Calcium intake in children with positive IgG RAST to cow's milk

Objective: This study was made to: (i) identify the prevalence of low calcium intakes in a paediatric population with loosely defined 'milk allergy'; and (ii) assess long-term (mean 21 months later) changes in calcium intake following a single nutrition counselling session with those patients initially found to have a low intake.
Methodology: Calcium intake was assessed in a cross-sectional study of 58 patients ages 5–16 years (mean 9.9 years) with IgG radioallergosorbent test (RAST) class II or higher for cow's milk protein. Those 31 patients found to have a low calcium intake were prospectively re-evaluated 12–30 months later following a single nutrition counselling session.
Results: Calcium intake was < recommended dietary allowance (RDA) for 31 of 58 (53%) patients. The patient's perception of their intake was unreliable; 44% of those who rated their calcium intake fair or good did not meet their RDA. Taking a calcium supplement did not ensure adequate intake; 21% of those taking supplements still did not meet their RDA. Milk intake predicted calcium intake; 8% of those who did not drink milk vs 68% of those who did drink at least some milk met their RDA without supplementation. The 31 patients with low intakes received counselling and were re-evaluated at an average follow-up of nearly 2 years. Calcium intake was increased a mean of 360 mg/day and use of supplements increased from 10 to 52% of the group. Despite these positive changes, 48% still did not meet their RDA.
Conclusion: Limited milk intake is likely to be associated with suboptimal calcium intake. Efforts should be made to educate the family about the importance of calcium and its non-dairy sources. With many families repeated discussions of this issue may be necessary to influence calcium intake.