In general, most children on well-planed vegetarian diets can achieve normal growth and development. However, elimination of animal products from the diet decreases the intake of some essential nutrients, such as calcium and vitamin D and may influence bone metabolism. This is especially important in childhood and adolescence, when growth and bone turnover are most intensive. Biochemical bone metabolism markers which showing global skeletal activity have lately been developed and validated for the assessment the dynamics of bone formation and resorption processes. Among them, products of the osteoblast activity (osteocalcin - OC, bone alkaline phosphatase - BALP), which are markers of bone formation, and products of osteoclast activity (collagen type I C-terminal telopeptide - CTX) markers of bone resorption are considered to be clinically useful. The aim of this study was to investigate the serum concentrations of biochemical bone turnover markers and vitamin D in prepubertal vegetarian children. We examined 50 children on vegetarian and 50 on omnivorous diets aged 2-10 years. In group of vegetarian children there were 28 lacto-ovo-vegetarians, 4 lacto-vagetarians, 5 ovo-vegetarians and 13 vegans. Dietary constituents were analysed using a local nutritional program. Serum bone formation and resorption marker concentrations were determined by specific enzyme immunoassays (ELISA) and 25-hydroxyvitamin D by chemiluminescence method (CLIA). Average daily energetic value and the percentage of energy from protein, fat and carbohydrates in diets were similar in both groups of children and were within the recommended range. We showed about two-fold lower daily intake of calcium and vitamin D in vegetarian diet than in the omnivorous one. Concentration of calcium and phosphate in serum all tested children were within physiological range, but 25-hydroxyvitamin D level in vegetarian children was nearly 2-fold lower compared with omnivores. In vegetarians, as compared to those in non-vegetarians, mean serum concentrations of OC, BALP and CTX were significantly lower by about 20%, 10% and 15%, respectively. Examined vegetarian children were on different kinds of diet, but mean values of bone markers for the vegans and lacto-ovo-vegetarians were not significantly different. Our preliminary results suggest that an inadequate dietary intake of calcium and vitamin D may impair bone turnover rate in children on vegetarian diets. Thus biochemical markers which reflect bone formation and resorption processes should be controlled in order to prevent abnormalities in bone metabolism in these population.

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