Vegetarianismo en niños

Should dairy be recommended as part of a healthy vegetarian diet? Point1–3
Connie M Weaver
ABSTRACT A benefit-risk evaluation of the evidence for including dairy foods in the diet is presented. For many persons dairy products provide a substantial portion of essential nutrients, but especially calcium, potassium, and magnesium. Dietary supplements and fortified foods can be alternative sources ofthese nutrients, although other components of dairy foods such as amino acid composition and conjugated linoleic acid may be instrumental in the benefits associated with dairy product consumption for bone health and reduced risk of stroke, metabolic syndrome, and some cancers. Newer evidence shows that protein-induced calciuria does not have a detrimental effect on net calcium retention, and theconcentrations of hormones in milk are not outside of the range of endogenous concentrations. Increased dietary protein, including from milk, can elevate serum concentrations of insulin-like growth factor I, which has an unknown relation to cancer. The concern over consumption of milk leading to increased risk of prostate cancer through reduction of serum 1,25-dihydroxyvitamin D, a potentanti-prostate cancer hormone, has been resolved with new evidence that local production of this hormone is independent of diet. Overall, evidence suggests that being a lactovegetarian has greater Am health benefits and reduced health risks than being a vegan. J Clin Nutr 2009;89(suppl):1634S–7S.

INTRODUCTION

A decision to consume dairy products, as with any food group, can be guided by a benefit-riskanalysis. This review considers the merits and concerns of dairy products as foods based on peerreviewed literature and does not address preferences, beliefs, or other issues such as production practices. The evidence that led to the recommendation of 3 cups (720 mL) of milk and milk products daily by the 2005 Dietary Guidelines for Americans Committee is reviewed. The most touted risks ofconsuming dairy foods include protein-induced calciuria, the presence of hormones and steroids, increased risk of prostate cancer, and the presence of lactose and saturated fats. Dairy foods void of lactose and fat are widely available; therefore, these issues are not discussed.
BENEFITS

patterns by the 2005 Dietary Guidelines for Americans (1). The percentage of the requirements set by the DietaryReference Intakes of the Institute of Medicine provided by 3 cups low-fat milk for women aged 31–50 y is given in Table 1. In the food patterns, milk and milk products contribute .10% of the requirements of many nutrients, including riboflavin, vitamin B-12, vitamin A, thiamin, calcium, phosphorus, magnesium, zinc, potassium, protein, and carbohydrates (1). The nutrients most at risk if milk productsare excluded are calcium, potassium, and magnesium. For a woman aged 19–50 y, calcium and magnesium recommendations are met with the food guide pattern in MyPyramid. However, without milk products, only 44% of calcium and 57% of magnesium recommendations are met. For potassium, the proportion of the recommended intakes with milk products is 73% compared with 57% without milk products. MyPyramidis based on minimal changes to the typical American diet in an attempt to achieve nutrient recommendations without exceeding energy needs. An analysis of the National Health and Examination Survey 2001–2002 showed that it is impossible to meet calcium recommendations for adolescents while meeting other nutrient recommendations with a dairy-free diet within the current US dietary pattern (2).Although a number of calcium-fortified foods are available and many with good calcium bioavailability (3), they are not selected in sufficient quantities to correct the calcium shortfall created by excluding dairy products. The calcium-fortified food that most closely matches the nutrient profile of milk is calcium-fortified soymilk (Table 1); this product is now allowed in the special supplemental...