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Calcium intake in children with positive IgG RAST to cow's milk
1Division of Orthopaedics, University of North Carolina, Chapel Hill 27599-7055, United States of America.
Insights
Many children with suspected milk allergy have low calcium intake. A single nutrition counseling session improved calcium intake, but nearly half still did not meet recommendations, highlighting the need for ongoing education.
Area of Science:
- Pediatric Nutrition
- Dietary Assessment
- Allergy Management
Background:
- Low calcium intake is a concern in pediatric populations, particularly those with self-diagnosed or loosely defined 'milk allergies'.
- Accurate assessment of calcium intake is crucial for identifying at-risk children.
- Patient perception of dietary intake can be unreliable, complicating nutritional management.
Purpose of the Study:
- To determine the prevalence of inadequate calcium intake among children with suspected milk allergy.
- To evaluate the long-term impact of a single nutrition counseling session on calcium intake in this population.
Main Methods:
- A cross-sectional study assessed calcium intake in 58 children (ages 5-16) with confirmed cow's milk protein sensitivity (IgG RAST class II+).
- Thirty-one children with low calcium intake (< recommended dietary allowance) received one nutrition counseling session.
- Calcium intake was reassessed prospectively 12-30 months post-counseling.
Main Results:
- Over half (53%) of the children had calcium intake below the recommended dietary allowance (RDA).
- Neither self-rated intake nor calcium supplementation guaranteed adequate intake; 48% of supplemented children remained below RDA.
- Milk consumption was a strong predictor of adequate calcium intake.
- Following counseling, mean calcium intake increased by 360 mg/day, and supplement use rose from 10% to 52%.
- Despite improvements, 48% of the initially low-intake group still did not meet their RDA at follow-up.
Conclusions:
- Limited milk consumption is a significant factor contributing to suboptimal calcium intake in children with milk protein sensitivity.
- Education on calcium importance and non-dairy sources is vital for families.
- Repeated nutritional interventions may be necessary to achieve and maintain adequate calcium intake in this vulnerable group.
Objective:
This study was made to: (i) identify the prevalence of low calcium intakes in a paediatric population with loosely defined 'milk allergy'; and (ii) assess long-term (mean 21 months later) changes in calcium intake following a single nutrition counselling session with those patients initially found to have a low intake.
Methodology:
Calcium intake was assessed in a cross-sectional study of 58 patients ages 5-16 years (mean 9.9 years) with IgG radioallergosorbent test (RAST) class II or higher for cow's milk protein. Those 31 patients found to have a low calcium intake were prospectively re-evaluated 12-30 months later following a single nutrition counselling session.
Results:
Calcium intake was < recommended dietary allowance (RDA) for 31 of 58 (53%) patients. The patient's perception of their intake was unreliable; 44% of those who rated their calcium intake fair or good did not meet their RDA. Taking a calcium supplement did not ensure adequate intake; 21% of those taking supplements still did not meet their RDA. Milk intake predicted calcium intake; 8% of those who did not drink milk vs 68% of those who did drink at least some milk met their RDA without supplementation. The 31 patients with low intakes received counselling and were re-evaluated at an average follow-up of nearly 2 years. Calcium intake was increased a mean of 360 mg/day and use of supplements increased from 10 to 52% of the group. Despite these positive changes, 48% still did not meet their RDA.
Conclusion:
Limited milk intake is likely to be associated with suboptimal calcium intake. Efforts should be made to educate the family about the importance of calcium and its non-dairy sources. With many families repeated discussions of this issue may be necessary to influence calcium intake.