With Labor Day almost upon us, the annual debate on banning flavored milk in schools has hit the airwaves. Simple as it may seem, milk is a lightning rod for controversy. How did milk get so complicated? And what does scientific research offer by way of answers?
At the heart of the controversy over flavored milk in school is this question: Is drinking sweetened milk better than drinking less total milk overall for kids who reject the plain white stuff? And are kids who drink flavored milk more likely to become obese? Research is mixed, and interpreting it is likely complicated by a presumed publication bias stemming from the fact that most milk research is sponsored by the dairy industry. Nonetheless, here's what I can glean:
In terms of added sugar, research from multiple sources suggests that flavored milk contributes only a minor percentage of it (less than 5 percent) to kids' diets. On average, American children today eat about 113 more calories per day than they did in the late 1970s, and these increases are not being driven by milk and dairy. In fact, national data show that milk consumption has been declining among children for the past several decades – the same time period over which childhood obesity has been increasing – whereas consumption of high-fat and salty snacks, cookies, candy and sweet beverages like juice, fruit drinks and sports drinks is up. As sugary beverages crowd out milk as kids' drink of choice, the contribution of flavored milk to obesity appears largely overstated.
[Read Is Dairy Healthy or Not?]
Indeed, a 2008 study published in the Journal of the American Dietetic Association (funded by the National Dairy Council) showed that among a cohort of 7,557 children and adolescents, those who consumed flavored milk did not have a higher body mass index (BMI) than children who didn't drink flavored milk. Furthermore, total intakes of added sugar did not differ between the two groups.
In other words, in the absence of flavored milk, those extra calories and sugar found other inroads into kids' diets. However, those who drank no milk at all had significantly lower amounts of calcium, potassium, magnesium, phosphorous and vitamin A in their diets. This suggests that if kids aren't drinking milk – sweetened or otherwise – they aren't likely replacing it with other nutritious foods and beverages.
A 2002 study of about 3,900 children and adolescents (also funded by the National Dairy Council) similarly found no difference in added sugar content between the diets of kids who drank flavored milk and those who did not.
Still, these studies aren't proof-positive that flavored milk is benign. A recent study of 2,270 children conducted in England, for example, showed that overweight children who drank flavored milk at age 10 lost less of their body fat as they grew into adolescence than those who didn't drink flavored milk.
Clearly, more research is needed to parse out the nature of flavored milk's role in children's diets and obesity risk. But based on currently available research, I'm hard-pressed to find much evidence that flavored school milk has contributed to the rise in childhood obesity rates since the late 1970s in any meaningful way.
Meanwhile, as the controversy rages on, the dairy industry has proposed reducing sugar in flavored milk … by replacing it with calorie-free sweeteners such as aspartame and stevia. (Sigh.) To do this, they've asked the U.S. Food and Drug Administration to change the standards of what can be called simply "milk." Currently, a dairy product containing calorie-free sweeteners must be labeled as "reduced-calorie" or something similar to proclaim the alteration of its nutrient content.
Two major dairy industry groups have petitioned to allow any FDA-approved sweetener to be added to various dairy products without the nutrient claim to help bolster the appeal of lower-calorie flavored milk to children. The argument is that kids don't like to see words like "low-calorie" on the things they eat.
This raises several issues. Is aspartame safe enough for kids that it's appropriate to serve in school milk? And do families really need to be shielded from the fact that their chocolate milk might have fewer calories, thanks to a sweetener swap?
The biggest issue, though, is a parent's right to know what's in their child's food (and drink). Sensitivities to artificial food additives are widely documented – from attention deficit symptoms associated with food dyes to headaches associated with aspartame. Furthermore, research has raised the possibility that artificial sweeteners could contribute to obesity by reinforcing a high threshold for sweet flavors in order to feel satiated.
Food manufacturers will bury the debate in piles of data citing the safety record of aspartame, but there are plenty of compelling reasons why parents would still choose to avoid serving it to their kids. They have a right to do so and, therefore, a right to know what's in their child's school milk.
While manufacturers would still be required to list which sweeteners they use, kids and parents would have to read the fine print under the nutrition facts label to find out. If the dairy industry gets its way, a standard carton of chocolate milk can be sweetened with whatever the manufacturer chooses.
And so, the debate rages on.
Here's my advice for parents caught in the school milk crossfire: Don't let the flavored milk circus divert your attention from the primary sources of sugar in your kid's diet – both hidden and overt. Because even if your school district bans flavored milk, an average of 21 teaspoons of added sugar is finding its way into your 4- to 8-year-old's mouth every day. That number goes up to roughly 30 teaspoons or more if you've got a teenage son. (By way of context, an 8-ounce carton of low-fat chocolate milk has about 4 teaspoons of added sugar).
Substantial amounts of sugar are hidden in "whole-grain" breakfast cereals, fruit snacks, yogurt and pasta sauce … to say nothing of the obvious sources like cookies, candy, cakes, ice cream, soda, fruit drinks and sports drinks.
Of course, plain white milk is a preferable alternative to sweetened milks. And it's hard to find fault with efforts to decrease our children's intake of added sugars. But with regards to childhood obesity, I have met the enemy … and it's not chocolate milk.
[Read: Debunking Common Nutrition Myths.]
Michelle Truong-Leikauf, a dietetic intern and master's degree candidate at Columbia University Teacher's College in New York City, contributed to this article.
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Tamara Duker Freuman, MS, RD, CDN, is a NYC-based registered dietitian whose clinical practice specializes in digestive disorders, Celiac Disease, and food intolerances. Her personal blog, www.tamaraduker.com, focuses on healthy eating and gluten-free living.