Longitudinal evaluation of milk type consumed and weight status in preschoolers
- 1Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- 2Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Correspondence to Dr Mark Daniel DeBoer, Division of Pediatric Endocrinology, University of Virginia School of Medicine, PO Box 800386, Charlottesville, VA 22908, USA;
- Received 4 September 2012
- Revised 10 December 2012
- Accepted 16 January 2013
- Published Online First 18 March 2013
Objective To evaluate relationships between type of milk consumed and weight status among preschool children.
Design Longitudinal cohort study.
Setting The Early Childhood Longitudinal Study, Birth Cohort, a representative sample of US children.
Participants 10 700 US children examined at age 2 and 4 years.
Main outcome measures Body mass index (BMI) z score and overweight/obese status as a function of milk type intake.
Results The majority of children drank whole or 2% milk (87% at 2 years, 79.3% at 4 years). Across racial/ethnic and socio-economic status subgroups, 1%/skim milk drinkers had higher BMI z scores than 2%/whole milk drinkers. In multivariable analyses, increasing fat content in the type of milk consumed was inversely associated with BMI z score (p<0.0001). Compared to those drinking 2%/whole milk, 2- and 4-year-old children drinking 1%/skim milk had an increased adjusted odds of being overweight (age 2 OR 1.64, p<0.0001; age 4 OR 1.63, p<0.0001) or obese (age 2 OR 1.57, p<0.01; age 4 OR 1.64, p<0.0001). In longitudinal analysis, children drinking 1%/skim milk at both 2 and 4 years were more likely to become overweight/obese between these time points (adjusted OR 1.57, p<0.05).
Conclusions Consumption of 1%/skim milk is more common among overweight/obese preschoolers, potentially reflecting the choice of parents to give overweight/obese children low-fat milk to drink. Nevertheless, 1%/skim milk does not appear to restrain body weight gain between 2 and 4 years of age in this age range, emphasising a need for weight-targeted recommendations with a stronger evidence base.