Evaluation of a Free Milk in Schools Program in New Zealand: Effects on Children's Milk Consumption and Anthropometrics.
Samantha Marsh, Yannan Jiang, Karen Carter and 1 others
PMID 29992602WHAT IT FOUND
In Auckland schools that began a free milk program, the share of children meeting milk guidelines rose from 72% to 84% over 2 years, while BMI relative to growth standards did not change significantly; no comparator group means it cannot show the milk caused this.
Key findings
01Across all schools, 72% of children met the New Zealand milk guideline over 7 days at baseline, 76% at 1 year, and 84% at 2 years; the adjusted p value for baseline to 2 years was .0002.
02BMI z scores did not change significantly overall or by school quintile, and the proportion of children in BMI categories did not differ significantly over time.
03In the parent survey, 141 parents responded, and 72% reported the program had positively impacted their child's health, while 48% reported an increased taste preference for milk.
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What it does not show
There was no comparator group, so the observed increase in milk guideline attainment could not be separated from changes over time. Milk intake was self-reported by children aged 7 to 9 using an unvalidated questionnaire, and recall and comprehension may have changed over the 2 years. Schools and parents could opt in or out, so sampling bias may have occurred; only one school from the lowest socioeconomic quintile was included. Loss to follow-up was 88 children at 1 year and 132 children at 2 years, and missing data were not imputed. The parent survey was not validated, relied on self-report, and was not linked to child data.
Declared interests
The supplied text does not report a funding or conflict-of-interest declaration. Fonterra, which provided the Milk for Schools program milk, approached schools and principals about participation.
The easy way to misread this
Do not conclude that the free milk program caused the increase in guideline attainment or had no effect on BMI. The study had no comparator group, children self-reported intake, and the authors say they cannot say with certainty that the initiative caused the change.