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.
"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. "
[Show abstract][Hide abstract] ABSTRACT: The recent Deoni et al. (2013) manuscript proposed that breastfeeding was associated with increased cognitive ability and white-matter in older children (over 26 months), using ms-DESPOT MRI imaging to indirectly measure white matter in children who were either breastfed, formula fed, or combined breast + formula fed. In this response, we identify limitations in drawing causal inference among white matter, cognitive ability, and breastfeeding. We propose that the observed cognitive and neurodevelopmental differences between breastfed and formula-fed infants might actually be caused by the premature introduction of cow's milk in the second year of life, among other contributing factors.
[Show abstract][Hide abstract] ABSTRACT: • The true prevalence of nutritional iron deficiency (ID) in childhood is unclear because of the uncertainty over its definition
and the insensitivity of markers of ID.
• The major cause in developed countries is likely to be the excessive and early use of cow’s milk and a diet poor in haem
• Recent neuro-physiological observations support the many field studies correlating ID with cognitive and motor developmental
delay in young children, although proof of causality has not been established because of environmental confounding.
• Population iron supplementation is a potentially effective means of prevention of ID but is limited by poor compliance and
the risk of increased morbidity and mortality in malarious regions.
• Fortification of milk and essential infant foods is likely to be the most cost-effective means of improving the iron status
of child populations.
Key WordsRisk factors-psychomotor development-iron supplementation and fortification-anaemia screening
Canadian Medical Association Journal 08/2013; 185(14). DOI:10.1503/cmaj.130150 · 5.96 Impact Factor
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