Vegetarian and vegan diets during the first 1000 days of life: a review of the evidence and recommendations for clinical practice
DOI:
https://doi.org/10.14409/sigme.2025.4.e0026Keywords:
Vegetarian, Vegan diets, Pregnancy, Breastfeeding, Infant, Complementary feeding, First 1000 days, Nutritional supplementationAbstract
To review the available scientific evidence on the feasibility, nutritional adequacy, and practical considerations of vegetarian and vegan diets (VDDs) during pregnancy, breastfeeding, and the first two years of life (the first 1000 days), in order to develop evidence-based technical recommendations for healthcare teams. A narrative review of the scientific literature published in recent decades was conducted, obtained from databases such as PubMed, Scopus, Web of Science, and SciELO, as well as documents from international organizations and scientific societies. Studies addressing the nutritional composition, clinical impacts, and supplementation recommendations for VDDs in this population were selected, applying predefined inclusion and exclusion criteria. A well-planned VDD can be nutritionally adequate and offer health benefits during this critical stage. However, it carries an inherent risk of specific nutrient deficiencies, with vitamin B12, iron, DHA (omega-3), and, to a lesser extent, zinc, iodine, calcium, and vitamin D being of greatest concern. Evidence indicates that strategic supplementation and consumption of fortified foods are essential to prevent deficiencies and ensure optimal development. Discrepancies in the positions of various scientific societies were identified. VVDs are feasible during the first 1000 days of life but require meticulous planning, nutritional education, and ongoing monitoring. The healthcare team plays a crucial role in counseling, focusing on mandatory vitamin B12 supplementation, adequate iron and omega-3 intake, and individualized assessment of nutritional status to ensure favorable maternal and child outcomes
References
Alberti, M. A. J., & Desantadina, M. A. V. (2019). Dietas vegetarianas en la infancia. Archivos Argentinos de Pediatría, 118(4), S130–S141.
Amit, M. (2010). Vegetarian diets in children and adolescents. Paediatrics & Child Health, 15(5), 303–308.
Andreatta, M. M., Sudria, M. E., & Defagó, M. D. (2021). Población veg(etari)ana argentina: una aproximación a sus características sociodemográficas, estado nutricional y alimentación habitual. Revista Española de Nutrición Comunitaria, 27(2), 124–130. Nexus Medica Editores.
Aveyá Gilardón, O. E. (2016). Una evaluación crítica de los programas alimentarios en Argentina. Salud Colectiva, 12, 589–604.
Baroni, L., Goggi, S., Battaglino, R., et al. (2018). Vegan nutrition for mothers and children: Practical tools for healthcare providers. Nutrients, 11(1).
Brenna, J. T., Varamini, B., Jensen, R. G., Diersen-Schade, D. A., Boettcher, J. A., & Arterburn, L. M. (2007). Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. American Journal of Clinical Nutrition, 85(6), 1457–1464.
Cabana, J., Sabatelli, D., Tonietti, M., Flores, A., Conti, R., Pasqualini, D., Gaete, L., & Gil, S. M. (2020). Origen de la salud y enfermedad en el curso de la vida. Sociedad Argentina de Pediatría. Archivos Argentinos de Pediatría, 118(4), S118–S129.
Dirección Nacional de Maternidad e Infancia. Ministerio de Salud de Argentina. (2013). Ley N.º 25.630/02 de fortificación de harinas. Recomendaciones para la práctica del control preconcepcional, prenatal y puerperal.
Donato, H., Piazza, N., Rapetti, M. C., de Grandis, S., Bacciedoni, V., Fabeiro, M., Cedola, A., Hernández, J., Coirini, M., Pita de Portela, M. L., Sosa, P., & Desantadina, V. (2017). Deficiencia de hierro y anemia ferropénica: guía para su prevención, diagnóstico y tratamiento. Archivos Argentinos de Pediatría, 115(4).
FAO & FINUT. (2012). Grasas y ácidos grasos en nutrición humana. Consulta de expertos [Internet]. Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO). Disponible en: http://www.fao.org/3/v4700s/v4700s05.htm
Fernández, A., Sosa, P., Setton, D., et al. (2011). Calcio y nutrición. Sociedad Argentina de Pediatría. Disponible en: https://sub.sap.org.ar/storage/app/media/pdf/calcio.pdf
Foster, M., Chu, A., Petocz, P., & Samman, S. (2013). Effect of vegetarian diets on zinc status: A systematic review and meta-analysis of studies in humans. Journal of the Science of Food and Agriculture, 93(10), 2362–2371.
Foster, M., & Samman, S. (2015). Vegetarian diets across the lifecycle: Impact on zinc intake and status. Advances in Food and Nutrition Research, 74, 93–131.
García-Maldonado, E., Gallego-Narbón, A., & Vaquero, M. P. (2019). ¿Son las dietas vegetarianas nutricionalmente adecuadas? Nutrición Hospitalaria, 36(4), 950–961. https://doi.org/10.20960/nh.02550
Goodman & Gilman. (2019). Las bases farmacológicas de la terapéutica (13.ª ed.). McGraw-Hill Education. Disponible en: https://accessmedicina.mhmedical.com/book.aspx?bookID=2457
Ho-Pham, L. T., Vu, B. Q., Lai, T. Q., Nguyen, N. D., & Nguyen, T. V. (2012). Vegetarianism, bone loss, fracture and vitamin D: A longitudinal study in Asian vegans and non-vegans. European Journal of Clinical Nutrition, 66(1), 75–82.
Hurrell, R., & Egli, I. (2010). Iron bioavailability and dietary reference values. American Journal of Clinical Nutrition, 91(5), 1461S–1467S.
Karcz, K., & Królak-Olejnik, B. (2021). Vegan or vegetarian diet and breast milk composition: A systematic review. Critical Reviews in Food Science and Nutrition, 61(7), 1081–1098. https://doi.org/10.1080/10408398.2020.1753650
Kniskern, M. A., & Johnston, C. S. (2011). Protein dietary reference intakes may be inadequate for vegetarians if low amounts of animal protein are consumed. Nutrition, 27(6), 727–730.
Lacagnina, S. (2019). The Developmental Origins of Health and Disease (DOHaD). American Journal of Lifestyle Medicine, 14(1), 47–50. https://doi.org/10.1177/1559827619879694
López Linares, S., & Heer, I. M. (2014). Contenido de yodo en sal a nivel de puestos de venta provenientes de distintas localidades en tres regiones argentinas. Revista Argentina de Endocrinología y Metabolismo, 59–65.
Mangels, A. R., & Messina, V. (2001). Considerations in planning vegan diets: Infants. Journal of the American Dietetic Association, 101(6), 670–677.
Martínez Biarge, M. (2019). Niños vegetarianos, ¿niños sanos? En AEPap (Ed.), Congreso de Actualización Pediatría 2019 (pp. 65–77). Madrid: Lúa Ediciones 3.0.
Martínez de Victoria Muñoz, E. (2012). Informe del Comité Científico de la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN) sobre la situación nutricional de la mujer en edad fértil, durante la gestación y la lactancia con respecto a la ingesta adecuada de yodo. Revista del Comité Científico de la AESAN, 37, 105–151.
Melina, V., Craig, W., & Levin, S. (2016). Position of the Academy of Nutrition and Dietetics: Vegetarian diets. Journal of the Academy of Nutrition and Dietetics, 116(12), 1970–1980.
Messina, M., Duncan, A. M., Glenn, A. J., & Mariotti, F. (2023). Plant-based meat alternatives can help facilitate and maintain a lower animal to plant protein intake ratio. Advances in Nutrition, 14(3), 392–405. https://doi.org/10.1016/j.advnut.2023.03.003
Pawlak, R. (2017). To vegan or not to vegan when pregnant, lactating or feeding young children. European Journal of Clinical Nutrition, 71(11), 1259–1262.
Pawlak, R., Vos, P., Shahab-Ferdows, S., Hampel, D., Allen, L. H., & Perrin, M. T. (2018). Vitamin B12 content in breast milk of vegan, vegetarian, and nonvegetarian lactating women in the United States. American Journal of Clinical Nutrition, 108(3), 525–531.
Perrin, M. T., Pawlak, R., Dean, L. L., Christis, A., & Friend, L. (2019). A cross-sectional study of fatty acids and brain-derived neurotrophic factor (BDNF) in human milk from lactating women following vegan, vegetarian, and omnivore diets. European Journal of Nutrition, 58(6), 2401–2410.
Refsum, H., Yajnik, C. S., Gadkari, M., Schneede, J., Vollset, S. E., & Orning, L. (2001). Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. American Journal of Clinical Nutrition, 74(2), 233–241.
Robles, G. A. L., Hernández, N. G., & López, L. M. P. (2016). Importancia de la nutrición: primeros 1.000 días de vida. Acta Pediátrica Hondureña, 7(1), 597–607.
Rodríguez, M. L., Méndez, J. S., Martínez, M. S., & Domínguez, M. C. (2010). Suplementos en embarazadas: controversias, evidencias y recomendaciones. Información Terapéutica del Sistema Nacional de Salud, 34(4), 117–128.
Rojas Allende, D., Figueras Díaz, F., & Durán Agüero, S. (2017). Ventajas y desventajas nutricionales de ser vegano o vegetariano. Revista Chilena de Nutrición, 44(3), 218–225.
Ryan, L., & Symington, A. M. (2015). Algal-oil supplements are a viable alternative to fish-oil supplements in terms of docosahexaenoic acid (22:6n-3; DHA). Journal of Functional Foods, 19, 852–858. https://doi.org/10.1016/j.jff.2014.06.023
Sanders, T. A. (1992). The growth and development of vegan children. Journal of Human Nutrition and Dietetics, 5(1), 11–21.
Sanders, T. A. B. (2009). DHA status of vegetarians. Prostaglandins, Leukotrienes and Essential Fatty Acids, 81(2–3), 137–141.
Trang, H. M., Cole, D. E., Rubin, L. A., Pierratos, A., Siu, S., & Vieth, R. (1998). Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2. American Journal of Clinical Nutrition, 68(4), 854–858.
Van Winckel, M., Vande Velde, S., De Bruyne, R., & Van Biervliet, S. (2011). Clinical practice: Vegetarian infant and child nutrition. European Journal of Pediatrics, 170(12), 1489–1494.
Wagner, C. L., & Greer, F. R. (2008). Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics, 122(5), 1142–1152.
Watanabe, F. (2007). Vitamin B12 sources and bioavailability. Experimental Biology and Medicine, 232(10), 1266–1274.
Weaver, C. M., Proulx, W. R., & Heaney, R. (1999). Choices for achieving adequate dietary calcium with a vegetarian diet. American Journal of Clinical Nutrition, 70(3 Suppl.), 543S–548S.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Jesica Diaz, Milagros Ferrando, Florencia Fontana, Albana Marchesini
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
