(P13-058-25) Association Between Dietary Micronutrients and Unexpected Low Cow Milk Intake in 24-Month-Old Children

Objectives: (1) Determine daily cow milk compared to alternative milk consumption among 24-month-olds. (2) Explore associations between cow milk intake, micronutrients and growth patterns.

Methods: This was an observational, longitudinal study in healthy newborns (Philadelphia, PA) followed for two years. The goal of this analysis was to examine dietary patterns. Trained caregivers recorded at least two 24-hour diet records at 12 and 24 months. Research dietitians entered records into Nutrition Data System for Research and examined for plausibility. Percent dietary reference intakes (%DRI) were calculated for each day. Cow milk (grams) was determined for each day. Anthropometric measurements were completed in triplicate and averaged. Weight was measured sitting or standing and stature was measured supine. Growth was assessed using z-scores, the WHO reference data was used for weight-for-age (WAZ) and length-for-age (LAZ) calculations. Stata was used for DRI calculations, correlations and t-tests.

Results: 585 record days from 203 children (24±1 [mean±SD] months) were included in this analysis. No cow milk intake was reported on 29% days (170 of 585 days) and 22% reported no cow or alternative milk. Alternative milk was reported on less than 10% of days. Total cow milk was positively correlated with %DRI for vitamin D (r=0.62, p< 0.01), calcium (r=0.58, p< 0.01), vitamin A (r=0.40, p< 0.01), and phosphorus (r=0.54, 0 < 0.00001) and negatively correlated with iron (r=-0.17, < 0.01). WAZ (0.2±1) and HAZ (0.1±1) indicated typical growth patterns. There were no differences in WAZ (p=0.9) or HAZ (p=0.9) between children who consumed cow milk compared to non-consumers. Ninety six percent of days did not meet the DRI for vitamin D; 43% did not meet the 25% DRI value. Thirty-eight percent of days met at least 25% DRI for vitamin D and 14% met at least 50%. Fifty-five did not meet the DRI for iron, 50% for calcium, 46% for vitamin A, and 12% for phosphorus.

Conclusions: Most children consumed cow milk; only a few reported alternative milk intake. The cow milk and micronutrient correlations were expected and justifies the clinical concern of unexpected low milk intake in healthy 24-month-olds. While there were no differences in growth between cow milk consumers and non-consumers, there may be deviation as these children continue to grow.

Funding Sources: National Institutes of Health