Kids and Calcium: Is Your Child at Risk for Osteoporosis?
How Much Is Enough?
The USDA food guide pyramid for children recommends two servings a day from the milk group for children ages two to six; children one to three years old require 500 mg of calcium daily, while children four to eight require 800 mg. Rudolph suggests that parents look at labels on foods, keeping in mind that calcium intakes on most labels are indicated as a percentage of an RDA (recommended daily allowance) value of 1000 mg. As an example, if a food has 25 percent of the RDA of calcium, it has 250 mg of calcium or half of the RDA for a toddler.
The Bone Bank
Drink your milk. You can probably hear your own mother saying those words when you didn’t drink what she thought was enough. And now that you’re a parent, you know that milk equals calcium, and calcium equals strong bones—but have you ever considered the long-term effects on your child’s health if he or she isn’t getting enough calcium? And how much is enough, anyway?
“Children need calcium for adequate bone development and growth,” says Kristen Rudolph, a pediatric dietitian at Cincinnati Children’s Hospital. “If children don’t get enough calcium and their bone density is poor, they can get osteoporosis later in life.” Osteoporosis is a complex disorder in which bones become so fragile they are susceptible to breaks with minimal trauma. And while the most important time for children to get adequate calcium is between ages 11 and 24, Rudolph says it is crucial that parents establish healthy eating habits—to include calcium—from toddlerhood. “As kids get into adolescent years one of the first things to go is dairy products, for various reasons—drinking milk isn’t perceived as cool, or girls are trying to diet and give up milk—and kids will actually drink a lot sodas which inhibits the growth of calcium,” says Rudolph. “Parents need to start children on calcium early on.”
Rudolph has the support of the American Academy of Pediatrics (AAP) which says, “Maintaining adequate calcium intake during childhood is necessary for the development of a maximal peak bone mass. Increasing peak bone mass may be an important way to reduce the risk of osteoporosis in later adulthood.”
Sources of Calcium
Knowing where to find sources of dietary calcium is necessary for increasing a child’s intake of calcium-rich foods.
- Got Milk?: If you’re looking for an optimal way for your child to get calcium, try milk. Milk is one of the best sources of calcium because it also provides vitamin D, which helps the body absorb calcium. “Up until age two, we usually recommend whole milk; afterwards, two percent or skim milk is fine for a child,” says Rudolph. And kids don’t need to drink a lot of milk to reap its benefits; the calcium absorption of milk is generally high compared to that of vegetables, for example. There is good news for parents with lactose intolerant kids. “There are plenty of products that are lactose free, including lactose-free milk,” says Rudolph. “There are also tablets and drops that can go into dairy products that help with the digestion. Children can also try soy products. Parents have to look to be sure it’s fortified with calcium. Calcium-added orange juice is great too.”
- The AAP recommends that alternatives such as solid cheeses and yogurt may be better tolerated than milk by lactose intolerant kids.
- Flavored Milk—Think Pink!: Though some parents worry that chocolate, strawberry, or other flavored milk will result in a high sugar intake for their kids, a study at the University of Vermont shows otherwise. Researchers evaluating over 3500 children found that kids who drink flavored milk actually consume less nutrient-poor sodas and fruit drinks than children who don’t drink flavored milk, and that flavored milk boosts a child’s overall calcium intake without impacting the total added sugar intake.
- Traditional Sources: Think a glass of milk is the only way for your kids to get calcium? While it is likely the most popular source of calcium, the USDA also recommends other sources of calcium such as yogurt, natural cheeses, canned fish with soft bones such as salmon and sardines, dark-green leafy vegetables, broccoli, legumes, soy products, fruit juice with added calcium, pudding or soup made with milk, and some grains. Even frozen yogurt, ice cream, and cottage cheese can boost the calcium intake in a child’s diet.
- Fortified Cereal: For years parents have been told that breakfast can be the most important meal of the day, and now a good food for boosting your child’s calcium is as near as your grocery store’s cereal aisle. A study from the Children’s Nutrition Research Center (CNRC), published in the October 2001 Journal of Pediatrics shows that kids who ate fortified cereal absorbed about 50 mg more calcium (about two additional ounces of milk) than those who ate a non-fortified cereal. Iron absorption, sometimes hindered with calcium intake, was not decreased when the kids ate the cereal.
- The Big Cheese: There’s no need to avoid all cheese due to concerns about fat intake. Cheeses such as Swiss, Mozzarella, and Parmesan are naturally low in fat and excellent, natural sources of calcium. According to the USDA, a 1 1/2-ounce serving of natural cheese supplies the same amount of calcium as 1 cup of milk or yogurt. (As an added bonus, the American Dairy Association says certain cheeses such as Cheddar, Swiss, Blue, Monterey Jack, Brie, Gouda, Mozzarella, Roquefort, and processed American can help reduce the risk of tooth decay.)
- Go for Yogurt: Yogurt is a great source of calcium, and today’s yogurts have smooth, creamy textures that appeal to kids. Several brands of low-fat yogurt are marketed for kids with fun packaging, yummy flavors, and mix-ins such as fruit or granola. Yogurt has Vitamin D, is a good source of protein, and contains beneficial live and active cultures.
- Non-Dairy Snacks: “There are so many foods that are fortified with calcium—cereals, fruit and grain bars, graham crackers, snack cookies made for kids . . . ” says Rudolph. She encourages parents to check the food labels to find these non-dairy, fortified foods.
Getting Calcium Into Your Child’s Diet
Learning good sources of calcium is the first step. Getting your kids to eat them is the next. Try these suggestions to boost your child’s calcium intake:
- Add flavorings to milk or serve hot chocolate made with low-fat milk
- Serve yogurt, pudding made with milk, string cheese, or a bowl of cereal at snack time
- Drizzle melted cheese on vegetables and baked potatoes
- Serve smoothies made with fresh fruit and yogurt for a cold treat
- Blend a milkshake made with low-fat milk and fruit or milk flavoring
- Sprinkle shredded cheese in scrambled eggs
- Top whole wheat or multi-grain crackers with cheese
- Set out yogurt as dip for fresh fruit
- Slice apple wedges and serve with cheese
- Serve salads including greens with sprinkled cheese on top
- Add dark green leafy vegetables to salads and casseroles such as lasagna or baked ziti
- Roll a slice of cheese and low-fat lunch meat in a tortilla—add greens or yogurt dressing and vegetables
- Heat quesadillas made with cheese and add vegetables or grilled chicken as desired
- Blend low-fat frozen yogurt, calcium-fortified orange juice, and a few ice cubes to make an orange smoothie
- Freeze yogurt or pudding made with milk in popsicle containers
- Use yogurt in place of mayonnaise or sour cream in some recipes
- Add powdered milk to baked products
- Use milk instead of water when making pancakes, hot cereals, and soups
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