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Milk Matters
Childhood and Adolescent Nutrition:
Why
Milk Matters Now for Children and Teens
 Good health starts with good
nutrition. Good nutrition can protect against disease later
in life. The Food Guide Pyramid, and the Dietary Guidelines
for Americans, are national recommendations to help people choose
diets that promote health and reduce disease risks. A healthy
diet should include food from the major food groups: grains
(bread, cereal, rice, and pasta); vegetables; fruits; dairy
products; meat (poultry, fish, dry beans, eggs and nuts). Fats
and oils, located at the top of the food pyramid, should be
used sparingly.
Recent studies show
that few American children are meeting all of the recommendations
outlined in the food pyramid. Teenage girls, on average, failed
to meet any of them. One essential nutrient lacking in the diets
of many children and teens is calcium, found primarily in dairy
products and in dark, leafy green vegetables. Calcium plays
a role in the proper functioning of the heart, muscles and nerves
and in maintaining blood flow. But most calcium is used in building
bone mass in order to support physical activity throughout life
and to reduce the risk of bone fracture, especially that due
to osteoporosis, the weakening of bone that can occur late in
adulthood.
Building
Strong Bones
Though they appear hard, rigid, and lifeless, bones are actually
growing and alive. Exercise and adequate calcium both influence
bone mass. Weight-bearing exercise, such as dancing, weight-lifting,
or running, determines bone mass, shape, and strength. Smoking,
unhealthy eating patterns, and alcohol use detract from bone
mass. Excessive salt intake may increase the amount of calcium
lost in the urine, and therefore, increase the body s need
for calcium.
Scientists agree
that diets deficient in calcium during childhood and adolescence
contribute to the development of osteoporosis, which is not
visible until late in life. A positive calcium balance taking
in more than is lost throughout childhood, adolescence, and
young adulthood will allow bones to develop to their maximum
density. But it is during the teen years that optimal calcium
intake is most important. Bones grow and incorporate calcium
most rapidly then. Soon after, by the age of 17, approximately
90% of the adult bone mass will be established. By the age of
21 or soon after, calcium is no longer added to bones and a
few years later, a steady process of loss of calcium from bones
begins. Genetically, people differ in how much calcium is in
their bones when they reach maturity, but how much calcium they
eat while they are growing has an important influence. The more
calcium that is in the bones when loss begins, the longer it
will take before the bones become fragile and fracture easily.
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CALCIUM:
WHO GETS ENOUGH?
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Age
Group
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%
Getting the 1989 RDA
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Under
5 (males and females)
Males (6-11)
Males (12-19)
Males (20-29)
Females (6-11)
Females (12-19)
Females (20-29)
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45.4
53.3
35.1
45.0
43.1
14.4
17.8
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Source:
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USDA
Continuing Survey of Food Intakes by Individuals,
1994. This survey was evaluated using
1989 Recommended Dietary Allowance (RDA); new
calcium guidelines, Dietary Reference Intakes,
were issued in August 1997 and generally set
a higher intake standard.
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No
Bones About it, Kids and Teens Can t Do Without It
Research sponsored by the National Institute of Child Health
and Human Development (NICHD) has shown that a "window of opportunity"
exists to add to the bone bank during the teen years. NICHD
researchers have found that supplementing the daily diets of
girls, ages 12 to 16, with an extra 350 mg of calcium, produced
a 14% increase in their bone density, in comparison to unsupplemented
girls. If this 14% increase in their bone density could be maintained,
its impact would be striking.
For every 5% increase
in bone density, the risk of later bone fracture declines by
40%. It is becoming increasingly evident that adequate calcium
intake is critical during adolescent years.
Kids
and Calcium: How Much Do They Need?
The new federal calcium guidelines, the Dietary Reference Intakes,
recommend that children ages 4-8 get 800 mg of calcium per day,
or the equivalent of 2-3 glasses of low-fat milk. Adolescents
and young adults, ages 9-18, whose bones are growing very fast,
need more calcium. They should have 1300 mg, or about 4-5 glasses
of low-fat milk per day.
Kids
and Calcium: Who Gets Enough?
Unfortunately, most children and teens do not meet dietary calcium
recommendations. National nutrition surveys say that more than
one-half of all children under 5 and nearly seven-eighths
of girls ages 12-19 do not meet the 1989 federal recommendations
for calcium. In fact, teenage girls only average about 800 mg
of calcium per day, well below the amount needed for normal
growth and development. This is especially critical since the
new Dietary Reference Intakes set even higher calcium levels
than the 1989 guidelines. Individuals with inadequate intake
of dietary calcium may increase their risk for bone fractures
and development of osteoporosis.
Where
Is the Calcium?
The NICHD believes low-fat milk or low-fat milk products are
the best sources of calcium because they contain large amounts
of calcium, along with additional nutrients to help the body
better absorb calcium. They are also already part of most American
diets. Along with calcium, milk provides other essential nutrients,
including vitamin D, potassium and magnesium, all essential
for optimal bone health and human development. Green leafy vegetables
are healthy sources of calcium too, but it takes at least 5
servings of collards a day to get the same amount of calcium
that is in 3-4 glasses of milk.
| RECOMMENDED
LEVELS OF CALCIUM |
| Age
Group |
1997
Adequate Intake Values (mg) |
| Birth
to 6 months |
210 |
| 6-12
months |
270 |
| 1-3
years |
500 |
| 4-8
years |
800
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| 9-13
years |
1,300 |
| 14-18
years |
1,300 |
| Pregnant
or lactating teens |
1,300 |
| Recommendations
based on the Dietary Reference Intakes for Calcium, National
Academy of Sciences, 1997 |
Lactose
Intolerance
Some parents may think that their child or teen is lactose intolerant.
Lactose intolerance is the inability to properly digest lactose,
a sugar found in milk and other dairy foods. Lactose intolerance
results in symptoms of bloating, gas, stomach cramping and diarrhea
after eating dairy products. However, most children can tolerate
lactose. African-American, Mexican-American, and American Indian
children and Asian Pacific Islanders are more likely than Caucasian
children to be lactose intolerant. Recent studies show, however,
that even children diagnosed with lactose intolerance can drink
one to two cups of milk each day without suffering abdominal
discomfort.
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SOURCES OF
CALCIUM
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TYPES OF
MILK (8 oz.)
Fat-free/non-fat
Lowfat, 2%
Whole
Chocolate milk, lowfat, 2%
..fat-free, lowfat, whole or chocolate...all have
about 300 mg of calcium
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APPROXIMATE
CALCIUM (MG)
300
300
300
300
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OTHER
SOURCES OF CALCIUM
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SERVING
SIZE
8 fluid oz.
1 oz.
1 cup
1/2 cup
1 slice
1
1/2 cup
1 slice
8 fluid oz.
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FOOD
ITEM
Yogurt, plain, lowfat
Cheese, cheddar
Broccoli, cooked, fresh
Ice cream, soft serve
Bread, white or whole wheat
Orange, medium
macaroni and cheese*
Pizza, cheese*
Calcium fortified orange juice
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CALCIUM
(MG)
415
204
136
118
20
52
180
220
300
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*Calcium
content varies depending on ingredients
Sources: American Dietetic Association, USDA Handbook 8,
and National Dairy Council. |
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For children and
teens with lactose intolerance, milk is often better tolerated
when consumed with a meal. Some dairy foods, such as hard cheeses,
or yogurt, contain less lactose than milk and cause fewer symptoms.
In addition, lactose-reduced and lactose-free milk products
are now readily available in most supermarkets. For those who
cannot tolerate any milk, dietary calcium can come from non-dairy
sources such as green vegetables like broccoli and spinach.
Alternatively, calcium-fortified foods, such as orange juice,
or calcium tablets, which provide 200-500 mg per tablet, can
serve as the source of necessary calcium.
| Types
of Milk |
| 8 oz. Milk |
Calories |
Fat (g) |
Saturated Fat (g) |
Calcium (mg) |
Skim/non-fat
1/2 % fat
1 % fat
2 % fat
Whole |
80
90
100
120
150 |
0
1
2.5
5
8 |
0
1
1.5
3
5 |
300
300
300
300
300 |
Solving
the Calcium Crunch
Children and teens can get enough calcium in their daily diets
by drinking 3-4 glasses of milk throughout the day, in breakfast
cereal, with lunch, dinner, or as a snack. Making milk the standard
and routine drink with meals throughout childhood and adolescence,
and even through the adult years, is the best way to assure
adequate calcium intake. For children over the age of two, low-fat
or non-fat milk is recommended because it will add calcium to
the diet without the fat. There are now a variety of milk products
available, ranging from whole milk to non-fat or skim milk
but an 8 oz. glass of any variety still contains about 300 mg
of calcium. Teens and young adults concerned about calorie intake
and weight gain should know that 12 oz. of fat-free milk contains
less calories than a 12 oz. soft drink, and provides 1/3 of
daily calcium needs as well as many other important nutrients.
The recognized inadequate
calcium consumption among children and adolescents to be a growing
problem and a serious threat to their later healthy growth and
development. Researchers are working to develop methods to prevent
osteoporosis both through physical activity and through dietary
means in childhood. Although adequate calcium benefits bones
of all ages, children and teens need more calcium today to protect
against bone fractures tomorrow.
NICHD Clearinghouse
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