Etudes sur les enfants végétaliens

Jusque récemment, il existait remarquablement peu d’études sur les enfants végétaliens. Une synthèse de 2017 (Schürman et al., ci-dessous) n’en trouvait que 2 correspondant à ses critères d’inclusion. De nouvelles études sont en cours, mais il manque particulièrement de suivi à long terme, d’études poussées des biomarqueurs, d’autant qu’une étude récente constate des modifications du métabolisme chez les enfants végétaliens. Il manque aussi généralement une étude de certains nutriments potentiellement problématiques comme la choline et la vitamine K2.
Si vous connaissez d’autres études sur les enfants végétaliens, n’hésitez pas à me les signaler, en commentaire ici ou sur Twitter (@fabiensapiens)
Cette page ne contient que des études primaires et des revues systématiques ou méta-analyses. Pour les différents avis sur le végétarisme voir la page [Avis divers sur les végéta*ismes]

[Retour au sommaire des données scientifiques]


Vegan diet in young children remodels metabolism and challenges the statuses of essential nutrients [PDF]
Hovinen et al.
EMBO. Molecular medicine, 2021

Our evidence indicates that vegan children show remarkable metabolic differences compared to omnivores. The data indicate that strict vegan diet affects metabolism of healthy children. Our study indicates the importance of detailed longitudinal and cross-sectional studies on the nutritional and health effects of a vegan diet before it can be recommended for infants or children.

Growth, body composition, and cardiovascular and nutritional risk of 5-
to 10-y-old children consuming vegetarian, vegan, or omnivore diets [PDF]
Desmond et al.
American journal of clinical nutrition, 2021

Several unanswered questions remain. Assuming validity of
our findings regarding decreased height and BMC in vegans and
vegetarians, it is unclear which aspects of PBDs can contribute
to these outcomes, at what age, or whether supplementation or
dietary change can rectify these problems. We do not know the
extent and consequences of long-term cardiometabolic benefits
or nutritional risks. Additional research and replication of our
findings using longitudinal studies are desirable. Our data relate
to ages 5–10 y, but the risks and benefits for children of
different ages, especially infants, might vary. We propose that
physicians and dietitians educate their patients on both potential
benefits and risks of PBDs in children, emphasizing potential
effects on stature and bone associated with veganism. Vegan and
vegetarian children need guidelines on how to eat healthfully,
beyond advice on supplementation. Finally, current debates on
PBDs and the position statements of expert organizations should
focus even more on customizing the advice to vegans compared
with vegetarians and different age groups so that the established
benefits of these diets are maximized and the risks minimized in
the pediatric population.

Food group intake of children and adolescents (6–18 years) on a vegetarian, vegan or omnivore diet: results of the VeChi Youth Study [Abstract]
Alexy et al. (Weder)
British journal of nutrition, 2021

Longitudinal studies are necessary to evaluate the long-term health consequences of vegetarian, vegan and omnivore food patterns, especially in childhood and adolescence.

Nutrient Intake and Status of German Children and Adolescents Consuming Vegetarian, Vegan or Omnivore Diets: Results of the VeChi Youth Study [Texte]
Alexy et al. (Weder)
Nutrients, 2021

The total energy intake did not differ significantly between groups, but intake of carbohydrates was higher among vegetarians and vegans than among omnivores (p = 0.0002, respectively). The median protein intake exceeded 0.9 g/kg body weight/day in all diet groups and was lowest among vegetarians (p < 0.02). There was no significant difference of haemoglobin, vitamin B2, 25-OH vitamin D3, HDL-C and triglycerides blood concentrations between diet groups. Vegan participants had higher folate concentrations than vegetarian participants (p = 0.0053). Ferritin concentration was significantly higher in omnivores than in vegetarians (p = 0.0134) and vegans (p = 0.0404). Vegetarians had lower concentrations of holotranscobalamin (p = 0.0042) and higher concentrations of methylmalonic acid (p = 0.0253) than omnivores. Vegans had the lowest non-HDL-C and LDL-C concentrations in comparison to vegetarians (p = 0.0053 and p = 0.0041) and omnivores (p = 0.0010 and p = 0.0010). A high prevalence (>30%) of 25-OH vitamin D3 and vitamin B2 concentrations below reference values were found irrespective of the diet group. In conclusion, the Vechi Youth Study did not indicate specific nutritional risks among vegetarian and vegan children and adolescents compared to omnivores.

Intake of micronutrients and fatty acids of vegetarian, vegan, and omnivorous children (1–3 years) in Germany (VeChi Diet Study) [Texte]
Weder et al.
European Journal of Nutrition, 2021

In early childhood, VN and VG diets can provide most micronutrients in desirable amounts and a preferable fat quality compared to an OM diet. Special focus should be paid to (potentially) critical nutrients, particularly vitamin D, iodine, and DHA for all children regardless of diet, as well as vitamin B2, vitamin B12, calcium, and iron for VG and VN children.
[…] Critical nutrients for all three diet groups were vitamin D (without supplements), iodine, and DHA, with OM children having the highest intakes. For VG and VN children, vitamins B2 and B12, and iron are considered critical, as well as calcium for VN children.

Energy, Macronutrient Intake, and Anthropometrics of Vegetarian, Vegan, and Omnivorous Children (1–3 Years) in Germany (VeChi Diet Study) [Texte]
Weder et al.
Nutrients, 2019

Due to the lack of current, large-scale studies examining their dietary intake and health, there are concerns about vegetarian (VG) and vegan (VN) diets in childhood. Therefore, the Vegetarian and Vegan Children Study (VeChi Diet Study) examined the energy and macronutrient intake as well as the anthropometrics of 430 VG, VN, and omnivorous (OM) children (1–3 years) in Germany. A 3-day weighed dietary record assessed dietary intake, and an online questionnaire assessed lifestyle, body weight (BW), and height. Average dietary intakes and anthropometrics were compared between groups using ANCOVA. There were no significant differences in energy intake or density and anthropometrics between the study groups. OM children had the highest adjusted median intakes of protein (OM: 2.7, VG: 2.3, VN: 2.4 g/kg BW, p < 0.0001), fat (OM: 36.0, VG: 33.5, VN: 31.2%E, p < 0.0001), and added sugars (OM: 5.3, VG: 4.5, VN: 3.8%E, p = 0.002), whereas VN children had the highest adjusted intakes of carbohydrates (OM: 50.1, VG: 54.1, VN: 56.2%E, p < 0.0001) and fiber (OM: 12.2, VG: 16.5, VN: 21.8 g/1,000 kcal, p < 0.0001). Therefore, a VG and VN diet in early childhood can provide the same amount of energy and macronutrients, leading to a normal growth in comparison to OM children.

Seules 2 études sur les enfants végétaliens remplissaient les critères d’inclusion dans cette revue systématique de 2017.

Vegetarian diets in children: a systematic review [Texte]
Schürmann et al.
European journal of nutrition, 2017

This review demonstrates that the available data do not allow firm conclusions to be drawn on the benefits or risks of present-day vegetarian-type diets with respect to nutritional or health status of infants, children, and ado-lescents. Apart from the scarcity and heterogeneity of the studies, in general, there has in particular not yet been any long-term follow-up.
[…] Increased health risks of vegetarian diets were particularly reported for iron status. Studies in children on vegan diets are scarce and the two studies identified in this review did not analyse biomarkers.

Growth of Vegetarian Children: The Farm Study [Abstract]
Joan M. O’Connell et al.
Pediatrics, 1989.

Porte sur une communauté très particulière, suivie de 1980 à 1983, qui prend pas mal de compléments alimentaires (Vitamine B12, A et D, plus d’autres vitamines et minéraux, dit la publi), qui est d’un excellent niveau de compétence nutritionnelle, qui produit elle-même une part de sa nourriture. L’étude n’investigue rien d’autre que la taille et le poids des enfants, ne fait aucune recherche supplémentaire. Elle trouve une taille et un poids un peu inférieurs à la normale, mais sans que ce soit significatif.
Une telle étude ne peut en aucun cas être extrapolée aux personnes se supplémentant uniquement en B12, à la population générale moins compétente en nutrition, aux personnes consommant une nourriture industrielle. Elle ne conclut par ailleurs rien sur d’éventuels autres aspects que le poids et la taille, et ne peut en aucun cas conclure à une absence de problèmes sanitaires des enfants étudiés, puisqu’elle ne les investigue pas. Difficile de conclure aussi sur les éventuelles conséquences à long terme d’une telle alimentation à partir d’un suivi de 3 ans seulement.

Farm Study

Etudes menées par Sanders

Vegetarian diets and children
TAB Sanders
Pediatric Clinics, 1995.
Vegetarian diets and children
TAB Sanders and Sheela Red
American journal of clinical nutrition, 1994.
Une partie du papier porte sur un sous-groupe indien végétarien. Or, les données génétiques suggèrent que les populations du continent indien ont sélectionné plusieurs modifications génétiques favorables au végétarisme, notamment les allèles favorables des gènes FADS1 et FADS2.
Sanders passe sous silence le résultat essentiel de son étude de 1992 (voir plus haut) où il constate des différences importantes de statut en DHA entre les enfants allaités de mère végane et omnivore.
Cette publication est issue de la même étude que celle de 1988.

The growth and development of vegan children
Sanders & Manning
Journal of human nutrition and dietetics, 1992
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-277X.1992.tb00129.x

The growth and development of the children were normal but they tended to be lighter in weight and exceptionally lean compared with standards.[…]
The results of this study show that children can be successfully reared on a vegan diet providing sufficient care is taken to avoid the known pitfalls of a bulky diet and vitamin B12 deficiency.

Growth and developpement of british vegan children
Thomas AB Sanders
American journal of clinical nutrition, 1988
https://academic.oup.com/ajcn/article-abstract/48/3/822/4716540?redirectedFrom=PDF

Sanders souligne le risque de déficience en taurine, carnitine et certains acides gras. Mais il écarte ces risques parce que les enfants peuvent les trouver dans le lait maternel. Mais l’alaitement est de durée variable, et les études de cas plus haut sur cette page montrent que le lait maternel peut être déficient si la mère est carencée elle-même.En taille, on trouve environ 15% des garçons sous la limite inférieure des 3%, et en poids, environ 18% sur cette limite +- marge d’erreur. Il me semble que ce résultat devrait interpeller, et, vu le faible échantillon, appeler à la prudence et à des études plus poussées. Sanders néglige ce fait.

Sanders height of british boys
Sanders wheight of british boys
An anthropometric and dietary assessment of the nutritional status of vegan preschool children.

Sanders & Purves
Journal of human nutrition, 1981
https://www.ncbi.nlm.nih.gov/pubmed/7288184

The nutritional status of 23 vegan children between one and five years was assessed using anthropometric and dietary criteria. All of the children had been breastfed for at least the first six months of life and in most cases well into the second year. The majority of the children were growing normally but they did tend to be smaller in stature and lighter in weight when compared with standards. Energy, calcium and vitamin D intakes were usually below those recommended. Their diets, however, were generally adequate but a few children had low intakes of riboflavin and vitamin B12. It is concluded that, provided sufficient care is taken, a vegan diet can meet the nutritional requirements of the preschool child.

Dans celle-ci, on trouve des taux d’EPA et de DHA très bas chez les enfants végans, et un rapport oméga/6 sur oméga 3 très élevé. A l’époque, Sanders considère ça comme peu important, et du fait que le cholestérol est plus bas chez les végans, considère que le profil lipidique est meilleur chez les végans.

Studies of vegans: the fatty acid composition of plasma choline phosphoglycerides,
erythrocytes, adipose tissue, and breast milk, and some indicators of susceptibility to ischemic heart disease in vegans and omnivore controls
Sanders et al.
American Journal of clinical nutrition, 1978

Cliquer pour accéder à 1e071c2a6505622eeb07c6a461560170eac6.pdf

Sanders acides gras végans 1978


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