Position on Institute of Medicine (IOM) Recommended Nutrition Standards for Schools
International Dairy Foods Association, May 2007
The IOM proposed standards recognize the central role lowfat and fat-free milk and milk products play in good nutrition for kids and teens. The standards also rightly seek to reduce student access to high-calorie foods of low nutritional value. However, the standards are more restrictive than the U.S. Dietary Guidelines, and, if adopted as written, could inadvertently reduce dairy consumption among students and hinder federal nutrition goals for children and teens. 1. Efforts to restrict high-calorie foods of minimal nutritional value are warranted in the face of obesity, overweight, and the need to create lifelong eating habits. The IOM report rightly recognizes that milk and milk products are part of the solution.
The proposed IOM standards take a positive step in attempting to reduce the number of high-calorie foods of minimal nutritional value marketed to kids in schools in places other than the school lunch line. The report rightly suggests limiting foods of minimal nutritional value and promoting consumption of fat-free and lowfat milk and dairy products.
The report states that "if competitive foods are available, they should consist of nutritious fruits, vegetables, whole grains and nonfat or lowfat milk and dairy products, consistent with the 2005 Dietary Guidelines for Americans, to help children and adolescents develop healthful lifelong eating patterns."
2. Milk and milk products play a central role in the nutrition of our children and teens.
Milk has long set the gold standard in school nutrition due to its natural nutrient package. Leading pediatric and nutrition groups have voiced concern about the encroachment of soft drinks and other nutrient-void foods and beverages on milk and dairy consumption among children and teens.
Milk and dairy products provide more than 70% of the calcium in the American diet. The Dietary Guidelines recommend that children age 9 and older consume three servings of lowfat or fat-free milk or dairy products a day — and dairy products in schools are a cornerstone of that goal.
The Dietary Guidelines state that "consuming three servings of milk and milk products each day can reduce the risk of low bone mass and contribute important amounts of many nutrients. Furthermore, this amount of milk product consumption may have additional benefits and is not associated with increased body weight
Milk is the number one source of protein, calcium, potassium, phosphorus, magnesium, vitamin A and vitamin B-12 in American kids' diets. Milk is among the top four food sources of folate, thiamin, vitamin B-6 and zinc for both children and teens.
Flavored milk has been particularly valuable in nutrition efforts. About 70% of all milk consumed in schools is flavored milk. Studies suggest that children who drink flavored milk are more likely to meet daily calcium recommendations than those who don't, without increasing total added sugars or fat.
The Child Nutrition Act recently reinforced milk's place as the preferred school beverage and gave schools the ability to offer milk "anytime, anywhere", pushing back on soft drink exclusivity contracts that prevented schools from offering milk outside the lunch line.
The dairy industry continues to work with school nutrition professionals to help increase the availability and appeal of milk and dairy products in schools across the country.
3. While the IOM states that it wants to make recommendations consistent with the U.S. Dietary Guidelines, its proposed standards are more restrictive than the Dietary Guidelines and could exclude important milk products, including most yogurts and flavored milks.
The IOM standards propose specific limits to the amounts of fats, salt, sugar and calories in each serving of food, but do so regardless of the offsetting nutritional benefits of that food. Milk and dairy products — and particularly flavored milk — are key providers of nutrients to school-aged children. Recognizing the importance of dairy, the standards include very limited exceptions for flavored fat-free and lowfat milk and yogurt. But the exceptions provided are inadequate for most of these products. Such an approach deviates from the intent of the Dietary Guidelines.
Products that would be prohibited under the proposed standards include most lowfat and fat-free flavored milks available in the marketplace, as well as many yogurt products, yogurt drinks and smoothies — even lowfat and fat-free varieties.
Despite its nutrient density, virtually all cheese products — including reduced-fat versions — and most ingredient usage of cheese would be eliminated. The Dietary Guidelines give special focus to the concern that many Americans consume too many calories and not enough nutrients. The guidelines recommend nutrient-dense foods like dairy, but also acknowledge the challenge faced by parents and school foodservice directors in increasing healthy eating habits: namely, taste and palatability.
The guidelines recognize that "sugars can improve the palatability of foods and beverages that otherwise might not be consumed. This may explain why consumption of sweetened dairy foods and beverages and pre-sweetened cereals is positively associated with children's and adolescents' nutrient intake."
The Dietary Guidelines note that "choosing a variety of foods within the dairy food group was strongly associated with improved nutrient adequacy." IOM's proposed standards would limit the variety of dairy choices, negatively impacting students' nutrient intake.
4. Limiting Choice in Dairy Products Leads to Less Dairy Consumption
In a recent pilot program in New York City, removing flavored milk from school lunch rooms led to disastrous results. Nationally, flavored milk accounts for more than 70% of all school milk. When the New York City health department decided to severely limit flavored milk sales in a group of "test" schools, overall milk consumption for NYC schools declined by 10%-15%. Local reports suggest that in the test schools, milk consumption dropped by as much as 50%, which certainly negatively impacted the students' nutrient intake.
5. Excluding Non-Nutritive Sweeteners Also Severely Limits Dairy Choices
The IOM's recommendation to exclude the use of non-nutritive sweeteners will limit the ability to offer nutrient-dense, lower-calorie milk and dairy products that are palatable for school age children.
While the U.S. Food and Drug Administration (FDA) has confirmed the safety of a number of non-nutritive sweeteners, the proposed standards limit their use to foods and beverages sold at high schools after the end of the day.
Ironically, it appears that part of the IOM committee's intent in excluding these sweeteners was to steer students toward dairy, not away from it: "There is some evidence that non-nutritive sweeteners in beverages specifically are an effective weight management tool; however, because they have been shown to displace milk and 100% juice when they are chosen at mealtimes, these competitive beverages should be allowed only in high schools, and only after the school day has ended."
Unfortunately, the IOM's approach will also limit choices in flavored milks, many lower-calorie yogurts and other dairy products. Permitting non-nutritive sweeteners in nutrient-dense foods like flavored milk and yogurt would provide students with dairy choices that are lower in sugar and have fewer calories, but are high in nutrients.
6. It Can Be Dangerous to Restrict Diet Based Solely on Individual Food Profiles
The Dietary Guidelines are meant to be applied to a diet as a whole and to encourage Americans to adopt healthier eating patterns. The guidelines are not meant to be applied to individual foods, but to overall food choices over a period of time. Otherwise, many healthy foods would be eliminated from the diet, and the variety of foods consumed would be greatly limited, negatively impacting the nutritional adequacy of the American diet.
It would be beneficial to consider the new IOM standards in this same light, considering how foods fit into a total diet, and allowing for more variety in nutrient-dense foods and beverages such as milk, flavored milks, yogurts and other dairy products.
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Posted May 21, 2007