Tofu, oats, broccoli, juice cited as alternatives

Children who drink more milk do not necessarily develop healthier bones, researchers said in a report that stresses exercise and modest consumption of calcium-rich foods such as tofu.

The U.S. government has gradually increased recommendations for daily calcium intake, largely from dairy products, to between 800 and 1,300 milligrams to promote healthy bones and prevent osteoporosis.

But the report, published in the journal Pediatrics, said boosting consumption of milk or other dairy products was not necessarily the best way to provide the minimal calcium intake of at least 400 milligrams per day.

Other ways to obtain the absorbable calcium found in one cup of cow's milk include a cup of fortified orange juice, a cup of cooked kale or turnip greens, two packages of instant oats, two-thirds cup of tofu, or 1 2/3 cups of broccoli, the report said.

In a review of 37 studies examining the impact of calcium consumption on bone strength in children older than 7, researchers at the Physicians Committee for Responsible Medicine in Washington found 27 did not support drinking more milk to boost calcium.

The PCRM identifies itself as a "research advocacy" group which opposes unethical human experiments and promotes alternatives to animal experiments.

"Currently, available evidence does not support nutrition guidelines focused specifically on increasing milk or other dairy product intake for promoting child and adolescent bone mineralization," lead researcher Amy Lanou wrote.

Several studies, which examined such factors as bone density and rate of fractures, concluded that exercise may be more important than increased calcium consumption in developing strong bones.

Data was scarce on the effect of calcium intake for children younger than 7 years.

Dairy products provide 18 percent of the total energy and 25 percent of the total fat intake in the diets of American children, who are developing increasing rates of obesity.

In an accompanying commentary, Frank Greer, a pediatrician at the University of Wisconsin in Madison, said the ideal way to achieve the goal of healthy bones is to make sure children exercise and consume up to 1,300 milligrams a day of calcium.

The easiest way to get that calcium is from low-fat dairy products, which also contain valuable nutrients such as vitamin D, which is generally not available from other dietary sources, he wrote.