Chocolate and Other Flavoured Milk, Diet Quality and Health
Consistent evidence indicates that chocolate milk helps improve diet quality in children and adolescents without any increase in added sugars and caloric intakes, or any adverse effect on weight.
There is consistent evidence from several studies suggesting that the inclusion of chocolate or flavoured milk in the diets of children and adolescents has an overall beneficial impact on diet quality with no adverse effect on weight.
Furthermore, a growing body of evidence suggests that chocolate milk may be an ideal post-exercise recovery beverage for physically active adults and athletes.
In a 2016 systematic review, the role that flavoured milk plays in children’s health was evaluated in 53 studies.1
- Consumers of flavoured milk had an overall greater milk intake and were more likely to meet calcium recommendations;
- When flavoured milk was not available, less plain milk was consumed such that overall consumption decreased;
- No association between flavoured milk intake and weight status was found among normal-weight children;
- The role that flavoured milk plays in weight among overweight children is unclear.
The 2015 policy statement from the American Academy of Pediatrics highlighted the following:2
- The objective should be to maximize nutrient density within recommended calorie ranges and use available discretionary calories to encourage greater consumption of nutrient-rich foods and beverages;
- Flavoured milk may represent a nutritious alternative that can help children improve their diet quality and calcium intake.
The conclusions from the 2009 scientific statement from the American Heart Association regarding dietary sugars and cardiovascular health included the following:3
- When “sugars are added to otherwise nutrient-rich foods, such as sugar-sweetened dairy products like flavoured milk and yogurts and sugar-sweetened cereal, the quality of children’s and adolescents’ diets improves, and in the case of flavoured milks, no adverse effects on weight status were found”;
- Increases in the intake of soft drinks, fruit drinks, desserts, sugars, jellies, candy and ready-to-eat cereals largely account for the increased energy intake from sugars and added sugars;
- The form in which added sugars are consumed appears to be an important modifier of the impact on diet quality. Soft drinks, sugar and sweets are more likely to have a negative impact on diet quality, whereas dairy foods, milk drinks and pre-sweetened cereals may have a positive impact.
In the Avon Longitudinal Study of Parents and Children, the prospective relationship between flavoured milk consumption and body composition among a cohort of 2,270 children was examined.4
- No relationship between flavoured milk and change in body fat or body weight was observed among normal-weight children;
- Among children who were overweight/obese, both consumers of flavoured milk and non-consumers had a decrease in body fat, but the change in consumers of flavoured milk was smaller (-0.16% vs. -3.4%, p = 0.02).
Henry et al. assessed the impact of removing chocolate milk from Canadian schools.5
- There was a substantial reduction of ~48% in overall milk consumption when chocolate milk was no longer an option;
- As well, more milk was wasted when only plain milk was offered;
- There was a decrease in several key nutrients (calcium, vitamin D, vitamin A, protein) for the students who did not switch to drinking plain milk when chocolate milk was no longer an option;
- Nutrient modelling scenarios to “replace” these lost nutrients with alternative foods showed that they exceeded chocolate milk in either calories, sugar or both in every case.
Similarly, a study in the US also found that removing chocolate milk from elementary schools may not be advantageous:6
- The proportion of students who took milk decreased by 8.2% (p < 0.01);
- Although the purchase of plain milk increased, more milk was thrown away.
The inclusion of chocolate and other flavoured milk in the diets of children and adolescents has benefits with respect to ensuring overall diet quality and does not appear to have a negative impact on body weight or the intake of added calories and sugars.
Furthermore, given the fact that a large proportion of Canadians, including children and adolescents, are not meeting the minimum recommended intakes of milk products, flavoured milks, including chocolate milk, represent another option to help them meet the recommended intakes for the Milk and Alternatives food group.
Removing chocolate milk from schools may have a negative impact on the consumption of milk products and may therefore exacerbate the current problem of inadequate milk product consumption by Canadian children and adolescents.
Additional research is needed to evaluate how flavoured milk may impact body weight or composition in already overweight and obese children.
Canadian data and more randomized controlled trials, especially in the North American context, are also needed.
- Fayet-Moore F. Effect of flavored milk vs plain milk on total milk intake and nutrient provision in children. Nutr Rev 2016;74:1-17.
- American Academy of Pediatrics. Council on School Health and Committee on Nutrition. Snacks, sweetened beverages, added sugars, and schools. Pediatrics 2015;135:575-583.
- Johnson RK et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation 2009;120:1011-1020.
- Noel SE et al. Associations between flavored milk consumption and changes in weight and body composition over time: differences among normal and overweight children. Eur J Clin Nutr 2013;67:295-300.
- Henry C et al. Impact of the removal of chocolate milk from school milk programs for children in Saskatoon, Canada. Appl Physiol Nutr Metab 2015;40:245-250.
- Hanks AS et al. Chocolate milk consequences: a pilot study evaluating the consequences of banning chocolate milk in school cafeterias. PLoS One 2014;9:e91022.