Reacción a "A large study analyzes the benefits and risks of vegetarian and vegan diets in children"

The study is a systematic review and meta-analysis comparing ovo-lacto-vegetarian and vegan diets with omnivorous diets in children and adolescents (<18 years) in various countries worldwide, providing a valuable synthesis of current evidence in pediatric populations. It is the most comprehensive synthesis to date on these types of diets in childhood and adolescence, including 59 studies and more than 48,000 participants. The results were stratified by country income level (low/middle versus high) and by age (preschool <6 years and school-age >6 years).

The study confirms that plant-based diets, when well-planned, can support healthy growth in this population and offer advantages such as lower total and LDL cholesterol levels. Furthermore, these children tend to be leaner and have a lower risk of being overweight. However, if these diets are not well-supervised, other risks arise, such as vitamin B12 deficiency (vegan diets), anemia, and reduced height, the latter possibly associated with iron, calcium, and vitamin D intake. Interestingly, vegan children consumed more iron than omnivorous children, but it was not enough to maintain ferritin levels because it was non-heme iron.

The authors state that randomized controlled trials were not included because the intention was to observe associations between the habitual consumption of these diets with nutrient intake and markers of nutritional status, but it would be appropriate to do so in the future to be able to make causal inferences.

On the other hand, high heterogeneity was found in the results due to age. Although stratified by age (<6 years and >6 years), there is a great difference in their state of physiological maturity between children around 6 years old and adolescents up to 18 years old, who were in the same group.

Another point of criticism is that only four studies excluded participants taking supplements, and supplement use was reported inconsistently across studies. This complicates the interpretation of the results and suggests that unsupplemented ovo-lacto-vegetarian and vegan diets may lead to a greater risk of nutritional deficiencies than observed. Furthermore, data on bone markers were not available for vegan participants.

Therefore, while this is a valuable study, it needs to be complemented by prospective studies and clinical trials to evaluate the long-term effects of these diets on pediatric development.