When British celebrity chef Jamie Oliver visited an elementary school in America's "fattest" city, Huntington, W.Va., he saw the children tossing out fresh fruit in favor of processed chicken nuggets and chowing down on egg pizza for breakfast. But it was the sugar-laden chocolate milk that would stick in his mind, as he recounted this year in a speech he gave when receiving a TED Prize. "It epitomizes the trouble we're in, guys," said the star of ABC's "Food Revolution," a show that promoted healthy eating in public schools. "In that [milk] is nearly as much sugar as your favorite cans of fizzy pop."
As schools have gradually been eliminating soda machines from their cafeterias to battle childhood obesity, a growing chorus of food activists has shifted its focus to chocolate- and strawberry-flavored milks, which account for more than 70% of school milk consumption.
The U.S. Department of Agriculture's food pyramid recommends that children consume 2 to 3 cups of dairy products per day to maintain calcium levels, thought to be important for growing bones, along with adequate levels of magnesium, potassium and phosphorous. Although the pyramid endorses both plain or flavored milks, the 100 to 200 calories of added sugar per day from sweetened milk are nearly all the added sugar a child should have that day. That means no cookies. No ice cream. No after-school soft drinks. We all know how likely that is.
The National Dairy Council has launched an aggressive public relations campaign, Raise Your Hand for Chocolate Milk, to keep flavored milk in schools. Pediatricians, public health experts and school administrators are divided as to whether the nutritional benefits of flavored milks outweigh their sugary downside.
Read on for two competing views on the topic.
Chocolate milk is better than no milk at all
Rachel Johnson is a dietitian at the University of Vermont in Burlington whose research has been funded by the National Dairy Council.
I definitely support having milk in school meals, including flavored milk. What we need to do is find the lowest-fat and lowest-added-sugar milk that children will readily accept and consume.
Milk is not only a source for calcium and Vitamin D, but for several nutrients that are in limited supply in a child's diet, including potassium and magnesium. Our research has shown that only children who consume milk during lunch come close to meeting their calcium requirements. A study by the Milk Processor Education Program found that there was a 35% drop in milk consumption when flavored milk was eliminated or limited to certain days of the week.
When children don't drink flavored milk, they are substituting it with other sugary beverages, including sodas and sweetened fruit drinks, so they aren't getting any less added sugar, but they are getting a lot less essential nutrients. When we looked at the impact of flavored and plain milk on the body mass index in 7,557 children, we found that flavored milk was not associated with any adverse effects.
If you are going to eliminate flavored milk and milk consumption is going to drop by so much, you are going to have to think about re-planning the whole school menu so you add those nutrients back. We did some nutrition modeling, and what we found is, to meet the daily dietary needs, you end up adding back more calories and more fat than were reduced by removing flavored milk.
Childhood obesity is the No. 1 health issue our nation is facing, and we need to make evidence-based changes that are going to have a positive impact without having unintended consequences.
Keep flavored milks out of cafeterias
Marlene Schwartz is a psychologist and deputy director of the Rudd Center for Food Policy and Obesity at Yale University.
Flavored milk is fine as an occasional treat, but I don't think it should be served every day at home or at school. I have three children, and they do have chocolate milk sometimes when we go out to dinner, but at home and school, they have plain milk.
We know that American children consume too much added sugar, and much of this comes from sugar-sweetened sodas. But that doesn't means that the sugar added to otherwise healthy products like milk or breakfast cereal should be ignored. In the Johnson study, it's important to note that among the 3- to 5-year-olds, those that consume flavored milk had higher intakes of added sugar than those that did not. We have data from preschools in Connecticut that serve only white milk, and the children happily drink plenty of it. I would hypothesize that by providing flavored milk to young children you are likely training them to prefer — and eventually overconsume — sugar-sweetened beverages.
Rather than working to decrease the amount of added sugar in flavored milk, the dairy industry seems more interested in funding studies to convince parents and food service directors that kids won't drink plain milk. The data from the study that showed a 35% drop in milk consumption when there was no flavored milk in school lunches are unconvincing to me, because most of their observations came from school districts that sold white milk every day and only offered flavored milk on certain days each week. I am not surprised that more children purchased the flavored milk when it was offered. You would find the same thing if on some days you offered plain strawberries and on other days you offered chocolate-covered strawberries. Does that mean we should always offer chocolate-covered fruit to make sure that children get enough nutrients?
It's important to look at the big picture. This debate is not just about flavored milk; it's about flavoring everything that's marketed to children. People seem to think that for children to eat yogurt, it has to be neon-colored, and for children to eat cereal, it has to include marshmallows, cookies or candy pieces. A little bit of added sugar in the diet is fine, but what people need to realize is that if you use it all up in your milk and your cereal, you won't have any left for dessert.