Health effects of vegan diets among children and adolescents are a controversial public health topic. Thus, the aim of the present systematic review is to evaluate a broad range of health outcomes among vegan children and adolescents aged 0 to 18 years. 18 studies met the inclusion criteria (17 cross-sectional, 1 RCT). Meta-analyses showed lower protein, calcium, vitamin B2, saturated fatty acid, and cholesterol intakes, and lower ferritin, HDL and LDL levels as well as height in vegan compared to omnivorous children/adolescents. Higher intakes of carbohydrates, polyunsaturated fatty acids, fiber, folate, vitamins C and E, magnesium, iron, and potassium were observed in vegans. Blood levels of vitamin B12 were higher among vegan children due to supplement use. Single study results suggested further differences between vegan and non-vegan children, such as lower bone mineral content or urinary iodine among vegan children. Risk of Bias was rated as high or very high in 7 out of 18 studies. The certainty of evidence for the meta-analyses was low (n = 2) or very low (n = 46). Overall, the available evidence points to both risks and benefits associated with a vegan diet among children, although more and better designed studies are needed.

Center for Public Health Medical University of Vienna Vienna Austria

Centre for Public Health Promotion The National Institute of Public Health Prague Czech Republic

Centre for Research on Diabetes Metabolism and Nutrition of 3rd Faculty of Medicine Charles University Prague Czech Republic

Department of Epidemiology and Biostatistics 3rd Faculty of Medicine Charles University Prague Czech Republic

Department of Internal Medicine 3rd Faculty of Medicine Charles University and Královské Vinohrady University Hospital Prague Czech Republic

Department of Nutritional Sciences University of Vienna Vienna Austria

Department of Paediatrics University Hospital Královské Vinohrady and 3rd Faculty of Medicine Charles University Prague Czech Republic

Department of Social and Preventive Medicine Center for Public Health Medical University of Vienna Vienna Austria

Division of Chronic Disease Epidemiology Epidemiology Biostatistics and Prevention Institute University of Zurich Zurich Switzerland

Faculty of Medicine and University Hospital Heidelberg Institute of Global Health Heidelberg Germany

Faculty of Medicine University of Zurich Zurich Switzerland

Federal Office of Public Health Bern Switzerland

German Center for Diabetes Research Partner Düsseldorf Munich Neuherberg Germany

German Diabetes Center Institute for Biometrics and Epidemiology Düsseldorf Germany

Institute for Clinical and Experimental Medicine Prague Czech Republic

The Institute for Global Food Security School of Biological Sciences Queen's University Belfast Northern Ireland UK

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