United States President Donald Trump recently signed bipartisan legislation allowing school cafeterias to serve whole milk and 2% milk – another step toward fulfilling the administration’s promise to “end the war” on saturated fats.
The move is the latest chapter in a long debate about whether milk fat is helpful or harmful for children.
Since 2012, any school that participates in the National School Lunch Program, which offers federal funding for meals, has served only nonfat or 1% milk to reduce children’s risk of obesity and cardiovascular disease.
Recently, Health Secretary Robert F. Kennedy Jr. and members of his “Make America Healthy Again” movement have championed whole milk; new federal dietary guidelines released recently encourage Americans to drink more of it.
Representatives for the dairy industry, who lobbied for the change, and the legislators who voted for it say that there’s no evidence that whole milk is harmful to children’s health.
Some children may prefer higher-fat milk, so allowing it to be served in schools could encourage them to drink more of it – increasing children’s consumption of the nutrients it provides.
But it’s not clear if bringing whole milk back to schools will improve children’s health, nutrition experts said.
The debate around milk
There’s no question that milk provides essential nutrients, and for that reason health organisations have recommended that children ages five to eight consume up to 2.5 cups of milk per day, and those ages nine and older consume up to three cups per day.
But health experts and legislators have disagreed about which types to promote.
Since 1990, federal dietary guidelines have suggested that children age two and older should consume skim or low-fat milk to limit their consumption of saturated fats.
Several health organisations, including the American Academy of Pediatrics and the American Heart Association, have supported that advice.
Megan Lott, a registered dietitian at Duke University and the deputy director for Healthy Eating Research, an organisation that helped develop guidelines from health organisations on what school-age children should drink, said that lower-fat options contain the same amount of essential nutrients – like protein, calcium, potassium and vitamin D – as higher-fat milks, but with fewer calories and less saturated fat.
Consuming too much saturated fat can raise cholesterol levels and, over time, increase the risk of cardiovascular disease, research suggests. And consuming excess calories could contribute to weight gain in children, Lott said.
One cup of whole milk has 80% more calories than nonfat milk; it contains 4.5g of saturated fat, whereas nonfat milk contains only trace amounts.
The new change to the school lunch programme stipulates that the saturated fat in milk will not count toward the current limits on the fats served in schools.
That “leaves even more room for excess saturated fat,” the Center for Science and the Public Interest, a food and health watchdog group that opposed the amendment, said in a statement.
Already, 75% to 85% of US children consume more than the recommended amount of saturated fat, the organisation added.
“We certainly don’t want kids to get an overwhelming amount of saturated fat,” said Dr Steven Abrams, a professor of paediatrics at the University of Texas at Austin Dell Medical School, who was not involved with the new legislation.
But he supports the law, he said, in part because there is not good evidence that drinking whole milk leads to obesity or worsens the health of children with a healthy weight, despite its saturated fat content.
In fact, some studies have found the opposite. In a 2020 review, researchers found that children who consumed whole milk were less likely to be overweight or obese than children who drank lower-fat options. Limited research also suggests that the type of milk children drink appears to have little effect on their blood pressure or blood cholesterol levels.
Most of the research has been observational, meaning it cannot show cause and effect, and many of the studies did not fully account for other aspects of the children’s diets or health.
But in two small clinical trials performed in Australia, researchers found that children who drank whole milk for three months did not gain more weight than children who drank lower-fat milks.
There are several larger and ongoing clinical trials in the United States and Canada comparing the effects of whole milk with lower-fat options on children’s health. Lott said she hoped they would help settle this debate.
What type is best?
The best type of milk for a child depends on his or her health. If your child is older than two and is significantly overweight, “then the calories matter,” and nonfat or 1% milk might be a better choice, Abrams said.
But for most children, he said, any type of unsweetened, pasteurised milk is fine. (Children should never consume unpasteurised or raw milk, he added, because doing so carries a risk of foodborne illness.)
Higher-fat milk might be better for a child who is underweight, Lott said. A paediatrician or dietitian can offer individualised advice, she added.
Milk consumption among US children has dropped significantly in recent decades, and they have been drinking more soda, sports drinks and other sweetened beverages instead, Abrams said.
That’s a concern, he added, because milk is an important source of calcium, vitamin D and protein. If allowing whole milk in schools leads to children drinking more milk, that could improve their health, he said.
But Lott lamented that the new legislation would have done more to improve children’s health if it had eliminated flavoured milks from schools, since they contribute to excess added sugars in children’s diets. Such a change would be backed by better evidence, she said.
