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DEBORAH AMOS, host:

Back now with DAY TO DAY. Remember promising your parents you'd rather send that broccoli to starving children around the world rather than eat the green stuff. These days there are some American kids who eat only the vegetables. Some choose to become vegetarians by themselves. Others follow the example of their parents. Is a vegetarian diet healthy for kids? We turn to Dr. Sydney Spiesel, a pediatrician and Yale Medical School professor, to find out. Dr. Spiesel writes the Medical Examiner column for the online magazine Slate. And he joins us regularly to talk about medicine. Welcome back to the program, Sid.

Dr. SYDNEY SPIESEL (Yale Medical School): Thank you, Deborah.

AMOS: We have found an interesting figure: one million school-aged children are vegetarians. You know, there's a traditional thinking that says boys and girls need a healthy diet that includes plenty of meat, and that's because of the protein. So can a vegetarian diet provide the kind of protein that kids need?

Dr. SPIESEL: A vegetarian diet can be a pure vegetarian diet or one supplemented with dairy products and eggs. And the ones that are supplemented with dairy products and eggs are more likely to have very good quality protein, of the kind that we need for good growth. It's a little bit more difficult if you have protein that is just purely vegetable origin, because then some of the vegetable proteins are not complete. And you have to use vegetable proteins from two different sources. Now, sometimes local cultures have learned about this. For example, proteins from corn are not adequate by themselves; the protein from beans are not adequate by themselves. But if you take corn and beans at the same meal, you're going to wind up with very good quality protein.

AMOS: Are kids going to miss out on any important vitamins or minerals if they eat a strictly vegetarian diet?

Dr. SPIESEL: Truly purely vegetarian diets that don't involve milk or cheese or eggs almost never contain enough vitamin B12, which is important for the nervous system development, other kind of development. So we do recommend that people on a purely vegetarian diet, that they get some vitamin supplement for the B12. Some other diets, vegetarian diets, are inadequate in zinc. Maybe they don't have enough calcium, although if you eat tofu - there's plenty of calcium in that. And iron is often very deficient in some vegetarian diets.

AMOS: We have been talking about older kids who have, you know, the authority over themselves to decide this is how I want to eat. There are also parents who are vegetarians, have been their whole lives, perhaps now have a small baby and decide, okay, I'm going to continue this with my infant. Are there any precautions for very young kids?

Dr. SPIESEL: There are some precautions for very young kids. There have been a number of sort of disasters where adults were following very strict and very rigorous and very limited, nutritionally inadequate vegetarian diets, the kind of very severe macrobiotic diets, and they think that that's going to be good for their kids, and tragically they're so devoid in the vitamins and other nutrients that kids need that both growth and intellectual development have been harmed. Some of these kids have even died of malnutrition. So if parents are following these very strict macrobiotic diets, kids have been known to get in terrible trouble. So I'd be much more careful about that, although I haven't had any problems of that in my own practice. This is just what I know from the literature.

AMOS: Thank you very much. That's opinion from Dr. Sydney Spiesel. He's a pediatrician and professor at Yale Medical School and he writes for slate.com.

Dr. SPIESEL: Thank you.

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