At National Dairy Council we are frequently asked by health and wellness professionals and parents what type of milk children should drink for good health. Should they drink only low-fat or fat-free milk, or is 2 percent or whole milk sometimes okay? We generally respond with current recommendations from the Dietary Guidelines, then direct parents to consult their child’s pediatrician for personalized care.
For example, the American Academy of Pediatrics (AAP) recently published guidance for pediatricians in their updated clinical report, Optimizing Bone Health in Children and Adolescents. To optimize bone mass development in youth, the report encourages increased dietary consumption of calcium- and vitamin D-containing foods and beverages to meet daily requirements. It suggests that pediatricians recommend two to three servings of milk, yogurt, or cheese per day for children ages 4 to 8 years and four servings for adolescents. It mentions that low-fat dairy foods, such as fat-free milk and low-fat yogurts are good sources of calcium.
The guidance in the AAP report was not meant to indicate an exclusive course of treatment; however, it recognizes that pediatricians must take individual circumstances into account when caring for a patient. As health and wellness practitioners, you also recognize the importance of individualizing dietary advice. You know that each child is unique and should be given a customized plan to address his/her growth pattern, taste and health needs. Is the child overweight or underweight? Are they a picky eater, or do they always clean their plate? Do they get outside to play every day, or do they spend most of their time inside and inactive? Do they drink soda and other sugar-sweetened drinks – or eat nutrient-poor snacks?
Counseling a parent of an overweight child to switch from whole milk to low-fat or fat-free milk may seem like an easy way to help maintain a healthy weight. But is it the most effective? Prospective studies in young children and adolescents observed the same or greater rates of weight gain with consumption of low-fat/fat-free milk compared with 2 percent or whole milk – suggesting that factors other than the type of milk consumed may be more important.
For example, a longitudinal cohort study among more than 10,000 young children between the ages or two and four published last year, found that consumption of low-fat and fat-free milk was associated with increased risk of overweight and/or obesity. This result potentially reflects the choice of parents to give overweight/obese children low-fat milk to drink, the authors acknowledge. Nevertheless, drinking low-fat or fat-free milk did not appear to slow body weight gain between two and four years of age. The authors say practitioners should reconsider using low-fat and fat-free milk consumption as the sole way to restrain weight gain in preschoolers. Instead, they should incorporate other strategies shown to be effective, such as decreased television viewing, increased physical activity, and reduced consumption of sugar-sweetened beverages that provide excess calories and few essential nutrients.
As you work with parents and pediatricians to provide individualized nutritional care for young children, you can help encourage drinking milk to help ensure they continue to meet dairy recommendations and goals for bone health as they grow. I welcome your comments.