Suivi longitudinal de la densité osseuse et du statut en vitamine D chez des enfants prépubères avec une allergie au lait de vache non résolue
Background: Previous studies have shown that most children lose their allergy to cow's milk (CMA) by the age of 3-5 years. However, recent studies have documented increasing persistence of this allergy until later age. Although, dairy products mainly contribute to dietary intake of two key bone nutrients, namely calcium and vitamin D, regular monitoring of bone health is not part of the current management of CMA. A cross-sectional study aimed at characterizing bone health of prepubertal children with persistent CMA found that bone mineral density (BMD) of these children was significantly lower than the control group, made of children with non-dairy food allergies (NCMA). Aims: In light of these findings, the aim of this study was to document and compare the evolution of BMD, vitamin D status, calcium and vitamin D intakes, and supplementation compliance of CMA (n=36) and NCMA (n=19) children recruited in the initial cross-sectional study. Results: The average annualized gain in lumbar spine BMD was similar between cases and controls. Although BMD did not differ significantly between the groups, lumbar spine BMD values of CMA children were lower than those of controls. Moreover, whole body BMD score-Z tended to be lower in cases than in controls.  Serum concentrations of 25OHD as well as the rate of vitamin D insufficiency were similar between CMA and NCMA children. No significant differences were detected for total intakes of calcium and vitamin D between baseline and follow-up for both groups. Compared to baseline, more children with CMA took calcium supplements (42% vs. 49%, p<0.05) but compliance decreased to 4 days/week. Conclusion: An early evaluation of bone density in children with persistent CMA could be recommended to ensure normal bone development during growth. Our study emphasizes the importance of monitoring calcium and vitamin D intakes in these children, to encourage consumption of alternate sources of dietary calcium and vitamin D, to promote routine supplementation and to provide education to improve compliance.
calcium bone density vitamin D food allergies allergy to cow's milk