Dairy Consumption Status in Adolescents with a History of Cow's Milk Allergy

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.