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Long-term avoidance of milk in children results in poor bone health


Milk is an essential source of minerals, vitamins, energy, and protein in children. The reasons young children avoid drinking cow milk include lactose intolerance or a parent’s lifestyle choice. A recent study published by Black et al. in the American Journal of Clinical Nutrition compared New Zealand children who were long-term "milk avoiders" with children who habitually drank milk, by evaluating the daily calcium intake, bone mineral content, bone size, stature, and skeletal size of both groups. Children who were milk avoiders had significantly worse bone health and shorter stature than children who drank milk.

The 50 non-milk-drinking children were all white, averaged 6 years of age, had typically begun to avoid milk soon after the age of 1, and had not consumed milk for an average of 73% of their entire their lives. Their daily dietary calcium intakes, bone mineral density, skeletal size, and stature were compared with a control group of 200 white children who were habitual milk drinkers. Although all of the milk-avoiding children were apparently healthy, 15, or 30% were overweight or obese. Milk-avoiding children were significantly shorter in stature, had smaller bones and a lower total-body bone mineral content than the control group. Only 4 of the milk avoiders had adequate intakes of calcium, and ten forearm fractures were reported, for an annual incidence of 3.5% rather than the expected 1%.

Only half of the milk-avoiders reported having experienced any unpleasant physical symptoms from milk consumption, and 78% had a family member who also avoided cow milk. Many avoided milk because they disliked the taste or because family members chose not to offer it to them, rather than because of physical symptoms. The increased rate of overweight or obesity in children who avoided milk was considered to be due to the substitution of more calorie-rich fluids such as carbonated drinks or fruit juices.

The authors conclude that children who avoided drinking milk in early life should increase their calcium intakes to satisfy the increased requirements for their growing skeletons. Parents of children who do not drink milk are advised to seek professional nutritional advice to help optimize their children’s bone health.

Black, Ruth E. et al. Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health. Am J Clin Nutr 2002;76:675-80.

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Elizabeth Horowitz | EurekAlert!

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