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 Parents often report that children with milk allergy, who must avoid
all dairy, have difficulty getting enough calcium or vitamin D from
milk substitutes, said senior author Dr. Anne Des Roches of the
allergy division at the Centre Hospitalier Universitaire
Sainte-Justine Research Center of the University of Montreal in
Canada.
“Milk allergy is one of the most frequent food allergies in
infants,” Des Roches told Reuters Health by email.
Infants can have formula instead, and older children may have soy
milk, rice milk or almond milk, but these may be less nutritive, she
said.
“For all children with milk allergy, a consultation with a
nutritionist is always a good thing,” she said.
Between 2011 and 2014, the researchers compared 52 kids with cow’s
milk allergies around age seven years with 29 similar kids who had
other food allergies. They measured the kids’ total body
composition, blood levels of vitamin D and lumbar spine bone mineral
density and used dietary questionnaires to assess dietary calcium
and vitamin D intake.
More than 60 percent of kids with cow’s milk allergy did not meet
recommended daily allowances of dietary calcium, compared to 25
percent of kids with other food allergies. Less than 15 percent of
both groups met recommended daily allowances for vitamin D intake.
Kids with cow’s milk allergy had lower bone mineral density than
others, and 6 percent had low bone mass, while none of the kids in
the comparison group had low bone mass, according to the results in
Pediatrics.
“The important message is that these children should be followed
preventively to be sure that they take sufficient calcium and
vitamin D to have strong bones and avoid bone problems,” Des Roches
said. “Otherwise, these kids are in very good health.”
Less than half of kids with cow’s milk allergy were taking calcium
and vitamin D supplements.
Low lumbar spine bone mineral density is tied to higher fracture
risk for kids, said Tania Winzenberg of the Menzies Institute for
Medical Research and School of Medicine at the University of
Tasmania in Australia who was not part of the new study.
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“Overall, the results are not surprising – as the authors indicate
removing dairy from the diet has impacts on nutritional factors
other than calcium and vitamin D and previous research has shown
that milk avoidance is associated with lower bone mineral density in
prepubertal children,” she said.
Some dairy milk replacements, such as soy, are supplemented with
calcium, and tofu, fish, nuts and some vegetables can be good
sources of extra calcium too, she said.
“To maximize bone health generally, fruit and vegetable intake is
likely to be important, and participation in weight bearing physical
activity and sports is also important,” Winzenberg told Reuters
Health by email.
For both groups of kids in this study, “having multiple food
allergies was very common, and these were attendees at an allergy
clinic, suggesting that these particular results cannot be assumed
to hold in children with simple and/or less severe cow’s milk
allergy,” she said.
“Children with cow’s milk allergy are not less healthy than others
per se, but in this sample they had lower calcium intake and lower
bone mineral densities,” said Dr. Matthew Greenhawt of the allergy
section at Children's Hospital Colorado in Aurora, who was not part
of the new study.
“This is a very realistic risk for such kids and one that primary
care physicians and allergists need to be aware of when managing
such patients,” Greenhawt told Reuters Health by email.
SOURCE: http://bit.ly/26ffd2i Pediatrics, online April 20, 2016.
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