I hear the same question over and over again from so many of my patients: “Why doesn’t my other doctor know that?” It’s because their other doctors are listening to the misguided committees and councils that qualify as “authorities” in the U.S.
Just so you can see how silly these folks are, let me take you through some highlights from a recent Medscape article that summarized the American Academy of Pediatrics’ newly updated clinical guidelines for pediatric bone health. I’ll interject as needed. Get ready for a laugh (or sob):
“The best way to promote bone health for children continues to be through diet. The report offers clinical guidance for pediatric bone health from birth through adolescence and includes discussions of weight-bearing exercise, diet, supplements, screening, and intervention.”
OK–I am totally down with that. (See, who says I don’t agree with anything the mainstream says?)
“In infancy, human milk or infant formula are the primary sources of calcium. The recommended dietary allowance (RDA) from birth through age 6 months is 200 mg calcium per day, increasing to 260 mg from 6 to 12 months of age.”
The RDA is a joke. And only an extra 60 mg per day in a growing infant? Really?
“Toddlers need 700 mg calcium daily through age 3 years, increasing to 1,000 mg daily from age 4 years through age 8 years and 1,300 mg daily for children aged 9 to 18 years.” Not bad advice. Yet.
“Milk and other dairy products typically contribute 70% to 80% of dietary calcium. An 8-ounce glass of milk provides 300 mg of calcium, as does a cup of yogurt or 1.5 ounces of cheese.”
OK, now we’re starting to tread into dangerous waters. Cheese is ok, but the sugar in milk and yogurt cancel out any of the healthy benefits kids might get from the calcium.
“Green leafy vegetables, legumes, nuts, fruit juice, and some fortified breakfast cereals also contain calcium.”
All good here… until the fruit juice and fortified breakfast cereals part. I’ve mentioned many, many times before that fruit juice is a one-way ticket to obesity and diabetes —not to mention other chronic health problems And breakfast cereal? Really? Just because a box of Froot Loops or Lucky Charms has been “fortified” with calcium doesn’t suddenly make it a health food.
“Although bioavailability of calcium from vegetables is high in general, the report states, it takes a lot of vegetables to meet the daily calcium requirement, and oxalates in some vegetables, including spinach, collard greens, and beans, reduce calcium bioavailability. In addition, diets low in protein may predispose children to reduced calcium retention.”
Heaven forbid they recommend vegetables. Or come out and say that kids need more lean protein (and NOT more “fortified” garbage).
“Declining milk consumption is an issue for both preadolescents and adolescents. In 2011, only 14.9% of high school students drank 3 or more 8-ounce servings of milk daily, and only 9.3% of girls drank that much milk.”
And that’s bad because? As far as I’m concerned, this is the best news in the entire article. And a trend that I hope continues, considering the recent evidence concerning the dangers of regular milk consumption (namely increased risk of DEATH).
“Many teenage girls consider milk ‘fattening,’ although, the authors note, ‘one 8-oz serving of skim milk contains no fat and only approximately 80 kcal, approximately the same caloric content as an apple.’”
Skim milk has no nutritional value whatsoever. And whole milk contains 4% fat compared to skim’s 0% (news flash: that’s not a big difference). Also, an apple contains fiber, vitamins B6 and C, magnesium and of course, phytonutrients and antioxidants—none of which are found in significant quantities in milk.
“Furthermore, milk provides protein and a number of important nutrients other than calcium, including vitamin D, phosphorus, and magnesium, which are important in bone health.”
For the record, there are only 8 grams of protein in a cup of milk (vs. 25 grams of sugar, which they conveniently “forgot” to mention). Phosphorus actually inhibits the absorption of calcium. And the amount of vitamin D added to milk (about 100 IU per cup) is ridiculously minuscule.
“Milk alternatives, such as soy-based or almond-based beverages, are also at a disadvantage to milk: both have reduced levels of bioavailable calcium per glass than milk, even when calcium-fortified, the authors write.”
First of all, I’m not a fan of soy milk either. But there is no conclusive evidence proving that cow’s milk offers superior calcium bioavailability over the alternatives. What cow’s milk DOES have that the alternatives don’t is antibiotic residue and the growth hormone residue from commercially-raised animals. (Again, they conveniently left that part out of this discussion.)
“‘The investigators concluded that, from a public health perspective, calcium supplementation of healthy children is unlikely to result in a clinically significant reduction in fracture risk,’ the authors write.
There is not one shred of evidence to support that statement.
“Vitamin D is essential for calcium absorption; without it, only 10% to 15% of dietary calcium is absorbed. In 2011, the IOM boosted the RDAs for vitamin D. From birth to 12 months, infants need 400 IU vitamin D daily. From age 1 year through adolescence, the amount rises to 600 IU.”
600 IU? For adolescents?! No wonder kids today have no bone strength. They don’t go outdoors. And if they do, they get slathered with SPF 1,000,000 sunscreen. THIS should be the core of the pediatric bone health discussion. Not a side note in a ridiculous article extolling the so-called wonders of milk.
“Children older than 1 year who are obese or receiving anticonvulsant, glucocorticoid, antifungal, or antiretroviral medication may require 2 to 4 times more than the 600 IU vitamin D daily, but there are no definitive recommendations for these children at this time.”
OF COURSE there aren’t. And that’s not likely to change anytime soon. Especially considering the next gem from this article:
“There is insufficient evidence to recommend universal vitamin D screening.”
Why not? These clowns admitted vitamin D is crucial for bone development. So you’d think they would recommend regular screening to make sure kids are getting enough.
I could go on and on but this is what your regular, primary care doctor reads (if he reads at all). So tell me, is it any wonder that so many doctors don’t know what they are doing?
When it comes to kids and bone health, in particular, don’t rely on your pediatrician to give you the best information. The fact is, kids shouldn’t be drinking milk. They SHOULD be eating vegetables. They SHOULD be getting some exercise—outdoors. And they absolutely should be taking 800-1,500 mg of calcium citrate and 2,000 IU of vitamin D every single day.