Some groups may have special dietary needs. These include pregnant and lactating women, infants and children, and those following a therapeutic diet for medical reasons. The needs of all these groups can be adequately met by a vegetarian diet. Pregnancy and Lactation -- Infants and Children -- Therapeutic Diets PREGNANCY AND LACTATION During pregnancy, women have increased nutritional requirements for energy, protein, folate, vitamin A, vitamin C, and vitamin D. The increased energy and protein requirements are small and can be met without any obvious changes in food intake. If energy intake is reduced due to appetite changes or morning sickness then a reduction in high fibre foods and increased energy and nutrient dense foods may be appropriate. The extra vitamins needed are generally present at higher levels in vegetarian than non-vegetarian diets, with the exception of vitamin D. Both vegetarian and non-vegetarian pregnant women may be advised to take supplementary vitamin D (Departmentof Health,1991). There are no official dietary recommendations for increased mineral requirements during pregnancy. However, it is important that adequate intakes are ensured in order to maintain body stores. Ideally, all women should have sufficient body iron stores to cope with the demands of pregnancy. However, many women may have low levels of stored iron and mild anaemia is not uncommon during pregnancy. Vegetarian women need to ensure that they are obtaining adequate iron from their diets. Vegan women need to ensure that their dietary needs for vitamin B12, vitamin D and calcium are met during pregnancy. During lactation, increased protein and vitamin needs can be met by a varied vegetarian diet. Recommended intakes for calcium and zinc are also increased and so extra food sources of these may be appropriate. INFANTS AND CHILDREN A vegetarian diet is suitable for children of all ages and can provide all the nutrients needed for normal growth and development (COMA,1994b). Studies have found that vegetarian children show similar patterns of growth and development as non-vegetarian children (Dwyer, 198Z; Tayter, 1989; Nathan, 1993). Anthropometric measurements indicate vegetarian children are similar in height, weight and skinfold measurements. Vegetarian children are often leaner and less likely to be obese (Dwyer, 1980). Sabate (1991) studied 895 non-vegetarian children and 870 vegetarian children aged 7 to 18 years and found that for both boys and girls the vegetarian children were taller. This did not change after adjustment for parental height and socioeconomic class. The vegetarian children consumed less convenience foods and dairy products and more starchy foods, pulses, fruit and vegetables which may play a part in their being taller. No differences in maturation or timing of growth spurts has been observed between vegetarian and non-vegetarian boys. Vegetarian girls may have a delayed maturation onset, though heights finally attained are similar to non-vegetarian counterparts (Sabate, 1992). This maturation delay is linked with a later age of menarche which may be protective against breast and other hormone dependant cancers in later life. Children raised on vegan diets also display growth and development within acceptable limits though they are more likely to be lighter and leaner and may also be shorter in stature than other children (O'Connell, 1988; Sanders, 1992). Where concern has been expressed over the growth of infants and children on vegetarian-type diets it has involved communities where diets followed are very restrictive and not typical vegetarian or vegan diets. These have included Dutch children on macrobiotic diets (van Stavaren, 1988) and Israeli Black Hebrews (Shinwell, 1982). Infants, children and adolescents can meet all of their nutritional requirements on a vegetarian diet. Nutrient intakes for vegetarian children compare favourably with dietary recommendations providing that total fat intakes are not excessive and iron intakes are adequate. Nutritional deficiencies are no more commonly reported among vegetarian children than among omnivore children. Vegan children may need more carefully planned diets to ensure nutrient needs are met, especially for vitamin B12, vitamin D and calcium. As well as meeting dietary needs, vegetarian diets for children may be beneficial in promoting health and protecting against a variety of health problems including constipation, other bowel disorders and obesity The typical diet of school children in the UK is high in fat and low in fibre and complex carbohydrates and it is recommended children eat more starchy foods, fruit and vegetables. A vegetarian diet can also protect against risk factors for chronic degenerative diseases in later life (Jacobs, 1988). Risk factors for diet-related diseases, including cardiovascular disease, can be identified in children and dietary habits which influence these risks are learnt in childhood. A vegetarian diet for children can help establish healthy dietary patterns which may be carried on into adult life and help protect against chronic disease. A healthy adult diet is not necessarily appropriate for infants and young children under the age of five years. Diets low in fat and high in fibre are unsuitable for infants as their limited stomach capacity may be filled-up before they are able to meet their energy or nutrient needs. Infant diets need to include energy and nutrient dense foods such as cereal products, mashed lentils, vegetable oils, bananas and avocados. Excessive intake of high fibre or watery foods should be avoided. THERAPEUTIC DIETS   As well as being protective against many chronic degenerative diseases, vegetarian diets have been effectively used in the treatment of various conditions including rheumatoid arthritis (Kjeldsen-Kragh, 1991) and nephrotic syndrome (D'Amico, 1992). A vegetarian diet is also appropriate for most people following a therapeutic diet for medical conditions, such as diabetes or coeliac disease. Professional dietetic assistance should be sought for all therapeutic diets. previous page : next page