PURPOSE: In general, most children on well-planned 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. The aim of this study was to investigate the serum concentrations of biochemical bone turnover markers in prepubertal vegetarian children. MATERIAL AND METHODS:We examined 50 children on vegetarian and 50 on omnivorous diets aged 2-10 years. Dietary constituents were analyzed using a local nutritional program. Serum bone formation (OC, BALP) and resorption (CTX) markers were determined by specific enzyme immunoassays (ELISA) and 25-hydroxyvitamin D by the chemiluminescence method (CLIA). RESULTS:The average daily energetic value and the percentage of energy from protein, fat and carbohydrates in the diets were similar in both groups of children and were within the recommended range. The vegetarian children showed about a two-fold lower daily intake of calcium and vitamin D than their omnivorous counterparts. The level of 25-hydroxyvitamin D in the serum of vegetarian children was also nearly 2-fold lower compared with omnivores. In vegetarians, as compared to non-vegetarians, mean serum concentrations of OC, BALP and CTX were lower by about 20%, 10% and 15%, respectively. CONCLUSION:Our preliminary results suggest that an inadequate dietary intake of calcium and vitamin D may impair bone turnover rate in vegetarian children. The parameters of bone metabolism should be monitored in these children in order to prevent bone abnormalities.