Eliminating chocolate and other flavored milks from school cafeteria menus resulted in a dramatic drop in milk consumption along with a substantial reduction in nutrients – which are not easy or affordable to replace, according to a new study presented at the School Nutrition Association's Annual National Conference.
The largest of its kind to date, the study included nearly 700 measurement days over three months at 58 elementary and secondary schools across the country. It found that when lowfat flavored milk was not available in school cafeterias, many children chose not to drink milk and missed out on the essential nutrients that milk provides. On days when only white milk was offered, milk consumption dropped an average of 35%, with some schools experiencing a decline of more than 50%. The study also revealed that milk consumption stayed down in schools that were in their second year of eliminating or restricting flavored milks.
"When flavored milk was not an option, many children wouldn't take the white milk or if they did, they frequently threw it away," said Linda Stoll, MPH, executive director of food services at Jeffco Public Schools in Jefferson County, Colo., which participated in the study. "It was tragic to see all the nutrients go down the drain."
The researchers estimate that this decline in consumption translates to an alarming drop in nutrients – including calcium, vitamins A and D, potassium, magnesium and protein. This includes three of the four "shortfall nutrients" the 2010 Dietary Guidelines Advisory Committee has said both adults and children need to consume more of: vitamin D, calcium and potassium. The researchers concluded it would require up to four different foods to match the nutrient contributions of milk, yet these foods would add back more calories and fat and cost up to $4,500 more annually per 100 students.
Conducted by Prime Consulting Group and funded by the Milk Processor Education Program, the study analyzed the impact of changing the availability of flavored milk in schools on children's milk consumption and intakes of key nutrients in seven school districts across the country that had made decisions to either eliminate flavored milks, or limit the days they were offered. While the findings reinforced previous research that showed restricting flavored milk reduced overall milk consumption*, this was the first study to examine the amount of milk taken by students and then measure the actual quantity of milk discarded to estimate the nutrients lost.
Nutrients Down the Drain
All seven school districts experienced a decline in milk consumption when flavors were not available. Overall, milk consumption dropped an average of 35%. Two districts found that milk consumption dropped by an average of 43% when only white milk was offered. In addition, five of the individual schools participating in the study saw consumption drop by more than 50%.
The study also revealed that the drop in consumption did not recover over a year's time. Even the 40 schools that were in their second year of a limited- or no-flavors policy did not see students moving to white milk. On average, students at these schools drank 37% less milk compared to when they had flavored milk available every school day.
"It's important for parents and school professionals to recognize the implications of removing chocolate milk from school meals," said Rachel K. Johnson, PhD, RD, a professor of nutrition at the University of Vermont who reviewed the study and provided consultation on the impact of the flavored milk changes on the children's nutrient intakes. "As the study demonstrated, there could be well-meaning but negative consequences of limiting the availability of flavored milks."
The results indicate that the essential nutrients lost from the decline of milk consumption with the elimination of flavors are substantial and are not easily replaced by other foods. For a first grader, the drop in milk consumption equates to an average loss in daily nutrients of about 10% of their recommended daily calcium, protein and vitamin A, and about 15% loss of vitamin D and phosphorus.
"Milk ranks among the top sources of calcium, vitamin D, protein, potassium, magnesium, phosphorus and vitamin A," Johnson said. "Schools would need to re-plan their menus to ensure they deliver the important nutrients that are lost due to reduced milk consumption."
"It seems clear to me that there are far better ways to trim calories and added sugars from the menu than removing chocolate milk, which makes so many positive contributions to children's diets," Stoll said. "Chocolate milk is just as nutrient-rich as white milk, and if it helps children drink more milk, then that's a positive strategy."
Nearly 70% of the milk children choose to drink in school is flavored, which offers the same nine essential nutrients as white milk. The majority of milk offered in schools, both white and flavored, is lowfat or fat-free.
A Nutrient-Rich Option
The nation's leading health and nutrition organizations and the Dietary Guidelines for Americans recognize the valuable role that milk, including flavored milk, can play in meeting daily nutrient needs. In addition, they recognize the small amount of added sugars in flavored milk is an acceptable trade-off for the nutrients provided.
Stoll said it's unfair to try to compare the sugar content of flavored milk and other sugar-sweetened beverages like soft drinks because milk is such a nutrient-rich beverage that supplies protein, calcium and so many of the other vitamins and minerals that kids need.
Additionally, studies show that children who drink flavored milk drink more milk overall, have better quality diets, do not have higher intakes of sugar, fat or calories, and are more likely to be at a healthy weight compared to kids who drink little or no milk (2–4)
"I think it comes down to the importance of offering a choice," Stoll said. "We have a lot of kids – and the study showed it – who won't drink white milk. If chocolate or flavored milk is what they want, to me, that is far preferable to no milk. It is a cost-effective way to provide essential nutrients they may not be getting elsewhere."
Recognizing that many schools want to reduce the sugar content in all their menu offerings, more than 90 industry-partner milk companies across the U.S. have proactively reformulated flavored milk to lower its added sugars, fat and total calories, while preserving its nutritional value. These new products aim for 150 calories and less than 25 grams of sugar per 8-ounce serving, while striving to provide a product with a taste students will accept so they will continue to choose and enjoy drinking nutrient-rich flavored milk.
About the In-School Study
Conducted by Prime Consulting Group and funded by the Milk Processor Education Program, the study analyzed milk consumption in 58 elementary and secondary schools in seven school districts across the country that had made decisions to either eliminate chocolate and other flavored milks, or limit the days they were offered. The participants monitored the amount of milk selected and measured "plate waste" (the amount of milk thrown away) to calculate the ounces of milk consumed or wasted. The study included a total of nearly 700 observation days over a three-month period. Prime Consulting Group worked with nutrition and school food service professionals to calculate the nutrients lost by the decline in milk consumption and the menu changes required to make up for the lost nutrients.
About the Milk Processor Education Program
The Milk Processor Education Program (MilkPEP), Washington, D.C., is funded by the nation's milk processors, who are committed to increasing fluid milk consumption. The National Fluid Milk Processor Promotion Board, through MilkPEP, runs the National Milk Mustache "got milk?®" Campaign, a multi-faceted campaign designed to educate consumers about the health benefits of milk. For more information, go to www.whymilk.com. Deutsch, A Lowe and Partners Company, is the creative agency for the National Milk Mustache "got milk?®" Campaign.
* Patterson J, Saidel M. The removal of flavored milk in schools results in a reduction in total milk purchases in all grades, K-12. J Am Diet Assoc. 2009; 109,(9): A97.2. 2. Johnson RK, Frary C, Wang MQ. The nutritional consequences of flavored milk consumption by school-aged children and adolescents in the United States. J Am Diet Assoc. 2002; 102(6):853-856. 3. Frary CD, Johnson RK, Wang MQ. Children and adolescents' choices of foods and beverages high in added sugars are associated with intakes of key nutrients and food groups. J Adolesc Health 2004; 34(1):56-63. 4. Murphy MM, Douglas JS, Johnson RK,Spence LA. Drinking flavored or plain milk is positively associated with nutrient intake and is not associated with adverse effects on weight status in U.S. children and adolescents. J Am Diet Assoc. 2008; 108:631-639.