Q & A KiddieCal

Q?

What is in KiddieCal, and why do you have to have these ingredients?

A.

KiddieCal contains calcium, phosphorus, vitamin D and vitamin K which are required for strong, healthy bones. The mineralization of calcium and phosphorus are essentially what forms strong and rigid bones. Vitamin D is well known for its role in bone health, increasing the absorption and regulating the metabolism and homeostasis of calcium and phosphorus. The formation and maintenance of strong bones requires a protein, carboxylated osteocalcin. Its job is to bind to calcium phosphate minerals and place them in a specific hexagonal structure to maximize strength. But in order for this to occur, the protein relies on vitamin D and vitamin K for its production and regulation. Each of these ingredients in KiddieCal have specific roles which work together to produce and maintain strong, healthy bones. Therefore, it is important to obtain all these nutrients, in particular during the most influential period when bones are growing and developing, in early childhood. Once we stop growing, our bones can’t get any stronger (only maintained), thus it is important to build a strong baseline. If a child is not getting enough of any one of these nutrients, the pathways of bone formation can be significantly hampered. This can result in bone, muscle and joint problems that can severely hamper the development of posture, balance, facial features, movement, flexibility, coordination, fine and gross motor skills, body strength and agility as well as an increase risk of bone fractures and tooth cavities.

Q?

What is the ideal intake for vitamins and minerals found in KiddieCal?

A.

The World Health Organisation’s (WHO) recommended nutrient intake (RNI)/day of each ingredient is listed below, except for phosphorus, which was obtained from the National Health & Medical Research Council (NHMRC).

Group Calcium (mg) Phosphorus (mg) Vitamin D (g) Vitamin K (g)
1-3 years 500 460 5 15
4-6 years 600 500 5 20
7-9 years 700 1250 5 25
10-18 years 1300 1250 5 35-55*
Adult 1000 1000 5 55-65*
Pregnancy 1200 1000 5 55
Lactating 1000 1000 5 55
Postmenopausal 1300 1000 10-15# 55

*RNI values for females and males (respectively)
#10µg between 51-65 years of age, 15µg for over 65 years of age

Q?

If my child doesn’t have this level of intake, what would happen? What are the short term and long term effect?

A.

If your child is not quite reaching the dietary intake of any one of these nutrients on a regular basis, they could develop marginal or slight deficiencies. This can lead to pain and tenderness in muscles, joints and bones; weak, fragile bones and teeth; general weakness and delayed muscle coordination; fatigue, irritability, anxiety and an increase risk of bone fractures and teeth cavities. If your child is not reaching these daily levels of nutrient intake at all, then more serious, long term effects can arise such as bone deformities, rickets, osteomalacia, movement disorders, sleep disorders, haemorrhaging and stunted growth. If these deficiencies (even marginal) are not rectified during early development they can lead to problems later in life, such as osteoporosis, arthritis, high blood pressure and heart irregularities.

Q?

My child has been eating a lot of food, does she/he need to take KiddieCal? Will KiddieCal make my child fat/obese?

A.

Eating a lot of food does not necessarily mean they are obtaining their daily nutrient requirements as it depends greatly on the quality of the food rather than quantity. If they are eating a lot of dairy (milk, yogurt and cheese) as well as green vegetables (spinach, brussel sprouts and beans) on a daily basis, then they should not require the supplementation of KiddieCal to reach adequate levels of the vitamins and minerals it contains. However, it also depends on how the food is prepared and cooked, for example; if food is fried, the level of nutrients in food can be reduced by up to 80% (vegetables are best lightly steamed). While many children can eat a lot, it may be difficult getting them to eat dairy and green vegetables (without frying them) to the amount or often enough to reach their recommend daily intake every day. Thus if they are eating a lot of food but not those rich in calcium, phosphorus, vitamin D and K, then they will need KiddieCal (either once or day, or perhaps just on the days they did not have much dairy or green vegetables. When they do take KiddieCal, parents can be assured at least for that day they obtained a sufficient level of nutrients for growing bones. The addition of KiddieCal to a child’s diet, regardless of how much they eat, will not make your child fat or obese. KiddieCal contains vitamins and minerals that are required on a daily basis for our bodies to function and do not contribute to the storage of fats in adipose tissue. What does make children fat or obese is the consumption of food and drinks high in fats and sugar combined with a lack of regular exercise. Whether they do or do not take KiddieCal, it will have no bearing on this outcome.

Q?

What is the standard height for children aged from 1 year to 19 years old?

A.

This data was taken from the WHO multicentre growth reference study, 1997-2003 (n = 8,500 children from Brazil, Ghana, Norway, Oman and USA) [1]. Values represent the median height at that age and are classified as the international standard.

Age (years) Female (cm) Male (cm)
1 74 76
2 86 87
3 95 96
4 103 103
5 109 110
6 115 116
7 121 122
8 127 127
9 133 133
10 139 138
11 145 143
12 151 149
13 156 156
14 160 163
15 162 169
16 163 173
17 163 175
18 163 176
19 163 176

The average height for a Vietnamese male adult (166cm) is 10cm below the international median, while Vietnamese female adults (155cm) are 8cm below the international median [2-3]. In Australia, the height of adult men (175cm) and women (163cm) is similar to the international medians [4]. Height provides an indication of overall physical development, not simply a measure of short and tall individuals. An interesting observation was the literal rise of the Dutch in the 20th century. They went from being one of the shortest in the world (average adult male: 164cm) during the 19th century to being one of the tallest in the world (average adult male currently: 183cm) [5-6]. The Dutch are now well renowned for their work in maternal and paediatric care.

Q?

Can KiddieCal be given to children under 12 months?

A.

During the first 6 months, breast milk and formula should supply enough nutrients for infants to reach their daily requirements without the use of KiddieCal. Whilst infants are getting a regular supply of breast milk, they will not need the addition of KiddieCal. From 6 to 12 months, formula and food intake should also be a sufficient source of nutrients without them taking KiddieCal. However there are some circumstances where infants would benefit from KiddieCal. In scenarios where mothers cannot breastfeed and/or infants have trouble adapting to formula, the child may not receive an adequate amount of vitamins and minerals (in particular, calcium) for bone development on a regular basis. Thus in events like this, KiddieCal may be offered to infants as an alternative way to obtain adequate nutrient levels for bone development. Ideally, KiddieCal should only be considered for use in children under 6 months if they are diagnosed with deficiency problems and levels cannot be rectified by the use of breast milk or formula. After 6 months and closer to 12 months, infants can be given half a capsule per day of KiddieCal on a regular basis, but this would only be recommended if there is concern they are not getting enough calcium, phosphorus, vitamin D and/or K. In cases where every so often, your infant goes through stages or has days where you can’t get them to eat anything or drink their formula, they can take one whole capsule of KiddieCal. But this is their maximum dose, thus it is not recommended that they have one capsule every day (it cannot replace diet), but the dose can be used sporadically when it is obvious daily nutrient requirements are not met. After 12 months, the recommended daily nutrient levels increase and children are able to tolerate higher doses. Therefore, they can be given one capsule of KiddieCal daily on a regular basis. During the first 12 months of life, for many nutrients, it cannot be determined how much they can consume without causing harm. Thus for safety reasons, it is important they do not consume excessive amounts of nutrients. A point must also be made to clarify that there are many other nutrients that infants require for general development. Hence, KiddieCal will only assist in the levels of calcium, phosphorus, vitamin D and K for bone development. If there is concern of your infants overall nutrient intake, KiddieCal cannot replace breast milk or good quality formulas which also contain omega-3 fatty acids, zinc, iron, magnesium, vitamins A, C, E and B-group vitamins etc. In this event, please seek the advice of a healthcare professional.

Q?

Why is KiddieCal any different from other calcium supplements?

A.

There are two main differences between KiddieCal and other calcium supplements. The first is the dosage form. KiddieCal comes in a tasty softgel chewable capsule, making it ideal to administer to young children who can’t swallow. This is a major advantage because it is at this stage of development where bone development is most crucial. Other chewable calcium supplements can also have a chalky texture and taste to them, which make them more difficult to administer to children. The second major difference is that KiddieCal also contains vitamin D and K which increase the absorption and proper distribution of calcium in the body. The calcium in KiddieCal is also bound with phosphorus (calcium hydrogen phosphate anhydrous). The mineralization of these two nutrients forms the majority of bone. While the link of calcium with bone health is well known; the importance of other vitamins and minerals found in KiddieCal should not be underestimated.

Q?

Do you have any other advice for parents of young kids on what they should do to help their kids grow to their potential?

A.

To assist children growing to their potential it is important to create a well-balanced lifestyle. Make sure they have a balanced diet and eat a range of foods such as diary, fruit and vegetables, grains, meat and seafood. Limiting fatty and sugary foods is crucial as well; you don’t have to cut them out completely, just restrict them to occasional foods, eaten only a couple of times a week. Nutrition and a balanced diet however, is only one side of the coin. Filling your children up with the correct nutrients is only of real benefit if they are given the chance to use them. Spending quality time with your children and keeping them stimulated encourages the growth of their bodily systems. Eg. Kick a ball with them and it encourages them to use their brain, eyes, muscles and bones. If they are not given a chance to stimulate their brain or exercise their muscles, they won’t develop. Growth and maturation of the body requires stimulation and experiences. But just like their diet, they need a balance to their lifestyle: nurturing them/giving them independence, educating and learning/letting them relax and play. Too much of one thing can always have a negative impact, it’s that fine balance that allows children to grow to their full potential. Their own interests should be encouraged and not forced upon by family members.

References

  1. World Health Organisation (WHO) The WHO Multicentre Growth Reference Study (MGRS). January 4, 2011; Available from: http://www.who.int/childgrowth/mgrs/en/.
  2. Thanh Nien News, Vietnam aims to increase average height by 2030. 23/11/10. http://www.dztimes.net/post/health/vietnam-aims-to-increase-average-height-by-2030.aspx
  3. Hung, M.V. and S. Pak, The impact of environment on morphological and physical indexes of Vietnamese and South Korean students. VNU Journal of Science, Natural Sciences and Technology, 2008. 24: p. 50-55.
  4. Australian Bureau of Statistics 1995; Available from: http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/Lookup/CA25687100069892CA256889001F4A36/$File/43590_1995.pdf.
  5. Steckel, R.H., HEALTH AND NUTRITION IN THE PREINDUSTRIAL ERA: INSIGHTS FROM A MILLENNIUM OF AVERAGE HEIGHTS IN NORTHERN EUROPE. 2001; Available from: http://www.j-bradford-delong.net/articles_of_the_month/pdf/w8542.pdf.
  6. Centraal Bureau voor de Statistiek 2009; Available from: http://statline.cbs.nl/StatWeb/publication/?DM=SLEN&PA=03799ENG&D1=242-253,255-266&D2=27-44&D3=0&D4=a&LA=EN&HDR=T&STB=G1,G2,G3&VW=T.

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