Excessive dietary fat consumption, particularly of animal origin, contribute to the causes of disease in affluent society, and vegetarians have been reported to have a lower incidence of cardiovascular diseases, 1,2 hypercholesterolemia, 3,4 cancers 1,2 and hypertension. 4–6 There is some reluctance to put children on a vegetarian diet because several studies have shown problems of nutritional deficiencies, such as growth retardation, 7 iron, 8 calcium 9 and vitamin B12 deficiencies occurring in vegetarian children. Most studies have been made in Western countries. Whether the same nutritional problems occur in the Eastern countries, where there is a different culture of dietary practices, remains to be examined. Like many cities in Asia, lifestyle in Hong Kong has undergone significant changes with urbanization and Western- ization. Obesity and hyperlipidemia among the childhood popu- lation is of concern, with 21% and 10% of 11-year-old boys and girls, respectively. 10 A local cohort study of 7-year-old children, almost all of whom were omnivores, showed that 53% of them had total serum cholesterol > 4.40 mmol/L. 11 The aim of this study was to see if Chinese vegetarian children might have a lower coronary risk without nutritional deficiencies. MATERIALS AND METHODS Subjects Attempts were made to the local vegetarian societies and religious groups by advertising through magazines, letters and telephone contacts. Local vegetarian societies are mainly for adults and the main vegetarian groups are Buddhists and Seventh-Day Adventists. A vegetarian diet was defined as one that may include dairy products or eggs, but no meat or meat products and no fish. Criterion for inclusion was that they should be of age between 4 and 14 years and have had a vege- tarian diet for at least 1 year. Dietary assessment The method resembled an established food frequency method which was employed for the local children 12 and the adult dietary survey. 13 Subjects were requested to record a 7-day dietary intake in the week before the interview. Parents of children of younger ages were asked to assist their children to complete the dietary record. The amount of intake was des- cribed in terms of usual household utensils. At the time of interview, trained interviewers showed food pictures of bowls and plates of various sizes for the subjects and their parents to clarify the exact portion referred at each meal. Data were cross- checked by examining the dietary pattern (for example, if meals were missed) to see if they corresponded to the number of times staple foods such as rice or noodles were consumed over a 1-week period. The amount of cooking oil was estimated according to the method of preparing different food. Data were analyzed using a computer program comprising nutrient contents of food items in fixed portions. The nutrient contents database was compiled using food tables from J. Paediatr. Child Health (2001) 37, 247–253 Growth and nutrition of Chinese vegetarian children in Hong Kong SSF LEUNG, 1 RHY LEE, 1 RYT SUNG, 1 HY LUO, 1 CWK LAM, 2 MP YUEN, 1 M HJELM 2 and SH LEE 3 Departments of 1 Paediatrics, 2 Chemical Pathology, 3 School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR Objective: The study investigated the nutritional status of Chinese lacto-ovo-vegetarian children aged 4–14 years. Methodology: Dietary intake over 7 days was assessed using a computer program, previously used for a local population- based dietary survey. Anthropometric measurements were made and fasting venous blood was examined for serum lipids, haematological data, iron, vitamin B12 and folate status. Bone mineral density (BMD) of the spine (L2 – L4) was measured as a reflection of calcium status. Results: Fifty-one lacto-ovo-vegetarians aged 4–14 years were investigated. The mean ± standard deviation (SD) daily energy intake was 1600 ± 425 kcal. The mean (± SD) daily protein intake was 1.6 ± 0.6 g/kg bodyweight which met the United States recommended dietary allowance. Compared to that of the local omnivore diet, the vegetarian diet was closer to the recom- mended healthy diet with lower fat (20–23%), more fibre (5.8–8.7 g/day) and better polyunsaturated to saturated fatty acid ratio (1.0–1.1). Growth and BMD of the vegetarian children were comparable to the general omnivore population. Two children had iron deficiency and two children had anaemia. The calcium status, as reflected by the BMD, was not impaired. Serum folate and vitamin B12 were within the normal range. Six (25%) boys and four (15%) girls were obese. Three boys had hyperlipidaemia. Conclusions: A Hong Kong Chinese vegetarian diet appears healthy, providing adequate iron and vitamin B12 nutrition, but the prevalence of obesity was high. Key words: growth; nutrition; vegetarian diet. Correspondence: Dr SSF Leung, Department of Paediatrics, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR. Email: sophie-leung@cuhk.edu.hk Accepted for publication 13 November 2000.