Two-year changes in bone and body composition in young children with a history of prolonged milk avoidance.
No previous longitudinal studies of calcium intake, anthropometry and bone health in young children with a history of avoiding cow's milk have been undertaken. We report the 2-year changes of a group of 46 Caucasian children (28 girls, l8 boys) aged 8.1+/-2.0 years (mean +/- SD) who had low calcium intakes at baseline and were short in stature, with elevated body mass index, poor skeletons and lower Z scores for both areal bone mineral density (BMD, in grams per square centimeter) and volumetric density (bone mineral apparent density, BMAD, in grams per cubic centimeter), compared with a reference population of milk drinkers. At follow-up, adverse symptoms to milk had diminished and modest increases in milk consumption and calcium intake had occurred. Total body bone mineral content (BMC) and bone area assessed by dual energy X-ray absorptiometry had increased (P<0.05), and calcium intake from all sources was associated with both these measures (P<0.05). However, although some catch-up in height had taken place, the group remained significantly shorter than the reference population (Z scores -0.39+/-1.14), with elevated body mass index (Z scores 0.46+/-1.0). The ultradistal radius BMC Z scores remained low (-0.31+/-0.98). The Z scores for BMD had improved to lie within the normal range at predominantly cortical sites (33% radius, neck of femur and hip trochanter) but had worsened at predominantly trabecular sites (ultradistal radius and lumbar spine), where values lay below those of the reference group (P<0.05). Similarly, although volumetric BMAD Z scores at the 33% radius had normalized, BMAD Z scores at the lumbar spine remained below the reference population at follow-up (-0.67+/-1.12, P<0.001). Our results demonstrate persisting height reduction, overweight and osteopenia at the ultradistal radius and lumbar spine in young milk avoiders over 2 years of follow-up.
Rockell
J E P
JE
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Williams
S M
SM
Taylor
R W
RW
Grant
A M
AM
Jones
I E
IE
Goulding
A
A
D015502:Absorptiometry, Photon; D000818:Animals; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology*; D001827:Body Height / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D002136:Calcium, Dietary / Q000008:administration & dosage; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D006128:Growth / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D008892:Milk; D011884:Radius / Q000502:physiology
D002136:Calcium, Dietary