Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health.

Am J Clin Nutr. 2002 Sep;76(3):675-80.

Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health.

Black RE, Williams SM, Jones IE, Goulding A.

Abstract

BACKGROUND:

Information concerning the adequacy of bone mineralization in children who customarily avoid drinking cow milk is sparse.

OBJECTIVE:

The objective was to evaluate dietary calcium intakes, anthropometric measures, and bone health in prepubertal children with a history of long-term milk avoidance.

DESIGN:

We recruited 50 milk avoiders (30 girls, 20 boys) aged 3-10 y by advertisement. We measured current dietary calcium intakes with a food-frequency questionnaire and body composition and bone mineral density with dual-energy X-ray absorptiometry and compared the results with those of 200 milk-drinking control children.

RESULTS:

The reasons for milk avoidance were intolerance (40%), bad taste (42%), and lifestyle choice (18%). Dietary calcium intakes were low (443 +/- 230 mg Ca/d), and few children consumed substitute calcium-rich drinks or mineral supplements. Although 9 children (18%) were obese, the milk avoiders were shorter (P < 0.01), had smaller skeletons (P < 0.01), had a lower total-body bone mineral content (P < 0.01), and had lower z scores (P < 0.05) for areal bone mineral density at the femoral neck, hip trochanter, lumbar spine, ultradistal radius, and 33% radius than did control children of the same age and sex from the same community. The z scores for volumetric (size-adjusted) bone mineral density (g/cm(3)) were -0.72 +/- 1.17 for the lumbar spine and -0.72 +/- 1.35 for the 33% radius (P < 0.001). Twelve children (24%) had previously broken bones.

CONCLUSIONS:

In growing children, long-term avoidance of cow milk is associated with small stature and poor bone health. This is a major concern that warrants further study.

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