Are vegan diets appropriate for children?

Grades: outstanding (check). Physical activity: competitive high school sports (check). Weight: holding steady since she's no longer growing taller (check). Diet: healthy vegan choices (check).

The high school student was in for her sports physical and was slender and fit, making my job pretty easy. I still did a little probing, though, to make sure she was hitting all of the important nutrients in her no meat, no dairy, no egg diet.

The intelligent teen had done her homework and was extremely well-informed about vegan-related nutrition and proper food choices. She even identified several milk-alternatives which could provide sources of calcium and vitamin D.

My main concern was that she wasn't incorporating many of these alternates into her otherwise very carefully thought-out diet.

Lest vegans and vegetarians think I'm picking on them while turning my back on their burger-sliding, pop-swilling peers, let me assure you that I am an equal-opportunity nagger (just ask my kids).

I spend a good part of each infant, school and sports physical covering a patient's diet. You love milk? Great, but 6 glasses a day is going a bit overboard. Crazy about meat and potatoes? Fine, but what about those colorful fresh foods waiting around in the produce bin? Hooked on three glasses of pop a day? Your teeth and waistline will thank you if you cut down to one or two cans a week.

Of course, I try to be diplomatic and constructive, but the point is, whatever dietary lifestyle kids choose to follow, the key to good health and proper nutrition is always found in careful balance.

The vegan diet, which does not use animal products, can be a healthy one if done right. In its 2009 position statement, the American Dietetic Association declared that "appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate and … are appropriate for individuals during all stages of the life cycle."

In fact, the dietetic group finds that vegetarian diets are linked to lower cholesterol, blood pressure, and BMI levels, as well as lower risks of heart disease, Type 2 diabetes, and cancer.

The ADA does caution that if "poorly planned," vegan diets may be lower in calcium, vitamin D, zinc, long-chain n-3 fatty acids, and vitamin B-12; therefore, vegans need to make a point of adding foods with these nutrients or choose to take supplements.

In their article in Pediatrics in Review, Drs. Meredith Renda and Philip Fischer encourage parents to provide their vegan children with a variety of age-appropriate foods. These foods should include sources of calcium - such as kale, broccoli, fortified orange juice, fortified soy, and figs; zinc - whole grains, legumes, nuts, wheat germ, and whole grain pasta; omega-3 fatty acids - flaxseed, dark greens, tofu, and nuts; and vitamin B12 - cereals, breads and some fortified soy.

All infants, children, and adolescents, vegan and otherwise, also need a dietary source of vitamin D or a supplement. In addition, particular nutritional attention should be paid to strictly breast-fed infants who may need vitamin B12 supplementation to avoid deficiency if their vegan mothers are not taking in adequate vitamin B12 through their own diets of fortified foods or through supplements.

• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.