The Flavored Milk Conundrum

December 16, 2008

by Jean Saunders, HSC School Wellness Director

Milk
The Chicago Tribune reported recently that concerns over rising childhood obesity rates have led some Illinois school districts to reevaluate the milk they offer on their lunch menus. Changes are happening in both directions. Many school districts find that milk consumption among students increases if flavored milk is offered as part of the meal program. But compared with unflavored milk, flavored milk contains added calories — mostly from added sugar. So while some schools are increasing the number of flavored milk options they offer to students in hopes of increasing milk consumption (and, we can guess, discouraging consumption of other beverages such as soda), other school districts are cutting back on offering flavored milk out of concern for kids' overall calorie consumption, an issue of particular relevance in light of skyrocketing childhood obesity rates.

This is clearly a complicated issue, with no simple answer, and the current federal school food guidelines do not offer any guidance. (Plus, all of this is apart from the debate that has been going on for years about the health pros and cons of consuming milk in general.) Here are what I understand to be some of the considerations for school food service directors, dietitians and other health professionals trying to make this decision:

Children need calcium for development, but many are not getting as much calcium in their diets as recommended by the 2005 Dietary Guidelines for Americans, and this deficiency increases as children get older. Nine of every 10 pre-teen girls fall short of the federally recommended three calcium servings a day, according to the National Health and Nutrition Examination Survey. Milk is a good source of calcium and other nutrients — including potassium, phosphorus, protein, vitamin D, vitamin A, vitamin B12, riboflavin and niacin — that are essential to building strong bones and teeth.

The Dietary Guidelines for Americans recommend that “children and adolescents consume 2 cups per day of fat-free or low-fat milk or equivalent milk products. Children 9 years of age and older should consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.”

The USDA encourages milk consumption in schools by requiring that federally funded school meals include milk and by funding the Special Milk Program, which provides milk to children in schools and child care institutions that do not participate in other federal meal service programs. The USDA does not provide any guidelines, however, on flavored milk.

The National Dairy Council, through its Nutrition Explorations Program makes the argument in favor of flavored milk by saying that studies have found that students who drink flavored milk are more likely to meet their calcium requirements. They also point out that while flavored milk contains more calories than plain milk, it contains fewer calories than other beverages students have access to at school, such as fruit punch and sweetened carbonated beverages.

This means that  school food service directors are left to sort through all of this information and make tough decision about “the lesser of two evils” – the risk that students do not get enough calcium or the risk that students will consume more calories than they should. 

The USDA has asked that the Institute of Medicine bring the guidelines for school meals into alignment with the Dietary Guidelines for Americans. We at HSC encourage the USDA and the Institute of Medicine to move quickly on this work and to help bring clarity to this and other complex school nutrition issues.

We encourage our nation's leading health scientists to help schools make this type of difficult decision.