Calcium intake and cows' milk free diets

Area of Science:

• Pediatric Nutrition
• Dermatology
• Clinical Dietetics

Background:

• Atopic eczema (atopic dermatitis) is a common chronic inflammatory skin condition in children.
• Elimination diets are frequently used to manage atopic eczema by identifying and removing trigger foods, including cow's milk.
• Cow's milk is a significant source of calcium in pediatric diets.

Purpose of the Study:

• To assess the calcium intake adequacy in children with atopic eczema undergoing elimination diets.
• To identify risk factors for inadequate calcium intake in this population.

Main Methods:

• Retrospective analysis of dietary records for children with atopic eczema on elimination diets.
• Comparison of reported calcium intake against estimated average requirements.
• Categorization based on milk avoidance and type of milk substitute used.

Main Results:

• A high proportion (15/20) of children avoiding cow's milk without any milk substitute had calcium intake below estimated requirements.
• A smaller proportion (3/26) of children avoiding cow's milk but using soya or casein hydrolysate formula also had insufficient calcium intake.
• The use of appropriate milk substitutes significantly improved calcium intake adequacy.

Conclusions:

• Elimination diets for atopic eczema, especially those excluding cow's milk, pose a risk of inadequate calcium intake in children.
• Monitoring calcium intake and utilizing appropriate milk substitutes are crucial for children with atopic eczema on elimination diets.
• Further research into optimal calcium supplementation or fortified alternatives is warranted.