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It's a 'milk off' for kids

These days everyone seems to be looking for an alternative.

When it comes to our eats, some people do require alternatives because of allergies or intolerances. For others, this 'search' for the perfect alternative appears to have stemmed from a world that constantly aims to promote a new dietary fad, trend or superfood.

Promotion of certain foods and lifestyles by celebrities and ‘health experts’ has made people feel that they need an alternative to what they have been doing for many years. Often doing well – for many years. So when it comes to milk (and OMG the MANY MANY options available), how do the alternatives stack up against cow’s milk, and do our kids in particular really need an alternative?

The most popular cows milk alternatives appear to be soy, rice, coconut and the ever-popular almond milks, especially with the boom of recent dietary trends. Whatever your reasons for using one of these alternatives, I think its important that we highlight the differences in nutritional value between these milks so that you know what your children are getting, and what they may be lacking.

Cows Milk

First and foremost, lets take a quick look at regular cows milk. We have been drinking it for years, providing us with a neat package of readily absorbed calcium, vitamin D, protein, carbohydrate, vitamin B12, riboflavin, magnesium, zinc, phosphorus and potassium - offering many health benefits beyond keeping our bones healthy and strong. It's safety when it comes to heart health was questioned for many years, however new research shows that the fat in milk does not impact on our weight or cardiovascular disease risk. It's got a good punch of protein and some low GI carbs to keep you feeling full. If your child doesn't have an allergy or doesn't need to avoid it for cultural or moral reasons, then there is really no need to find an alternative.

If your child has a lactose intolerance (trouble digesting the natural carbohydrate in milk) you can now get tasty, fresh and long-life lactose free cows milk from supermarkets and cafes. 

Soy milk

if you prefer soy milk as an alternative for your child, first of all it’s important to choose the calcium-fortified stuff (added calcium). They will have similar calcium, fat and protein contents per serve to cow’s milk, making fortified soy an ideal alternative.

There is still a lot to learn about the long-term safety of soy in children beyond infancy. This uncertainty is due to limited research (the same can be said for many foods in our supply), however certain populations have been consuming large amounts of soy throughout the life span for centuries, without any adverse effects. I don’t think soy is something children need to avoid but like all things nutrition, moderation is the key, with the Harvard Medical School suggesting children drink one or two glasses of soy milk a day if soy is there preference.

Almond & Rice milks

A handful of almonds provides a boost of many essential nutrients including protein, fibre and healthy fats. However, when we grind them down and add water to make almond milk, these nutritional qualities do not translate. Just like rice milk, almond milk pretty much has no natural calcium and not all almond and rice products are fortified. Even if they are, they are generally much lower in calcium than cow and soy milks with the absorption of the calcium being questioned. The bottom line, if your children do choose almond and rice milks look for different ways to get more calcium.

Protein is another important nutrient lacking in almond and rice milks compared to cow and soy milks. This means that children relying on almond and rice milks may be at a higher risk of an inadequate protein intake. This will of course negatively impact on their growth and development. If your child does predominantly have these milks, chat to an Accredited Practising Dietitian to ensure that they are getting enough protein from their whole diet.

In some situations adults should also assess their protein intake when relying on almond and rice milks. For one, protein keeps your feeling full. So when a switch from cows milk to rice or almond milk is made at breakfast time for example, adults often report that there appetite increases between meals. Athletes and active adults will also need to ensure that they are meeting increased needs for protein and timing this right for optimal muscle recovery – having a glass of almond milk is not the same as a glass of cows milk when it comes to nutrients for recovery!

Coconut milk

Although coconut milk is great to use in cooking, just like rice and almond milks, it should not be used as a cow’s milk alternative in your child’s diet. Coconut milk is low in protein and calcium and high in kilojoules. Save it for those nourishing curries or as an occasional snack.

The verdict...

Soy milk can be a great cow’s milk alternative for kids (providing similar amounts of available protein and calcium), meaning you can swap like for like servings to meet requirements. However rice, almond and coconut milks are not. If your child still includes these milks in their diet just ensure that they are receiving adequate amounts of protein, calcium, vitamin D, vitamin B12 and riboflavin elsewhere. You may need to chat to an Accredited Practising Dietitian. 


Healthy school snacks

Are you in the process of getting your kids ready to go back to school?

No doubt you are busy getting books, bags and shoes organised...but what about healthy lunch box and after school snacks?

Kids require adequate fuel to get them through a busy and active day at school. They also require nutrients to optimise their growth and development. Snacks are a fantastic opportunity to help meet these requirements, but one of the most common questions I get asked is: “What makes a healthy snack?”

Foods coming from our core food groups almost always make a healthy snack. This includes fruit, vegetables, dairy, grain foods and lean meats and alternatives. If these foods are presented in a minimally processed way, they are one step closer to a healthy snack.

I think one of the most important aspects to consider when organising healthy snacks for kids is to make them interesting and fun. Getting them involved in the preparation process and asking them what they like and what they think is healthy also helps ensure that they don’t swap, or throw out their intended healthy snacks.

Lets take a look at how we can use our core food groups in an appealing way to minimise the number of packaged or processed snacks for kids. Not only will this help to improve your child’s health, but reduce your family’s carbon footprint.

1.  Fruit and vegetables

Fruit and vegetable based snacks can provide fibre, water, phytochemicals and a range of vitamins and minerals. Snacks may include:

  • Frozen fruit such as frozen berries mixed through natural yoghurt
  • Small portions of dried apricots mixed with cubes of cheese or seeds such as sunflower or pumpkin seeds
  • Tinned fruit in natural juices
  • Savoury wholemeal flour or quinoa muffins with grated vegetables
  • Corn fritters
  • Fruit salad OR
  • Veggie sticks with a nutritious dip such as hommous or tazziki – why not make your own?

2.  Dairy foods

Dairy based snacks can help to provide protein, low glycemic index (GI) carbohydrates, calcium, vitamin D, B vitamins and zinc. Snacks may include:

  • A container holding a mix of cherry bocconcini and cherry tomatoes
  • Tubs of natural, Greek or flavoured yoghurt –freeze tubs of yoghurt (or small containers of yoghurt) before putting in your child’s lunch box to keep them cold
  • Small portions of flavoured or plain milk (including soy milk) OR
  • A slice of low fat cheddar cheese on wholegrain crisp breads.

3.  Lean meats and alternatives

Lean meat and alterative based snacks provide protein, iron, zinc and B12. Snacks may include:

  • Roasted chickpeas (a nice replacement for chips) – roast canned chickpeas with a sprinkle of paprika and cumin for about one hour on ~150 degrees (fan forced oven)
  • Hard-boiled eggs
  • Felafels
  • Tinned bean mixes and fish OR
  • Mini vegetable frittatas.

4.  Grain foods

Grain foods will provide fibre, carbohydrate, B vitamins, zinc, vitamin E, magnesium, iron and phosphorus. Snacks may include:

  • Wholemeal lavish bread with a nutritious dip such as beetroot
  • Wholemeal savoury or fruit pikelets
  • Dried cereal such as weetbix biscuits topped with cheese and a thin scrape of vegemite or peanut butter.

Choosing a healthy muesli bar

I often get asked about choosing healthy muesli bars, which can be a great convenient snack, especially for active kids.

My recommendations are to always try and choose the muesli bar that is highest in fibre, lowest in sodium and lowest in saturated fat per 100g. Most will have a little bit of added sugar to increase the palatability of the product without displacing key nutrients, however some bars marketed at children can have way too much sugar than required.

Unfortunately, reading sugar on the nutrition information panel is not always the best indication of a healthier option as the presence of natural sugars such as fruit or yoghurt will be listed under ‘sugars’ on the nutrition information panel. These natural sources of sugar are nutrient dense.

The ingredients list can help you identify added sugars. Look for sucrose, cane sugar, raw sugar, dextrose, glucose, honey, brown sugar, malt syrup, fructose, lactose, molasses, barley malt and caramel. If one of these ingredients is high on the list, this means that there is likely a large quantity of it in the product.

More infomration on this can be found here.

After school snacks

Feeding hungry kids after school can be challenging, especially when trying to find something that is fun, nutritious and easy to prepare. Try:

  • Mini ‘pizzas’ with wholegrain English muffins topped with ‘no added salt’ tomato paste (or homemade tomato sauce), tomato, pineapple and cheese and placed under the grill
  • Freezing any left over fruit to make smoothies – use frozen fruit such as as banana and strawberries and blend with yoghurt and milk
  • Celery filled with your child’s favourite nut butter and a sprinkle of sultanas
  • Baked bean filled toasties OR
  • A platter filled with cubed cheddar cheese, sushi, rice crackers, lavish bread, dried fruit and a nutritious dip.

Dairy and Bone Health

It was National Healthy Bones Week on August 4th-10th 2013, a week that aims to increase the awareness of the role calcium rich foods, predominantly dairy foods play in the development of strong healthy bones. Now personally I love dairy foods. I enjoy milk for recovery after training, enjoy the satiating qualities that yoghurts poses for a PM snack (the full fat type) and can’t go past a lovely cheese platter over a catch up with friends. However, many do not share this same love.

Eight out of ten adults do not meet the recommended number of servings of dairy (or dairy alternatives such as soy products) a day as outlined in our Australian Dietary Guidelines.

I am very much aware that many people need to avoid or limit dairy foods due to intolerances or personal dietary preferences.  Others just do not share the same view when it comes to the health benefits of dairy foods. The many reasons that people may or may not include dairy in their diet are very contracting which makes it very confusing for people trying to eat for health.

Because of this, I asked friends and family via social media what they wanted to know about dairy foods and bone health and why some may avoid this whole food group. Many wanted to know how they can get enough calcium through non-dairy sources, some wanted to know whether full fat or low fat was best and some were avoiding because of a fear of weight gain.

This led me to explore some of the views and evidence of the pro-dairy faction and have a look at other science-based views and most importantly determine how everyone can get enough calcium in their diets.

But let’s not forget that this all came about because of National Healthy Bones Week and calcium is just one piece of the puzzle.

The healthy bones puzzle

Building healthy bones is an area of our health that isn’t talked about a lot, especially during the crucial ages for bone building (our teenage years) when focus may be on eating for weight versus eating for health and wellness.

It is important to piece each part of the puzzle together to build healthy bones. This puzzle involves three main pieces including adequate dietary calcium intake, adequate vitamin D (which many of us are deficient in) mainly from sunshine and regular bone strengthening exercise such as jogging, brisk walking, balance exercises and resistance exercise.

The role of calcium

Most people know that calcium is important to help build healthy teeth and bones. This occurs when the calcium deposits as a crystal onto our bones to give them their hard strength. Our body also requires calcium to help transmit nerves, regulate the hearts rhythm and assist with blood clotting. But remember, our bodies can't use calcium without adequate vitamin D.

Our body gets calcium through the foods that we eat. It can also borrow calcium from our bones when our blood levels start to drop to low. If this is not replaced our bones will lose their strength. So it’s pretty safe to say we need calcium in our diets!

While no one is questioning the important role of lifelong calcium intake for the health of our bones, the debate comes down to just how much calcium do we really need and what are the best sources of calcium in our diets?

When we sort through the opinion and look closely at the evidence, there’s no ‘final answer’ on how much we need. But here is what we know about calcium, food sources and what our current recommendations are.

How much calcium do we need?

The Australian recommendations suggest that children require 500mg-1000mg, teens require 1300mg and adults require 1000mg-1300mg of calcium a day depending on their age and gender.

How to meet these recommendations

The new Australian Dietary Guidelines recommend 2 ½ - 4 serves of dairy foods a day for adults (depending on their age) to help meet calcium requirements and gain additional health benefits from dairy foods.

A serve of dairy contains approximately 350-450mg of calcium per serve with one serve equating to:

  • 250ml of cows milk
  • 250ml of soy milk (with at least 100mg of added calcium per 100ml)
  • 200g of yoghurt
  • ½ a cup of ricotta cheese, or
  • 40g of cheese.

The list is endless when we think about how we can include these foods in our diets. Think:

  • milk after exercise
  • Greek yoghurt on curries
  • ricotta cheese in salads, and
  • plain yoghurt with fruit for dessert.

The Great Dairy Debate

Although the new Australian Dietary Guidelines are based on scientific evidence, some groups question if we really need this much calcium, particularly from dairy foods for bone health. However, contradictory studies only show correlation, not conclusive evidence that would alter the guidelines.


Weight, diabetes and heart disease risk

Consuming calcium through dairy foods may offer benefits beyond bone health including lowering cardiovascular disease risk, reducing fat mass, increasing lean muscle mass and potentially reducing the risk of type 2 diabetes. There is also no evidence to suggest that enjoying the recommended serves of dairy foods increases total weight and waist circumference (it could in fact improve it). These benefits may be due to complex structure of dairy foods including the role of calcium binding to the fat, the presence of additional vitamins and minerals and the type of fats present in dairy foods. In regards to milk and yoghurts, they have satiating qualities due to their low glycemic index (GI) and protein content, meaning you feel fuller for longer, which may mean there is no need to reach for other energy dense/nutritionally poor snack foods such as biscuits, crackers and snack bars.

Full fat or low fat?

Early studies also suggest that there is no difference between low fat and full fat dairy foods when we look at these health benefits.

So as far as I’m concerned, I will continue to enjoy my 2-3 serves of dairy a day and encourage the people around me to do the same. If people have cut out dairy because they do not like the taste of the low-fat variety I would encourage them to put the full fat type back in, as long as its in the presence of a healthy diet that is adequate for their energy budgets. If your not sure always check with an Accredited Practising Dietitian.


Dairy alternatives for calcium – soy, rice and almond products

Dairy alternatives include soy, rice and almond products. Some people prefer these alternatives because of a lactose intolerance or personal dietary preference (if a lactose intolerance is a concern there are now fresh and UHT lactose free milks available in all supermarkets, which are a great source of calcium).

It is important to choose calcium fortified (added calcium) dairy alternatives. Calcium fortified soy milks and cow’s milk have a similar calcium content per serve. However, fortified almond and rice milks are generally much lower in calcium (approximately 180mg versus approximately 350mg of calcium per 250ml serve) and many almond and rice products are not fortified.

Food is complex and it’s not just the nutrient content of a food that is important to consider, but how our body will use this nutrient.

Our bodies tend to use the calcium from dairy foods more effectively compared with some dairy alternatives. If dairy alternatives are fortified with calcium phosphate, the calcium absorption is generally 75% of the absorption from cow’s milk. If products are fortified with calcium carbonate the absorption is equivalent to cows milk. You can check the fortification method by reading the ingredients list on the label.

Some people worry about having a high intake of soy products. The Cancer Council of Australia have published a position statement that support the use of soy products in the diet, however warn women with existing breast cancer or past breast cancer to be cautious in consuming large quantities of soy foods or phyto-oestrogen supplements.


Fish sources

Calcium can also be found in fish with edible bones such as sardines (489mg per 90g serve) and salmon (279mg per 90g serve), which are absorbed well. These sources of oily fish also contain omega 3 fish oils and vitamin D and are great foods for building healthy bones.

Vegetable sources

Many people believe they can get enough calcium through vegetable sources, especially with vegetables such as kale that is becoming increasingly popular.

However, the amount of calcium per serve of these foods is quiet low and the absorption of the calcium is questionable. The absorption of calcium from almonds (30mg for 10 almonds), legumes (43mg per cup of baked beans) and dark green vegetables such as kale (100mg per cup) and broccoli (15mg per 2 florets) depends on the phytate content. Phytate is a plant compound that blocks the absorption of calcium in the gut.

Oxalates, another plant compound, also block the absorption of calcium. Although spinach has been labeled a good source of calcium in the past it should not even be considered as a source of calcium because of its oxalate content.

Although some of your favourite green leaves may not be as calcium rich as once thought, they do contain vitamin K, which has been shown to give some assistance in building healthy bones.


Final notes

  • If you rely on vegetable sources to meet your calcium needs you may not be getting as much as what you initially expected.
  • Consider including some calcium fortified soy products (seek advice if you have a existing or past breast cancer diagnosis) if you choose to leave dairy out of your diet.
  • For all of those dairy lovers, continue to include milk, yoghurt and cheese in your diet for various health benefits beyond bone health.
  • If you have cut out dairy because you don't like the taste of low fat dairy, put the full fat dairy back in making sure you have a healthy balanced diet that is appropriate for your energy budget.

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Images are not my own.

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