“Drink your milk !” This is a common parental request that is not always heeded. Often children grimace at the sight of their milk glass and may be picky as well with other calcium-containing foods. In fact, although milk is widely known to be a healthy and important part of a child’s diet, most children are not getting the recommended daily amount of calcium in their diet. The informed parent asks, “Why is calcium important, and how much does my child need?As most are aware, calcium is a very important component of bones, with 99% of the body’s calcium found in the skeleton. The calcium level in the blood is controlled by several hormones and absorption facilitated by "
vitamin D. Adequate calcium intake is needed to achieve adequate bone mass. This is affected as well by exercise-- another factor important in maintaining healthy bones.
Recent studies have investigated the risks of low calcium intake. A study in 1998 looked at a group of girls with distal forearm fractures and found that a lower calcium intake was reported for those with fractures compared to the controls matched for age. Another study showed some protection against fractures in adolescent children with high calcium intake. An association between increased cola intake and fractures has also been demonstrated, though it is not clear whether this is secondary to an effect of the cola itself or to a decrease in calcium intake associated with drinking more cola. More data is needed to fully understand the relationship between calcium intake and fractures in children, but it seems safe to conclude that a low calcium diet may be a risk factor for fractures. Achieving adequate bone mass is also important in preventing future osteoporosis.
Not much data are available on calcium requirements in prepubertal children. However, what is available indicates that about 800 mg per day should be adequate. We have more information on requirements in children aged 9 - 18. For this group, intake between about 1200 - 1500 mg per day seems adequate. Excess calcium above this amount is just excreted by the body. But below this level, the bones may not receive the calcium they need, thus, increasing the risks for fractures and future osteoporosis.
The following are the 1997 recommendations from the National Academy of Sciences Food and Nutrition Board:
|Age||Daily Calcium Requirement|
|0-6 mos||210 mg/day|
|6-12 mos||270 mg/day|
|1-3 yrs||500 mg/day|
|4-8 yrs.||800 mg/day|
|9-18 yrs.||1300 mg/day|
Although milk is the obvious calcium-containing food, many others exist and some are listed below. It can also be helpful to read labels, though keep in mind that the percent of daily intake of calcium is based on an intake of 1000 mg/day. As noted above, the goal for adolescents is actually about 1300 mg/day. Remember, then, to interpret “20% of daily calcium intake” as 200 mg, which is less than 20% of an adolescent’s daily needs.
The following chart includes some common foods and their calcium content:
|Food||Serving Size||Calcium Content|
|Milk||1 cup||300 mg|
|Broccoli cooked||1/2 cup||35 mg|
|Cheddar cheese||1.5 oz.||300 mg|
|Low-fat yogurt||8 oz.||300-415 mg|
|Calcium-fortified orange juice||1 cup||300 mg|
|Orange||1 med||50 mg|
|Sweet potatoes||1/2 cup||44 mg|
If your child cannot seem to get the recommended daily amount, a calcium supplement may be needed. Your pediatrician can tell you when that is appropriate. It certainly can be frustrating to get a child to take in an adequate amount of calcium. However, as with many things, it often works to teach by example. Calcium is not just important in a growing child, but all throughout life as an essential component of healthy bones. Parents need calcium too. So, from a pediatrician to the informed parent: “Drink your milk!”