Yet another authoritative confirmation of what has already emerged in recent years: vegetarian and especially vegan diets are not adequate to allow correct and physiological neurocognitive development in children.

The position paper signed SIPPS-SIMP-FIMP-SIMA, the four most important pediatric nutrition companies in Italy, is very clear: “In recent years there have been various favorable positions towards the possible use of vegetarian diet in children, starting from complementary feeding but also earlier, in case of breast milk unavailability. In the beginning, these were only documents that, although accompanied by scientific literature, did not have the rigorous methodology indispensable in addressing a topic with a thousand potentially critical repercussions on child health“, said Andrea Vania, head of the Pediatric Dietology and Nutrition Center of the Pediatrics Department of the Sapienza, University of Rome.

He presented on ‘Preventive & Social Pediatrics’, the official body of the Italian Society of Preventive and Social Pediatrics (SIPPS), the Inter-company position paper ‘Vegetarian diets in pregnancy and in developmental age’, in collaboration with the Italian Federation of Pediatricians (FIMP), the Italian Society of Perinatal Medicine (SIMP) and the Italian Society of Environmental Medicine (SIMA).

It was necessary for these four societies to “investigate some critical points connected to the adequacy of vegetarian diets in children,” explains Vania, and the document finally makes clear the effects of “veg” nutrition on the growth and neurocognitive development of children. “Iron, zinc, DHA and vitamin B12 are all micronutrients whose deficiency in vegetarian diets is possible and greater in more restrictive diets – the document explains – reaching the maximum levels of deficiency in vegan or macrobiotic diets“.

These nutrients play a fundamental role in children’s neuronal and neurocognitive development, which has critical periods of particular vulnerability in which exposure to malnutrition or deficiencies in environmental stimuli or both can produce a reduction in neural plasticity. These new pieces of evidence, of high scientific quality, replace those few studies of very low methodological quality in favor of “veg diets”. In fact, on vegetarian diets “studies of good methodological quality are lacking, while this recent scientific evidence consists of systematic reviews with meta-analysis on the individual nutrients deficiencies, all consistent in demonstrating important short and long-term outcomes on the neurodevelopment”.

These negative effects could be irreversible: “In infants, vitamin B12 deficiency occurs between 4 and 6 months and it has been associated with abnormal myelination, damaging auditory and visual systems and interfering with learning and social interaction. It cannot be excluded that vegetarian and vegan diets of the breastfeeding mother, if not supplemented, lead to serious clinical outcomes on the auxological and/or psychomotor development of babies – the position paper declares – and the same risks can be highlighted later, in the second half of the year, in children who introduce an exclusively vegetarian complementary diet that is not adequately supplemented”.

Problems seem to exist in children, and also to persist later in adulthood: “Iron deficiency in pregnancy or in the early years of life has been linked to a greater frequency of anxiety, depression and schizophrenia in adulthood, as well as folate and vitamin B12 deficits associated with an increased risk of depression in adults. A zinc deficit in children – the document continues – has been associated with various behavioural, cognitive and motor disorders“.

Conclusions and final recommendations of the authoritative position paper signed by SIPPS, FIMP, SIMA and SIMP leave no doubts: “The scientific evidence demonstrates important short and long-term negative outcomes on neurodevelopment due to nutrient deficiency, and specifically iron, zinc and vitamin B12 deficit: therefore vegetarian diets must be considered inadequate to guarantee correct psychomotor development in children – the document concludes – recommending careful nutritional monitoring of the breastfeeding vegetarian/vegan mother, providing the necessary supplements for preventing serious clinical outcomes such as growth deficiency, anemia, and neurological deficits.”

Therefore “periodic and specific nutritional assessments and adequate supplements, such as iron, vitamin B12, and fortified foods are recommended in children following a vegan diet, especially in early childhood, and monitoring and possibly supplementing the intake in children following a lacto-ovo-vegetarian diet. “The English version of the inter-company scientific report, coordinated by the SIPPS President Giuseppe Di Mauro and Margherita Caroli, a specialist in Pediatrics and Dietary Nutrition Science, is in progress and will soon be presented to the entire international scientific community.