Milk-and-Dairy-Products-in-Human-Nutrition-FAO

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Milk and dairy products in human nutrition
tion globally, affects 36.5 percent of school-aged children (WHO, 2012). Anaemia
is estimated to affect 1.62 billion people and is most widely prevalent among
preschool-aged children (47.4 percent) and pregnant women (41.8 percent) (WHO,
2012). The condition may arise from multiple causes, several of which are related to
dietary deficiencies in iron, vitamin A and B 12 , folate, riboflavin and copper, and can
lead to impairment of cognitive and physical development in young children, poor
birth outcomes in pregnant women and, in severe cases, increased risk of mortality
in certain populations (Hoffbrand, Moss and Pettit, 2006).
Poor diets and high infection burden are the primary causes of micronutrient
deficiencies in developing countries. Diets often lack animal-source foods (ASF)
that provide several critical micronutrients in more bio-available forms than are
available in plant-based diets (Demment, Young and Sensenig, 2003; Murphy and
Allen, 2003).
Milk is an excellent source of both macro- and micronutrients, as discussed in
Chapters 3 and 4. It is high in energy, lipids and high-quality proteins. Milk also
contains nutrients critical for growth and development, including calcium, vitamin
A, riboflavin and vitamin B 12 (Hoppe et al., 2008). Insulin-like growth factor,
found in milk, is also known to promote linear growth (Hoppe, Mølgaard and
Michaelsen, 2006).
In some countries, both under- and overnutrition are prevalent in the population
and even within the same household. The causes of this are multifactoral and
related to changes in dietary patterns towards more energy-dense foods, increasing
urbanization and lifestyle changes that are reducing physical activity (WHO, 2003;
Pdairopkin, 2006). There is some evidence linking food-supplementation programmes
in Latin America with weight gain above the reference median (Uauy,
Albala and Kain, 2001). However, milk programming has not been implicated in
increasing obesity, though an awareness of the problem is needed moving forward.
The association between dairy intake and weight gain and obesity is examined in
detail in Chapter 4.
There is widespread consensus and strong evidence now showing that undernutrition
during the first two years of life is a strong predictor of child mortality
(Black et al., 2008) and that, among those who survive, early childhood malnutrition
has long-term, serious health and developmental consequences (Victora et al.,
2008). Interventions targeting infants and young children are widely recognized to
be the most effective in terms of increasing child survival and improving growth
(Bhutta et al., 2008).
This chapter focuses on milk programmes affecting undernutrition, as the major
challenge in developing countries for young children in particular. A review of the
literature is presented covering four major programme types: dairy production
and agriculture programmes; school-based milk programmes; fortified-milk programmes;
and milk powder and blended foods. Under each programme type, there is
a brief description of the typical programme model, followed by an overview of the
evidence-base linking the milk-related interventions to nutrition. Most of the programmes
reviewed in three of the categories (dairy production and agriculture programmes,
fortified-milk programmes and milk powder and blended foods) targeted
children less than five years of age. School-based milk programmes were generally
aimed at improving nutrition for primary-school-aged children, 6–11 years.