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Milk is Good but Watch the Sugar

 

Maria Luisa B. Caparas-Panlilio, MD, DPPS, MSc (Public Health Nutrition)

Wednesday, July 1st, 2020

Data from the 2018 Feeding Infants and Toddlers Study (FITS) and Kids Nutrition and Health Study (KIDS) studies showed the trend towards consumption of nutrients from processed products over fresh food sources. This is equitable since both are important parts of the food supply and both ensure food availability. The contention lies on the additives in processed foods that could impact a child’s health. Milk as an example, provides nutrients that are encouraged to be added (i.e. calcium, vitamin D & A) but also contains constituents that need to be limited (e.g. sugar).

Daily calcium needs of children

Calcium in dairy is an essential nutrient that cannot be produced by the body. It must therefore be provided in food to meet the daily requirements ranging from 400 mg to 1,000 mg depending on the child’s age (Table 1). In the FITS study, milk consumption as the main source of calcium showed that only 32% of children aged 3 to 6 years consumed milk for their calcium needs.

Given that majority of children do not consume enough food, consequent nutrient deficits were possible as observed in the major insufficiencies of iron, vitamin C, and calcium (Figure 1). The prevalence of inadequate calcium intake was high in all age groups. This was attributed to the replacement of milk in the diet with other beverages particularly sugar-sweetened drinks.

Analyzing the sugar in milk

Although milk is good, it has also its limitations especially when sugar is added to the mix. Several milk preparations are available depending on nutrient requirements for different age groups. Choosing the appropriate milk depends primarily on its ingredients. Ideally, the first three ingredients should contain milk protein, otherwise, the milk may just be a product prepared from adjusted ratios of sugar and fat to optimize palate pleasure.

WHO guideline recommends daily intake of added sugars (e.g., sucrose, table sugar) to less than 5 to 10% of the total energy intake. The guideline does not however restrict the sugar that is naturally present in milk (lactose) since no evidence of adverse effects have been reported in consuming lactose (Table 2). Milk that is 100% lactose should be given to children to avoid consumption of sucrose or table sugar, the less beneficial carbohydrate. Limiting added sugars in the diet is advised to avoid the unfavorable consequences of excessive weight gain, dental caries and increased risk of other health problems.

Milk for good health

Calcium is an essential mineral that must be supplied in the diet. Milk is a good source of calcium with lactose as its naturally occurring sugar. Avoid milk with added sugars (i.e., sucrose, corn syrup, fructose, maltose) to avoid its negative health effects.

 


 References:

1. Angeles-Agdeppa I, et al. Inadequate nutrient intakes in Filipino schoolchildren and adolescents are common among those from rural areas and poor families. Food Nutr Res. 2019; 63: 10.29219/fnr.v63.3435.

2. Battad G, Panlilio MLBC. The Sugar Story. 2019. Feeding Infant and Toddlers Study - State of the Nutrition Address, Nestle Nutrition Institute. PowerPoint Presentation.

3. Davis OL, Lindmeier C. WHO calls on countries to reduce sugars intake among adults and children. World Health Organization [Internet]. 2015 March 4 [cited 2020 May 18]. Available from: https://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/.

4. Denney L, Angeles-Agdeppa I, et al. Nutrient Intakes and Food Sources of Filipino Infants, Toddlers and Young Children are Inadequate: Findings from the National Nutrition Survey 2013. Nutrients 2018;10: 1730.

5. Food and Nutrition Research Institute, Department of Science and Technology. Philippine Dietary Reference Intakes 2015: Summary Tables. 2018 September.

6. Panlilio MLBC. “Young Child Feeding Should Be Right and Tight”. 2019. Nestle Nutrition Institute, article.

7. Romero-Velarde, Enrique et al. The Importance of Lactose in the Human Diet: Outcomes of a Mexican Consensus Meeting. Nutrients. 12 Nov. 2019.11(11):2737.

8. Tamborlane WV. The Yale Guide to Children’s Nutrition. New Haven, Yale University Press, 1997.

9. World Health Organization (WHO). e-Library of Evidence for Nutrition Actions (eLENA), Guidelines: Reducing free sugars intake in children and adults, 2015.

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