Report From the LI Conference, part 24

A lot of good stuff in the next presentation, so let's jump right in.

Treatment Recommendations in Children
Catherine M. Gordon, M.D., M.Sc.
Director
Children's Hospital Bone Health Program
Adolescent/Young Adult Medicine and Endocrinology
Children's Hospital Boston
Associate Professor of Pediatrics
Harvard Medical School

A big question that I haven't seen answered before is whether avoiding dairy - and not making the effort to replace the calcium that would be found in a dairy heavy diet - really makes a difference to health.

There are a few studies which say that not having dairy hurts your bones. And generally speaking, we can say that people who know they are lactose intolerant (LI) have less dairy - if any at all - than people who don't consider themselves to be LI. Vertebral fractures are higher in people with LI. Bone mineral density is lower, and the more severe the symptoms reported the lower the density became. This started to be true even in a population of girls aged from 10 to 13. If children aren't having dairy, they are highly unlikely to do so later in life.

How to get more dairy into your diet if you have LI? Here are several suggestions.

1. Consume small amounts of lactose-containing foods.

2. Chronic/repeated intake of lactose-containing foods allows colonic bacteria to adapt and more efficiently metabolize lactose.

3. Co-ingest lactose-containing foods with a meal.

4. Consider the form of the lactose-containing food. Hard cheeses, chocolate, higher fat milks, and ice cream are well tolerated.

5. Eat live culture yogurt.

6. Utilize commercially available lactose digestive aids.

7. Modify behaviors and perceptions from past experiences to learn that dairy/lactose-containing foods can be easily incorporated into the diet.

8. Consider the consumption of calcium-fortified foods.

The idea behind having more dairy is getting the calcium it provides. If you don't want dairy in your diet, calcium supplements are a useful source. Just be sure not to take more than 500 mg of calcium in any individual dose. Some people get constipation from calcium supplements. Before quitting them, try increasing the amount of fiber and water in your diet to see if that counteracts the constipation.

Children can take any of several varieties of supplements, including the common calcium carbonate (which is more likely to be found in chewable form), calcium citrate, and calcium glubionate.