- The late Dr. Benjamin Spock, arguably
the most influential pediatrician of all time, left children and their
parents with a surprising and rather demanding legacy: advice that they
stick to a vegetarian diet devoid of all dairy products after age 2.
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- The seventh edition of "Baby and
Child Care," issued last month by Pocket Books within a few months
of his death at age 94, recommends an approach to childhood nutrition that
many experts, including his co-author, Dr. Steven Parker, consider too
extreme and likely to result in nutritional deficiencies unless it is very
carefully planned and executed.
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- "We now know that there are harmful
effects of a meaty diet," the new book tells parents.
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- "Children can get plenty of protein
and iron from vegetables, beans and other plant foods that avoid the fat
and cholesterol that are in animal products."
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- As for dairy foods, Spock says, "I
no longer recommend dairy products after the age of 2 years. Other calcium
sources offer many advantages that dairy products do not have."
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- Given the influence of the world-famous
book, pediatricians and nutritionists have reacted with concern to Spock's
new recommendations to raise children on an all-plant, or vegan, diet.
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- Throughout its 52-year history, "Baby
and Child Care" has been the second-best selling book after the Bible.
Overall, parents continue to rely heavily on Spock as an authoritative
guide to raising children.
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- Dr. T. Berry Brazelton, a pediatrician
specializing in child behavior at Boston City Hospital and a longtime admirer
and friend of Spock's, called his new dietary recommendations "absolutely
insane."
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- "I don't agree with them at all,"
he said.
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- "A vegetarian diet doesn't make
any sense. Meat is an excellent source of the iron and protein children
need, and to take milk away from children -- I think that's really dangerous.
Milk is needed for calcium and vitamin D."
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- Experts expressed concern about the ability
of small children to consume calories and fat to sustain normal growth
on an all-plant diet, as well as the diet's adequacy in supplying recommended
amounts of such essential nutrients as calcium, riboflavin, vitamin D,
iron and zinc and possibly even protein.
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- These experts also said that having to
follow a vegetarian diet free of dairy products could place undue social
pressures on children, few of whom like to be different from their friends.
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- "Raising children on an all-plant
diet can be done, but it would be like climbing Mount Everest," said
Dr. Michael Georgieff, professor of pediatrics and child development at
the University of Minnesota in Minneapolis.
-
- "It would take an incredible amount
of planning and balancing of nutrients."
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- Georgieff, who wrote the chapter on vegetarian
diets in the American Academy of Pediatrics nutrition handbook, said a
strictly vegetarian diet "involves very significant risks."
-
- "It would probably provide only
about 60 percent of a small child's calorie needs and maybe the same proportion
of protein and would require supplementation with vitamin D, calcium, iron
and zinc."
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- Dr. Marc Jacobson, a specialist in adolescent
medicine at Schneider Children's Hospital in New Hyde Park, N.Y., said,
"If a strict vegetarian diet is part of someone's long-term culture,
the kids grow fine, though not as big.
-
- "But for those who became vegans
recently, I can't say it's dangerous -- but there are risks."
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- Starting with the first edition of his
landmark book in 1946, Spock always included meat and milk products as
part of a child's recommended diet.
-
- Spock's revisions of what had been his
most recent nutritional advice -- to include small amounts of lean animal
foods in children's diets -- stemmed from a switch he himself made to an
all-plant diet in 1991, after a series of illnesses that left him weak
and unable to walk unaided.
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- His wife, Mary Morgan, said his health
rebounded after he made the dietary change. He lost 50 pounds, regained
his ability to walk and became healthier overall and more energetic, she
said.
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- "It enabled him to revise his book
before he died, which was his most important goal," Morgan said.
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- Dr. Neal Barnard, president of the Physicians
for Responsible Medicine, a Washington-based organization that advocates
strict vegetarian diets for everyone, said that he had drafted the section
on nutrition in the new edition of Spock's book, but that Spock had edited
it to give it "his personal touch."
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- Morgan said that "Ben had a hand
in every part of the book" and that he was "very committed"
to the diet.
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- "It is not difficult at all to get
complete nutrition on a vegan diet if it is supplemented with Vitamin D
and B-12," Barnard said in an interview.
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- He said diet-related problems such as
obesity and atherosclerosis begin in childhood and added, "Today's
kids are in worse health than ever before."
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- But Parker, the book's co-author and
an expert in behavioral pediatrics at Boston Medical Center, objected to
the stringency of the dietary advice and suggested that parents at least
be offered two alternatives.
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- However, Spock rejected this idea, stating
in a letter to Parker that he wanted his book to be "in the forefront"
of the growing awareness of the link between animal foods and disease.
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- However, some experts questioned the
need to be so extreme.
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- "We should be sticking to dietary
changes that have demonstrable health benefits, like those outlined in
the food pyramid -- that's where the evidence is right now," said
Dr. Johanna Dwyer, nutrition expert at Tufts-New England Medical Center
in Boston who has studied the effects of vegetarian diets on growth and
development.
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- The food pyramid, a dietary guide developed
by the U.S. Department of Agriculture, emphasizes grain-based foods, fruits
and vegetables but also includes meats, poultry, fish and dairy products.
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- Dwyer said it would be possible to provide
growing children adequate nutrition by following Spock's recommendations,
but added, "Most people would need a lot of help to do it."
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- Nutrition experts strongly disagreed
with Spock's advice to avoid dairy foods. The book states that "most
green leafy vegetables and beans have a form of calcium that is absorbed
as well as or even a bit better than that in milk."
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- But the experts noted that calcium-rich
vegetables contain substances such as oxalates, phytates and other fibers
that interfere with calcium absorption in the gut.
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- Spock also suggested calcium-fortified
rice milk and orange juice as sources of this mineral that is critical
to the proper development of bones.
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