Henriksen C, Eggesbø M, Halvorsen R, Botten G
Voksentoppen Center for Asthma, Allergy and Chronic Lung Diseases in Children, University Hospital, Oslo, Norway.
Acta Paediatr. 2000 Mar;89(3):272-8.
Approximately 2-3% of young children develop allergy or intolerance to cows' milk. The only available treatment is elimination of milk from the diet. However, as milk is an important source of nutrients in childhood, a milk-free diet may not adequately meet the child's nutritional needs. A dietary survey was conducted to assess the nutrient intake of children on cows' milk-restricted diets. A population-based sample of families with young children (31-37 mo) with adverse reaction to cows' milk and/or eggs was contacted, of which 75% agreed to complete a dietary intake assessment. Dietary intake was assessed using a 4-d weighed recording. The nutrient intake in a group of children on cows' milk protein-free (n = 16) and cows' milk reduced (n = 8) diets were compared to a group of cows' milk consumers (n = 10). There were significant differences in nutrient intake of children on milk-free diets and children consuming milk. Children on milk-free diets had significantly lower intake of energy, fat, protein, calcium, riboflavin and niacin. Use of milk substitutes improved the nutritional content of the cows' milk-free diets; however, the recommendations for riboflavin and calcium were still not met.
The results reveal a risk for malnutrition in children on cows' milk-free diets, unless precautions are taken to replace the valuable nutrients from milk in the diet. Parents of children on milk-free diets need advice about food choices in order to reduce the risk of low intake of energy, fat and protein. Supplements with calcium, vitamin D and riboflavin are indicated.
约2% - 3%的幼儿会对牛奶产生过敏或不耐受。唯一可行的治疗方法是从饮食中去除牛奶。然而,由于牛奶是儿童重要的营养来源,无奶饮食可能无法充分满足儿童的营养需求。进行了一项饮食调查,以评估限制饮用牛奶的儿童的营养摄入情况。联系了以社区为基础的有幼儿(31 - 37个月)且对牛奶和/或鸡蛋有不良反应的家庭样本,其中75%同意完成饮食摄入评估。饮食摄入通过4天的称重记录进行评估。将一组无牛奶蛋白饮食(n = 16)和低牛奶饮食(n = 8)的儿童的营养摄入与一组饮用牛奶的儿童(n = 10)进行比较。无奶饮食儿童和饮用牛奶儿童的营养摄入存在显著差异。无奶饮食儿童的能量、脂肪、蛋白质、钙、核黄素和烟酸摄入量显著较低。使用牛奶替代品改善了无奶饮食的营养成分;然而,核黄素和钙的摄入量仍未达到推荐量。
结果显示,除非采取措施在饮食中替代牛奶中的宝贵营养成分,否则无奶饮食的儿童存在营养不良风险。无奶饮食儿童的家长需要关于食物选择的建议,以降低能量、脂肪和蛋白质摄入量低的风险。建议补充钙、维生素D和核黄素。