Calcium, Dairy Products, and Bone Health in Children and Young Adults
Posted on: Sunday, 5 June 2005, 03:00 CDT
To the Editor.
For reasons that arE not quite clear, some vegetarian health professionals presenting at public meetings on beneficial diets for children have focused more on the supposed evils (this word used with intention) of dairy-product consumption as they do on the benefits of a plant-based diet. The commentary in the March 2005 issue of Pediatrics by Lanou and colleagues from the Physicians Committee for Responsible Medicine follows this pattern.1 A quick look at their Web site confirms our concern. A banner at the top of their Web site (www.pcrm.org/index.html) reads:
New Study in Pediatrics Shatters Milk Myth
For Strong Bones, Kids Need Exercise, Sunshine, and a Dairy-Free Diet
The Lanou et al commentary does not show that a "dairy-free diet" is advantageous, nor would the editors of Pediatrics permit such a gross overstatement from the data presented. Rather, the authors contend that "increasing milk or other dairy product intake [is unnecessary] for promoting child and adolescent bone mineralization."1 The tip-off here is that no possible advantages are provided in the commentary for dairy foods in the diet.
These authors are biased in their selection of studies of dairyproduct use. This is best shown by their exclusion of data from children consuming products that are fortified with vitamin D. This is how responsible pediatricians suggest cow's milk to be given when possible.2
There are consequences to removing 1 element from a diet without an awareness of what will take its place.3-4 In clinical practice, the alternative to low-fat cow's milk for children will be sugar- laden beverages including juice, soda, and "drinks" with an associated increased risk for obesity.5 The use of low-fat dairy products is well documented to be effective in preventing and treating essential hypertension.6 The dairy component of the Dietary Approach to Preventing Hypertension (DASH) may have a positive impact on bone mineralization.6-7
There is substantial advantage to be had from restoring the place of plant-based foods in the diets of children, because they are beneficial to their nutritional status and long-term health.8 The antimilk stance of the Physicians Committee for Responsible Medicine, however, does no service to reach these ends.
REFERENCES
1. Lanou AJ, Berkow SE, Barnard ND. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics. 2005;115:736-743
2. American Academy of Pediatrics, Committee on Nutrition. Nutritional aspects of vegetarian diets. In: Kleinman RE, ed. Pediatric Nutrition Handbook. 5th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2004:198-200
3. Karp RJ. The problem of changing food habits: (1) How habits are formed. In: Karp RJ, ed. Malnourished Children in the United States: Caught, in the Cycle of Poverty. New York, NY: Springer Publishing Co; 1993: 177-193
4. Nelson M, Bowser R, Lugton B, et al. The problem of changing food habits: (2) Reaching families through their own culture. In: Karp RJ, ed. Malnourished Children in the United States: Caught in the Cycle of Poverty. New York, NY: Springer Publishing Co; 1993:194- 211
5. Barba G, Troiano E, Russo P, Venezia A, Siani A. Inverse association between body mass and frequency of milk consumption in children. Br J Nutr. 2005;93:15-19
6. Fleet JC. DASH without the dash (of salt) can lower blood pressure. Nutr Rev. 2001;59:291-293
7. Cashman DL. The DASH diet may have beneficial effects on bone health. Nutr Rev. 2004;62:215-220
8. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81:341-354
doi:10.1542/peds.2005-0639
ROBERT KARP, MD
State University of New York-Downstate Medical Center
Brooklyn, NY 11203
SANDY HASSINK, MD, FAAP
Dupont Hospital for Children
Wilmington, DE 19803-3616
Conflict of interest: Drs Karp and Hassink are Chair and immediate past Chair, respectively, of the Nutrition Special Interest Group of the Ambulatory Pediatric Association.
Copyright American Academy of Pediatrics Jun 2005
Source: Pediatrics
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