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Rapid Responses: Rapid Responses published:
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Vitamin D in form of sunlight needs including in the recommendations
- Helga M. Rhein (15 October 2006)
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Re: Vitamin D in form of sunlight needs including in the recommendations
- Amy Joy Lanou (16 October 2006)
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Bone Health in Children
- Roberta S. Gray, M.D. (23 October 2006)
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Bone health in children: according to a vegan
- Gregory D. Miller (16 December 2006)
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Helga M. Rhein, General Practitioner EH11 4AU
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Shouldn't the last sentence have included the recommendation to spend sufficient time in the sun, without sun blocker, and thereby obtaining enough Vitamin D? (A recommendation which should go out, indeed, to all ages) Competing interests: None declared |
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Amy Joy Lanou, Assistant Professor University of North Carolina Asheville
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Yes, regular sun exposure, as children might get from active play out of doors, is an excellent way to promote vitamin D status and should have been included on the list of recommendations for promoting bone health. Thank you for pointing out the oversight. Competing interests: None declared |
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Roberta S. Gray, M.D., pediatric nephrologist South Carolina, 29730
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To the Editor: Amy Lanou’s excellent editorial with recommendations for revising calcium guidelines for children is right on target, and a progressive message that needs to be heard by more physicians, policymakers, and nutrition researchers [“Bone health in children,” 10/14/06]. Having practiced pediatric nephrology, endocrinology, and metabolism for over two decades, I have evaluated and treated numerous children with calcium derangements and bone disorders with their associated complications of rickets, poor growth, crystalluria syndromes and nephrolithiasis. I can attest to being faced with the daunting task of dispelling the myth behind cow’s milk nearly every day. Parents have been taught that they should provide calcium in their children’s diet by offering them cow’s milk and other dairy products. It is not uncommon to encounter pre-pubertal youngsters consuming 40 – 60 ounces of cow’s milk daily and much more than that in teenagers, often with cheese in the daily diet as well. What parents do not know is that the detrimental effects of all that milk and cheese far outweigh any benefit. These negative effects include not only significant obesity but protein, sodium, and phosphate loading. The result of this high dietary protein, phosphate, and sodium is calcium wasting with osteopenia, and later life osteoporosis. Urinary tract complications are also common and include uricosuria and hypercalciuria with renal stones and bladder dysfunction. I encourage my patients’ parents to aim for plant-based sources of calcium in their children’s diets and to increase their children’s physical activity. Although there is now a push to increase physical activity for obesity prevention, physicans and parents often are not knowledgeable about the important relationship between weight-bearing exercise and building strong bones in children. This is becoming more frequently recognized in the geriatric population. Lanou’s assessment of the scientific evidence behind what really builds strong bones is helping to dispel the myth behind our unnecessarily high dairy recommendations. More widespread awareness of this evidence will help build a new paradigm in which we can keep children healthy, fit, and strong for life. Exercise, avoidance of animal protein, combined with adequate vitamin D and calcium intake from plant-based sources will do more for our children’s bones than pushing extra milk or calcium supplements. Sincerely, Roberta Gray, M.D.,FAAP 2871 Oak Park Rd. Rock Hill, SC 29730 Competing interests: None declared |
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Gregory D. Miller, Execuive Vice President Science & Innovation National Diry Council, 10255 West Higgins Rd., Rosemont, IL 60018
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Dear Editor, I am disappointed that the British Medical Journal recently published an editorial by Amy Lanou, a member of the Physicians Committee for Responsible Medicine (PCRM), without disclosing her affiliation with a group that is biased against the consumption of animal products. As you may know, PCRM is an animal rights group that has received significant funding from People for the Ethical Treatment of Animals (PETA) and whose nutrition views have been repeatedly denounced by the mainstream health community. While we, too, value vigorous debate and respect PCRM’s right to be included in your journal, we believe it is important that you fully disclose this and other activist groups’ true agendas, so that readers may fully understand the author’s motives. This is particularly important when a group such as PCRM questions well-established science such as the link between calcium and bone development in children. Dairy’s role in strengthening bones has long been recognized by the nutrition science community, and is reflected in official policies and campaigns by the U.S. Surgeon General, the National Institute of Child Health and Human Development and the Centers for Disease Control and Prevention. In addition, the American Academy of Pediatrics has a longstanding calcium policy statement that underscores how critical calcium intake from dairy products is for children to achieve peak bone mass. These groups rightly contend that milk and dairy products are a good way for kids and teens to get the bone-building calcium they need. Regards, Competing interests: National Dairy Council employee |
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