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

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Milk and dairy products in human nutrition
dish with minced beef, group 2 with ultra-high temperature (UHT) cow milk and
group 3 with added oil.
All intervention groups gained more weight than the control group, with the
greatest effects among young children, boys and those with lower socio-economic
status (SES) (Grillenberger et al., 2003). Milk supplementation had the greatest
impact on height gain among children stunted at baseline; children in this substratum
receiving daily milk showed a 1.3 cm greater increase in height (15 percent) than
the control group. Children in the meat group had the greatest increase in mid-arm
muscle area, followed by those in the milk group (Grillenberger et al., 2003; Neumann
et al., 2007). Children in the milk group demonstrated a significantly lower
rate of increase in Raven’s Progressive Matrices, a measure of cognitive development,
than the other groups (Neumann et al., 2007). No significant differences
were observed for the verbal meaning and digit span tests, but the milk and control
groups performed significantly worse in the arithmetic tests than the other intervention
groups. It should be noted that baseline milk consumption in this population
was not accounted for and may have influenced outcomes.
The other well-designed study of school-based milk distribution was conducted
in China from 1999 to 2001 (Du et al., 2004). Nine schools were matched on SES
characteristics and randomly assigned to three groups. Pre-adolescent 10-year-old
girls participated in the trial. Girls in group 1 received 330 ml of milk each school
day for two years. Girls in group 2 received the same amount of milk supplemented
with cholecalciferol (15 μg/litre in the first two batches of milk, 24 μg/litre in the last
four batches). Group 3, the control, received no supplementary milk. Girls receiving
milk with or without cholecalciferol showed significant increases in growth and
bone mineral content and density compared with the control group. Those receiving
milk with cholecalciferol had greater increases in bone mineral content and density
than those who received milk but no cholecalciferol. A follow-up study three years
after the supplementation trial ended demonstrated a sustained height effect (sitting
height), but no significant differences in vitamin D status (Zhu et al., 2006).
Both of these studies, which used a strong quasi-experimental design, provide
important contributions to the evidence base for milk and nutrition in schoolbased
programming.
7.4.2 Asia and the Pacific
School-based milk programmes appear to be more widely supported through
governments and public funds in the Asia and Pacific region than elsewhere. While
several programmes reviewed do include nutrition objectives, there is limited information
concerning nutrition impacts. One study in Viet Nam evaluated the impacts
of a large-scale school nutrition programme supplementing primary school children
with milk and a wheat flour biscuit (Hall et al., 2007). This cluster-designed study,
which achieved a plausibility ranking, compared growth of children in grade 1 of
primary schools offering a snack of 200 ml of UHT milk fortified with vitamins
A and D together with a fortified wheat biscuit with that of children in grade 1
primary schools without the supplementation programme over a 17-month period.
Only gains in weight remained statistically significant after controlling for other
variables including school clustering (Hall et al., 2007). Unfortunately, the effects of
the milk alone could not be separated from the biscuit because of the study design.