title: Potential population-level nutritional impact of replacing whole and reduced-fat milk with low-fat and skim milk among US children aged 2-19 years.
abstract: OBJECTIVE
  Dietary guidance emphasizes plain low-fat and skim milk over whole, reduced-fat, and flavored milk (milk eligible for replacement [MER]). The objective of this study was to evaluate the population-level impact of such a change on energy, macronutrient and nutrient intakes, and diet cost.
  
  
  METHODS
  Cross-sectional modeling study.
  
  
  METHODS
  Data from the 2001-2002 and 2003-2004 National Health and Nutrition Examination Survey.
  
  
  METHODS
  A total of 8,112 children aged 2-19 years.
  
  
  METHODS
  Energy, macronutrient, and micronutrient intake before and after replacement of MER with low-fat or skim milk.
  
  
  METHODS
  Survey-weighted linear regression models.
  
  
  RESULTS
  Milk eligible for replacement accounted for 46% of dairy servings. Among MER consumers, replacement with skim or low-fat milk would lead to a projected reduction in energy of 113 (95% confidence interval [CI], 107-119) and 77 (95% CI, 73-82) kcal/d and percent energy from saturated fat by an absolute value of 2.5% of total energy (95% CI, 2.4-2.6) and 1.4% (95% CI, 1.3-1.5), respectively. Replacement of MER does not change diet costs or calcium and potassium intake.
  
  
  CONCLUSIONS
  Substitution of MER has the potential to reduce energy and total and saturated fat intake with no impact on diet costs or micronutrient density. The feasibility of such replacement has not been examined and there may be negative consequences if replacement is done with non-nutrient-rich beverages.
authors.affiliation: Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA. Electronic address: crehm@uw.edu.
authors.forename: Colin D
authors.initials: CD
authors.lastname: Rehm
authors.affiliation: Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA.
authors.forename: Adam
authors.initials: A
authors.lastname: Drewnowski
authors.affiliation: Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA; United Kingdom Clinical Research Collaboration, Centre for Diet and Activity Research, Cambridge, UK.
authors.forename: Pablo
authors.initials: P
authors.lastname: Monsivais
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D000818:Animals; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018752:Diet, Fat-Restricted / Q000009:adverse effects; D002149:Energy Intake; D006801:Humans; D008892:Milk / Q000009:adverse effects; D008954:Models, Biological; D018673:Nutrition Policy; D009749:Nutrition Surveys; D050177:Overweight / Q000517:prevention & control*; D014481:United States; D055815:Young Adult
keywords: child; dairy products; diet; energy intake; obesity; policy