Research Study highlights

In this study of adolescents who had cow’s milk allergy (CMA) and atopic eczema in infancy, we observed their dairy consumption and vitamin D status. We compared these adolescents with those who had a negative CMA test in infancy and a control group without CMA. Key findings include:

1. Dairy Consumption and Vitamin D Status

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   • There was no significant difference in dairy product consumption or vitamin D levels between those with a history of CMA, those with a negative CMA challenge, and the control group.
   • Dietary vitamin D intake was similar across all groups.
   • 56.7% of participants consumed less than the recommended 500g of liquid dairy products per day, but 93.1% were still sufficient in vitamin D.

2. Growth and Health:

   • Infants with CMA were shorter and thinner than healthy controls, but there was no difference in height or BMI-for-age in adolescence.
   • Children with CMA showed catch-up growth after stopping the elimination diet.
   • Adolescents with a history of CMA had similar height and weight compared to non-allergic peers.

3. Milk Reintroduction

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   • In Finland, most children began consuming dairy products by age 3 after stopping a milk elimination diet.
   • Only a small percentage of children met the national recommendations for dairy intake.
   • In our study, median milk intake among adolescents with a history of CMA was less than one glass per day, similar to non-allergic peers.

4. Vitamin D Supplementation

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   • Despite only 57% taking regular vitamin D supplements, only 6.9% had vitamin D insufficiency due to fortified foods.
   • Combining food and supplement intake, the median vitamin D intake was 13.7 µg/d, above the recommended 10 µg/d.

5. Comparison with Other Studies

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   • Previous studies showed lower vitamin D levels in children with CMA, but our study found no significant difference.
   • Variations in analytical methods for measuring vitamin D might explain discrepancies in findings.

6. Study Strengths and Limitations

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   • Strengths include using DBPCFC (double-blind, placebo-controlled food challenges) for CMA diagnosis.
   • Limitations include a high proportion of females and special diets in the control group, which might affect generalizability.
   • The study did not account for total milk intake from mixed dishes or the timing of milk reintroduction.

7. Conclusions:

   • Adolescents with a history of CMA successfully reintroduced dairy into their diet.
   • The Finnish fortification program for vitamin D in dairy products is effective.
   • Current management of CMA in children appears sufficient, and additional monitoring after developing milk tolerance is unnecessary.

This study supports that dietary management and vitamin D fortification programs are working well for children with a history of CMA, and concerns about long-term dietary restrictions may be unfounded.