The importance of meeting calcium needs with foods.

Calcium can be obtained from foods naturally rich in calcium such as dairy foods, from calcium-fortified foods and beverages, from supplements or from a combination of these. Recognition of calcium's many health benefits, along with Americans' low calcium intake, has led to interest in how best to meet calcium needs. Foods are the preferred source of calcium. Milk and other dairy foods are the major source of calcium in the U.S. In addition, these foods provide substantial amounts of other essential nutrients. Consequently, intake of dairy foods improves the overall nutritional quality of the diet. Other foods such as some green leafy vegetables, legumes and cereals provide calcium, but generally in lower amounts per serving than do dairy foods. Also, some components such as phytates in cereals and oxalates in spinach reduce the bioavailability of calcium. Calcium-fortified foods and calcium supplements are an option for individuals who cannot meet their calcium needs from foods naturally containing this mineral. However, their intake cannot correct poor dietary patterns of food selection which underlie Americans' low calcium intake. Considering the adverse health and economic effects of low calcium intakes, strategies are needed to optimize calcium intake. A first step is to recognize factors influencing dietary calcium consumption. Substituting soft drinks for milk and eating away from home are among the barriers to adequate calcium intake. The American public needs to understand why consuming foods containing calcium is the best way to meet calcium needs and learn how to accomplish this objective.

Enhancing the nutrition of America's youth.

Today, we know more about what foods children should eat for optimal growth and development, as well as future health, than ever before. Yet, many of our nation's youth are not meeting their nutritional needs and are following a sedentary lifestyle. Overweight among American children has increased dramatically during the past decade. Also, children's low calcium intake can compromise their bone health and increase their future risk of osteoporosis. Health professionals, parents, educators and others responsible for children can play a key role in enhancing the nutrition of America's youth. However, they first need to be aware of the important issues regarding children's nutrition and how best to positively impact children's nutrition. A recent briefing by experts in child nutrition and a roundtable discussion was held in Washington, DC, to address these topics. This review summarizes the information presented. Focusing on dietary restrictions, such as a low fat diet, was identified as an obstacle to positively impacting children's nutrition. To improve children's dietary intake and their ability to learn in school, efforts are being made to increase the availability of and participation in the School Breakfast Program. Parents and other child care providers can serve as role models and positively influence what foods children like and will actually eat. Children are not little adults and, as such, dietary guidelines based on adult data should not be extrapolated to children. Support for the development of separate dietary guidelines for children is growing. These guidelines should be based on sound scientific evidence of efficacy and safety. Enhancing the nutrition of America's youth is emerging as a priority, both locally (i.e., community school feeding programs) and nationally (i.e., dietary guidelines).

Allaying fears and fallacies about lactose intolerance.

Public awareness and misunderstandings of lactose intolerance are at an all-time high. Many people erroneously believe they are lactose intolerant or develop gastrointestinal symptoms after intake of lactose. Consequently, lactose-containing foods such as milk and other dairy foods may be eliminated unnecessarily from the diet. Because these foods are a major source of calcium, low intake of them can compromise calcium nutriture. This, in turn, can increase the risk of major chronic diseases such as osteoporosis (porous bones) and hypertension. This review is intended to help dietetics professionals alleviate clients' fears about lactose intolerance and recommend dietary strategies to improve tolerance to lactose. Scientific findings indicate that the prevalence of lactose intolerance is grossly overestimated. Other physiologic and psychologic factors can contribute to gastrointestinal symptoms that mimic lactose intolerance. Scientific findings also indicate that people with laboratory-confirmed low levels of the enzyme lactase can consume 1 serving of milk with a meal or 2 servings of milk per day in divided doses at breakfast and dinner without experiencing symptoms. Several dietary strategies are available to help lactose maldigesters include milk and other dairy foods in their diet without experiencing symptoms.

Osteoporosis: visions for care and prevention--a conference report.

Osteoporosis, a bone-thinning disease that leads to fractures, affects 25 million Americans, mostly women. The good news is that this disease is preventable and treatable. Adequate nutrition, for example, is estimated to reduce the impact of osteoporosis by as much as one half. The bad news is that unless more attention is given to communicating preventive strategies, osteoporosis and its related costs will continue to escalate. To make osteoporosis a priority among health professionals and communicators, The American Dietetic Association, in cooperation with National Diary Council, held a conference on this subject in November 1993. Recognized national experts addressed the issue of osteoporosis from various perspectives. This article summarizes the information presented at this conference. Prevention of osteoporosis focuses on increasing peak bone mass, which is usually reached between the age of 30 to 35 years, and reducing bone loss in later years. Bone health is influenced by three major interacting factors: diet, exercise, and estrogen. To optimize bone health, accumulating scientific findings support intakes of calcium and vitamin D exceeding current Recommended Dietary Allowances (RDAs) for these nutrients. Unfortunately, most women in the United States, in particular female adolescents, do not consume the RDA for calcium. Although recommendations to prevent osteoporosis can be made, there are several obstacles to translating these recommendations into action. Examples include failure to inspire people to make lifestyle changes early in life and to provide understandable recommendations. To be facilitators of change and not just nutrition experts, dietitians and other health professionals need to overcome these obstacles and to effectively market the risks of and prevention strategies for osteoporosis.(ABSTRACT TRUNCATED AT 250 WORDS)