Got milk in school? Farmers fight health advocates over the creamy ‘whole’ variety

Reviewed by Megan Craig, M.Sc.Jul 13 2023

Amanda Condo works at her family's Pennsylvania dairy farm, but her son often won't drink milk at school. He doesn't like the flavor.

Blame Congress for the absence of full-bodied, creamy whole milk from school cafeterias. In 2010, lawmakers revamped the National School Lunch Program, which led to a whole-milk ban for participating schools two years later. The goal was to reduce childhood obesity.

Now, lobbyists for the milk industry are pushing to bring it back. And their campaign is supported by a bipartisan House effort and a growing number of studies that call into question long-held beliefs about the negative health effects of whole milk.

The dairy industry is also trying to stave off a Department of Agriculture proposal to ban in middle and elementary schools the type of milk that kids like best: flavored milk, often chocolate, be it low-fat or skim.

America's milk producers worry about the type of milk schools serve, amid a decades-long decline in milk sales. New competition from oat, soy, and almond milk is taking an increasing share of the beverage market from cow's milk.

In June, the Republican-controlled House Committee on Education & the Workforce advanced a bill that would restore the ability of schools in the program to serve whole and 2% milk, an override of USDA guidelines. The bill's lead sponsor, Rep. Glenn "GT" Thompson (R-Pa.), who chairs the powerful House Agriculture Committee, considers milk a top issue, and not just because Pennsylvania is a leading dairy producer.

Thompson's bill would bypass a USDA and Department of Health and Human Services advisory committee made up of health experts that determines U.S. dietary guidelines, which in turn determine what schools serve.

Thompson and the milk lobby are concerned about milk consumption in school because if kids don't like the taste of lower-fat milk offered in the cafeteria, they are less likely to ask their parents to buy milk or to buy it themselves when they become adults. Instead of milk, they may drink soda and other high-sugar drinks, Thompson said.

Schools, which buy about 8% of milk, have not served whole milk for over a decade, yet the 3.25% fat milk is still the most common type of milk sold in the United States. Americans still buy about four times as much whole and 2% milk as they do skim and 1%, according to National Milk Producers Federation data from IRI, a market data firm.

Health advocacy organizations such as the American Heart Association and the Center for Science in the Public Interest oppose the bill, arguing that whole milk is bad for children's health and that decisions on the foods and drinks schools serve should be made by health experts, not Congress.

A growing number of studies published in recent years challenge the decades-long belief that whole milk contributes to childhood obesity. Much of that research was funded by the dairy industry.

Yet, a top researcher not funded by the dairy industry says his studies and those by others prove whole milk is not as bad for health as once thought and might even be healthier than lower-fat kinds of milk.

"The research is quite consistent: There is very little evidence that whole-fat dairy is worse for your health than reduced-fat dairy, and there is some evidence it may be better," said Dariush Mozaffarian, a cardiologist and nutrition professor at Tufts University in Massachusetts.

He pointed to a 2020 study published in The American Journal of Clinical Nutrition that analyzed 28 other studies that compared children who drank whole milk with those who drank milk with 2% fat or less. That analysis found that, in 18 of the studies, higher milk-fat consumption was associated with lower child obesity, while 10 studies found no association with obesity levels. Combining the data from these studies, the researchers found the risk for being overweight or obese was reduced 40% among the kids who drank whole milk, and the risk for obesity declined as whole milk consumption increased.

The idea that whole milk can be as good for health as skim or low-fat milk may sound counterintuitive, said Mozaffarian. He said that when people skip fat, "what happens in the real world is people compensate for the change and increase their starch and sugar intake." Another benefit of whole milk: The saturated fat in dairy foods is not the same as the fat in meat and other foods, he said.

But other health experts disagree, and there appears to be little consensus on the health risks of whole milk.

The Center for Science in the Public Interest said congressional efforts to restore whole milk in school put "Big Dairy" over children's health. "Congress should not be reversing this hard-fought win by making school meals less healthy by allowing whole milk," said Meghan Maroney, a campaign manager with the food safety and nutrition-labeling advocacy group.

Eduardo Sanchez, the American Heart Association's chief medical officer for prevention, said the preponderance of the scientific data shows whole milk is worse than low-fat milk at reducing the risk of heart problems and obesity.

The association supports a USDA proposal to ban flavored milk in elementary and middle schools.

Mozaffarian agrees that flavored milk should be banned because of the higher sugar content. He doesn't buy the argument that chocolate milk is better for kids than no milk at all. "Adding sugar to milk is not a way to make it healthy for kids," he said. "If you are worried about getting kids to drink more milk, bring back whole." Chocolate milk contains as much as 24 grams of added sugar in a serving of 250 grams, or 1 cup — about half the sugar in the same amount of Sprite. The USDA is recommending cutting that to 10 grams.

Amy Reed, a spokesperson for the Academy of Nutrition and Dietetics, an advocacy group for dietitians, finds a middle ground among the conflicting opinions. For most children, she said, low-fat milk is their healthiest option, but drinking whole milk is acceptable "as long as they do not eat excess saturated fat in other ways and it is included as part of an overall healthy dietary pattern."

The academy favors the USDA keeping flavored fat-free and low-fat milk in all schools, saying eliminating those options would lead to a decline in milk consumption. It says the decision to bring whole milk back to schools should be guided by national dietary guidelines, which are revised every five years by nutrition experts.

The American Academy of Pediatrics and the Center for Science in the Public Interest don't oppose the serving of flavored low-fat milk in school, noting how milk producers have already begun to reduce the sugar in these products in schools ahead of the USDA plan.

Industry observers expect the USDA to issue its final rule on flavored milk by early next year.

Meanwhile, back on the farm in Mill Hall, Pennsylvania, Condo said her son wants the option to drink chocolate milk at school. "I feel like milk is getting all the blame for childhood obesity while they are getting so much fat and sugar from other places. I feel parents should look at the amount of Mountain Dew their kids get."