New Findings Show Milk Substitutes Improve Nutritional Status in Cow's Milk Allergy Patients

The cross-sectional study, published in Pediatric Allergy and Immunology, showed that milk substitute use generally improves dietary intake of calcium, riboflavin, and vitamin D in children with cow's milk allergy, although the extent of their contribution can vary. The researchers revealed that individuals who do not use milk substitutes are at a higher risk of inadequate dietary calcium intake.

Cow's milk allergy affects approximately 2-3% of infants and young children, causing a range of symptoms from mild rashes to severe anaphylactic reactions. For these children, finding suitable nutritional substitutes is crucial to ensure they receive essential nutrients that are typically found in cow's milk, such as calcium, vitamin D, and protein.

Against the above background, Ozge Soyer, Department of Pediatrics, Division of Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey, and colleagues aimed to determine the impact of alternative milk substitutes on the nutritional status of children with CMA, the prevailing cause of food allergies.

For this purpose, the researchers performed a cross-sectional study in children older than two years with IgE-mediated CMA. The study evaluated patients' clinical characteristics, anthropometric measurements, dietary intake through a 3-day food diary, and biochemical markers of nutritional status.

The researchers reported the following findings:

• One hundred two children with CMA (68.6% boys; median age, 3.7 years; 51% multiple food allergies) were evaluated.
• 44.1% of the children consumed plant-based beverages (PBB), 19.6% therapeutic formula, and 36.3% did not consume any milk substitutes.
• In all age groups, dietary calcium, riboflavin, and vitamin D intake of those who did not use milk substitutes were lower than those who consumed formula or PBB.
• In the 2–3-year-old age group, dietary zinc and iron intake of the formula-fed group was higher.
• Formula-fed patients had higher levels of 25-OH vitamin D (μg/L) and serum vitamin B12 (ng/L) than PBB-fed patients and those who did not consume any milk substitute.
• Patients of all ages who did not utilize a milk substitute failed to obtain an adequate amount of dietary calcium.

"Our findings highlight the importance of personalized nutritional guidance due to the diverse clinical factors impacting nutritional status and the varying effects of individual approaches to managing cow's milk allergy," the researchers concluded.

Reference:

Parlak-Hela, Z., Sahiner, U. M., Sekerel, B. E., & Soyer, O. (2024). The contribution of milk substitutes to the nutritional status of children with cow's milk allergy. Pediatric Allergy and Immunology, 35(7), e14202. https://doi.org/10.1111/pai.14202