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free tools for patients, expert nutrition advice and information on updated
dairy nutrition resources.
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Educate your patients on the importance of 3-A-Day of Dairy: Here's
a great
tool (PDF: 618k) to show families how to get their 3-A-Day of Dairy
every day for stronger bones.
Developed in conjunction with The American Academy of Family
Physicians, The American Academy of Pediatrics, The American Dietetic
Association, and The National Medical Association.
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Dairy Council Digest Archives
The Role of Dairy Foods and Activity for Growing Children
Children's Milk Drinking Behavior
Dairy Food Intake . Current dietary recommendations for calcium are 800mg/day for children ages 4 through 8 years and 1,300mg/day for children and adolescents 9 through 18 years (33). However, there is a substantial gap between recommended and typical calcium intakes of growing children (11,12). Dietary calcium intake declines as children get older and, at all ages, females consume less calcium than do males. According to USDA's 1994-96 Continuing Survey of Food Intakes by Individuals (12), 71% of girls 6 to 11 years and 62% of similar aged boys fail to meet calcium recommendations. Among females and males 12 to 19 years of age, 88% and 68%, respectively, do not meet their calcium recommendation of 1,300mg/day (12). Low intake of milk and other dairy foods is a major factor contributing to growing children's calcium shortage (7,8,12). USDA data indicate that less than half of children aged 6 to 11 years (i.e., 47% of males and 36% of females) consume the recommended number of servings of dairy foods/day (7). Among adolescents 12 to 19 years, even fewer (i.e., 28% of males and 11% of females) consume the recommended number of servings/day of dairy foods (7). Children's intake of milk and other dairy foods begins to decline around the age of 6 to 11 years (7,12). Also, school-aged children's intake of dairy products has decreased over the years without a compensatory increase in other calcium-rich foods (9,36).
The American Academy of Pediatrics recommends milk, cheese, yogurt, and other calcium-rich foods for growing children to help build bone mass.
Without liberal intake of dairy foods, meeting current calcium recommendations becomes especially difficult (22,33,37). The federal government's Healthy People 2010 health objectives for the nation states that "…with current food selection practices, use of dairy products may constitute the difference between getting enough calcium in one's diet or not" (37). Recognizing children's low calcium intake, the American Academy of Pediatrics (4) issued a policy statement urging pediatricians to recommend milk, cheese, yogurt, and other calcium-rich foods for children's daily diets to help build bone mass and prevent rickets. The policy statement recommends that children meet their calcium needs from food first because eating patterns developed during childhood tend to be followed throughout life (4).
Factors Influencing Children's Milk-Drinking Behavior. Children's decision to consume dairy foods such as milk is influenced by a variety of factors, including the following:
- Availability of soft drinks and other competing beverages . Studies of children's eating patterns reveal that children's milk intake is decreasing, while their consumption of soft drinks and non-citrus juices has risen dramatically (9,10,36). Contracts with school districts for exclusive soda rights encourage children as young as elementary school to consume soft drinks.
Intake of soft drinks at the expense of milk may compromise children's calcium intake and increase their risk for fractures during childhood and osteoporosis in later years (4,9,38). Physically active adolescent girls who regularly consumed soft drinks were found to be more likely to suffer bone fractures than their milk-drinking peers (38). Choosing soft drinks and non-citrus juices over milk may also reduce the overall nutritional quality of children's diets (20,39). Other potentially adverse health consequences of consuming soft drinks at the expense of milk include promotion of dental caries and enamel erosion (due to sugar and phosphoric acid intake, respectively), as well as obesity (due to extra calories) (9,40).
Although there is no scientific evidence that a single food or beverage causes obesity, some children may gain weight because they are unable to compensate for the extra calories provided by regular soft drinks and other sweetened beverages. A recent 19-month investigation of 548 children aged 11 and 12 years found that each additional serving of sugar-sweetened beverage consumed, including soft drinks, significantly increased the chance of becoming obese (40). The American Academy of Pediatrics, in a recent policy statement on the use and misuse of fruit juice for infants, children, and adolescents, states that excessive intake of juice may contribute to the development of obesity, as well as other problems such as malnutrition and tooth decay (41).
Recognition of the potential adverse health consequences of consuming soft drinks instead of milk is leading to efforts to limit children's access to soft drinks in schools and to encourage children to choose milk and other dairy products (4,42-45). For example, pediatricians of the Ohio chapter of the American Academy of Pediatrics (44) have issued a statement alerting parents, superintendents, and members of district school boards about the health consequences of exclusive soda contracts in this state's schools. Also, a bill, "The Better Nutrition for School Children Act of 2001," has been introduced, that if approved, would give USDA increased authority to regulate the sale of soft drinks in schools (45).
- Concern About Body Weight . The pursuit of thinness, along with the misperception that milk and other dairy foods are fattening, can lead children, particularly adolescent females, to limit their intake of dairy foods and calcium (4,46-48). In an investigation of 36,000 students in grades 7 through 12, dieting among both males and females was strongly linked to low intake of dairy foods (48). Studies in children and adolescents demonstrate that dairy foods can be consumed without increasing children's body weight (49).
- Eating Away From Home . With the exception of federally supported school meals, eating away from home is associated with children's low milk and calcium intake (50). According to a study of adolescents in grades 7 and 10, students said that they rarely order milk when eating at fast food establishments because milk is unavailable, not promoted, or as visible as other beverage options such as soft drinks (51). Encouraging children to improve their away-from-home food choices and to eat more meals at home may increase their intake of dairy foods and improve the overall nutritional adequacy of their diets (52). A recent pilot study found that a number of adolescents rarely eat meals with their families and that many watch television during meals (53). Watching television while eating is associated with increased intake of soft drinks and other foods of low nutritional value (54).
- Participation in School Feeding Programs . Children who participate in the National School Lunch Program (NSLP) and/or School Breakfast Program (SBP) consume more servings of milk during the meal and over 24 hours, as well as more calcium and several other essential nutrients, than do nonparticipants (55). New findings from USDA's School Nutrition Dietary Assessment Study reveal that school breakfasts and school lunches provide more calcium than the amounts required (56).
A new study shows that mothers who drink milk more often have young daughters who are frequent milk drinkers and who consume fewer soft drinks.
- Parents . Parents, particularly mothers, can influence their children's intake of milk by drinking it themselves and by making it readily available (51,57-59). A recent study of 180 mothers and their 5-year old daughters demonstrates that mothers' own beverage consumption patterns determine the extent to which their daughters' intake of milk is displaced by soft drinks (59). Mothers, by serving as role models, can shape their daughters' beverage choices, calcium intake, and future risk for osteoporosis (59). For both mothers and daughters, intake of soft drinks was negatively associated with both milk and calcium intake (59).
- Taste . Taste is an important factor influencing children's food choices, including their decision to consume milk (46,51,57). Milk's flavor affects children's milk-drinking behavior (60). A recent study of elementary school children found that children prefer chocolate milk (60). Therefore, making flavored milk available can increase children's milk and calcium intake.
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