In Long Fight Over School Chocolate Milk, Perhaps A Whole New Flavor

Betti Wiggins, also known as the "rebel lunch lady," didn't do it in Detroit, where she revolutionized school food, and she doesn't do it now, as school nutrition chief in Houston.

"I don't find it necessary to serve children chocolate milk," she says, "simply because of the sugar."

"Chocolate milk is a treat," she adds, to be seen more as candy than a regular beverage. "You don't need flavored milk. It's just a response, I believe, to the market. And there are fellow food service directors around the country who feel the same way I do."

There are. But there are also many who offer chocolate and flavored milks: As of a 2010 report in The New York Times, over 70 percent of milk consumed in American schools is flavored.

At a school food conference at Harvard, where I asked Wiggins about chocolate milk, the information table also featured National Dairy Council flyers with headlines like "Top Five Reasons to Raise Your Hand for Flavored Milk." (Reason No. 1: "Milk provides nutrients essential for good health and kids will drink more when it's flavored.")

The federal Department of Agriculture, under President Trump, is clearly in favor of flavored milks: It announced last month that it would ease the requirement that they be fat-free, and allow schools to serve them with 1 percent fat, as part of the plan to "make school meals great again."

The chocolate milk fight has spread even into pediatrics. In late 2015, three professors published a letter of protest in the journal Pediatrics against an American Academy of Pediatrics school snack-and-drink policy that supported flavored milks.

"The kids I see in my practice, who are all low-income, are not just drinking sugared, flavored milk once a day at school," says the letter's lead author, Dr. Diane Dooley of the University of California, San Francisco. "Sometimes they're drinking it two or three times a day at school, because there's breakfast, lunch, and then there's snack. And then they're drinking it at home, in part because it becomes an expectation.

"With an epidemic of obesity in our country," she argues, "we shouldn't be offering sugared milk, just like we don't offer candy apples in schools."

"We shouldn't be offering sugared milk, just like we don't offer candy apples in schools."

Dr. Diane Dooley

Last month, the American Academy of Pediatrics recommended against fruit juice, which is high in sugar, for children under 1. But on milks, Dr. Steven Abrams, incoming chair of the academy's committee on nutrition, says the academy and "I, personally, generally think that including some flavored milks in the schools is OK.

"The manufacturers have brought down the amount of sugar in chocolate milk quite a bit in recent years," he says. "It's not necessarily as good as white milk, because it does have more sugar, but we don't think that flavored milk should be entirely removed," because "then you will tend to decrease the amount of milk the children are drinking."

Tricky, right? It's a debate that has been going on for years now, and a dilemma that many a parent will recognize: You want to get healthy nutrients into your child, and a spoonful (or more) of sugar helps. But sugar, at least in excess, is looking increasingly bad for our health. So when is the trade-off worth it?

As a parent, my head was whipping back and forth between the two sides — until, at the Harvard conference, I spoke with Dr. Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts, and he turned my head all the way around toward an out-of-the-box answer: Bring back whole milk in the schools. (Current federal guidelines allow only 1 percent or skim, even if the milk is unflavored.)

It's a central challenge that whole milk has been removed from the schools, he says, because kids don't tend to like the taste of skim milk, so food programs often turn to sugar and flavor.

"But I think that healthier foods with more calories are better for kids," Mozaffarian says. "It's better to have 100 calories of nuts or 100 calories of broccoli than 80 calories of soda. And similarly, I think it's better to have whole milk than to have chocolate skim milk with a little bit fewer calories."

The science doesn't strongly support skim milk over whole milk for kids' health, he says.

So why, then, do we not have whole, unflavored milk in schools? Guidelines on dairy tend to be based on theories about getting certain nutrients into our diets, Mozaffarian explains.

"We need calcium and vitamin D, so we should have three servings of dairy," he says. "We want to avoid calories and fat, so we should have skim milk. That makes sense if you have an isolated, reductionist view of food. But we're learning that foods are really complicated: Yogurt has probiotics in it. Cheese is fermented, which may change its nutritional qualities and have health benefits. And milk has many other compounds, many other types of fatty acids, many other nutrients beyond calcium and vitamin D."

Mozaffarian says guidelines should be based on actual evidence about people who eat or drink the food in question, rather than on a "nutrient theory." And "if you actually look at the evidence, kids who drink whole milk don't gain weight more than kids who drink skim milk. In fact, on average, kids who drink whole milk maybe gain a little bit of less weight. Adults who eat yogurt actually lose weight."

Ultimately, he says, "I think we need to move away from the low-fat/high-fat focus for dairy. We've done that for many other foods, and I think it's time to do that for dairy."

So, I asked Mozaffarian, if you were speaking to parents whose schools were debating whether to have chocolate milk, what would you say?

The challenge, he responds, is that right now, the federal guidelines bar schools from offering whole milk. Unless or until that policy changes, "for now, we're stuck with skim milk or chocolate milk," and it's not clear whether chocolate skim milk is better or worse than juice. More research on that is needed.

"But I think we can be comfortable that at home, anyway, parents should be giving their kids smaller amounts of whole milk, or maybe nonfat milk if the kids like it, but not chocolate milk," Mozaffarian says. "At school, I think we're sort of stuck right now, and I don't think we have a lot of evidence to make strong statements. I'd prefer if the kids drank unsweetened milk, but if they don't, you're kind of stuck."

Betti Wiggins, the "rebel lunch lady," agrees that federal authorities should look into returning fat to school milk.

"White milk that has fat in it tastes great," she says. "But this low-fat milk doesn't taste as [good], and so the sugar is to try to get people to drink more milk. But that's a trade-off I just won't deal with."

Readers, will you? How do you see this trade-off?