儿童青少年素食饮食行为对健康的影响

doi:10.12372/jcp.2025.23e1184

摘要/Abstract

摘要：

素食由于其对部分疾病的潜在防治作用而日益受到关注，近年来有多项研究聚焦成年素食人群的营养水平以及素食对于健康的影响。但是对素食人群中儿童与青少年的关注较少。本文以儿童青少年的素食与健康现状为切入点，系统检索了截至2023年8月的相关文献24篇，综述了素食儿童青少年总体营养水平以及关键营养素（维生素B₁₂、维生素D、钙、铁、锌）的情况，总结素食对于生长发育的影响和与疾病的关联，以期为医疗卫生工作者进一步了解并指导素食儿童青少年进行合理饮食提供科学依据，也为代谢性疾病的饮食防治提供新思路。

关键词: 儿童, 青少年, 素食, 生长发育, 营养水平

Abstract:

Vegetarian diets have become increasingly popular due to their perceived health benefits, with the majority of research focusing on the nutritional status and disease implications in adults. However, less attention has been paid to children and adolescents with plant-based food pattern. This review has systematically searched 24 relevant researches on vegetarian children and adolescents up to August 2023 and summarized the overall nutritional status, including vitamin B₁₂, vitamin D, calcium and iron. Additionally, it has demonstrated the impact of vegetarianism on growth and its association with diseases of vegetarian children and adolescents. Further, more studies are warranted to enhance health workers’ understanding about healthy vegetarian patterns and provide scientific evidence to guide children and adolescents to have a balanced vegetarian diet, and potentially inspire new approaches to dietary therapy for metabolic diseases.

Key words: children, adolescents, vegetarian diet, growth and development, nutritional status

张硕, 赵雪珉, 沈秀华. 儿童青少年素食饮食行为对健康的影响[J]. 临床儿科杂志, 2025, 43(2): 157-162.

ZHANG Shuo, ZHAO Xuemin, SHEN Xiuhua. The effect of vegetarian diet on children and adolescents[J]. Journal of Clinical Pediatrics, 2025, 43(2): 157-162.

参考文献 41

[1]	中国营养学会. 中国居民膳食指南(2022)[M] 中国居民膳食指南(2022). 北京: 人民卫生出版社, 2022: 281-288.
	Chinese Nutrition Society. Dietary guidelines for Chinese residents (2022)[M] Dietary Guidelines for Chinese Residents (2022). Beijing: People's Medical Publishing House, 2022: 281-288.
[2]	Wang T, Masedunskas A, Willett WC, et al. Vegetarian and vegan diets: benefits and drawbacks[J]. Eur Heart J, 2023, 44(36): 3423-3439. doi: 10.1093/eurheartj/ehad436 pmid: 37450568
[3]	王变, 毛绚霞, 唐文静, 等. 上海市素食人群膳食结构与营养摄入情况调查[J]. 卫生研究, 2016, 45(3): 503-507.
	Wang B, Mao XX, Tang WJ, et al. Survey on dietary structure and nutritional intake of vegetarian population in Shanghai[J]. Weisheng Yanjiu, 2016, 45(3): 503-507.
[4]	Stahler CM. How Many Youth in the U.S. are Vegan? How Many Teens Eat Vegetarian When Eating Out? The Vegetarian Resource Group Asks in a YouGov Poll[EB/OL]. [2021-04-09]. https://www.vrg.org/blog/2021/04/09/.
[5]	Rowicka G, Klemarczyk W, Ambroszkiewicz J, et al. Assessment of oxidant and antioxidant status in prepubertal children following vegetarian and omnivorous diets[J]. Antioxidants (Basel), 2023, 12(3): 682.
[6]	Ambroszkiewicz J, Gajewska J, Mazur J, et al. Dietary intake and circulating amino acid concentrations in relation with bone metabolism markers in children following vegetarian and omnivorous diets[J]. Nutrients, 2023, 15(6): 1376.
[7]	Mokhtari E, Mirzaei S, Asadi A, et al. Association between plant-based diets and metabolic health status in adolescents with overweight and obesity[J]. Sci Rep, 2022, 12(1): 13772.
[8]	孙长颢. 营养与食品卫生学[M]. 人民卫生出版社, 2017.
	Sun CH. Nutrition and Food Hygiene[M]. People's Medical Publishing House, 2017.
[9]	Sutter DO, Bender N. Nutrient status and growth in vegan children[J]. Nutr Res, 2021, 91: 13-25. doi: 10.1016/j.nutres.2021.04.005 pmid: 34130207
[10]	Desmond MA, Sobiecki JG, Jaworski M, et al. Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets[J]. Am J Clin Nutr, 2021, 113(6): 1565-1577. doi: 10.1093/ajcn/nqaa445 pmid: 33740036
[11]	Alexy U, FischerI M, Weder S, et al. Nutrient intake and status of German children and adolescents consuming vegetarian, vegan or omnivore diets: results of the VeChi Youth Study[J]. Nutrients, 2021, 13(5): 1707.
[12]	Macknin M, Kong T, Weier A, et al. Plant-based, no-added-fat or American Heart Association diets: impact on cardiovascular risk in obese children with hyper-cholesterolemia and their parents[J]. J Paediatr, 2015, 166(4): 953-959.
[13]	Leung SS, Lee RH, Sung RY, et al. Growth and nutrition of Chinese vegetarian children in Hong Kong[J]. J Paediatr Child Health, 2001, 37(3): 247-253.
[14]	O’connell JM, Dibley MJ, Sierra J, et al. Growth of vegetarian children: The Farm Study[J]. Pediatrics, 1989, 84(3): 475-481. pmid: 2771551
[15]	Jensen CF. Vitamin B12 levels in children and adolescents on plant-based diets: a systematic review and meta-analysis[J]. Nutr Rev, 2023, 81(8): 951-966.
[16]	Svetnicka M, Sigal A, Selinger E, et al. Cross-sectional study of the prevalence of cobalamin deficiency and vitamin B12 supplementation habits among vegetarian and vegan children in the Czech Republic[J]. Nutrients, 2022, 14(3): 535.
[17]	Roth DE, Morris SK, Zlotkin S, et al. Vitamin D supplementation in pregnancy and lactation and infant growth[J]. N Engl J Med, 2018, 379(6): 535-546.
[18]	Chen G, Su M, Chu X, et al. Plant-based diets and body composition in Chinese omnivorous children aged 6-9 years old: a cross-sectional study[J]. Front Nutr, 2022, 9: 918944.
[19]	Ambroszkiewicz J, Gajewska J, Mazur J, et al. Does a vegetarian diet affect the levels of myokine and adipokine in prepubertal children?[J]. J Clin Med, 2021, 10(17): 3995.
[20]	Hebbelinck M, Clarys P, De Malsche A. Growth, development, and physical fitness of Flemish vegetarian children, adolescents, and young adults[J]. Am J Clin Nutr, 1999, 70(3 Suppl): 579S-585S.
[21]	Hovinen T, Korkalo L, Freese R, et al. Vegan diet in young children remodels metabolism and challenges the statuses of essential nutrients[J]. EMBO Mol Med, 2021, 13(2): e13492.
[22]	Ambroszkiewicz J, Klemarczyk W, Gajewska J, et al. Serum concentration of biochemical bone turnover markers in vegetarian children[J]. Adv Med Sci, 2007, 52: 279-282.
[23]	Institute of Medicine (US). Committee to review dietary reference intakes for vitamin D and calcium. dietary reference intakes for calcium and vitamin D[M]. Washington (DC): National Academies Press (US), 2011.
[24]	Larsson CL, Johansson GK. Dietary intake and nutritional status of young vegans and omnivores in Sweden[J]. Am J Clin Nutr, 2002, 76(1): 100-106. pmid: 12081822
[25]	Bas M, Karabudak E, Kiziltan G. Vegetarianism and eating disorders: association between eating attitudes and other psychological factors among Turkish adolescents[J]. Appetite, 2005, 44(3): 309-315. pmid: 15927731
[26]	Weder S, Keller M, Fischer M, et al. Intake of micronutrients and fatty acids of vegetarian, vegan, and omnivorous children (1-3 years) in Germany (VeChi Diet Study)[J]. Eur J Nutr, 2022, 61(3): 1507-1520.
[27]	Segovia-Siapco G, Burkholder-Cooley N, Haddad Tabrizi S, et al. Beyond meat: a comparison of the dietary intakes of vegetarian and non-vegetarian adolescents[J]. Front Nutr, 2019, 6: 86. doi: 10.3389/fnut.2019.00086 pmid: 31249832
[28]	Craig WJ. Nutrition concerns and health effects of vegetarian diets[J]. Nutr Clin Pract, 2010, 25(6): 613-620. doi: 10.1177/0884533610385707 pmid: 21139125
[29]	Growth of vegetarian children[J]. Nutr Rev, 1979, 37(4): 108-109. pmid: 503364
[30]	Dwyer JT, Andrew EM, Berkey C, et al. Growth in “new” vegetarian preschool children using the Jenss-Bayley curve fitting technique[J]. Am J Clin Nutr, 1983, 37(5): 815-827. pmid: 6846221
[31]	Rona RJ, Chinn S, Duggal S, et al. Vegetarianism and growth in Urdu, Gujarati, and Punjabi children in Britain[J]. J Epidemiol Community Health, 1987, 41(3): 233-236.
[32]	Nathan I, Hackett AF, Kirby S. A longitudinal study of the growth of matched pairs of vegetarian and omnivorous children, aged 7-11 years, in the north-west of England[J]. Eur J Nutr, 1997, 51(1): 20-25.
[33]	Ambroszkiewicz J, Chelchowska M, Rowicka G, et al. Anti-inflammatory and pro-inflammatory adipokine profiles in children on vegetarian and omnivorous diets[J]. Nutrients, 2018, 10(9): 1241.
[34]	Elliott LJ, Keown-Stoneman CDG, Birken CS, et al. Vegetarian diet, growth, and nutrition in early childhood: a longitudinal cohort study[J]. Pediatrics, 2022, 149(6): e2021052598.
[35]	Position of the American Dietetic Association: vegetarian diets--technical support paper[J]. J Am Diet Assoc, 1988, 88(3): 352-355. pmid: 3346498
[36]	American Dietetic Association, Dietitians of Canada. Position of the American Dietetic Association and Dietitians of Canada: vegetarian diets[J]. J Am Diet Assoc, 2003, 64(2): 62-81.
[37]	Sabate J, Lindsted KD, Harris RD, et al. Attained height of lacto-ovo vegetarian children and adolescents[J]. Eur J Nutr, 1991, 45(1): 51-58.
[38]	梁淑芳, 罗祥瑛, 阮文宾, 等. 香港素食小儿之营养状况[J]. 中国实用儿科杂志, 1997, (4): 49-50.
	Liang SF, Luo XY, Ruan WB, et al. Nutritional status of vegetarian children in Hong Kong[J]. Zhongguo Shiyong Erke Zazhi, 1997, (4): 49-50.
[39]	Larsson CL, Johansson GK. Dietary intake and nutritional status of young vegans and omnivores in Sweden[J]. Am J Clin Nutr, 2002, 76(1): 100-106. pmid: 12081822
[40]	Perry CL, Mcguire MT, Neumark-Sztainer D, et al. Characteristics of vegetarian adolescents in a multiethnic urban population[J]. J Adolesc Health, 2001, 29(6): 406-416.
[41]	Sergentanis TN, Chelmi ME, Liampas A, et al. Vegetarian diets and eating disorders in adolescents and young adults: a systematic review[J]. Children (Basel), 2020, 8(1): 12.