Nutrient Intake and Status in Children and Adolescents Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review

Health authorities increasingly recommend sustainable and healthy diets rich in plant foods and with moderate amounts of animal foods. However, there are concerns about whether such diets can meet all nutrient requirements, especially in children and adolescents, who have relatively high nutrient needs for growth and development. Therefore, we aimed to evaluate the nutrient intake and status of children and adolescents (2-18 y) consuming plant-based (i.e., vegetarian and vegan) diets compared to those of meat-eating children following a systematic literature review of studies published between 2000 and 2022. Mean intake and status data of nutrients were calculated across studies and benchmarked to dietary reference values and cut-off values for nutrient deficiencies. A total of 30 studies were included (15 in children 2-5 y, 24 in children 6-12 y, and 11 in adolescents 13-18 y). In all diets, there were risks of inadequate intakes of vitamin D and calcium. Children consuming meat had a risk of inadequate folate and vitamin E intake; and mean fiber, SAFA, and PUFA intakes were not in line with the recommendations. Children consuming plant-based diets risked inadequate vitamin B12, iron, and zinc intakes. In contrast to vegans, vegetarian children may not meet the recommended intakes of fiber, SAFA, and possibly PUFA, but their mean intakes were more favorable than in meat-eating children. Although the data are limited and need further validation, our findings indicate that there are risks of nutritional inadequacies in all diet groups. Therefore, increasing consumption of a variety of plant-based foods, in combination with food fortification and supplementation where needed, is recommended for children and adolescents to have sustainable and nutritionally adequate diets.

An evidence-based systematic review of vitamin A by the natural standard research collaboration

An evidence-based systematic review of vitamin A by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated and reproducible grading rationale. This paper includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

Fruit and vegetable purchasing patterns and preferences in South Delhi

This study examines associations between consumer characteristics, beliefs, and preferences and fruit and vegetable (FV) purchasing and intake in South Delhi, India. Home interviews were conducted with 245 households, using a structured questionnaire to assess FV consumption and purchasing frequency, spending, place of purchase, mode of travel, knowledge and attitudes toward organics, and beliefs about barriers to FV consumption. In-depth interviews with 62 experts and key informants validated survey findings that street vendors and markets are currently the dominant source of FV in South Delhi and that affordability, not accessibility, is the main barrier to increasing FV intake.

The role of expanded coverage of the national vitamin A program in preventing morbidity and mortality among preschool children in India

Higher food prices increase the risk of vitamin A deficiency among preschool children in poor families, because a larger part of the household food budget is spent on grain foods and less on vitamin A-rich foods. Vitamin A supplementation is an important source of vitamin A for children. Our objective was to characterize coverage of the India national vitamin A program for preschool children and identify risk factors for not receiving vitamin A. Anthropometric and demographic data were examined in 23,008 children aged 12-59 mo in the India National Family Health Survey, 2005-2006. Within the last 6 mo, 20.2% of children received vitamin A supplementation. The prevalence of stunting, severe stunting, underweight, and severe underweight was higher among children who did not receive vitamin A compared with those who received vitamin A (P < 0.0001). In families with a child who did and did not receive vitamin A, respectively, the proportion with a history of under-5 child mortality was 8.4 vs. 11.4% (P < 0.0001). By state, vitamin A program coverage was inversely proportional to the under-5 child mortality rate (r = -0.51; P = 0.004). Maternal education of > or =10 y [odds ratio (OR) 2.22; 95% CI 1.69-2.91], 7-9 y (OR 1.99; 95% CI 1.57-2.53), or 1-6 y (OR 1.65; 95% CI 1.28-2.13) compared with no education was an important factor related to receipt of vitamin A. Poor coverage of the vitamin A supplementation program in India has serious implications in the face of rising food prices. Expanded coverage of the vitamin A program in India will help protect children from morbidity, mortality, and blindness.

Low intake of vitamin A-rich foods among children, aged 12-35 months, in India: association with malnutrition, anemia, and missed child survival interventions

OBJECTIVE

To determine whether children in India who have a low intake of vitamin A-rich foods are at higher risk of malnutrition, anemia, and not receiving child health interventions.

METHODS

We analyzed data from the India National Family Health Survey, 2005-2006.

RESULTS

Of 17 847 children (41.9%), aged 12-35 months, 7020 did not receive vitamin A-rich foods, based on 24-h recall. The prevalence of stunting, severe stunting, underweight, and severe underweight among children who did and did not receive vitamin A-rich foods was, respectively, 52.5% versus 59.0%, 26.7% versus 32.9%, 43.8% versus 48.5%, and 17.9% versus 21.6% (all P<0.0001). Children who did not receive vitamin A-rich foods were more likely to be anemic, not have completed childhood immunizations, and not to have received vitamin A supplementation in the previous 6 mo (all P<0.0001). Maternal education of ≥10, 7-9, and 1-6 y, respectively, compared with no formal education was associated with the child receiving vitamin A-rich foods (odds ratio 1.41, 95% confidence interval 1.20-1,67, P<0.0001; odds ratio 1.20, 95% confidence interval 1.04-1.37, P=0.01; odds ratio 1.16, 95% confidence interval 1.02-1.32, P=0.02) in a multivariate logistic regression model adjusting for maternal age, household size, socioeconomic status, and location.

CONCLUSION

Children who did not receive vitamin A-rich foods were more likely to be malnourished and to have missed basic child health interventions, including vitamin A supplementation. Children were more likely to receive vitamin A-rich foods if their mothers had previously achieved higher primary or secondary education levels.

Nutritional optic and peripheral neuropathy: a case report

Introduction

The link between nutritional status and either optic or peripheral neuropathies is well established with tobacco, ethanol, deficiencies in thiamine, vitamin A, B12, B3 and B6 and protein-energy malnutrition all being causative.

Case presentation

We describe the case of a 32-year-old Afro-Caribbean of Jamaican origin presenting with blurred vision and a painful burning sensation in his feet. The clinical features were consistent with optic and peripheral neuropathy.

Conclusions

The patient followed a strict vegan diet and consumed no animal products. A review of the literature highlights similarities between this case and Strachan's syndrome, a combination of optic and peripheral neuropathy and cutaneous excoriation, providing further evidence for the association between this clinical presentation, dietary deficiency and, as recently postulated, previous residence in a tropical or sub-tropical climate.