Should My Child Be Drinking Low-fat Milk?

The science is in: Kids fed low-fat milk aren't in better shape than their whole-milk peers, quite the contrary if anything. Also, Israelis are totally confused, their shopping habits show.

Arnold Slyper
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Israel has a vast range of dairy products, but choosing the low-fat options isn't backed by science.Credit: Kaplan Boroda
Arnold Slyper

Should my child limit dairy fat? Given the spread of obesity, that seems to make sense. Yet surprisingly, the science doesn't support any such conclusion.

Obesity is a major problem throughout the world and is a looming healthcare disaster in America and England. Even in Israel, it's on the rise.

Whole milk is loaded with fat, and fat contains twice as many calories as carbohydrate and protein.Therefore, drinking calorically less-dense low-fat milk should theoretically help prevent obesity. Moreover, the predominant fat in milk is saturated fat, and saturated fat has, according to the conventional wisdom, been linked to cardiovascular disease.

Milk is good, misinformation less so

Most doctors agree that children, and even adults, should drink an "adequate" amount of milk.

Milk is an extremely wholesome and filling food. It contains calcium necessary for bone development. It is fortified with vitamins D and A. American recommendations are that children from ages 2 to 3 years drink two cups a day, two and a half cups a day from ages 4 to 8, and three cups a day from age 9 and onwards, including in adulthood.

But what type of milk? The influential American Board of Pediatrics advises that all children over 2 years of age, and also adolescents, drink either fat-free or low-fat (1%) milk.

The English National Health Service is less categorical, but suggests that children can gradually move to semi-skimmed milk after aged 2, provided they are eating a varied and balanced diet and growing well. Fat-free or 1% milk is not advised until at least five years of age, since it contain insufficient vitamin A, and fat-free milk contains inadequate calories.

Your thighs and creamy milk

What is the truth on this subject? Surprising as it may seem, there is almost no scientific evidence to support low-fat recommendations. All the assumptions about milk mentioned in the first paragraph of this article are untrue.

Consider cardiovascular disease. Researchers have followed large numbers of adults to see how diet influences the development of cardiovascular disease, and almost none have found milk to have a deleterious effect. In fact, in a few of studies it was slightly protective. Some of these studies were performed before low-fat recommendations were made, so that volunteers were drinking only whole milk.

This finding is consistent with more recent studies, including a large meta-analysis recently published in the prestigious medical journal the New England Journal of Medicine, which showed that saturated fat has no influence on risk for heart disease. This study turns current recommendations on their head.

A meta-analysis is a study that combines multiple smaller studies together and analyzes them as one large study, thereby making the conclusion that much more sensitive and reliable.

What about excessive weight gain? Many studies in adults and children have shown that milk protects against excessive weight gain. Pediatric studies have looked specifically at the fat content of milk and many have shown that children who drink low-fat milk are actually heavier than those who do not!

What does this mean? It probably means that children who drink low-fat milk are fatter to begin with. At the very least, it means that low-fat milk is not helpful at all in preventing obesity.

Other interventions would be more useful

Writing in one of the main pediatric journals, two nutritional experts had the following to say about low-fat milk: The recommendation to replace whole milk with reduced-fat milk lacks any evidence basis for weight management or cardiovascular disease prevention

And another scientific article on the subject of low-fat milk concluded: This may mean that efforts towards weight control among overweight/obese preschoolers would be better directed at other interventions with established efficacy.

Does any of this make sense? It actually does.

When kids don't drink enough milk, they are more likely to consume other drinks proven to cause excessive weight gain, such as sweetened soft drinks and excessive amounts of fruit juice. (Even artificially sweetened drinks have proved not to help in weight loss; if anything the truth seems to be the opposite.) This may be an important reason why milk has been found to protect against obesity.

Also, because low-fat milk contains less calories than whole milk, children often compensate for the lower amount of calories by eating more snack foods and other highly-refined carbohydrate, such as sugar-containing low-fiber breakfast cereals. These foods are not filling, and especially when there is a family history of obesity, can lead to over-eating.

This also explains why low-fat diets are often unsuccessful in treating obesity over the long-term, since they easily lead to hunger and inappropriate food intake.

What about low-fat cheese and low-fat yogurt? Unfortunately, there is no scientific data on this. We know that a high-fat diet is not a healthy diet and can promote obesity. So can drinking too much milk. However, for most children it is unlikely that any deleterious effect ensues from eating moderate amounts of dairy fat in any form.

Whether whole milk is more protective against excessive weight gain than low-fat milk is unknown, since the definitive study has yet to be done. It is very clear, however, that whole milk is less fattening than other popular drinks such as sweetened soda and large amounts of fruit juice.

So, keep your child away from too much sugar. It is more fattening than moderate amounts of dairy fat.

Meanwhile, in Israel

Data from Israel, provided to Haaretz by MySupermarket, indicate that Israelis are totally confused on the matter.

On the one hand, 78% of milk sold in this country is whole milk.

However, non-milk dairy sold in Israel, such as cottage cheese and soft white cheese, is predominantly low-fat. Based on MySupermarket's data (July to August 2014), when it comes to soft white cheese, a whopping 92.3% of shoppers buy low-fat (1% to 5% fat), while 6.4% go for the 9% version.

Regarding cottage cheese, a staple on Israeli tables, low-fat again wins hands-down: 92.8% opt for 1% to 5% fat; only 7.2% prefer the 9% to 16% fat version.

Then we come to "cream cheese," or the Israeli variety thereof, where low-fat is not the obvious choice. Yet MySupermarket found that 55.8% of shoppers still went for the lower-fat versions (9% to 16% fat) but here, 40.8% did choose creamier versions (24% fat and up).

It looks very much as if Israelis are hedging their bets on the benefits or otherwise of low-fat dairy!

Dr. Slyper is a pediatric endocrinologist and the author of the book Saving Your Family From Obesity.