Vegetarian and vegan diets
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Child aged 0 to 2 years
- No routine tests
± if doubt about intake or growth faltering
- FBCif neededDoubt about adequate intake on history, or failure to thrive.
- Serum ferritinif neededDoubt about adequate intake on history, or failure to thrive.
- Serum calciumif neededDoubt about adequate intake on history, or failure to thrive.
- Serum phosphateif neededDoubt about adequate intake on history, or failure to thrive.
- Serum albuminif neededDoubt about adequate intake on history, or failure to thrive.
- Serum zinc (clinical signs of deficiency)if neededDiet that seems unbalanced or clinical signs of deficiency (developmental disorder, loss of taste): procedure 2003 is reimbursed for undernourished children, children of short stature or with clinical signs of deficiency.
- Vitamin B12if neededDoubt about adequate intake on history, or failure to thrive.
Child aged 2 to 10 years, vegetarian (eating dairy products) or vegan (not eating them)
- No routine tests
± if doubt about intake or growth faltering
- FBCif neededDoubt about adequate intake on history, or failure to thrive.
- Serum ferritinif neededDoubt about adequate intake on history, or failure to thrive.
- Serum calciumif neededDoubt about adequate intake on history, or failure to thrive.
- Serum phosphateif neededDoubt about adequate intake on history, or failure to thrive.
- Serum albuminif neededDoubt about adequate intake on history, or failure to thrive.
- Serum zinc (clinical signs of deficiency)if neededDiet that seems unbalanced or clinical signs of deficiency (developmental disorder, loss of taste): procedure 2003 is reimbursed for undernourished children, children of short stature or with clinical signs of deficiency.
- Vitamin B12if neededDoubt about adequate intake on history, or failure to thrive.
Adolescent, vegetarian (eating dairy products) or vegan (not eating them)
- No routine tests
± if doubt about dietary balance, absent or incomplete B12 supplementation, or suggestive symptoms
- Vitamin B12if neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- FBCif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum ferritinif neededDoubt about a varied and balanced diet or symptoms suggestive of iron deficiency; request with CRP.
- CRPif neededWith serum ferritin, to interpret a ferritin.
- TSHif neededDoubt about adequate iodine intake or clinical signs suggestive of hypothyroidism.
- Serum calciumif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum phosphateif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum albuminif neededClinical signs suggestive of malnutrition (prealbumin if the malnutrition seems recent).
- Serum methylmalonic acid (if B12 in the grey zone; not reimbursed in France)if neededSerum vitamin B12 in the grey zone: 150-300 pmol/L according to VégéClic, 133-258 pmol/L according to NICE (see the note).
- Serum zinc (if clinical signs of deficiency)if neededClinical signs of zinc deficiency (developmental disorders, loss of taste) or diet that seems unbalanced (the source mainly targets children).
Pregnant woman, vegetarian (eating dairy products) or vegan (not eating them)
- No routine tests
± if doubt about dietary balance, absent or incomplete B12 supplementation, or suggestive symptoms
- Vitamin B12if neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- FBCif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum ferritinif neededDoubt about a varied and balanced diet or symptoms suggestive of iron deficiency; request with CRP.
- CRPif neededWith serum ferritin, to interpret a ferritin.
- TSHif neededDoubt about adequate iodine intake or clinical signs suggestive of hypothyroidism.
- Serum calciumif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum phosphateif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum albuminif neededClinical signs suggestive of malnutrition (prealbumin if the malnutrition seems recent).
- Serum methylmalonic acid (if B12 in the grey zone; not reimbursed in France)if neededSerum vitamin B12 in the grey zone: 150-300 pmol/L according to VégéClic, 133-258 pmol/L according to NICE (see the note).
- Serum zinc (if clinical signs of deficiency)if neededClinical signs of zinc deficiency (developmental disorders, loss of taste) or diet that seems unbalanced (the source mainly targets children).
Adult, vegetarian (eating dairy products) or vegan (not eating them)
- No routine tests
± if doubt about dietary balance, absent or incomplete B12 supplementation, or suggestive symptoms
- Vitamin B12if neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- FBCif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum ferritinif neededDoubt about a varied and balanced diet or symptoms suggestive of iron deficiency; request with CRP.
- CRPif neededWith serum ferritin, to interpret a ferritin.
- TSHif neededDoubt about adequate iodine intake or clinical signs suggestive of hypothyroidism.
- Serum calciumif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum phosphateif neededDoubt about dietary balance, absent or incomplete vitamin B12 supplementation, or symptoms that may suggest a nutritional deficiency (VégéClic proposal, not consensual).
- Serum albuminif neededClinical signs suggestive of malnutrition (prealbumin if the malnutrition seems recent).
- Serum methylmalonic acid (if B12 in the grey zone; not reimbursed in France)if neededSerum vitamin B12 in the grey zone: 150-300 pmol/L according to VégéClic, 133-258 pmol/L according to NICE (see the note).
- Serum zinc (if clinical signs of deficiency)if neededClinical signs of zinc deficiency (developmental disorders, loss of taste) or diet that seems unbalanced (the source mainly targets children).
Sources (18)
- Allès B, Baudry J, Méjean C, et al. Comparison of Sociodemographic and Nutritional Characteristics between Self-Reported Vegetarians, Vegans, and Meat-Eaters from the NutriNet-Santé Study. Nutrients 2017;9(9):1023.
- VégéClic - Bilans biologiques
- Lemale J, Mas E, Jung C, Bellaiche M, Tounian P. Vegan diet in children and adolescents. Recommendations from the French-speaking Pediatric Hepatology, Gastroenterology and Nutrition Group (GFHGNP). Arch Pediatr. 2019;26(7):442-450.
- Kiely ME. Risks and benefits of vegan and vegetarian diets in children. Proc Nutr Soc. 2021;80(2):159-164.
- Jakše B, Fras Z, Fidler Mis N. Vegan Diets for Children: A Narrative Review of Position Papers Published by Relevant Associations. Nutrients. 2023;15(22):4715.
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 2003 (zinc plasmatique ou sérique), indications limitées ; absence d'acte pour l'iode urinaire, l'acide méthylmalonique, l'homocystéine et l'holotranscobalamine.
- Klug A, Barbaresko J, Alexy U, et al. Update of the DGE position on vegan diet – Position statement of the German Nutrition Society (DGE). Ernahrungs Umschau 2024;71(7):60-84. DOI 10.4455/eu.2024.22.
- Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016;116(12):1970-1980.
- Raj S, Guest NS, Landry MJ, Mangels AR, Pawlak R, Rozga M. Vegetarian Dietary Patterns for Adults: A Position Paper of the Academy of Nutrition and Dietetics. J Acad Nutr Diet. 2025;125(6):831-846.e2.
- Canton de Vaud (Suisse), Unité de promotion de la santé et de prévention en milieu scolaire. Recommandation : alimentation végétarienne, végétalienne ou végane chez l'enfant ou l'adolescent.e. Version du 29 octobre 2024.
- Conseil supérieur de la santé (Belgique). Alimentation végétarienne. Bruxelles : CSS ; 2021. Avis n° 9445 (avril 2021).
- Petit LM, Nydegger A, Müller P. Alimentation végétalienne de l'enfant : quels déficits surveiller ? Revue pratique pour le médecin. Rev Med Suisse. 2019;15(638):373-375.
- Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES). Avis relatif à l'établissement de repères alimentaires destinés aux personnes suivant un régime d'exclusion de tout ou partie des aliments d'origine animale. Saisine n° 2019-SA-0118, 3 février 2025.
- Neufingerl N, Eilander A. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients. 2022;14(1):29.
- National Institute for Health and Care Excellence. Vitamin B12 deficiency in over 16s: diagnosis and management. NICE guideline NG239. Published 6 March 2024.
- Agnoli, Claudia, et al. "Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition." Nutrition, Metabolism and Cardiovascular Diseases 27.12 (2017): 1037-1052.
- Institut national de santé publique du Québec (INSPQ). Régimes alimentaires et diètes pendant la grossesse (Mieux vivre avec notre enfant de la grossesse à deux ans).
- VégéClic