The Relationship Between Cow's Milk and Stores of Vitamin D and Iron in Early Childhood

The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
PEDIATRICS (Impact Factor: 5.47). 12/2012; 131(1). DOI: 10.1542/peds.2012-1793
Source: PubMed


To examine the association between cow's milk intake on both vitamin D and iron stores in healthy urban preschoolers.

Healthy children 2 to 5 years of age were recruited from December 2008 through December 2010 through the TARGet Kids! practice-based research network. Cow's milk intake was measured by parental report. Vitamin D and iron stores were measured by using serum 25-hydroxyvitamin D and ferritin. Bivariate multivariable linear regression was used to examine the effect of cow's milk intake simultaneously on 25-hydroxyvitamin D and serum ferritin. Analyses were stratified by important clinical variables including skin pigmentation, bottle feeding, vitamin D supplementation, and season.

Among 1311 children, increasing cow's milk consumption was associated with decreasing serum ferritin (P < .0001) and increasing 25-hydroxyvitamin D (P ≤ .0001). Two cups (500 mL) of cow's milk per day maintained 25-hydroxyvitamin D >75 nmol/L with minimal negative effect on serum ferritin for most children. Children with darker skin pigmentation not receiving vitamin D supplementation during the winter required 3 to 4 cups of cow's milk per day to maintain 25-hydroxyvitamin D >75 nmol/L. Cow's milk intake among children using a bottle did not increase 25-hydroxyvitamin D and resulted in more dramatic decreases in serum ferritin.

There is a trade-off between increasing 25-hydroxyvitamin D and decreasing serum ferritin with increasing milk intake. Two cups of cow's milk per day appears sufficient to maintain healthy vitamin D and iron stores for most children. Wintertime vitamin D supplementation was particularly important among children with darker skin pigmentation.

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    • "Differences in white matter and cognition among older children may be attributable to an entirely different dairy product altogether: cow's milk. It is advised that formula fed infants transition to cow's milk at 12 months, receiving 16 ounces per day thereafter (Committee on Nutrition, 1992; Maguire et al., 2013). White matter differences were not observed until children were over 26 months of age, when the " formula fed " groups would actually have been exposed to cow's milk longer than they had been exposed to formula. "
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