No meat? No fish? No big deal, even for kids who go vegetarian.

(James Steinberg)
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Carolyn Butler
Tuesday, December 14, 2010

Both of my sons have been voracious carnivores from the get-go, devouring baby beef and chicken purees with gusto before graduating to gnawing spare ribs clean, inhaling full pots of meatballs and downing two to three hot dogs in a sitting. Over the past several months, however, my 4-year-old has started to reject nearly all forms of animal protein, one by one: First, steak was declared "too tough," then chicken "yucky," and on and on, with pork, sausage, ground beef, fish of any sort and even, last week, his once beloved franks.

Hence, the macaroni-and-cheese marathon at our dinner table of late.

While Eli's distaste for meat may just be a brief spurt of picky eating, a small but growing number of children and adolescents are consciously opting for a vegetarian diet. Earlier this year, a nationwide survey of 1,258 8- to 18-year-olds found that 3 percent never eat meat, poultry or seafood, up from 1.4 percent in 1995. That's an estimated 1.4 million young vegetarians today, says Reed Mangels, nutrition advisor for the Vegetarian Resource Group. (That Baltimore-based organization commissioned the online survey, whose findings cannot be considered as reliable as polls using more traditional methodology.)

Mangels points out that two-thirds of these meatless kids are vegan, meaning that they also forgo animal products such as dairy and eggs. Vegetarianism "is definitely a more mainstream choice than ever before," says Mangels, whose family, including two teenage girls, is vegan.

Research on adult vegetarians suggests that a plant-based diet provides many ongoing health benefits, including a lower incidence of obesity, coronary heart disease, high blood pressure, Type 2 diabetes and possibly certain types of cancer. (One of the latest studies on the topic, a small sampling published this summer in the peer-reviewed Nutrition Journal, suggests that vegetarians may be less depressed and have better mood profiles than meat-eaters.) Lalita Kaul, a nutrition professor at Howard University College of Medicine and a spokeswoman for the American Dietetic Association, says eating a well-planned, well-balanced vegetarian diet "can be healthful and appropriate at any age."

Naturally, it didn't take long for my concern about Eli's de facto vegetarianism to morph into grand visions of a super-fit preschooler, fueled on broccoli and Brussels sprouts. But avoiding meat and other animal products doesn't automatically ensure good nutrition.

" 'Vegetarian' is not synonymous with 'healthy'; you have to be making good, healthy food choices and avoiding junk food," says Hemant Sharma, a pediatrician at Children's National Medical Center. In fact, he points out, parents of a young vegetarian often need to be extra-vigilant in monitoring their offspring's diet: "It's important to pay special attention and to plan different factors of a plant-based diet out carefully, to ensure that growing children get all of the nutrients they need."

Sharma notes that typically, the more strict the kid is about being vegetarian (i.e., the more foods avoided), the more oversight is needed. "Flexitarians," who occasionally eat meat, and "pescatarians," who consume fish, are on the less worrisome end of the spectrum, and true vegans, who don't touch milk, eggs or even honey, are at the opposite end.

Experts agree that getting enough food overall is key. "In plant-based diets, which tend to be very high in fiber, children often get a sense of fullness before they really ingest enough calories as they need, or eat enough food to provide adequate energy," says Sharma, who recommends three meals and three snacks a day for his vegetarian patients, all filled with such energy-dense options as nuts, seeds and avocado, as well as such high-protein foods as tofu and other soy products, beans and, for those who aren't vegan, low-fat dairy and eggs.

The main sources of concern about vitamins and minerals that meat-eaters get but that vegetarians might not are iron (particularly for teenage girls) and, for vegans, Vitamin D, Vitamin B12 and calcium, says registered dietitian Mangels. Still, she emphasizes that it is entirely possible to get the proper levels of all nutrients with some planning and a multivitamin if necessary.

My own finicky foodie aside, many kids choose to eat less meat or to become all-out vegetarians for perfectly valid, even admirable, reasons, from taste and moral objections to family preferences. But Sharma counsels that parents of older children who opt for a plant-based diet try to suss out whether their motives are entirely pure.

"It's important to look for clues and assess whether this choice to be a vegetarian might reflect an underlying eating disorder . . . which can sometimes present with just a restriction in what an adolescent will be willing to eat," he says.

Looking ahead, I'm thrilled that my son is eating mostly fruits, veggies and whole grains. We're working on adding such foods as tofu, edamame and a variety of beans to his daily diet, even if we still have to sneak them into quesadillas for now. But that doesn't mean that my husband and I have reconciled ourselves to an entirely meat-free life or that we're excited about preparing two meals for every breakfast, lunch and dinner.

Happily, cooking for a lone vegetarian or two doesn't have to be stressful or take much more effort, says Mangels, who suggests focusing on the meatless meals your family already eats, such as the aforementioned macaroni and cheese, a hearty minestrone or lentil soup, or bean burritos. From there, "it's all about looking at foods that you can make vegetarian or not quickly, like stir-frying a whole lot of vegetables and offering both tofu and chicken, so that everyone can mix what they like," she says, noting that giving up meat is positive for the environment and can be much less expensive. "Just try seeing it as an opportunity to help the whole family eat healthier."

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