By Leslie Cox
This is the time of year when many people choose to start a diet. As a pediatric nutritionist specializing in eating disorders, this gives me cause for concern. The majority of my patients tell me their eating disorder started months earlier because “I just wanted to eat healthy”. For children and teens, it is easy to misinterpret what “healthy” eating means. This often leads to unhealthy dietary practices such as skipping meals and fad diets. Maybe we should look for another word to use besides “healthy” when talking about nutrition.
As I reflect back on the last year, I think the most popular diet trend for my patients is a vegan diet. While a carefully planned vegan diet can meet a teenager’s nutritional needs, it should send a red flag to parents if their child announces they want to be a vegan. Vegans do not eat meat, fish, poultry or use other animal products or by-products such as eggs and dairy products. A poorly planned vegan diet can result in inadequate intake of calories, protein, calcium, Vitamin D, zinc, iron, and Vitamin B12. For children and teens, this can be especially harmful as growing kids have the highest calorie needs of any age group. A vegan diet omits all animal sources of nutrition, therefore these foods need to be replaced by plant-based sources of proteins and nutrients such as beans, pasta, grains, nuts and nut butters; plant based dairy products, oils, and fortified food sources of Vitamin B12. In my experience, most of my patients who have opted for a vegan diet do not want the additional grains and fats they need to make up the difference in animal foods they are no longer consuming. My patients often report not liking the taste of plant-based cheeses and meat analogs. If this is the case, then a vegan diet is not for you.
So where are kids getting their nutrition information? Jokingly, I tell my patients that I don’t think I knew what “vegan” meant until I was in college! Unfortunately, today many kids get their nutrition advice from YouTube and blogs by non-professionals. One former blogger, Jordan Younger, aka “the Blonde Vegan”, made her living blogging on her vegan lifestyle. During this time, she developed an eating disorder. Her 2015 book “Breaking Vegan” is an insightful memoir of her journey through veganism and extreme dieting and coming to terms with the fact that her plant-based lifestyle was no longer good for her health. She still blogs but is now known as “the Balanced Blonde”.
So when talking with our kids and our patients, what word should replace “healthy”? I like the word “balanced” when talking about nutrition. What is balanced for one may be different for another. Does your diet meet all your nutritional needs? Do you like the taste of the foods in your diet? Can you find these foods in social situations or when dining out with family and friends? These are questions to ask our kids if they are opting for a diet change.
Leslie Cox, MS, RD is a registered dietitian, board certified in pediatric nutrition who specializes in all forms of eating disorders. Leslie works as a clinical nutritionist at Children’s Healthcare of Atlanta where she is a founding member of the inpatient eating disorder team which provides medical stabilization for children and adolescents with eating disorders. Leslie also specializes in medical nutrition therapy for children and adolescents with a variety of gastrointestinal conditions; complex feeding issues requiring nutrition support, and infants and children with failure to thrive.