Abstract

Children with Cow's Milk Protein Allergy (CMPA), treated with a milk-free diet, may be at risk of deficiency of nutrients important for appropriate development. The aim of the study was to evaluate the diets and the nutritional status of children with CMPA. The study included 48 children, aged 4-6 years, with CMPA treated with a milk-free diet. The principles of the milk-free diet were defined and the compliance with the diet by children was monitored by a physician and a dietician. The control group consisted of 30 healthy controls, aged 4-6 years, on a traditional diet containing milk and milk products. The energy and nutritional value of the diets was determined on the basis of 3-day dietary records. Children's nutritional status was evaluated based on the normalised Body Mass Index (BMI z-score) and selected biochemical indices. The energy value of the diets of children with CMPA was higher compared to recommendations and significantly higher than the energy value of the diets of healthy controls. The intake of protein in both groups exceeded approximately three times the daily requirement. Children with CMPA consumed significantly more long-chain poly-unsaturated fatty acids, carbohydrates, iron, iodine, copper and vitamins D, E, B1, B6 and PP. Vitamin D deficiency was found in the diets of children from both groups. Calcium deficiency was recorded in the diets of 93.8% of children with CMPA and 90% of the controls. The evaluated biochemical indices in both groups did not different significantly and, except for the concentration of 25(OH) vitamin D in blood serum of children with allergy, were within the reference range. Milk-free diets in children with CMPA were adequate for most nutrients, but the children are at risk of vitamin D insufficiency despite the higher vitamin D content of their diets compared to the group of healthy children. The better balancing of the diets of children with allergy was probably due to continuous medical and nutritional care provided by paediatricians and dieticians.

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