Stallings V A, Oddleifson N W, Negrini B Y, Zemel B S, Wellens R
Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine 19104.
J Pediatr Gastroenterol Nutr. 1994 May;18(4):440-5. doi: 10.1097/00005176-199405000-00006.
Bone density is related to body size and other factors including dietary calcium intake. The purpose of this study was to determine the effect of a low-lactose, low-calcium diet on the bone mineral content (BMC) of prepubertal children with documented lactose intolerance. Radial BMC was determined by single-photon absorptiometry. Dietary intake was assessed by 24-h recall and two 3-day food records, and weight and height were measured. The group of lactose-intolerant children was compared with a group of healthy children of similar age, gender, race, and size and to the prediction equations based on body size from Chan's Utah children. Nineteen children, ages 9.6 +/- 1.9 years, participated in the study. They were relatively short compared with standards (height Z score, -0.30 +/- 0.83). BMC was 0.428 +/- 0.081 g/cm in the study group versus 0.440 +/- 0.116 g/cm in the comparison group (n = 19; p > 0.05). Both the study group and the size-selected comparison group had lower BMC than the Utah children. The diet of the study group was low in calcium: 84% of the Recommended Dietary Allowance in children < 11 years old and 32% in children > 11. Calcium intake was associated (p = 0.03) with BMC in the study group after adjusting for body size. The low-lactose diet resulted in a low calcium intake, and BMC was associated with calcium intake in prepubertal children with lactose intolerance. Evaluation of dietary calcium intake should be considered in this group of patients, with follow-up dietary counseling, calcium supplementation (diet or medication), and bone density assessment when clinically indicated.
骨密度与体型及其他因素有关，包括膳食钙摄入量。本研究的目的是确定低乳糖、低钙饮食对已证实患有乳糖不耐受的青春期前儿童骨矿物质含量（BMC）的影响。通过单光子吸收法测定桡骨BMC。通过24小时回顾法和两份3天的食物记录评估膳食摄入量，并测量体重和身高。将乳糖不耐受儿童组与一组年龄、性别、种族和体型相似的健康儿童组进行比较，并与基于Chan的犹他州儿童体型的预测方程进行比较。19名年龄为9.6±1.9岁的儿童参与了该研究。与标准相比，他们相对较矮（身高Z评分，-0.30±0.83）。研究组的BMC为0.428±0.081g/cm，而对照组为0.440±0.116g/cm（n = 19；p>0.05）。研究组和按体型选择的对照组的BMC均低于犹他州儿童。研究组的饮食钙含量较低：11岁以下儿童为推荐膳食摄入量的84%，11岁以上儿童为32%。在调整体型后，研究组中钙摄入量与BMC相关（p = 0.03）。低乳糖饮食导致钙摄入量较低，并且BMC与患有乳糖不耐受的青春期前儿童的钙摄入量相关。对于这组患者，应考虑评估膳食钙摄入量，并在临床指征明确时进行后续膳食咨询、钙补充（饮食或药物）以及骨密度评估。
