FRIDAY, Aug. 23, 2002 (HealthDayNews) -- With cartoon-character juices and sodas lining the lower level of store shelves, it has never been harder for parents to sell kids on the virtues of good old-fashioned milk.
However, according to new research, failure to get enough milk in childhood could keep those higher shelves out of reach for kids much longer than expected.
In comparing a group of 50 children who had avoided milk between the ages of 1 to about 6 with 200 habitual milk consumers in the same age group, researchers in New Zealand found the milk-avoiders were not only substantially shorter in stature, but had worse bone health and much higher rates of bone fractures.
Evaluations of calcium intake and bone mineral density showed that only four of the non-milk drinking children had adequate intakes of calcium, and in general, children in that group had a lower total-body bone mineral content than the control group.
In addition, the annual incidence of forearm fractures was 3.5 percent in milk-avoiding children, compared with an expected rate of about 1 percent in regular milk consumers.
Interestingly, while the milk-avoiding children were found to be in generally good health, about 30 percent were overweight or obese, a problem the researchers attribute to the likely substitution of sugary juices or sodas for their liquid intake.
"Milk and dairy products generally provide about 75 percent of the dietary calcium in Western diets," explains co-author Ailsa Goulding, a professorial research fellow at Otago University in New Zealand.
"But milk consumption is falling today in the U.S. and other countries, as many youngsters (are given) excessive fizzy drinks and fruit juices instead of milk because they are cheaper," she adds.
The findings appear in the August issue of the American Journal of Clinical Nutrition.
While other studies have shown lower calcium levels in children who have low milk consumption, Goulding says this is the first study to measure bone density throughout the skeleton of a group of young children who have chronically avoided cow milk; to ask about bone fractures; and to look at height and levels of obesity accurately.
"We were surprised not just by the severity of the low density in the children we studied, but also by the high number of young children we saw who had already broken bones and by their shortness and (excessive weight)," she says.
Goulding notes that only about half the participants had ever experienced any unpleasant physical symptoms from milk consumption. Many instead avoided milk simply because they disliked the taste or because family members chose not to offer it to them.
"One child refused milk merely because she didn't like cows," Goulding says.
The American Academy of Pediatrics (AAP) recommends 800 milligrams of calcium each day for children, and 1,200 to 1,500 milligrams per day for preteens and adolescents, or three servings of low-fat dairy products per day. Exercise is also important in enhancing bone mass.
Experts stress that fat-reduced dairy products such as skim milk are not less nutritious for older children than whole milk, and they say there are plenty of creative -- and appetizing -- alternatives to regular milk that parents can use to satisfy the calcium requirements.
Yogurts, cheeses and fruit smoothies containing milk, yogurt or ice cream are good choices, says Dr. Marc Jacobson, co-chair of the AAP's committee on nutrition and a professor of pediatrics at Schneider Children's Hospital in New Hyde Park, N.Y.
"Even chocolate milk is fine, " he adds.
Calcium supplements may help, but doctors say the nutritional mix provided in milk is much more valuable.
"Milk is a complex and well-balanced nutrient -- it's also a major source of protein, for example," Goulding says. "And in addition to the calcium, milk offers plenty of the vitamin D that's necessary to absorb the calcium efficiently."
While getting enough calcium is important throughout life, there's no time when it's more critical than in the developing years, when the bones are still growing, Jacobson adds.
"A good way to look at it is like making deposits in your bone bank, realizing that once you get to a certain age, usually in your 20s, that bank is no longer going to accept deposits and you just have to live with what you've got," Jacobson says.
"You can prevent loss in later years with good calcium intake, but you can't add new bone mineral. The skeletal structure is finished developing," he adds.
What To Do
You can read more about the American Academy of Pediatric's recommendations on calcium intake in its policy statement on Calcium Requirements of Infants, Children, and Adolescents.
And the American Dietetic Association offers helpful information on how Calcium Intake Increases When Milk Takes a Flavor and Getting Kids to Drink Milk.
