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Schools should dump sugary chocolate milk

Frederick J. Zimmerman is a professor of public health with a focus on children's health, at the UCLA School of Public Health. Beth Warshawsky Ricanati is a family physician. Zimmerman and Ricanati both have children in the Santa Monica-Malibu Unified School District. This op-ed originally appeared in the Los Angeles Times on Sunday, August 21, 2011.

The Santa Monica-Malibu Unified School District is scheduled to vote this week on whether students need sugar to make healthy choices. Of course, the vote won't be structured that way, but sugar is what's at stake. The school board will vote on whether the district should eliminate sugared milk from its lunchtime offerings. Sugar will not go quietly.

Last year, 76 percent of the milk served in the district was chocolate-flavored. Because each half-pint carton of flavored milk contains 8 grams more sugar than skim milk, last year alone about 5,600 pounds of added sugar was smuggled into children's diets through flavored milk. Someone's getting a sweet deal, and it's not the kids.

Public health professionals are concerned about sugary beverages because of sugar's known link to obesity. Yes, children should get plenty of outdoor physical activity and maintain an overall healthy diet. Although many children do those things, the effects of sugar are powerful. Several studies have shown a link from added sugar to obesity that is independent of the rest of the diet and the child's physical activity. The plain fact is sugar leads to obesity.

Rates of overweight children and obesity have doubled in the last two decades, so that now nearly one child out of two is either overweight or obese. This has real and damaging health consequences. Those with the misfortune to become overweight or obese as children are far more likely to be overweight or obese as adults, to develop hypertension, diabetes, pulmonary problems, bone and joint issues, and premature cardiovascular disease. These problems in turn consign their victims to a future that is not only difficult but short. Largely because of the pandemic of obesity, this generation of children may be the first in our nation's history to have a shorter life span than their parents.

Responding to the threat of obesity and sugar's role in it, the American Heart Assn. and the American Assn. of Pediatrics recommend limiting the intake of sugary beverages. Too many school systems have proved themselves unreliable partners in following these guidelines.

Santa Monica schools offer chocolate milk in addition to skim milk. Compared with soda pop or even water, milk offers substantial nutritional advantages. Milk contains vitamins, minerals, protein and, of course, calcium, in which up to two-thirds of American children are deficient. The choice between milk and soda is clear. For the same reasons, plain milk is more healthful than sugared milk.

Some on the school board believe that the elimination of sugared milk will lead to a reduction in calcium intake. They fear that children will not drink milk if it doesn't contain added sugar. Their fears are not entirely unreasonable. A recent study conducted by the milk-processing industry that adds sugar to milk claims that when sugary milk is not available, overall milk consumption drops by as much as 35 percent. Though the methodology and objectivity of this study have been questioned, it certainly raises the stakes for eliminating sugar.

These stakes are raised even higher by the structure of lunch reimbursements, an ironic, if unwitting ally of sugar's place on the menu. When schools distribute lunches, the federal government reimburses them only if the lunch includes a certain number of nutritious items, defined to include milk, whether sugared or not. If a child declines the milk and doesn't choose enough of the offered items to meet the target, the school is not reimbursed. This can add up to a substantial loss to the district.

Legitimate concerns about calcium intake, a distorted reimbursement scheme and an intensive marketing campaign on the part of sugared milk processors have combined to turn schools into a ready vehicle for sugary, processed milk. Nationwide, about 80 percent of all flavored milk sales are to school systems. Given the choice, parents overwhelmingly choose non-flavored milks for the children, but they do not have complete control over their children's choices at school.

Happily, a growing number of schools have begun to respect parental preferences. More than 50 school districts, including Los Angeles, Ventura, Berkeley, Carpinteria and Lompoc in Santa Barbara County, and Washington, D.C., have had the fortitude to ban flavored, sugared milk from their lunchrooms. These school districts have been willing to brave the financial risk, even in difficult times, because they believe they have a mission to support the formation of healthy habits. One food service director commented: "Chocolate milk is soda in drag. It works as a treat in homes, but it doesn't belong in schools." Another said: "We want kids to learn to appreciate flavors other than sweet."

Their experience has been instructive. When Oxnard schools, for example, banned sugared milk, they coupled the transition with a marketing campaign about the benefits of plain milk. In the year after the ban, milk consumption increased by 8 percent.

Food writer Michael Pollan has evocatively written about how plants use people to their own ends. In a similar way, sugar — whether from sugar cane, beets, corn — has become a stealth staple of the American diet.

The school board should stand with parents in removing sugary milk from its menus, thereby placing children's health and welfare before the interests of the milk-processing industry. Now that would be a sweet deal for our kids.
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