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September 15, 2025 39 mins

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Feeding kids well is foundational to health—but real-life meals can feel hard. Pediatrician Dr. Reshma Shah, co-author of Nourish: The Definitive Plant-Based Nutrition Guide for Families, joins Jessica to share simple, evidence-based ways to make family meals more nourishing and less stressful. We cover how to “add in” plants without power struggles, realistic swaps kids accept, why fiber is the real gap for most children, what actually keeps kids full (protein + fat + fiber), and a no-drama take on supplements (B12 for vegan kids, vitamin D for many, calcium via fortified milks, DHA/EPA considerations, and using iodized salt). Plus: how to stop feeding anxiety at the table and play the long game with picky eaters.

Dr. Reshma Shah is a pediatrician, parent coach, and co-author of Nourish: The Definitive Plant-Based Nutrition Guide for Families (with Brenda Davis, RD. To stay in contact with her, and for her free plant-based starter guide, recipes, please check out her website: reshmashahmd.com (free plant-based starter guide, recipes, and parent resources).
 

Your Child is Normal is the trusted podcast for parents, pediatricians, and child health experts who want smart, nuanced conversations about raising healthy, resilient kids. Hosted by Dr. Jessica Hochman — a board-certified practicing pediatrician — the show combines evidence-based medicine, expert interviews, and real-world parenting advice to help listeners navigate everything from sleep struggles to mental health, nutrition, screen time, and more.

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Episode Transcript

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Unknown (00:00):
Hello listeners. This is Dr Jessica Hochman. I'm

(00:02):
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(00:31):
Hi everybody. Welcome back toyour child is normal. I'm Dr
Jessica Hochman, and today we'retalking about how to feed our
kids a more plant based diet.
And let's be honest, feedingkids can feel frustrating in
real life. There are pickyphases, busy schedules and not
to mention all the conflictingadvice out there, how much
protein, fiber and vitamins doour kids really need? It can all
feel so overwhelming, and that'swhy I'm so excited about today's

(00:52):
guest, Dr Reshma Shah. She's theco author of nourish, the
definitive plant based nutritionguide for families, and she
offers evidence based, practicalsuggestions that parents can
actually use. In ourconversation, Dr Shah shares how
to add more plants withoutpressure, simple swaps that keep
kids full, and what supplements,if any, you should consider if
you've ever wished that mealtimecould feel less stressful and

(01:14):
more nourishing. And I'll betthat's every parent listening,
you're gonna love this episodewith Dr Reshma Shah, and I'm
hoping that this episodeinspires you to add more plants
into your day to day diet. And aquick reminder, before we get
started, please take a momentand leave a five star review
wherever it is. Listen topodcasts. Reviews help other
people find the show, which inturn helps grow the community of

(01:35):
your child is normal. Dr ReshmaShah, thank you so much for
taking the time to come on yourchild is normal. Is normal. I'm
so excited to have thisconversation with you, and I'm
really excited to be here withyou today.
So let's talk about yourpassion. Tell everybody about
the book that you wrote and whatdrew you to be so interested in
a vegetarian diet.

(01:56):
So the book that I wrote, I cowrote it with a registered
dietitian, Brenda Davis, it'scalled nourish, the definitive
plant based nutrition guide forfamilies. The way that I
accidentally came to beinterested in this topic is when
my kids were young, I waslooking at what was the
healthiest, best way to feedthem, and so I started to learn

(02:17):
more as much as I could so thatI could feed my family in a
healthy, enjoyable way. And themore research I did, the more I
came to the conclusion that amore plant centered, or a plant
focused diet is really thefoundation of a healthy,
sustainable diet. And so Istarted this journey learning as
much as I could, started goingto conferences, and just became

(02:39):
very entrenched in this world ofnutrition and specific pediatric
nutrition. And while there werea lot of resources out there for
adults in this field, I didn'tsee a lot of great resources for
parents looking for moreinformation. That's kind of why
I decided to write the book.
It's true. I do think there is alack of quality resources for
families to go to. I mean, youcan look at the food pyramid,

(03:01):
for example, where the bottom isall the grains and you don't see
any fruits and vegetables,unless they've made an
adjustment.
Yeah. So they have made a bit ofan adjustment. The latest
dietary guidelines, actually,for the last several years,
they're more than my platemodel. So we've kind of gotten
away from the pyramid, which Ithink is a it's a good thing,
because the My Plate representslike a visual representation, so
it's much more practical. Youcan kind of see the plate. And I

(03:23):
think the MyPlate model is agood starting point for kids,
but I wouldn't necessarily stopthere. So the MyPlate model has
half the plate being fruits andvegetables, a quarter being some
sort of grain or starch,preferably whole grains for at
least half of those, and then aquarter of the plate being a
protein source. And for kids,especially young kids, and for
kids who are athletic and havehigher energy needs, I think,

(03:45):
like maybe not quite half theplate being fruits and
vegetables, you might need tomake it more third, but it's the
general principle stilltrue. That's great to hear.
They've made some updates. Ithink that was a long time
coming. So what I would love todo with you is go through why
you advocate for a plant baseddiet, and then I would love to
ask you about a lot of questionsand concerns that I hear from
families that are consideringhaving more of a plant based

(04:07):
diet. If that's okay.
Yeah, that'd be great. So Ithink that when people are
looking to eat a vegetarian,vegan or semi vegetarian diet,
there are usually three mainreasons that families are
looking to eat this way. Thefirst is for health
considerations. We know that themore fruits and vegetables,
whole grains, beans, lentils,they tend to be health
promoting, and we see lowerrates of chronic diseases for

(04:29):
people who are following thispattern of eating. So I think
health is a primaryconsideration for a lot of
families. I think the secondreason is sustainability. We
know that animal agriculturetakes an enormous toll on our
planet in terms of greenhousegas emissions, land and water
use, and the more that we movetowards plant sources of
protein, the less of an impactit has on our environment. And

(04:52):
the final reason that a lot offamilies look to eat more plant
centered or plant based is forthe considerations around animal
agriculture and. In terms ofethics. For me, this was
definitely the lastconsideration that I looked at.
Being a pediatrician. I wasprimarily motivated by a lot of
the health considerations. Butif you really take the time to
look at some of the practices,especially factory farming,

(05:13):
there are a lot of just abusesof animals. So I think epics is
a huge consideration for a lotof families.
Absolutely, I am someone whodoes eat meat, and I can't let
myself go there and think about,yeah, those ethical
implications. Maybe I should bethinking more about it, but it's
it's hard to think about.
It's definitely a very difficulttopic to look at, and I think

(05:33):
that can be quite difficult todigest. No pun intended, yes,
and I do think there arecultural considerations that I
think a lot about. So forexample, I'm raised in America
where it's very common to eatcow, very common to eat chicken,
for example. And I was recentlyin Iceland with my husband, and
on the menu was horse. It's avery common food that is

(05:54):
consumed in Iceland. And I had ahard time wrapping my head
around the idea of eating ahorse. And then I thought, Well,
why does this bother me so much?
If I'm comfortable eating otherforms of animals, I think it is
an important thing to thinkabout. It is a life. So I do
think it's worth putting valueon that. Yeah, and I
think the way that you'reapproaching this is exact right
way, which is to begin withcuriosity. And you're just

(06:16):
asking yourself, look, why is itthat I'm totally fine eating a
cow, but a war somehow seemshigh appetizing, and I think if
you just follow your curiosity,you're gonna land in a place
that feels good for you. And youknow, I'm not someone who went
vegan overnight, even as I waslearning about some of these
ethical issues, it was a reallygradual approach, and I don't
think there is a exact right wayto do this, but leading with

(06:39):
curiosity and being willing toask yourself those questions is
the exact right way to approachit. I agree with that, because
I'm someone who believes thatsmall changes also can make a
big difference. Like, let's saysomebody's considering to be
fully vegetarian, that might bea daunting process. So just
making small changes, I thinkcan lead to big changes.
And I think that some people areready to go completely cold

(07:02):
tofu, and they're just ready tojust make a big change, and
especially if it's beenmotivated by a health
consideration. And for somepeople, it's much more gradual.
And for me, I grew up in avegetarian household, and so the
idea of eating a lot ofvegetarian meals was not foreign
to me, but it was a very gradualprocess. And I think the final
step was I was entirely plantbased or vegan at home, and I

(07:23):
gave myself some flexibility ifI was at a friend's house or
going out to dinner or onvacation, and those small
changes eventually can allow youto make the Bay of relief, and
that's what I found to be truefor myself. And so now I can
feel totally comfortablefollowing a vegan diet, and it
doesn't feel like a sacrifice,because I think I didn't in a
way that was really right for meand my family.

(07:43):
Now, you had mentioned thatthere are health benefits that
have been shown by research. Canyou mention more specifically
what those benefits are?
Yeah, absolutely. I think it'sreally important to talk about
the evidence in a very groundedapproach, and not make claims
that are over exaggerated orabsolute in terms of this causes
cancer or this does not causecancer. So my approach is really

(08:05):
to focus on what the evidencereally does tell us, and what I
can say is that people who eat amore plant centered or plant
focused diet doesn't necessarilyhave to be plant exclusive, so
it doesn't necessarily have tobe vegan, but eating a more
plant centered diet, we seelower rates of many of the
chronic diseases, such as heartdisease, diabetes, even there

(08:25):
have been some connections tomore cognitive impairment in
Alzheimer's and some of theseneurodegenerative conditions,
digestive health, autoimmuneconditions. It's very broad in
terms of the scope of chronicdiseases that can help to
decrease the risk of developingnow, can a plant based diet
absolutely prevent or cure someof these diseases? No evidence

(08:47):
doesn't suggest that, but weknow that the more plant
centered a diet is, the moreyou're including fruits,
vegetables, whole grain legumes,all of these things that we know
are health promoting, the moreyou improve your chances of not
experiencing some of thesechronic disease, and even people
who have high blood pressure,diabetes, elevated cholesterol,
can benefit from eating a moreplant centered diet.

(09:07):
And I've read as well, there'sgood evidence showing decrease
in certain cancers, like coloncancers, too correct from eating
a more high fibrous fruit andvegetable based diet.
And it makes sense, right?
Because we know that higherfiber diets are protective
against colon cancer. Fruits andVegetables contain many
antioxidants and polyphenolsthat are healthy and nutritious
for us and animal foods don'tcontain any of those plant

(09:29):
phenols or fiber.
It does make sense. I agree. Iagree. So for somebody like
myself, what would your advicebe to get started to have a
mostly plant based diet.
So for families like yours, Iwould call you a plant curious
family. And I love plant curiousfamilies because there's so many
fun ways that you can explore. Ithink the first step is really

(09:50):
instead of thinking about whatyou have to give up, where can
you add more plants to the foodsthat you're already enjoying,
and the more plant foods youstart to add to your diet, your.
Going to necessarily crowd outsome of those animal foods. So
it could be as simple as addingsome fresh fruit the breakfast.
You can add a cup of lentil soupat lunch, a big green salad at
dinner. So where can you addplant foods in once you've sort

(10:13):
of started to feel morecomfortable with that, you can
also look for a meal that yourfamily already enjoys. And how
can you make a plant based swap.
So instead of doing chicken stirfry, you could do a tofu stir
fry. And if your family isn'tready to go all in with just a
tofu stir fry, you could add alittle bit of chicken and a
little bit of tofu. So you'rekind of fading in those plant
based foods. You could alsostart with something like a

(10:35):
meatless Monday, and then makeit Meatless Monday and Tuesday,
or Meatless Monday, Wednesday orFriday, and kind of gradually
add it in that way. So I alwayslike to think about an add in
approach, and then where can youmake some really easy swaps with
things that your family alreadyenjoys?
I like thinking of a meatlessMonday because that's practical
one day a week. I feel like Icould do that.

(10:57):
Another approach that a lot ofpeople find useful is a vegan
before six, and so that's whereyou eat entirely plant based the
whole day. And then at dinnertime, you give yourself some
flexibility if you're going toinclude some fish or chicken or
whatever the case may be. So Ithink just experiment, have fun
with it, and figure out a systemthat works for you and for your
family.
So some common concerns that Ihear from parents when they're

(11:18):
considering adding more plantsto their child's diet, I'd say
the big one that I hear is afear of them not getting enough
protein. For parents that havethat concern, what would your
advice be?
Yeah, so I think the concern isreal, like you do have to plan.
You want the diet to beappropriately planned. But one
of the things I always remindparents too is that all diets
for children, whether they'revegan, vegetarian or omnivorous,

(11:40):
need to be well planned. I knowplenty of kids who are not
vegetarian or vegan, and theirdiet is basically mac and cheese
and pizza, and I would beworried about protein for that
kid as well. So I think proteinis something that you do have to
pay attention to, but you don'tneed to be obsessed with. I
think studies have shown thatmore than 97% of kids meet the
recommended protein intakes, andless than 5% of kids meet the

(12:02):
recommended intakes for fiber.
So I would be much moreconcerned in general, about kids
fiber intake than their proteinintake. Having said that, I
think some simple ways to ensurethat your kid is getting protein
in their diet. The first is makesure they're eating enough
calories. I think if you'reconsuming enough calories,
you're likely going to meet yourrecommended protein intakes, and
then try to make sure thatyou're including a variety of
protein forces at most meals andsnacks. Now, all of us have had

(12:25):
the dinner where it's just pastaand you don't necessarily get a
lot of protein, and that's okay,but I'm talking about on a
consistent basis, make sure thatyou have a good source of
protein most of your meals andsnacks. So it could be things
like tofu, tempeh, even some ofthe veggie meats, beans,
legumes, lentils, chickpeas,even nuts and seeds are going to
have some protein in them, aswell as whole grains. So think

(12:46):
about, Do I have a source ofprotein at this meal or snack?
And if not, how could I add one?
Easily. I'm also curious whatyou think about this. I feel
like our society has becomeprotein obsessed. There's the
idea that they have to havechicken and meat to get enough
protein, they need to haveprotein at every meal. And from
what I've read, kids only needto have about 10 to 15% of their

(13:08):
total daily calories to comefrom a protein source for them
to meet the sufficient needs fora growing child. And even then,
they don't need to have it everyday. If they don't have great
protein one day, they'll make upfor it the other day. And kids
often tend to crave what they'relacking. I believe, yeah, so I
do also think that we'reoverthinking protein for kids to
grow and thrive sufficiently. Ido think that our obsession with

(13:29):
protein is at a peak. And like Isaid, I think we should be
focused on low calorie fiber. Ithink that if kids are getting
adequate calories and they'reeating a variety of foods, and
if you have a really highlyselective eater, you might have
to pay a little bit moreattention to it, but if they're
eating a variety of food andthey're getting enough calories
in their diet, it's highlyunlikely that they're not going
to make their protein intakes.

(13:50):
There was a group of studiesdone out of Germany in the early
2000 20s, and they looked atprotein intakes of vegan
children, vegetarian childrenand omnivorous children. And it
is true that the omnivorouschildren had higher protein
intakes than the vegan children.
All three groups almost haddouble the recommended intakes
of protein. So everyone wasmeeting their protein intake. So
generally, if they are eating avariety of foods and they're

(14:12):
eating enough calories, I'musually not concerned about
protein intake for my vegetarianvegan families, right?
The real struggle, I find, is toget those nutrient based foods
like fruits and vegetables intheir kid's diet. So that leads
me to my next question. A lot ofparents struggle getting their
kids to eat fruits andvegetables. Specifically,

(14:33):
vegetables are really tricky forparents. Do you have any advice
for the picky eater, where kidsdon't want to touch a vegetable?
What would your advice be forthat family?
Yeah, and I think that it'sreally understandable, and I
have a lot of compassion forfamilies that are struggling
with this issue, because theirconcern is coming from a really
valid and a good place. They'reworried that their kid isn't

(14:53):
getting the nutrients they needto be able to grow and develop
well. And the problem I oftensee is that really. The
understandable concern getsdialed up and it gets turned
into anxiety. Once anxiety hascome to the dinner table, it's a
whole different ball game. Andyou know, parents end up using a
lot of pressure tactics, eithernegotiating or bribe, saying

(15:16):
you're not going to get yourdessert. And while I understand
why parents use these tactics.
It ends up backfiring in thelong term. It actually can work
in the immediate term, if you'resitting with a kid and you say,
unless you finish your broccoli,you're not getting the chocolate
chip cookie, chances are the kidwill end up eating the broccoli.
But in the long term, itactually doesn't work, because
it just escalates and escalates,and you've actually unknowingly

(15:39):
taught your child that thebroccoli actually isn't worth
eating and of itself. So I thinkthe first step is just checking
in with your own anxiety. Haveyou invited anxiety to the
table? Are you using some ofthese pressuring tactics to get
your kid to eat more? Fill inthe blank broccoli, lentils,
whatever the case may be, and ifyou are, it's okay. You haven't

(15:59):
ruined anything, you haven'tmessed anything up. But the
first step, I think, is reallyworking to take away the
pressure. And it's going to takea while. If these patterns and
habits have developed over time,it's going to take some time for
them to unwind themselves. But Ifind, in general, as long as
there isn't a specific feedingdisorder or underlying
neurodevelopmental issues ormedical conditions that really

(16:21):
are interfering with the child'scapacity to eat a variety of
foods. Once you improve thedynamics around feeding at the
dinner table, it's more of alast and gradually, they will
start to eat more of thesenutritious foods on their own.
And I always say, parents,you're in it for the long day.
You want your kids to be makingthese choices around food, not
just at your dinner table, butwhen they're away from your

(16:41):
dinner table. And I can sing itwith my son, who is in college
now, misses vegetables. He comeshome and he says, I'm not eating
enough vegetables at school, youknow? And I'm not saying that to
boast or bribe or anything hehas is definitely my more
selective eater, but I thinkhe's been taught to be able to
enjoy these foods in and ofthemselves, and he doesn't
require the promise of a cookieat the end of it to eat them.

(17:03):
It's very true. I find thisstatistic interesting in
reference to picky eaters. Whenyou pull parents of two year
olds, 50% of them will say thatthey have a picky eater. So it
is normal for toddlers to bepicky eaters. And I think that's
the hard part for parents, is tolook to the long game. Because I
agree with you, if we can fostera supportive family environment

(17:25):
around the dinner table, wherewe offer those foods but take
the pressure away somehow,without making it feel forced, I
think eventually that pays off.
Yeah, Ithink my general approach to
feeding is I have a caring butnot catering approach. So what I
mean by that is my goal is foryou to enjoy dinner, and I want
you to look forward to the mealand find it to be really tasty

(17:46):
and all those things. And so I'mgonna do my best to like, take
the family preferences andconsiderations, but I'm not
gonna cater. And so I think someof these habits and these
routines around dinner, you haveto have a goal and a vision. At
the onset of I want this to bean inviting, nourishing
environment for my family, andif you practice that with

(18:08):
consistency, it does get easier.
And for the kids, where you'rereading a lot of resistance, if
it's beyond the garden varietyto eating, I really like for
parents to get support earlierrather than later, because the
longer that they are goingwithout support, the more that
these unhelpful habits canreally make themselves firm and
established at their dinnertable.

(18:29):
I've also heard you referenceAlan sodders approach to feeding
kids at the dinner table.
Yeah, and I think her approachis really at the foundation of a
lot of feeding dynamics, and Ithink it's a really good
framework. I often tell parentsto feel free to personalize it,
because I think nothing is goingto be a one size fits all model.
And actually children withspecific temperaments, I always

(18:49):
say I have expertise, that theparents are the experts of their
family and their child. And soher division of Responsibility
framework basically says thatboth parents and children have a
set of responsibilities when itcomes to eating and feeding, and
you want to make sure it'sSenate developmentally
appropriate framework. Butbasically, parents decide the
what, the when and the wherefeeding. So you might decide

(19:10):
that we're having tofu stir fryat six o'clock at the dinner
table, like that's that's ourlane disdain. And then it's up
to the cat child, in adevelopmentally appropriate way
to decide how much and whetherthey're going to eat the foods
that are served. And that partreally scares parents, because
they often worry if I let mychild decide whether they're

(19:31):
going to eat the foods, theirdecision is going to be no if I
let my child decide which foodsthey're going to choose, they're
only going to choose the pasta.
And you mentioned that kidscrave the nutrients if they're
missing, and I do believe thereis some truth to that, and it's
true for a while, they mightjust end up eating the pasta and
the rice and the bread, buteventually, if you really stick
in your lane and you're notpressuring and you're not

(19:53):
forcing, they will have thecapacity to be able to eat a
more well rounded diet. And ifwe're feeling. Lot of resistance
at the table. Ask ourselves, AmI in my lane, or have I crossed
over into my child's lane byprompting them to eat more
broccoli or eat more carrots orwhatever the case may be,
one of the more common concernsI hear from parents when it
comes to eating at the dinnertable is this fear that if they

(20:14):
don't eat dinner, they'll go tobed hungry. And that really
doesn't sit well with a lot offamilies. So what would your
advice be to families? If thatwas a scene at the dinner table
where you offered it, you madeit available, but the child just
refused the tofu stir fry fordinner, should they then make a
second meal? Should they offersome fruit? What should the
boundaries be?
I think this is where caringwithout catering really comes

(20:36):
into play. Know your child, isthis a chronic, recurring thing,
or is this like a had a bad dayand they just need a little
extra support, or maybe an extrasnack? I think one rule of thumb
that has been really helpful is,don't make the snack more
enticing than the dinner. So ifthe snack is going to be, I
don't know, fill in the blankcookie, chocolate chip cookie.

(20:57):
Of course, I'm going to say I'mnot hungry for the dinner and
get to the chocolate chipcookies. So I think the blanket
answer of stick your dimes,don't give them a snack. I think
in practice, it's reallydifficult if your kid really is
hungry and they need a littleextra support. But you know, one
option could be, I saved dinnerfor you. I'm happy to re warm it
for you, or just not trying tomake that snack more enticing

(21:21):
than the dinner itself. And ifit's a chronic thing, like you
may have to look at your mealtimes, maybe they're having a
really late afternoon snack andthat's interfering with their
appetite at dinner. So be alittle curious as to why this is
happening, and then really tryto tailor your response to
what's happening for your child.
And I completely agree with youthat nuance matters. Every

(21:41):
family dynamics different. Ourapproach to what we feel like is
a good balanced meal, thetraditions and what foods are
prioritized may be differentfrom families, and so I do agree
with you that nuance reallymakes a difference. Yeah. So my
question for you is I tried withmy husband for a short while to
follow a vegetarian diet, andwhat I found was I was craving a

(22:03):
lot to feel full, and then Ifound that I was eating less
healthy than I typically would.
I was having a lot of bread, Iwas having a lot of pasta,
looking for foods to fill me up,because the fruits and
vegetables weren't doing thetrick for me. And then I found
for myself, having more meat inmy diet. I actually do find that
I eat healthier in a way. Whatwould your advice be for someone
like myself who's looking to eatless meat, but I also want to

(22:25):
make sure that I do it in ahealthy way?
Yeah, and I think it's a greatquestion, and I think a gradual
approach can work really wellfor some people, because you
have time to tackle me anddiscover what really feels
satisfying and nourishing. Thecommon mistakes I find when
people are going plant based orwine eating or wanting more
vegetarian, first is, oftentimesthey're not consuming enough
calories. I would neverdiscourage anyone from eating

(22:47):
fruits and vegetables. Go foreat as many fruits and
vegetables as you want, butthey're not very filling. So you
want to make sure, like, in mymind, a kale salad is not an
adequate lunch, you want to makesure that it has some roasted
chickpeas, or some tofu, or somepumpkin seeds, a good tahini
dressing. Things that are goingto have fat, fiber and protein,
those are the things that aregoing to feel satiating to you.

(23:09):
So you want to make sure thatyour snack isn't just an apple,
because I would be hungry afterthat. So making sure that it's
got protein, fiber and somehealthy fats in your meals and
snacks, so that they actuallyfeel filling and satisfying is
really important. So make sureyou're eating enough calories.
Add those things in. And I thinkthe bottom line is, make sure
you're eating enough calories,and don't be afraid to add

(23:31):
healthy fat, sources of proteinand fiber that are going to make
it a little bit more I thinkthat's fantastic advice, and
you're probably right. Iprobably wasn't getting enough
calories from the legumes, fromthe fats, from the nuts, so that
I wasn't craving so many simplecarbohydrates.
Yeah, I think this will be areally fun way to get the kids
involved. Have some excitement.
We're doing Meatless Monday.

(23:52):
What should we try this week?
Make them excited for it too.
It's great advice. Okay? Andthen another question that I
probably hear from parentsmultiple times a day is whether
or not consuming a vitamin or asupplement makes a difference.
Parents worry that they're notgoing to get the nutrients that
they need. Would you recommend avitamin for a kid in that
situation, or can they getenough if they're having a well

(24:14):
balanced plant based diet?
So it depends on a couplethings. It's going to depend on
how plant based they are. So forfamilies that are flexitarian,
where they're eating mostlyplant based, but they are
consuming some dairy, some fish,some eggs, some animal products
throughout the day, that kid'sneeds for supplements is going
to look different from a childthat's following an entirely
vegan or plant exclusive diet.
So there are some specific needsfor supplementation. The other

(24:37):
thing I remind parents ofthough, is every child may or
may not need supplements,depending on the diversity of
foods that they're including intheir diet, and I can give you
some specific examples. So forkids that are vegan in a plant
exclusive diet, they need tomake sure that they're getting
an adequate source of vitamin B12. And the reason for that is B
12 is found in animal sourcefoods. It's actually B 12. Is

(24:58):
found in bacteria in the soil,and when the animals grave on
it, that's how they get it.
Oftentimes, animals arefortified with B 12. Some people
say, Oh, you can find b 12 insome mushrooms and things like
that, but it's not a consistentand reliable source. And so the
safest thing for any kid that'sfollowing a vegan diet is to
take a vitamin B 12 supplement.
Some foods, like the plant basedmelts are fortified with vitamin

(25:20):
B 12. But you know, kids arevery particular. One day they're
drinking the plant based milk,and the next day they're not.
And so unless you have aconsistent intake of these
foods, the safest thing is totake a vitamin B 12 supplement.
That one's non negotiable, andthe reason for that is the
impacts of having a vitamin B 12deficiency can be pretty
devastating, especially foryoung, developing children, the

(25:41):
good news is that vitamin B 12supplements are pretty
inexpensive, like no risk ofside effects taken at the
recommended intakes, and they'repretty easy to take, so that
one's kind of a no brainer.
Something else I'd like tomention about vitamin B is that
it's water soluble, so if achild does take too much, the
body will urinate the extra. Soyou can't really overdo a

(26:01):
vitamin B 12 supplement,correct? Yeah, and
there are some formulations thatare super high doses, which I
would not recommend for kids,but if you're taking them in the
recommended doses, I have zeroto no concern that a vitamin B
12 supplement is going to beharmful, and then the rest of
the supplements are going to bea little bit more nuanced. One
that I find that a lot of kidsneed this vitamin D, and the

(26:21):
reason for that is, even you'redrinking cow's milk, if you're
drinking the amount recommendedby the AAP, you're still not
going to meet your vitamin Drequirements for the day. And
with sun exposure, we're tryingto limit it in terms of sun
protection, we're wearing sunframe, and especially with the
latitude that you may live at,the sun isn't always the best
source of vitamin D, so a lot ofkids may actually require a
Mindy supplement, regardless ofthe type of diet that they're

(26:44):
following. So that's anothernutrient. And some of the other
nutrients that don't necessarilyrequire supplements, but that
they do require some closerpaying attention to, is calcium.
And again, this is a nutrientthat not just plant based kids,
but even if you have familieswhere the kids aren't drinking a
lot of milk, they're likely notmeeting their recommended
intakes for calcium, and so forplant based families, you want

(27:06):
to make sure that your plantbased milk is fortified with
calcium. So we've coveredvitamin B, 12, vitamin D,
calcium, another nutrient. Thedata on this one isn't quite as
clear, but the omega three fattyacids, so DHA and EPA, the most
common source is found in fish.
And again, a lot of kids aren'tconsuming fish regularly, so if
you have a kid that's not eatingfish, you might consider a tha

(27:27):
EPA supplement. The studies aremore robust for pregnant and
nursing women, as well as foryounger children. So kids under
the age of two, I woulddefinitely consider one. And for
older kids, it's one of thosethings where I don't think it's
harmful. And for addedassurance, I would recommend
considering a DHA and EPAsupplement. And then one other
nutrient that I think has beengaining some increasing

(27:47):
attention of late is iodine,which might be like a peculiar
one to talk about, but the mainsources of iodine in the diet
are dairy and seafood. And forplant based families are not
including dairy, they aren'teating a lot of seafood, and if
they're not using iodized salt,so a lot of these, like pink
Himalayan sea salts, they'reoften not fortified with iodine.

(28:08):
So an iodized salt is the bestway and easiest way. But if
you're not using iodized salt,you want to make sure that
you're getting an adequatesource of iodine, and sometimes
most multivitamins will haveabout half the RDA vitamins. If
you're doing a multivitamin andthen eating regular foods, it's
usually just fine. So those themain supplements that come to
mind.

(28:28):
A typical scenario that I noticeis a family is not vegetarian,
has a teenager who isconsidering a vegetarian diet to
assuage the parents concerns. Doyou recommend that we check labs
on that child every so often.
And what labs would yourecommend, not
necessarily the standard labs,when you screen for anemia and
things like that, do thestandard labs if you have a

(28:51):
specific region to check labs,given an athlete and they're
feeling fatigue, or you'reconcerned about iron deficiency,
I definitely recommend checkinga CBC. The recommendations for
checking vitamin D are all overthe place, like, at first, we
were checking them a lot, andnow they're actually saying that
we shouldn't check them. But ifyou have a child that has
consistently not had a goodsource of vitamin D, they're not
drinking milk, they're nottaking a D supplement. It's not

(29:13):
a bad idea just to check theit's not super, super low in
terms of vitamin B 12. It takesa while for the deficiency to
develop. So if you've only beenvegetarian for a week or two,
you're not going to have avitamin B 12 deficiency. So you
don't need to worry about that.
If you've had months or years ofnot getting an adequate source
of vitamin B 12, I would check alevel and actually for vitamin B
12, instead of checking just aserum B 12, which you certainly

(29:34):
could do, checking thedownstream metabolites and MMA
or homocysteine, is actually amuch more sensitive measure of
vitamin B 12 status. So Irecommend those tests over just
a serum B 12. Interesting.
And so if somebody does have ahigh homocysteine, for example,
at that point, you'd recommend avitamin B 12 supplement,

(29:54):
correct.
Oh, I don't want them to get todivision C state. So if you have
a child that says, I'm.
Interested in being vegetarian.
You don't have to wait for thelab results to start the
supplementation. One time, I hada mom with a newborn who came to
see me, and she was vegan, andshe didn't share the information
with her health professionalbecause they were very
dismissive and discouraging, andso throughout her pregnancy, she

(30:15):
wasn't taking any B 12supplements. So that's a person
that I would check labs in, justto make sure that we're not
dealing with a deficiency state,but you absolutely do not need
to check a lab before starting aB 12 supplement. And in terms of
calcium, blood levels of calciumare going to be very tightly
regulated. The main downstreameffect of calcium is their bone
health. We want to preventosteoporosis and osteopenia

(30:37):
later in adulthood, and sochecking his serum level of
calcium is not to be thathelpful. If there is a lot of
parental anxiety, say thatteenager comes in, they're
really motivated, and the parentis feeling like I don't have the
tools, the resources, thebandwidth, the knowledge to know
how to do this safely. I thinkin those instances, meeting with
a registered dietitian who'sexperienced with plant based

(30:59):
diets, vegetarian vegan dietscan be incredibly helpful, not
forever, but just in the initialstages, to make sure that you're
covering your nutritional basis.
Now you brought up milk, whichis also a very common question
from parents. A lot of parentsbelieve that their kids need
enough milk to get the nutrientrequirements that they need for
their calcium and their vitaminD, but I'm curious what you

(31:20):
think, because it's of mybelief, that while, yes, milk
does have some added vitamin D,there's calcium, there's vitamin
A, there's protein, all of thosenutrients kids can get from
other dietary sources. So it'sokay, if their kid's not a big
milk drinker, they can get thatcalcium from dairy or legumes or
green leafy vegetables. Or,should I be encouraging a milk

(31:41):
alternative? In your opinion?
Yes and no to all that you said.
So dairy absolutely was notrequired in the diet to be
healthy, to have strong bones.
We know that kids, for a varietyof reasons, cannot consume
dairy. They may be following avegan diet, they may have
lactose intolerance, they mayhave a dairy allergy. So this
advice and guidance is for a lotof kids, and you think of over

(32:04):
70% of a global population islactose intolerant. So chances
are whether the families thatare vegan, you will have
families that are not consumingdairy. So this information is
helpful for a lot of familiesyou absolutely do not need dairy
to meet your calciumrequirement, having said that
things like cruciferousvegetables, broccoli, kale,
tahini, sesame seeds, almonds,oranges, all these foods contain

(32:27):
calcium, but the amount of thesefoods that a child would need to
be able to consume to meet theircalcium requirement is quite
high. And I don't know aboutyou, but I don't know a lot of
kids that are excited to eatbowls and bowls of kale or bowls
of broccoli. So I think for thevast majority of family, if
you're not consuming dairy, youwant to make sure that you're
including one to two cups of afortified plant based milk a

(32:49):
day. And for kids who don't liketo drink milk, you can find
creative ways of including this.
You can put it in your oatmeal.
You can make it into a smoothie.
Some kids actually don't minddrinking a cup of milk with
their breakfast or their lunch?
So I think for most kids, you dowant to be looking for a dairy
alternative, because it would beincredibly challenging for them
to meet their calcium needsthrough food source as well.

(33:12):
Now this may be a trickyquestion to answer, but I'm
going to ask for families thatare vegetable curious, or
they're vegetarian curious, asyou said, can you offer like,
two or three pieces of advicefor them to try to get their
kids to be more interested intasting vegetables?
I think the first thing is toinvite them into the process,

(33:33):
you know, get their opinions andget them to come up with some
ideas. We're so lucky inCalifornia to have so many
amazing farmers markets. Andwhen my kids were young, we
would grow the farmers markettogether, and a lot of times
they're offering samples, andthey would try, you know, a ripe
peach or a blueberry or a snappea. So get your kids involved
as much as you can. The secondthing I would say is to model

(33:55):
the behavior yourself. I cannottell you how many parents come
to me saying, my kids won't eatvegetables, and the parents
aren't eating them either. Soyou have to walk the talk. You
have to practice what youpreach. Let your kids see you
enjoying the vegetables too, oryou be willing to try a snap pea
or a food that you might nothave been open to trying before.

(34:15):
And then the third tip, I wouldsay, is explore a lot of
different cuisines. I think thatso many cultural cuisines,
whether it's Indian or Ethiopianor so many foods, have plant
based foods. They have thestaple in those cuisines. And if
you try a variety of differentethnic foods, that can be really
fun way to explore as well.
Absolutely, I have to say,specifically my 14 year old, I'm

(34:39):
so pleased to see how her howher diet has evolved. She was
that classic, picky two year oldwho wouldn't touch a tomato, and
we've just kept doing whatyou're saying. Honestly, we go
to farmers markets a lot. We trydifferent cuisines. We try to be
role models of healthy eaters inour house as best we can. And
now she loves pickles, she lovesonions, she loves mustard, she

(34:59):
loves spice. See, I tease myhusband. We've almost made her
too good of an eater, becauseover the weekend, we had some
Japanese food, we had someKorean food, and it's not cheap.
So the nextstep is to get her involved with
cooking some of these cuisines,so you can eat at home instead
of having to eat out so much.
That's a really good idea. Allright, that'll be our added on
to our Meatless Monday. Have herhelp cooking, but I but it's

(35:21):
actually been very rewarding asa parent to see that practice of
consistently offering a varietyof foods, putting out fruits and
vegetables, and then seeing herbecome as good of an eater as I
could have hoped. It's reallypaid off.
Yeah, I think as parents,sometimes we can have our own
fixed mindsets, right? We'relike, Oh, she's a picky eater,
oh, she's not going to eat that.
And yes, I think a lot of timeswe bring that expectation, that

(35:43):
anxiety, that legacy, yeah, andwe're bracing ourselves for the
battle. And it doesn't have tobe no and be open to the
possibility that it couldchange.
I do agree with the idea that asparents, if we can try to avoid
labeling our kids, that willserve us better in the long run,
because if we're always thinkingof our kid as the picky eater,
as opposed to their picky fornow, or they're picky for today,

(36:06):
that will provide thatenvironment where they're open,
and we're open to themcontinuing to expand their
palate.
And I don't know, I'd be curiousto know what you think about
this, but I think that a lot ofthis really goes back to
temperament. You know, you havethat kid that sometimes is slow
to warm, and that kid that'slike the life of the party and
can just go in. And I think thesame applies with the food.

(36:27):
Their kids were a little bitmore cautious. They need a
little bit more support. Theyneed a little more patience,
they need a little moretenderness. And then there's the
kid that'll be brilliant, I'lltry anything you heard and put
in front and I think as parents,we really need to tune into what
is my child's feedingtemperament and do they need a
little extra care? Do they needa little more patience? What are
the best parenting quotes I'veheard? You know, parenting the

(36:50):
child that you have versus thechild you wish you had, or that
you hoped you'd have, can reallymake a big difference.
It's so true. And there'sanother saying that I often
think about, especially with theyounger ones, where some kids
eat to live, and some kids liveto eat. And you know, I'm
thinking about what you'resaying about their difference in
temperaments. It's true. Youhave to work with the kid that
you have, yeah, and go fromthere, yeah. So this has been

(37:14):
really helpful. I reallyappreciate all of this
education, all the practicaltips, if parents want to learn
more from you and they'recurious about adopting a more
plant based diet in theirhousehold. Are you available
for coaching?
Yeah, absolutely. So I loveworking with parents, whether
they're plant curious or fullyvegan or have general questions

(37:34):
about feeding and parenting. Andthe best way to reach me and
find me is on my website, whichis my name, Reshma Shaw, MD,
parent coaching, very clever Iknow.com, and on my website
actually also have some freeresources. I have a plant based
Starter Guide that kind of goesover some of the nutrients that
we talked about, how to thinkabout composing a good, healthy
plate for your family. And thensome recipes that are fun and I

(37:55):
think, very tasty. And then Itry to share information on
Instagram, just healthy recipe,parenting tips, feeding tips,
and information and resources,specifically about some of the
things that we talked about.
Like, how do you choose the bestplant based
milk for your field? I love it.
And then I know you mentioned itat the top of the episode, but
remind us again the name of thebook that you co wrote,
yes. So it's called nourish, thedefinitive plant based nutrition

(38:18):
guide. And so if you are like,ready go in full tofu on the
whole plant based adventure, wereally wanted to create a
definitive resource for familiesto give you all the information
and the tools to be successful.
Thank you so much. I've reallyenjoyed this conversation. I've
learned a lot. I'm inspired, andI really believe that the
foundation of health is not whathappens when you come in to see

(38:39):
the doctor, it's what you'redoing at home, and a lot of that
is the diet that we consume on aregular basis. So thank you so
much for promoting health, and Iappreciate you taking the time
to be heretoday. Yeah, it's been wonderful
chatting with you, and I wouldlove to know how your meal is
Monday adventure goes.
Thank you so much. I'll keep youposted.
Thank you so much for listening,and if you enjoyed today's

(39:00):
episode. It would mean the worldto me if you could do two
things, share this episode witha friend or another parent who
might find it helpful, and leavea five star review wherever it
is. You listen to podcasts, itreally helps other parents find
the show and join thiscommunity. See you next. Monday.
Bye.
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