Plant-based beverages for young children: An updated analysis from the Practice-based Evidence in Nutrition (PEN)

Amidst recent efforts to transition towards plant-based eating, the suitability of plant-based beverages (PBBs) as a main beverage for young children to support optimal growth remains questionable. 

To this effect, a global resource for nutrition practice, Practice-based Evidence in Nutrition (PEN), has released an updated analysis on the suitability of PBBs for young children (aged 2 years and older). 

In Canada’s Food Guide, only milk and fortified soy beverages are included as part of protein foods. Although some PBBs are fortified in micronutrients (e.g., calcium and vitamin D), this does not address their low protein content. In fact, efforts to increase consumer awareness have been made, as Health Canada now requires manufacturers of PBBs that do not meet their protein criteria to indicate “Not a source of protein” on the packaging.

Young children aged 2-8 require 13-19g of protein per day which can typically be met by consuming 2 cups of milk, providing 16g of protein. In comparison, 1 cup of almond and rice beverage respectively contains only about 2% and 8% of the equivalent protein found in 1 cup of milk. This significant discrepancy in nutrient profile renders the substitution of milk with PBBs (other than fortified soy beverage) as a main beverage, a potential impediment for the child’s growth and development. In fact, a new guideline recommends that if consumers are to choose a PBB, it should contain 6g or more of protein per cup (250 ml), thus significantly reducing the potential options currently available.

Additional findings listed in the updated analysis are as follows:

• PBBs are low in fat and calorie content, which could possibly limit growth in young children when offered as a main beverage.
• Most PBBs have sugar listed as a second ingredient after water, which satisfies the criteria of a sugar-sweetened beverage.

The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) highlights that there are numerous adverse consequences stemming from the misuse of certain PBBs, including inability to gain weight, decreased stature, kwashiorkor, electrolyte disorders, kidney stones, and severe nutrient deficiencies (e.g., iron deficiency anemia, rickets, and scurvy).

Overall, offering these PBBs (except fortified soy beverage) as a main beverage does not provide adequate amounts of protein and micronutrients to support a young child’s nutritional needs, increasing urgency to compensate through other dietary means. PEN further notes that in cases of allergies or other concerns, dietitians should be consulted to ensure that all nutrient needs are met for an age-appropriate diet.