Energy: 129 calories (540 kJ) for 2% white milk

P4B nutrition recommendations are based on 2 documents: Eating Well with Canada’s Food Guide (published in 2007), and the Dietary Reference Intake (DRI) for calcium (published in 1997). Canada’s Food Guide recommends children age 9 to 18 consume 3 to 4 servings of milk and alternatives every day. The DRI recommendation for children age 9 to 18 is 1300 mg of calcium per day (DRI). The upper range, i.e. 4 servings of milk and alternatives per day, provides about 1200 mg of calcium – which is closer to the DRI calcium recommendations for this age group.

This is why we will always refer to the upper range of milk and alternative servings recommended in Canada’s Food Guide in the Power4Bones program.

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Health Canada recommends children age 9 to 18 consume 3 to 4 servings of milk and alternatives daily as recommended in Canada’s Food Guide. In 1997 requirements for nutrients were published stating that for children age 9 to 18, the calcium recommendation is 1300 mg per day. In the Canadian diet, milk and alternatives offer a rich source of calcium and other bone-building nutrients. One serving of milk or alternatives (e.g.,1 cup of milk, 3/4 cup of yogurt, 50 g cheese) provides about 300 mg of calcium, so 4 servings would be needed to almost reach the requirement.

The extra 100 mg of calcium needed per day can easily be met when the child eats other foods containing small amounts of calcium (e.g., fish with bones, some vegetables, some legumes). For adequate Vitamin D, Health Canada recommends all Canadians drink 2 cups of milk per day.

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A brand new Canada’s Food Guide was launched in February 2007. The Food Guide is revised regularly and it is based on scientific research. Food guides recommend what we should eat and in what amounts to get all the nutrients we need. They also reflect the foods that are most available in our country.

One cup of milk, 3/4 cup of yogurt or a 50 g portion of cheese are examples of a serving of a milk and alternatives. Canada's Food Guide currently recommends 3 to 4 servings per day for children age 9 to 18. The upper recommendation of 4 servings per day is appropriate to cover the current calcium recommendations (1300 mg of calcium per day) for this age group.

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Calcium is an essential nutrient. This means it is a nutrient our bodies can't make and we need to get enough of it from the food we eat. Calcium helps to build strong bones and teeth. Calcium is also needed for muscles like the heart to contract, blood to clot, and nerve impulses to transmit in the body. If your calcium needs are not met through the foods you eat, it will be withdrawn from your bones which can cause bone weakness. Therefore, we need to stock our bones well as a child and maintain them as we get older. Your bones act as a storehouse for calcium. Milk and alternatives are all sources of calcium. However, only fluid milk also contains vitamin D. Vitamin D helps our body absorb calcium and is equally important for bone health.

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In 1997, Canada and the US came out with Dietary Reference Intakes (DRI) for calcium, phosphorus, magnesium, vitamin D and fluoride. All of these nutrients are involved in maintaining bone health. The main difference between the old Canadian recommendations and the new DRIs is that the recommendations for calcium, vitamin D and magnesium have increased for most of us. The recommendation for phosphorus decreased slightly for adults and recommendations were newly developed for fluoride. By choosing a variety of foods from the 4 food groups and the maximum number of servings of milk and alternatives every day, you can make sure you get enough of these 5 bone-building nutrients.

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Bones need more than just calcium to be strong. They need vitamin D to use calcium and optimize bone mineralization. Without vitamin D, your body absorbs only about 10 to 15% of the calcium you eat.

Other than fluid milk, food sources that contain vitamin D are liver, fish oils, eggs and fortified margarine. Milk and alternatives such as cheese and yogurt are nutritious choices; however, only fluid milk is fortified with vitamin D.

While we do make vitamin D naturally when our skin is exposed to sunlight, certain factors that block this process include age, season, use of sunscreen, clothing, latitude, and glass windows. Without fluid milk, it may be very difficult for older adults and young children to meet their vitamin D requirements.

In the new food guide Health Canada recommends that all Canadians should drink 500 mL (2 cups) of milk each day to make sure that their vitamin D requirements are met. In addition, Canadians over 50 years of age are recommended to take a 400 IU supplement of Vitamin D.

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Yes. Like white milk, chocolate milk and other flavoured milks are healthy bone building choices. Chocolate milk is made from fresh white milk and it has all the nutrients you find in white milk, including calcium and vitamin D. Both white milk and chocolate milk are considered excellent sources of calcium. There's very little caffeine in chocolate milk, and it contains about the same amount of sugar as you would find in an equal amount of most unsweetened fruit juices.

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Unfortified soy beverages contain, on average, 28 mg of calcium per 250 mL (1 cup) serving and no Vitamin D, compared to 315 mg of calcium and 100 IU of Vitamin D for cows' milk. Milk also has considerably more riboflavin, vitamins B5, B12, A and D than soy beverages. Health Canada has now allowed manufacturers to fortify soy beverage with nutrients (including calcium and vitamin D) to mimic cows' milk. However, not all soy beverages are fortified with the same amount of calcium and Vitamin D. Check the product label to see how much calcium is provided on a per serving basis.

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There are more nutritional similarities than differences between goats' and cows' milk. They have a similar fat, protein, and carbohydrate content, and both are excellent sources of calcium and riboflavin. Because the lactose content is the same, goats' milk is not any better tolerated by lactose maldigesters. Unlike cows' milk, goats' milk contains very little folic acid, is low in vitamin B12, and is not fortified with vitamin D. Some processors may voluntarily add vitamin A and vitamin D to their product, but this is not required by law.

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Whole or 2% milk is a good choice for most young children and whole milk is actually recommended by the Canadian Pediatric Association for infants up to 2 years of age. After 2 years of age, the family's preferred type of milk is fine. The only difference between the different types of milk is the fat content; the nutrient composition is the same.

However, it is important to remember that children need plenty of nutritious, energy-dense foods to grow and develop to their full height and size. Because fat is the highest source of energy in the diet, it gives children more energy in a smaller amount of food. Canada's Food guide reminds parents and caregivers that children should not restrict nutritious foods because of their fat content.

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If your kids don't drink enough milk, you can help them get the nutrients and the energy they need by serving them a combination of foods made with milk or milk alternatives. Plus, you can always offer them yogurt or cheese.

The calcium requirements for children are:

Age	Adequate Daily Requirement
1-3	500 mg
4-9	800 mg
10-18	1300 mg
(source: 1997 Dietary Reference Intakes, National Academy of Medicine)

Estimated Calcium Content of Selected Food Sources

Milk & Milk Products	Serving Size	Calcium
*Milk (1%, 2%, skim, whole, lactose-free)	1 cup	315 mg
*Chocolate milk	1 cup	300 mg
Plain yogurt	3/4 cup	320 mg
Fruit-bottom yogurt	3/4 cup	281 mg
Cheddar cheese	50 g	363 mg
Mozzarella cheese	50 g	268 mg
Swiss cheese	50 g	476 mg
Feta cheese	50 g	255 mg
Cottage cheese	1 cup	164 mg
Yogurt beverage	200 mL	220 mg
Soups made with milk (such as cream of chicken or mushroom)	1 cup	192 mg

If a child doesn't consume milk and alternatives, meeting calcium requirements may be achieved with careful planning through other food sources. Some other food sources that contain calcium are:

Beans & Bean Products
Tofu (with calcium sulphate)	150 g	157 mg
White beans	3/4 cup	151 mg
Chickpeas	3/4 cup	57 mg
Baked beans	3/4 cup	100 mg
*Fortified soy beverage	1 cup	310 mg

 

Nuts & Seeds
Almonds	1/4 cup	103 mg
Sesame seeds	1/4 cup	46 mg

 

Fish
*Salmon, canned, with the bones	1/2 cup	181 mg
*Sardines, canned, with bones	4	183 mg

 

Fruits & Vegetables
Turnip greens	1/2 cup	104 mg
Bok choy, okra	1/2 cup	84 mg
Dried figs	3 medium	81 mg
Orange	1 medium	52 mg
Kale	1/2 cup	49 mg
Broccoli	1/2 cup	50 mg

*Indicates source also contains vitamin D.

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From 9 up to age 18, requirements for calcium are 1300 mg each day. From age 19 to 49, a person requires 1000 mg of calcium per day. By consuming the maximum number of servings from the milk and alternatives food group on Canada’s Food Guide, i.e., 4 servings each day for 9 to 18-year-olds, a youngster can adequately meet his/her calcium needs.

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It is never too early to think about calcium needs, and getting enough calcium as a teenager can help prevent osteoporosis in later years. Children age 9 to 18 require 1300 mg of calcium per day. Experts agree that the main source should be food — especially milk and milk alternatives.

An important point is that all milk has the same amount of calcium and vitamin D regardless of its fat content. For example, 1 cup of skim milk has 91 calories, virtually no fat (0.5 grams) and 315 mg of calcium, plus vitamin D. It is important for weight conscious teens and adults to recognize that milk is not fattening. Canada's Food Guide recommends that youngsters between 9 and 18 years of age consume 3 to 4 servings from the milk and alternatives food group each day. And the upper range of 4 servings provides 1200 mg of calcium per day – close to the current recommendations.

If a person doesn't consume milk and alternatives, meeting calcium requirements may be achieved with careful planning through other food sources. Other food sources that contain calcium that the body can absorb are:

Kale (cooked 1/2 cup)	49 mg calcium
Broccoli (cooked 1/2 cup)	50 mg calcium
Bok choy (cooked 1/2 cup)	84 mg calcium
Almonds (1/4 cup)	103 mg calcium
Salmon, pink, canned with bones (1/2 cup)	181 mg calcium
Sesame seeds (1/4 cup)	46 mg calcium

For people who can't get enough calcium through food, a calcium supplement is worth considering. Your physician and registered dietitian can help advise you on an eating plan that is personalized to meet specific needs and can provide information on specific vitamin and mineral supplements.

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While some vegetables do contain calcium, you need to consider

• the quantity of calcium present,
• the amount of calcium the body can absorb from the vegetable, and
• the amount of the vegetable that a person would have to consume to meet their calcium requirements.

Vegetables that offer highly absorbable calcium include broccoli, kale and bok choi. However, you would have to consume at least 3 cups of broccoli to get the same amount of calcium as you would get from 1 cup of milk!

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If you are concerned about eating too much fat and calories in your diet, simply choose lower-fat milk and alternatives when trying to meet your calcium requirements. Canada's Food Guide recommends that children not restrict nutritious foods because of their fat content.

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Very few foods other than milk, cheese and yogurt contain substantial amounts of calcium. Milk also contains vitamin D, which helps the body absorb the calcium better. In general, diets low in calcium tend to be low in other essential nutrients. Supplements cannot replace a healthy diet because their nutritional value is not equivalent to the nutritional value of foods such as milk.

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Yes; however, it is important to remember that even with a relatively high salt intake, your bones will remain healthy as long as your calcium intake is adequate. Limit your salt intake and at the same time include several servings of calcium-rich foods. Avoid regularly adding salt to your food, check labels for salt or sodium content, and only eat salty foods in moderation.

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For most people, eating a variety of foods suggested by Canada's Food Guide will provide all the necessary nutrients you need each day. The average healthy person does not require vitamin pills, even on a stressful day.

Daily calcium requirements vary depending on age and sex. If you are eating the recommended number of servings from the milk and alternatives food group, then you can probably be assured that your calcium requirements are being met. If a person doesn't consume milk and milk alternatives, meeting one's calcium requirements may be achieved with careful planning through other food sources.

For people who can't get enough calcium through food, a calcium supplement is worth considering. Your physician and registered dietitian can help advise you on an eating plan that is personalized to meet your specific needs and can provide information on specific vitamin and mineral supplements.

Health Canada does recommend that in addition to following Canada's Food Guide, adults over the age of 50 should take a Vitamin D supplement of 400 IU daily.

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Health Canada recommends that we not exceed 400 mg of caffeine per day, which is equal to 3 to 4 cups of coffee a day. Too much caffeine can force calcium out of your body, so try to stick to the 3 to 4 limit and remember to choose at least 2 servings of milk and alternatives every day.

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For every 1 gram of protein we eat, we lose only 1 mg of calcium. Milk and alternatives have substantially more calcium than protein. For example, one cup of milk contains 315 mg of calcium but only about 9 grams of protein. Any small losses of calcium that might occur are more than compensated for.

Canadians should be reminded to follow Canada's Food Guide to Healthy Eating and meet their minimum number of servings from each food group in the recommended serving size. Generally speaking, eating foods rich in calcium throughout life, combined with regular weight-bearing exercise, has proven to be the best prescription for maintaining the health of our bones.

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Magnesium, phosphorus and fluoride act like cement to help maintain bone strength. These minerals are widespread in many different foods. Magnesium is especially found in green, leafy vegetables, whole grain products, milk, nuts, beans, bananas and apricots. Phosphorus is especially plentiful in meats, milk products, nuts, peas and beans. Most people get adequate fluoride from their local water supply if it has been fluoridated and from fluoridated toothpaste.

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The number of proven cows' milk allergies is rare: less than 1% in adults and less than 3% in children. Before making any changes to your diet, you should first be seen by your doctor. Once a cows' milk allergy has been confirmed, you should see a registered dietitian specializing in food allergies. The dietitian will advise you on a diet that does not contain milk products but is nutritionally adequate. Typically, a milk allergy isn't necessarily life long and is outgrown by most children by the age of 3.

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Milk contains a natural sugar called lactose. People who are lactose intolerant or, more precisely, who are lactose maldigesters, lack enough of the enzyme (lactase) needed to completely digest the lactose. Lactose intolerance refers to the symptoms of gastrointestinal discomfort that some people feel after drinking milk or eating lactose-containing foods. With a little experimentation, some people find they can tolerate small servings of milk spread throughout the day. Certain cheeses and yogurts are lower in lactose. Other people use special lactose-free milk such as Lactaid or Lacteeze.

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This is milk in which the naturally occurring sugar called lactose is broken down. The lactose is broken down by adding the enzyme lactase during processing. About 99% of the lactose is broken down. Although these products can be beneficial for lactose maldigesters, they are generally unnecessary if milk is consumed in moderate amounts, and combined with other foods.

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