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Cow’s milk fat and child adiposity: a prospective cohort study

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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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Fig. 1: Participant flow diagram.
Fig. 2: The relationship between cow’s milk fat and zBMI in children aged 9 months to 8 years, adjusted for clinically relevant covariates.

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Acknowledgements

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.

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Authors

Contributions

SMV and JLM conceptualized and designed the research study, performed initial statistical analyses, drafted the manuscript, approved the final manuscript as submitted, and had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. CSB and DLO assisted in refining the study design, reviewed and revised the manuscript, and approved the final manuscript as submitted. KET and CDGKS reviewed and revised statistical analysis as well as the manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Jonathon L. Maguire.

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Competing interests

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

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