Acta Scientific Nutritional Health (ASNH)(ISSN: 2582-1423)

Research Article Volume 6 Issue 1

Is Flavored Milk Really a Bad Beverage Choice? The Nutritional Benefits of Flavored Milk Outweigh the Added Sugars Content

Theresa A Nicklas1*, Rabab Saab1 and Victor L Fulgoni III2

1USDA/ARS/CNRC, Baylor College of Medicine, USA
2Nutrition Impact, LLC, USA

*Corresponding Author: Theresa A Nicklas, USDA/ARS/CNRC, Baylor College of Medicine, USA.

Received: November 23, 2021; Published: December 27, 2021


The objective of this study was to re-examine the nutritional contribution of flavored milk in the diets of children with an emphasis on total milk consumption, added sugars, and the shortfall nutrients of public health concern using the most recent national data set available. Intake data from children 2 to 18 years (N = 28,259) participating in the NHANES 2001-2018 were obtained from the 24- hour dietary recall interviews. Mean nutrient intakes, nutrient adequacy, least square means and standard errors of energy and intakes of each nutrient were determined. Z-scores were used to assess population differences in nutrient adequacy. A conservative p-value of (p ≤ 0.001) was used. Compared with non-consumers, consumers of flavored milk had higher intakes of total energy, total sugars, and total added sugars. Consumers of flavored milk consumed more total milk (approximately 1-cup equivalent more) than non-consumers. Flavored milk consumers 2-to-18 years, had significantly (p < 0.0001) higher intakes of fiber, vitamins D, A and B-12, riboflavin, calcium, potassium, magnesium and phosphorus than non-consumers. Compared to non-consumers, consumers of flavored milk had a lower percentage not meeting dietary recommendations for vitamins A, D, and B-12, riboflavin, calcium, magnesium, and phosphorus. The percentage of flavored milk consumers with intakes above the AI was lower for fiber intake but higher for potassium intake compared to non-consumers. Based on data from this study, flavored milk is not a bad beverage of choice. The nutritional benefits of flavored milk far outweighs the added sugars content. 

Keywords: Flavored Milk; Added Sugars Intake; Nutrient Intake; Nutrient Adequacy; Child Nutrition; NHANES


  1. Dietary Guidelines Advisory Committee. “Scientific report of the 2020 dietary guidelines advisory committee”. Advisory report to the secretary of agriculture and the secretary of health and human services. Washington, DC: U.S. Department of Agriculture, Agricultural Research Service (2020).
  2. Nicklas TA., et al. "Flavored milk consumers drank more milk and had a higher prevalence of meeting calcium recommendation than nonconsumers”. Journal of School Health 9 (2017): 650-657.
  3. Quann EE., et al. "Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the united states: Diet modeling study based on nhanes 2007-2010”. Nutrition Journal 14 (2015): 90.
  4. Rice BH., et al. "Meeting and exceeding dairy recommendations: Effects of dairy consumption on nutrient intakes and risk of chronic disease”. Nutrition Reviews 4 (2013): 209-223.
  5. Fayet-Moore F. "Effect of flavored milk vs plain milk on total milk intake and nutrient provision in children”. Nutrition Reviews 1 (2016): 1-17.
  6. Nicklas TA., et al. "The nutritional role of flavored and white milk in the diets of children”. Journal of School Health 10 (2013): 728-733.
  7. Fayet F., et al. "Australian children who drink milk (plain or flavored) have higher milk and micronutrient intakes but similar body mass index to those who do not drink milk”. Nutrition Research 2 (2013): 95-102.
  8. Murphy MM., et al. "Drinking flavored or plain milk is positively associated with nutrient intake and is not associated with adverse effects on weight status in us children and adolescents”. Journal of the American Dietetic Association 4 (2008): 631-639.
  9. Nicklas TA. "Avoidance of dairy products: Implications for nutrient adequacy and health”. Canadian Nurse 7 (2012): 1.
  10. Nicklas TA., et al. "The role of dairy in meeting the recommendations for shortfall nutrients in the american diet”. Journal of the American College of Nutrition 1 (2009): 73S-81S.
  11. Hess JM and CJ Cifelli. "Energy and nutrient intake of americans according to meeting current dairy recommendations”. Nutrients10 (2020): 3006.
  12. Quagliani D and P Felt-Gunderson. "Closing america's fiber intake gap: Communication strategies from a food and fiber summit”. American Journal of Lifestyle Medicine 1 (2017): 80-85.
  13. Papanikolaou Yanni and Victor L III Fulgoni. "The role of fortified and enriched refined grains in the us dietary pattern: A nhanes 2009-2016 modeling analysis to examine nutrient adequacy”. Front Nutr 432 (2021).
  14. Cook A and JE Friday. "Pyramid servings intakes by u.S. Children and adults 1999-2002, 1 day”. U.S. Department of agriculture, agricultural research service, community nutrition research group, cnrg table set 3.0 (2021).
  15. S. Department of Agriculture and Agricultural Research Service. "What we eat in america food categories 2015-2016” (2020).
  16. Fayet-Moore F., et al. "Australian children and adolescents who were drinkers of plain and flavored milk had the highest intakes of milk, total dairy, and calcium”. Nutrition Research 66 (2019): 68-81.
  17. Li XE and M Drake. "Sensory perception, nutritional role, and challenges of flavored milk for children and adults”. Journal of Food Science 4 (2015): R665-670.
  18. Dairy council digest archives. "Why flavored milk is a nutritious choice for children” (2021).
  19. Nicklas TA., et al. "Association of usual intake of added sugars with nutrient adequacy”. International Journal of Clinical Nutrtion and Dietetics 126 (2018).
  20. Satija A., et al. "Understanding nutritional epidemiology and its role in policy”. Advances in Nutrition 1 (2015): 5-18.
  21. Cohen JFW., et al. "Impact of the updated usda school meal standards, chef-enhanced meals, and the removal of flavored milk on school meal selection and consumption”. Journal of the Academy of Nutrition and Dietetics 9 (2019): 1511-1515.
  22. Quann EE and DJ Adams. "Impact on milk consumption and nutrient intakes from eliminating flavored milk in elementary schools”. Nutrition Today 3 (2013): 127-134.
  23. Thompson HR., et al. "Effect of removing chocolate milk on milk and nutrient intake among urban secondary school students”. Preventing Chronic Disease 17 (2020): E95.
  24. Johnson RK., et al. "The nutritional consequences of flavored-milk consumption by school-aged children and adolescents in the united states”. Journal of the American Dietetic Association 6 (2002): 853-856.
  25. Dooley D., et al. "Chocolate milk in schools”. Pediatrics 6 (2015): e1680.
  26. Goldberg C. "In long fight over school chocolate milk, perhaps a whole new flavor”. WBUR News 2017 (2021).
  27. Cather E. "The dark side of chocolate milk in nyc schools” (2019).
  28. Dietary Guidelines Advisory Committee. “Scientific report of the 2015 dietary guidelines advisory committee: Advisory report to the secretary of health and human services and the secretary of agriculture”. U.S. Department of Agriculture, Agricultural Research Service (2015).
  29. Centers for Disease Control and Prevention. "National center for health statistics. National health and nutrition examination survey” (2021).
  30. Blanton CA., et al. "The usda automated multiple-pass method accurately estimates group total energy and nutrient intake”. Journal of Nutrition 10 (2006): 2594-2599.
  31. Moshfegh AJ., et al. "The us department of agriculture automated multiple-pass method reduces bias in the collection of energy intakes”. American Journal of Clinical Nutrition 2 (2008): 324-332.
  32. National Health and Nutrition Examination Survey. "Mec in-person dietary interviewers procedures manual pdf” (2002).
  33. Bowman SA, et al. "Mypyramid equivalents database, 2.0 for usda survey foods, 2003-2004 food surveys research group”. Beltsville human nutrition research center, agricultural (2018).
  34. Bowman SA., et al. "Food patterns equivalents database 2011-12: Methodology and user guide”. Food surveys research group, beltsville human nutrition research center, agricultural research service, U.S. Department of agriculture, beltsville, maryland (2014).
  35. S. Department of Agriculture. "Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans”. Appendix e-4: History of the Dietary Guidelines for Americans (2010).
  36. National Cancer Institute. Epidemiology and genomics research program. “Usual dietary intakes: Sas macros for analysis of a single dietary component” (2021).
  37. Tooze JA., et al. "A new statistical method for estimating the usual intake of episodically consumed foods with application to their distribution”. Journal of the American Dietetic Association 10 (2006): 1575-1587.
  38. "SUDAAN release 9.0.3”. Research triangle institute. Research triangle park (2007).
  39. Centers for Disease Control and Prevention. National Center for Health Statistics. “NHANES Analytical Guidelines” (2021).
  40. “Dietary reference intakes: Applications in dietary assessment”. Washington, DC: The National Academies Press (2000).
  41. Reinagel M. "The carrageenan controversy” (2015).
  42. S. Department of Health and Human Services. "Dietary Guidelines for Americans, 2020-2025”. Chapter 1: Nutrition and health across the lifespan (2020).
  43. Basch CE., et al. "Validation of mothers' reports of dietary intake by four to seven year- old children”. American Journal of Public Health 11 (1990): 1314-1317.
  44. Baranowski T., et al. "Accuracy of maternal dietary recall for preschool children”. Socioeconomic status and daycare factors”. Journal of the American Dietetic Association 91 (1991): 669-674.
  45. Schoeller DA. "How accurate is self-reported dietary energy intake?" Nutrition Reviews 10 (1990): 373-379.
  46. Marriott BP., et al. "Intake of added sugars and selected nutrients in the united states, national health and nutrition examination survey (nhanes) 2003-2006”. Critical Reviews in Food Science and Nutrition 3 (2010): 228-258.
  47. Livingstone MB and KL Rennie. "Added sugars and micronutrient dilution”. Obesity Reviews 1 (2009): 34-40.
  48. Rennie KL and MB Livingstone. "Associations between dietary added sugar intake and micronutrient intake: A systematic review”. British Journal of Nutrition 5 (2007): 832-841.
  49. Gibson SA. "Dietary sugars intake and micronutrient adequacy: A systematic review of the evidence”. Nutrition Research Reviews 2 (2007): 121-131.
  50. Erickson J and J Slavin. "Total, added, and free sugars: Are restrictive guidelines science-based or achievable?" Nutrients 4 (2015): 2866-2878.
  51. United states department of agriculture, agricultural research service. "Usda database for the added sugars content of selected foods, release”. 1 (2021).
  52. Archer E., et al. "Validity of U.S. Nutritional Surveillance:National Health and Nutrition Examination Survey Caloric Energy Intake Data, 1971-2010”. PLoS One 10 (2013): e76632.


Citation: Theresa A Nicklas., et al. “Is Flavored Milk Really a Bad Beverage Choice? The Nutritional Benefits of Flavored Milk Outweigh the Added Sugars Content". Acta Scientific Nutritional Health 6.1 (2022): 114-132.


Copyright: © 2022 Theresa A Nicklas., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.316

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is April 30th, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue".
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US