional Opinion

Based on the medical research and the glowing health of the children I see in my practice who eat a well-planned, vegan diet with B12 supplementation, I and many other physicians like me believe that a whole-food plant-based diet is a superior choice for children. It prevents disease during childhood as well as sets children up for a healthy adulthood. 

My Web Sites:

(1) Medical Practice - AllMedPhysicians.com

(2) Science Blogs, Article, Resources - DrCarney.com

(3) Online Video Sales, Food Coaching - Veggievore.com

(4) Social Network, Forum, Recipes  - Starch-Smart.com

Article References:

¹ Amit, M. “Vegetarian Diets in Children and Adolescents.” Pediatrics & Child Health 15.5 (2010): 303–308. PubMed. Web. 30 Aug. 2016

² Sanders, T. A. "Growth and Development of British Vegan Children." American Journal of Clinical Nutrition 3 Suppl 48 (1988): 822-25. PubMed. Web. 30 Aug. 2016.

³ Messina, V., and A. R. Mangels. "Considerations in Planning Vegan Diets: Children." Journal of the American Dietetics Association 101.6 (2001): 661-69. PubMed. Web. 30 Aug. 2016.

⁴ Moilanen, Brita C. "Vegan Diets in Infants, Children, and Adolescents." Pediatrics in Review 25.5 (2004): n. pag. May 2004. Web. 19 Aug. 2016.

⁵ Craig, W. J., A. R. Mangels, and American Dietetics Association. "Position of the American Dietetic Association: Vegetarian Diets." Journal of the American Dietetics Association 109.7 (2009): 1266-282. National Center for Biotechnology Information. U.S. National Library of Medicine. Web. 19 Aug. 2016.

⁶ "Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets." Journal of the Academy of Nutrition and Dietetics 103.6 (2003): 748-65. Elsevier. 2003. Web. 22 Aug. 2016.

⁷ Institute of Medicine (US) Committee on Use of Dietary Reference Intakes in Nutrition Labeling. Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification. Washington (DC): National Academies Press (US); 2003. 3, Overview of Food Fortification in the United States and Canada. Available from: http://www.ncbi.nlm.nih.gov/books/NBK208880/

⁸ Pappachan, M.J. “Increasing Prevalence of Lifestyle Diseases: High Time for Action.” The Indian Journal of Medical Research 134.2 (2011): 143–145. Print.

⁹ Vanhala, Mauno, Pasi Vanhala, Esko Kumpusalo, Pirjo Halonen, and Jormo Takala. "Obesity from Childhood to Adulthood May Lead to the Metabolic Syndrome." Bmj 317.7154 (1998): 319. Web. 31 Aug. 2016.

¹⁰ Galson, RADM Steven K. “Childhood Overweight and Obesity Prevention.” Public Health Reports 123.3 (2008): 258–259. Print.

¹¹ Sifferlin, Alexandra. "Sick Before Their Time: More Kids Diagnosed With Adult Diseases | TIME.com." Time. Time, Web. 31 Aug. 2016.

¹² "Obesity Rates & Trends." : The State of Obesity. Trust for America's Health and the Robert Wood Johnson Foundation, June 2016. Web. 31 Aug. 2016.

¹³ PCRM. "Vegetarian Diets for Children: Right from the Start." The Physicians Committee. N.p., 13 Oct. 2010. Web. 31 Aug. 2016.

¹⁴ Campbell, Thomas. "Top 10 Plant-Based Research and News Stories of 2015." Center for Nutrition Studies. T. Colin Campbell Center for Nutrition Studies, 22 Dec. 2015. Web. 31 Aug. 2016.

¹⁵ McDougall, John. "McDougall Newsletter: April 2012 - My Formal Report to the State of Florida about Our Largest Source of Child Abuse: Food." McDougall Newsletter: April 2012 - My Formal Report to the State of Florida about Our Largest Source of Child Abuse: Food. Apr. 2012. Web. 31 Aug. 2016.

¹⁶ "Rosane Oliveira, DVM, PhD: Director, Integrative Medicine at the University of California Davis Health System." Dr McDougall’s Health Medical Center. Web. 31 Aug. 2016.

¹⁷ Lichtenstein, Paul, and Neils V. Holm, et al. "Environmental and Heritable Factors in the Causation of Cancer - Analyses of Cohorts of Twins from Sweden, Denmark, and Finland — NEJM." New England Journal of Medicine. Massachusetts Medical Society, n.d. Web. 31 Aug. 2016.

¹⁸ Barnard, Neal D. "Power Foods for the Brain." Google Books. Grand Central Publishing, n.d. Web. 31 Aug. 2016.

¹⁹ Barnard, Neal D., and Ashley I. Bush, et al. Proc. of International Conference on Nutrition and the Brain, Washington, D.C. Neurobiology of Aging Sept. 2014: S74-78. Elsevier. Web. 31 Aug. 2016.

²⁰ McDougall, Craig, and John McDougall. “Plant-Based Diets Are Not Nutritionally Deficient.” The Permanente Journal 17.4 (2013): 93. PMC . Web. 31 Aug. 2016.

²¹ The Plant-Based Diet: A Healthier Way to Eat. Kaiser Permanente, 2014. Web. 31 Aug. 2016.

²² Tuso, Philip J et al. “Nutritional Update for Physicians: Plant-Based Diets.” The Permanente Journal 17.2 (2013): 61–66. PMC . Web. 31 Aug. 2016.

²³ Li Y, Zhou C, Zhou X, Li L. Egg consumption and risk of cardiovascular diseases and diabetes: A meta-analysis. Atherosclerosis. Published ahead of print April 17, 2013.

²⁴ Richman, Erin L et al. "Egg, red meat, and poultry intake and risk of lethal prostate cancer in the prostate-specific antigen-era: incidence and survival." Cancer Prevention Research (2011).

²⁵ Zeng, S. et al. "Egg Consumption Is Associated with Increased Risk of Ovarian Cancer: Evidence from a Meta-analysis of Observational Studies." Journal of Clinical Nutrition 34.4 (2015): 635-41. PubMed. Web. 31 Aug. 2016.

²⁶ Steinmetz, K. A., and J. D. Potter. "Egg Consumption and Cancer of the Colon and Rectum." European Journal of Cancer Prevention 3.3 (1994): 237-45. National Center for Biotechnology Information. U.S. National Library of Medicine. Web. 31 Aug. 2016.

²⁷ Choi, Yuni et al. "Egg consumption and coronary artery calcification in asymptomatic men and women." Atherosclerosis 241.2 (2015): 305-312.

²⁸ University of Liverpool. "How Bacteria In Cows' Milk May Cause Crohn's Disease." ScienceDaily. ScienceDaily, 13 December 2007.

²⁹ Malekinejad, H. et al. "Hormones in Dairy Foods and Their Impact on Public Health - A Narrative Review Article." Iranian Journal of Public Health 44.6 (2015): 742-58. Web. 31 Aug. 2016

³⁰ Lanou, A. J. "Calcium, Dairy Products, and Bone Health in Children and Young Adults: A Reevaluation of the Evidence." Pediatrics 115.3 (2005): 736-43. AAP Gateway. Web. 31 Aug. 2016.

³¹ O'connor, Anahad. "Advice From a Vegan Cardiologist." The New York Times. The New York Times, 06 Aug. 2014. Web. 31 Aug. 2016.

³² Fasting: Safe and Effective Use of an Ancient Powerful Healing Therapy. Perf. Michael Klaper, M.D. N.d. DVD.

³³ Fuhrman, Joel. Fasting and Eating for Health: A Medical Doctor's Program for Conquering Disease. New York: St. Martin's, 1995. 68. Kindle Edition.