Bone mineral status in children with cow milk allergy

Abstract

To investigate bone mineral status in children with verified cow milk allergy for more than 4 yr compared with a large reference population of 343 local healthy controls. Whole body bone mineral content (BMC), projected bone area and bone mineral density (BMD) were determined by dual energy x-ray absorptiometry in nine children (8-17 yr old, one girl and eight boys). All children had cow milk allergy for more than 4 yr. All children had asthma and was treated with corticosteroids. BMC and BMD were reduced for age (p < 0.01). Height for age was significantly reduced (p < 0.01), indicating 'short' bones. BMC for bone area was borderline reduced (p = 0.05), indicating reduced bone mineralization. The growth of the children was reduced compared with there parents and siblings (p < 0.01), and the bone age was retarded (mean 1.4 yr, p < 0.01). Calcium consumption calculated from food intake was about 25% of the recommended. All laboratory tests were normal. Short bones were the main reason for reduced BMC and BMD for age in children with cow milk allergy, but a borderline low BMC for bone area indicated reduced bone mineralization of the bones. A supplementation of calcium to children with cow milk allergy is recommended.

Cow's Milk Allergy and Bone Mineral Density in Prepubertal Children

“…Furthermore, we minimized the confounding effect of bone size by calculating the vBMD, a parameter not reported in the study by Jensen et al 6 The lower values observed in children with CMA thus reflect reduced bone mineral per volume unit, which might indicate decreased bone accretion. A greater proportion of children with CMA than with NCMA had been breastfed, which may have had an impact on bone mass.…”

“…In contrast to other studies, which have focused on milk avoiders 30 or included both prepubertal and pubertal children, 6,32,33 we included a well-defined population of prepubertal children with diagnosed CMA; with this approach, we removed the confounding effect of puberty on BMD. Furthermore, we studied atopic control subjects with similar characteristics, allowing us to control for the effects of age, physical activity, weight, lean mass, and steroid use on bone health.…”

“…Although resolution of CMA in 87% of children by 3 years of age has been reported, 3 more recent evidence suggests persistence of allergy until adolescence in 15% of cases. 4,5 The deleterious impact of CMA on bone mineral density (BMD) has been documented in small cohorts of children and adolescents, 6,7 probably resulting from deprivation of key bone nutrients during a period of intensive skeletal growth.…”

Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet

“…The risks of a cow's milk-free diet are well documented (Hidvegi et al, 2003;Jensen et al, 2004;Rockell et al, 2005). The diet should be balanced, providing adequate amounts of calcium and vitamin D, either by using the correct substitute foods or by supplementation (Grimshaw, 2006;Vandenplas et al, 2007).…”

Assessment of dietary food and nutrient intake and bone density in children with eczema

“…The bone density Z-score of their patients with a milk allergy serially increased with increasing calcium intake. In another study, Jensen et al 5 investigated BMD in children aged 8 to 17 years with verified cow's milk allergy (CMA) for more than 4 years and compared them with 343 healthy controls. Their patient's BMD was markedly reduced for age, and height for age was reduced indicating 'short' bones.…”