Risk of inadequate bone mineralization in diseases involving long-term suppression of dairy products.
BACKGROUND
Eighty percent of peak bone mass should be achieved from birth through adolescence. An adequate calcium intake is essential, and it is advisable that 60% of the recommended calcium allowance be dairy calcium. This study was conducted to examine bone mineral content (BMC) in patients with diseases that usually involve long-term suppression of dairy products.


METHODS
Thirty patients, aged 2 to 14 years (mean, 7 years), 10 with late-onset, genetically induced lactose intolerance, 7 with cow's milk protein allergy, 3 with short-bowel syndrome, and 10 with hypercholesterolemia were involved in the study. They were receiving various dietary regimens for periods longer than 2 years: 14 patients received special formulas for children (lactose-free cow's milk formula, highly hydrolyzed cow's milk protein formula, soy protein isolate formula), 4 patients received liquid soy beverages, 6 patients received skim milk (1% fat), and 6 patients had exclusion of dairy products. Bone mineral density (BMD) was assessed by dual-energy x-ray absorptiometry.


RESULTS
Nine patients had osteoporosis, 6 had osteopenia, and 15 had results within normal ranges. Overall, the group had a standard deviation score of -1.3 (osteopenia). The statistical correlation between the BMD value and the percentage intake of recommended daily allowance (RDA) of dairy (or substitute) calcium (in milligrams per day) was highly significant (P < 0.0001, r = 0.89).


CONCLUSIONS
All patients with diseases involving total or partial withdrawal from milk products for a prolonged period are a group at potential risk of defective bone mineralization and should be monitored through BMD assessment.
Infante
D
D
Unit of Gastroenterology and Nutrition, Hospital Materno-Infantil Vall d'Hebron, Autonomous University, Barcelona, Spain.
Tormo
R
R
D000293:Adolescent; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology; D002113:Calcification, Physiologic; D002118:Calcium / Q000008:administration & dosage / Q000172:deficiency*; D002648:Child; D002675:Child, Preschool; D003611:Dairy Products; D005526:Food, Formulated; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy; D007787:Lactose Intolerance / Q000178:diet therapy*; D016269:Milk Hypersensitivity / Q000178:diet therapy*; D010024:Osteoporosis / Q000209:etiology; D012778:Short Bowel Syndrome / Q000178:diet therapy*; D030262:Soybean Proteins / Q000008:administration & dosage
D030262:Soybean Proteins; D002118:Calcium