Whole Milk is illegal in public schools

A bill advancing in Congress aims to change that, but Democrats are opposed. Why?

Natural, whole milk, the kind you get direct from a cow, is illegal in America’s public schools.

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For those serving lunches funded by the US. Department of Agriculture (USDA), whole milk cannot even be sold in a vending machine, or anywhere on school grounds, between the hours of midnight and 30 minutes after the end of class. (No whole-milk snacking en route to sports practice allowed!)

Whole milk is just 3.25% fat by weight, compared to the 1% (low-fat) or 0% (skim) that are the only milks currently allowed in schools. The difference seems trivial, yet the battle is monumental. For three years now, Congressman Glenn “GT” Thompson, a Republican from Pennsylvania, has introduced bills intended to allow whole milk back in schools, and on Tuesday, his “Whole Milk for Healthy Kids Act” was approved by the House Education and Workforce Committee, in a 26-13 vote largely along partisan lines.

“When students turn away from milk, they often opt for far less healthy alternatives,” said Thompson. Like apple juice, with 15 grams of sugar per school-sized cup (4 oz), compared to just 6 grams of sugar in the same amount of skim milk.

Thompson’s bill is now headed for a vote in the full House, and passage is uncertain.

Milk is political?

In today’s environment where all science is bizarrely political, so too is whole milk. But why should Democrats and Republicans have such starkly opposing views on whether the fat content in milk causes ill-health? Isn’t this a question scientific studies could answer?

Some of the explanation is that whole milk was yanked from schools in 2010, as part of the Healthy Hunger-Free Kids Act that Michelle Obama called a “cornerstone” of her campaign to save children from obesity. She said it was “the most meaningful and comprehensive change to food in schools we’ve seen in a generation,” and any subsequent attempts to alter its provisions have been labeled by journalists friendly to her as attempts to “roll back” or “unravel” her efforts.

Also, many progressive intellectuals and groups, even in public health, now take a disparaging stance towards dairy products generally, prioritizing instead animal rights and climate concerns over human health. In fact, Rep. Jamaal Bowman, a Democrat from New York, commented in the hearing that schools needed more “climate friendly” beverages. He quoted extensively from a letter written by the Physicians Committee for Responsible Medicine (PCRM), which despite its name, is more of an animal-rights than a physician's group. Questions therefore overhang the group’s motivations for its longtime staunch opposition to any human consumption of eggs, meat or dairy. (Since forbidding whole milk has tanked milk consumption generally in schools, the ban clearly serves PCRM goals.)

Animal rights and climate change mitigation are certainly important concerns, but the stated goal of the government’s child nutrition programs is to try to keep our children healthy. And here, we’re clearly failing. Some 45 years ago, less than 5% of children ages 2 to 17 had obesity. In 2020, that number had quadrupled to nearly 20%, and after the pandemic’s disastrous effects on health, is now likely to be higher. Black and Hispanic children suffer even more, with roughly 25% obesity rates.

Is whole milk the problem? This chart can hopefully help answer that question:

[Credit for milk portion of graph: Progressive Dairy]

Obviously, whatever is driving the ill-health of our nation’s children, it is not the milk.

What about saturated fat and heart disease?

Some longstanding nutrition groups such as the Center for Science in the Public Interest (CSPI) and the American Heart Association (AHA) are opposed to whole milk not so much on obesity grounds but as a way to avoid saturated-fat, which they fear will lead to heart disease.

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Yet the expert committee for the current (2020) U.S. Dietary Guidelines found that there was “insufficient evidence” to show that restricting saturated fats in childhood could prevent heart-disease or mortality in adulthood.

This same expert review could only find a single clinical trial on school-aged children testing the potential health benefits of a fat-restricted diet. (Another clinical trial, called “STRIP” was also cited, but this study was restricted to children aged three and under). The lone relevant trial is called “DISC,” funded by the National Institutes of Health, with results in JAMA in 1995. Three hundred 7-to-10 year-old children were counseled, along with their parents, to eat a diet that limited saturated fat to 8 percent of calories and total fat to 28 percent, and this group was compared to an equal-sized group of controls.

Investigators found that the diet “modestly” lowered the “bad” LDL-cholesterol, yet it was problematic for the study that the boys and girls in the trial were not a normal sample: They had unusually high levels of LDL-cholesterol, in the 80th to 98th percentile. In other words, these children could very well have had familial hypercholesterolemia, the genetic condition that causes heart disease through a metabolic defect, which is entirely different from the way that cholesterol is altered by diet. This meant that the study’s results cannot not be generalized to the larger population of normal children, as the Dietary Guidelines expert committee itself noted in its review (p.33).

The Guidelines review, in 2020, was the first time the USDA had ever looked at the data on saturated fat and children, even though the agency had, without any evidence, already been advising kids to limit these fats for more than 40 years. During those decades, the USDA simply assumed that advice for middle-aged men and women could be extended to kids.

However, children are not simply small grown-ups. Their nutritional needs are very different, including the fact that they need more protein to support their growing bodies and more fat for their developing brains.

That the USDA waited so long to examine the data on children was clearly a mistake. That only a single trial (DISC) on a genetically atypical population was employed to justify continuing these population-wide recommendations for all school-aged children is, I believe, another mistake.

The data backing advice telling kids to radically lower their fat and saturated fat consumption were lacking in 1980 when the U.S. Guidelines were launched—and is still lacking today.

Adults and saturated fats: is the evidence stronger?

Even the USDA’s recent review of saturated fats on adults is clearly flawed. Although the review concluded that the evidence linking these fats to heart disease was “strong,” a peer-reviewed investigation by outside investigators (including myself) revealed that 88% of the studies cited by the committee did not in fact support this conclusion. Further, 94% of the studies reviewed, found that dairy foods either had no association or were negatively associated with coronary heart disease outcomes (i.e., higher dairy intake was associated with lower risk).

Why should CSPI and AHA continue to promote contested science, exclusively on adults, when weighing in on whole milk for children? At least part of the explanation is that these groups have simply been dug in on opposing saturated fats for decades, going back to the 1960s and 70s. In fact, CSPI was so much against saturated fats that in the late 1980s, the group ran a major campaign in favor of replacing these harmful fats with trans fats, billed by the group’s newsletter as “healthy” and “not a bad bargain” for combatting heart disease. (whoops! trans fats turned out to be even more of a heart-disease threat than saturated fats and were ultimately banned from the food supply).

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Over the past 13 years, nearly 25 systematic reviews and meta-analyses, of both clinical trial and observational data, by independent teams of scientists have been published, and nearly all concluded that we got it wrong on saturated fats. The most rigorous clinical trial data show that these fats do not cause cardiovascular mortality or total mortality.

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Mortality (death) data is definitive. That should be the last word.

Still, somehow, the AHA, and the USDA have managed simply to ignore these findings on mortality.

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USDA officials, even when presented personally with these data by top scientists in the field, paid no attention to them, as reported in the BMJ.

When I say ignore, I mean that these groups literally deny the mortality findings exist. I would call this “science denialism,” except that this term is usually reserved for those who oppose government narratives rather than the reverse.

While ignoring this definitive mortality data, CSPI, AHA, and the USDA have instead focused myopically on far lesser evidence showing that saturated fat can raise LDL-cholesterol. Dwelling on this lesser data is a bit like fixating on the half-way times of a marathon while ignoring what happens at the finish line. If you know the finishing time (the mortality data), there’s clearly no point in checking intermediary markers like LDL-C along the way. Propping up these lesser data, as the AHA, USDA and CSPI continue to do, is clearly not scientifically justified. (Washington Post columnist Tamar Haspal followed this exact same script in her column yesterday on saturated fats.)

Maybe these groups harbor a nostalgia for a hypothesis on saturated fats they’ve favored for so long. Maybe special interests invested in climate advocacy and animal rights are urging them along. Cognitive dissonance is probably rife. But the evidence clearly shows that the 60-year-old hypothesis claiming that saturated fats cause heart attacks and death is not supported by the best available data.

First, do no harm

Meanwhile, as with any policy intervention, one must consider not only the potential benefits but also the possible harms. What could go wrong when whole milk is swapped out for skim? Well, in the DISC study researchers found that the children on the low-fat diet ended up consuming less than two thirds of the Recommended Daily Allowance (RDA) for calcium, zinc, and vitamin E. They also got less magnesium, phosphorus, vitamin B12, thiamin, niacin, and riboflavin than did children in the control group.

Another, once-renown effort, the Bogalusa Heart Study published in Pediatrics, in 1992, found that children ages 8 to 10 on a low-fat diet had a significantly higher chance of failing to meet the RDAs for vitamins B1, B12, and E, as well as thiamin, riboflavin, and niacin, compared to a group eating more than 40 percent fat.

Milk, it turns out, is a naturally rich source of calcium, Vitamin B2, Vitamin B12, potassium, phosphorus, and is supplemented with both Vitamin A and Vitamin D. Quite a few of these nutrients require fat for complete absorption. Non-fat milk does not contain the fat necessary to fully absorb these crucial, essential nutrients.

How dare Congress tread on the domain of experts?

At the House Committee hearing this week, members of Congress were aware that, as non-experts, they could be seen as overstepping boundaries into an area that should rightfully be decided by scientists. However, for the first time—to my knowledge—members of Congress expressed doubt about the USDA’s expert group, called the Dietary Guidelines Advisory Committee.

Said Rep. Thompson,  “I agree we ought to do things with data and science, I just question the process of the Dietary Guidelines Advisory Committee. They’re completely appointed. These are unelected bureaucrats, and there’s no oversight.”

Awareness of this issue seems to be growing since our finding last year that 95% of the 2020 Dietary Guidelines Advisory Committee had a tie with a food or pharmaceutical company, and more than half the committee had 30 such ties or more. Of the many hundreds of ties we identified, only one was with a milk producer (“MilkPEP”).

Despite this, CSPI, without evidence, depicts the fight over whole milk as the back-room maneuverings of “Big Dairy.” Interestingly, I’ve discovered that dairy behemoths like Danone make more money by skimming the fat off the milk and charging for it in other products, like ice cream, rather than selling the whole milk itself. These multinationals have shown themselves to be dis-interested in promoting whole milk. From what I can see, whole-milk advocacy seems mainly to be driven by people concerned about child health and farmers from the rapidly diminishing number of dairy farms in the U.S., 95% of which are family-owned.

In the Committee hearing on Tuesday, one of the few Democrats to cross party lines and vote in favor of restoring whole milk to schools was Congresswoman Jahana Hayes, from Connecticut, who succinctly demonstrated how common sense can in today’s world somehow seem revolutionary.

“I drink whole milk. My kids drink whole milk. We like it” (shrug)

https://www.youtube.com/live/MCQshHVg0N8?feature=share&t=7670 (15 seconds)

If you want to keep tabs on this story from a pro-whole-milk source, follow Sherry Bunting, at @agmoos on Twitter, farmshine.net and http://agmoos.com

1. I’m taking a bit of poetic license here: I don’t mean that kids in schools should get unpasteurized, raw milk.

2. In CSPI’s primer on milk, it cites 2 clinical trials that compared whole milk to skim, in which body weight increased on whole-fat dairy, yet these were short-term trials on adults and cannot be extrapolated to growing children.

3. To read about this episode in CSPI’s history promoting “healthy” hydrogenated oils with trans fats, see my book, The Big Fat Surprise, starting at p.227.

4. A contrary finding was reported by the much-respected Cochrane Collaboration, whose review of clinical trials found that saturated fats had an effect on a composite endpoint of cardiovascular “events” like heart attacks, but this finding disappeared when subjected to a sensitivity analysis inside the Cochrane report. See: https://www.mdpi.com/2072-6643/13/10/3305

5. By contrast, CSPI acknowledges the mortality findings but contends, in its primer, that the clinical trials reporting these data were not sufficiently powered for this outcome. However, this statement is contradicted by the many systematic reviews and meta-analyses noted above, all by scientists who considered the mortality data valid.