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Grand Prairie, TX – September 12, 2008 – Today, the U.S. Department of Agriculture (USDA) issued new regulations on beverages that can be substituted for milk in the National School Meal Programs for children who are unable to consume cow’s milk because of medical or special dietary reasons. Since the 1940s fluid milk has played a central role in U.S. child nutrition programs ⁽¹⁾ and this most recent announcement reinforces milk’s vital role in children’s health due to its unique nutrient package.

The new regulations require that a beverage served as a substitute for cow’s milk must provide specific levels of calcium, protein, vitamins A and D, magnesium, phosphorus, potassium, riboflavin and vitamin B-12 in order to better match up to milk’s unique nutrient package. Other than these tighter nutrition standards and additional flexibility in paperwork requirements, the new regulations are similar to longstanding practice and do not permit general substitution of any beverage for milk, which is still required by law to be offered with each school meal. If a school decides to offer substitute beverages, the new rule notes that the schools will be responsible for determining which beverage will be substituted and will be accountable for any additional costs.

Health professionals continue to recognize the importance of dairy in the diets of all children. The 2005 Dietary Guidelines for Americans, ⁽²⁾ the National Medical Association (NMA), ⁽³⁾ the 2004 Report of the Surgeon General ⁽⁴⁾ and a 2006 American Academy of Pediatrics (AAP) report ⁽⁵⁾ all recommend that children 9 years of age or older consume at least three servings of low-fat or fat-free dairy foods each day.

For children who are lactose intolerant, the Dietary Guidelines ⁽²⁾ for Americans states that milk alternatives within the milk food group, such as lactose-reduced or lactose-free milk, are the most reliable and easiest way to get the health benefits associated with dairy. Research indicates ⁽⁶⁾ cow’s milk is the most reliable source of calcium because in many fortified beverages the calcium can settle to the bottom of the container.

"Lactose intolerance doesn’t always require avoiding dairy," said Wilma Wooten, M.D., M.P.H., co-author of the NMA Consensus Report, The Role of Dairy and Dairy Nutrients in the Diets of African Americans. "I recommend that parents work to find the dairy options that work best for their children. Strategies include serving milk with other foods at meal time or snacks; choosing a lactose-reduced milk, if needed; and trying yogurt with live active cultures or hard cheeses."  
  
Another AAP report from 2006 cautions that lactose intolerance should not require avoiding dairy foods. In fact, the AAP encourages children and adolescents with lactose intolerance to still consume dairy foods in order to get enough calcium, vitamin D, protein and other nutrients essential for bone health and overall growth.⁽⁷⁾ “Children with lactose intolerance should choose dairy foods first for overall diet quality and adequate intake of many nutrients, in addition to calcium, critical to their growth and development,” said Frank Greer, MD, FAAP (Fellow of the American Academy of Pediatrics) and chairman of the AAP Committee on Nutrition. “While calcium-fortified beverages and other foods can provide an alternative source of calcium, dairy foods made from cow’s milk are the most reliable choice, contain several, other essential nutrients, and come in lactose-reduced varieties.”

Since lactose-free milk is currently allowed as part of the reimbursable school meal program, the USDA says there is no need to offer a fortified milk substitute to a student whose medical or special dietary need is lactose intolerance; furthermore, documentation is not required for lactose-free milk. Lactose intolerance should not be confused with milk protein allergies. The prevalence of cow’s milk allergy in children is estimated at approximately 2%.⁽⁸⁾ Parents whose children have milk allergies should talk with their pediatricians or a registered dietitian to ensure that their children are not missing important nutrients vital to growth and development, which would otherwise come from milk.
  
Dairy foods are nutrient rich, providing a significant source of nutrients for growing children and teens. In fact, milk is the primary beverage source of several key nutrients in America’s diet – including calcium, potassium, phosphorous, protein, vitamin A, magnesium and zinc.⁽⁹⁾ Milk also provides three of the five nutrients that fall short in children's diets – calcium, potassium, and magnesium – as identified in the 2005 Dietary Guidelines for Americans.⁽²⁾

Encouraging kids to consume three servings of nutrient-rich milk, cheese or yogurt throughout the day, whether at home or school, is an easy way to help them build and maintain strong, healthy bones, muscles and teeth.

Less than half of children ages 2-8 meet the 2005 Dietary Guidelines for Americans recommendations for dairy foods. And only about one-quarter of children ages 9-19 meet recommended dairy food intake.⁽¹⁰⁾ “Milk provides nine essential nutrients that are important for growth and development,” said Ann Marie Krautheim, R.D. and senior vice president of Nutrition Affairs for the National Dairy Council. “The milk offered by the School Meal Programs helps children to get the nutrients they need.”

Plus, kids like the taste of milk. A School Milk Pilot Test (11) found that school milk consumption increased by 37 percent through specific improvements such as plastic packaging, one or more additional low-fat or fat-free flavors, and better refrigeration and merchandising.

For more information on the health benefits of dairy, visit www.NationalDairyCouncil.org.

¹Child Nutrition and WIC Reauthorization Act of 2004. P.L. 108-265, June 30, 2004. 118 Stat. 729-790.
²U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2005. 6th Edition, Washington, DC: U.S. Government Printing Office, January 2005.
³ Wooten, WJ and Price, W. Consensus Report of the National Medical Association: The Role of Dairy and Dairy Nutrients in the Diet of African Americans. J Natl Med Assoc 2004; 96(12): 1S-31S.
⁴ Surgeon General’s Report on Bone Health, 2004. http://www.surgeongeneral.gov/library/bonehealth/.
⁵ American Academy of Pediatrics, Optimizing bone health and calcium intakes of infants, children, and adolescents. Pediatrics. 2006; 117⁽²⁾:578-585.
⁶ Heaney RP, et al. Not all calcium fortified beverages are equal. Nutrition Today. 2005; 40(1):39-44.
⁷ American Academy of Pediatrics, Lactose intolerance in infants, children, and adolescents. Pediatrics. 2006; 118 (3):1279-1286.
⁸ Kleinmann, R.E., (Ed). Pediatric Nutrition Handbook 5th ed., Elk Grove Village, IL: American Academy of Pediatrics, 2004, pp.593-607.
⁹ Murphy, M.M., and J.S.  Douglas for ENVIRON International Co. What America Drinks. How Beverages Relate to Nutrient Intakes and Body Weight. Study commissioned by the Milk Processor Education Program. 2007.
¹⁰ National Dairy Council, unpublished data based on the National Health and Nutrition Survey (NHANES), 1999-2002.
¹¹ National Dairy Council and American School Food Service Association. The School Milk Pilot Test. Beverage Marketing Corporation for NDC and ASFSA, 2002.

                                                                
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