International guidelines recommend children aged 9 months to 2 years consume whole (3.25%) fat cow’s milk, and children older than age 2 years consume reduced (0.1–2%) fat cow’s milk to prevent obesity. The objective of this study was to evaluate the longitudinal relationship between cow’s milk fat (0.1–3.25%) intake and body mass index z-score (zBMI) in childhood. We hypothesized that higher cow’s milk fat intake was associated with lower zBMI.
A prospective cohort study of children aged 9 months to 8 years was conducted through the TARGet Kids! primary care research network. The exposure was cow’s milk fat consumption (skim (0.1%), 1%, 2%, whole (3.25%)), measured by parental report. The outcome was zBMI. Height and weight were measured by trained research assistants and zBMI was determined according to WHO growth standards. A linear mixed effects model and logistic generalized estimating equations were used to determine the longitudinal association between cow’s milk fat intake and child zBMI.
Among children aged 9 months to 8 years (N = 7467; 4699 of whom had repeated measures), each 1% increase in cow’s milk fat consumed was associated with a 0.05 lower zBMI score (95% CI −0.07 to −0.03, p < 0.0001) after adjustment for covariates including volume of milk consumed. Compared to children who consumed reduced fat (0.1–2%) milk, there was evidence that children who consumed whole milk had 16% lower odds of overweight (OR = 0.84, 95% CI 0.77 to 0.91, p < 0.0001) and 18% lower odds of obesity (OR = 0.82, 95% CI 0.68 to 1.00, p = 0.047).
Guidelines for reduced fat instead of whole cow’s milk during childhood may not be effective in preventing overweight or obesity.
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Funding was provided by the Canadian Institutes of Health Research (CIHR) Institute of Human Development, Child and Youth Health (grant number MOP-333560). The funding agency had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
JLM received an unrestricted research grant for a completed investigator-initiated study from the Dairy Farmers of Canada (2011–2012) and Ddrops provided non-financial support (vitamin D supplements) for an investigator-initiated study on vitamin D and respiratory tract infections (2011–2015). All other authors have no potential conflicts of interest.
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Vanderhout, S.M., Keown-Stoneman, C.D.G., Birken, C.S. et al. Cow’s milk fat and child adiposity: a prospective cohort study. Int J Obes 45, 2623–2628 (2021). https://doi.org/10.1038/s41366-021-00948-6