Being a nutritionist I pride myself in ensuring a balanced diet at home on most days. I constantly look at fruit and vegetable intake, the different colours, whole grains, see if there is sufficient milk and yoghurt consumed through the day, restrict sugar etc. I have a daughter who turned a teen this year. Recently, we visited her doctor, an “adolescent physician”, when she had a bout of fever. As an aside I love this idea of an adolescent physician, we can turn to, when our children seem too big to go to a regular paediatrician but have specific health issues that general physicians may not be clued in. There are not many but if you can find one it will be great for tweens/ teens. My daughter’s doctor over the past three years or so has monitored her bodily changes and talked to her about it and also pushed her to eat healthy, restrict junk and exercise. More importantly she engages with her and answers her queries and puts her worries to rest – a third person explaining could help, especially if your child is a teen!
Coming back to the theme of the blog, the doctor put her on calcium supplements for two years and iron supplements for 3 months and asked us to continue with iron over weekends for two more years. I was surprised at calcium, but not iron. I was anyways giving her iron sporadically as she eats a predominantly vegetarian diet and iron from plant food is not easily available to the body. She said many teen girls are anaemic and also have poor eating habits- skipping meals, indulging in junk. Also, calcium is needed as this is the peak bone growth phase and will support the growth phase. Much later, it can also help reduce the risk of getting osteoporosis. So, without the need for further convincing, we put her onto supplements right away.
Nevertheless I decided I had to do some homework on calcium. I browsed through the recent recommendation on various nutrients by the National Institute of Nutrition to see if she really needs the calcium tablet as she loves milk and yoghurt and takes sufficient quantities of both. What I found out, in the recent revision (2010) on nutrient intake for Indians the calcium per day had gone up by 200 mg – from 600mg/day to 800 mg/day. So the requirement goes up at 10 years from 600 mg to 800 mg and then drops back to 600 mg again at 18 yrs. This is not a random increase; this is done by scientists who do a thorough study of intake patterns, nutritional status of the target group, clinical studies, before arriving at a recommendation. Also in the pubertal phase generally (12-14yrs) there is 20% deposit of the total bone mineral content found in adults!
Then I did some rough math for my daughter – 200 ml of milk will give around 220 mg of calcium and she consumes around 400 ml of milk every day. 100 ml of curds will give around 120 mg of calcium and she consumes maybe around 125 ml– so she is getting around 600 mg per day from her dairy intake. She probably gets another 50-100 mg depending on what she eats – but she may not reach 800 everyday definitely. So I decided she needs the supplement, but decided to reduce it from 500 to 250 mg to ensure the gap is filled for the next couple of years to aid in her bone deposits and growth.
So if your teen is a dairy and meat lover you need not worry, but if you are a parent who is pleading with your teen on a daily basis to finish a glass of milk — you may want to give calcium supplements a serious thought during the peak pubertal period when they rapidly gain height and weight. Calcium story holds good for boys as well! So talk to your doctor or a nutritionist and discuss your child’s current and dairy and meat intake so they can decide the dosage.
To know more about iron requirements read the nutrition and wellness article (Could my child be anaemic?) in our March 2014 issue or the blog http://parentedge.in/why-is-iron-important-for-children/