There was a time — not so long ago — when milk was the main drink for kids. Water was the next best drink, while juice and soda were only for special occasions. Today, most children in the U.S. older than eight years don’t attain the recommended daily requirement of milk or dairy products and, therefore, have an inadequate intake of calcium and vitamin D. Soda, juice and sports drinks have replaced milk. According to the Centers for Disease Control’s Morbidity and Mortality Report (MMWR) of June 2012, 17.9 percent of high school students drank no milk and only 44.4 percent drank one to two glasses during a seven-day period.
Milk, dairy products and some calcium- and vitamin D-enriched foods are necessary in a child’s diet. These essential foods contain both calcium and vitamin D, which are necessary for attaining peak bone mass and, thus, reduce the risks of fractures and osteoporosis later in life.
Vitamin D is an oil-soluble vitamin that helps absorb dietary calcium and phosphorus from the intestines. It also prevents the parathyroids from releasing a hormone that causes bone resorption, thus reducing calcium in the bones. The natural source of vitamin D is sunlight, which helps synthesize vitamin D under the skin. The production of vitamin D from the skin is influenced by age, skin color and sun exposure. Because we now protect our skin with sunscreen, our production of vitamin D may be decreased. Foods that have natural vitamin D are fatty fish, cod-liver oil and eggs. Fortified milk contains 100 IU of vitamin D and 300 mg of calcium in eight ounces or one cup.
Calcium, a mineral necessary to maintain peak bone mass, is absorbed in the intestines with the help of calcium regulating hormones. The main sources of calcium are dairy products, with lesser amounts in foods such as salmon, fortified cereals and certain fruits and vegetables. (See chart below.)
Current research among children 9 to 18 years indicates that calcium absorption during this time is critical for bone mineralization. But at this age kids are not meeting the recommended daily requirements of calcium (1,300 mg/day) and vitamin D (600 IU/day). (See chart below.)
Parents and caregivers should make sure their kids achieve the recommended daily intake of calcium and vitamin D, and should be role models by drinking milk, too. Also, physical activity — primarily weight-bearing exercise such as running and jumping — helps to achieve peak bone mass and bone health.
When consuming dairy products is not possible, note that orange juice, apple juice, breakfast cereals and some soy products are also fortified with Vitamin D and calcium. Check with your provider before giving your child calcium and vitamin D supplements.
Many parents are unaware of the importance of milk and calcium-rich foods in their children’s diet. Educating parent and child on current recommendations and benefits makes a difference. Follow-up visits with your provider will often show a positive change in consuming dairy products. Your children also may find that they really do like milk.
Jo Ann Serota, DNP, RN, CPNP, FAANP, is a certified PNP and co-owner of Ambler Pediatrics, Blue Bell, PA. She is a Past President of NAPNAP and President of the NAPNAP Foundation.