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CMAJ. 2014 Nov 18;186(17):1287-93. doi: 10.1503/cmaj.140555. Epub 2014 Oct 20.

Consumption of non-cow's milk beverages and serum vitamin D levels in early childhood.

Author information

1
Departments of Nutritional Sciences (Lee, L'Abbé), Paediatrics (Birken, Parkin) and Health Policy, Management and Evaluation (Lebovic), University of Toronto; Department of Paediatrics (Lee, Maguire) and the Applied Research Centre at the Li Ka Shing Knowledge Institute (Lebovic, Chen, Maguire), St. Michael's Hospital; Department of Paediatric Medicine and the Paediatric Outcomes Research Team (Birken, Parkin), The Hospital for Sick Children, Toronto, Ont.
2
Departments of Nutritional Sciences (Lee, L'Abbé), Paediatrics (Birken, Parkin) and Health Policy, Management and Evaluation (Lebovic), University of Toronto; Department of Paediatrics (Lee, Maguire) and the Applied Research Centre at the Li Ka Shing Knowledge Institute (Lebovic, Chen, Maguire), St. Michael's Hospital; Department of Paediatric Medicine and the Paediatric Outcomes Research Team (Birken, Parkin), The Hospital for Sick Children, Toronto, Ont. jonathon.maguire@utoronto.ca.

Abstract

BACKGROUND:

Vitamin D fortification of non-cow's milk beverages is voluntary in North America. The effect of consuming non-cow's milk beverages on serum 25-hydroxyvitamin D levels in children is unclear. We studied the association between non-cow's milk consumption and 25-hydroxyvitamin D levels in healthy preschool-aged children. We also explored whether cow's milk consumption modified this association and analyzed the association between daily non-cow's milk and cow's milk consumption.

METHODS:

In this cross-sectional study, we recruited children 1-6 years of age attending routinely scheduled well-child visits. Survey responses, and anthropometric and laboratory measurements were collected. The association between non-cow's milk consumption and 25-hydroxyvitamin D levels was tested using multiple linear regression and logistic regression. Cow's milk consumption was explored as an effect modifier using an interaction term. The association between daily intake of non-cow's milk and cow's milk was explored using multiple linear regression.

RESULTS:

A total of 2831 children were included. The interaction between non-cow's milk and cow's milk consumption was statistically significant (p = 0.03). Drinking non-cow's milk beverages was associated with a 4.2-nmol/L decrease in 25-hydroxyvitamin D level per 250-mL cup consumed among children who also drank cow's milk (p = 0.008). Children who drank only non-cow's milk were at higher risk of having a 25-hydroxyvitamin D level below 50 nmol/L than children who drank only cow's milk (odds ratio 2.7, 95% confidence interval 1.6 to 4.7).

INTERPRETATION:

Consumption of non-cow's milk beverages was associated with decreased serum 25-hydroxyvitamin D levels in early childhood. This association was modified by cow's milk consumption, which suggests a trade-off between consumption of cow's milk fortified with higher levels of vitamin D and non-cow's milk with lower vitamin D content.

Comment in

PMID:
25332367
PMCID:
PMC4234713
DOI:
10.1503/cmaj.140555
[Indexed for MEDLINE]
Free PMC Article

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