Objective
Evaluate relationships between type of milk consumed and weight status among preschool children.
Design
Longitudinal cohort study.
Setting
Early Childhood Longitudinal Study–Birth Cohort, a representative sample of U.S. children.
Participants
10,700 U.S. children examined at age 2 and 4 years.
Main Outcome Measures
BMI z-score and overweight/obese status as a function of milk type intake.
Results
The majority of children drank whole or 2% milk (87% at 2 years, 79.3% at 4 years). Across racial/ethnic and SES subgroups 1%/skim-milk drinkers had higher BMI z-scores than 2%/whole-milk drinkers. In multivariable analyses, increasing fat content in the type of milk consumed was inversely associated with BMI z-score (p<0.0001). Compared to those drinking 2%/whole milk, 2- and 4-year-old children drinking 1%/skim milk had an increased adjusted odds of being overweight (age 2 OR 1.64, p<0.0001; age 4 OR 1.63 p<0.0001) or obese (age 2 OR 1.57 p<0.01; age 4 OR 1.64, p<0.0001). In longitudinal analysis, children drinking 1%/skim milk at both 2 and 4 years were more likely to become overweight/obese between these time points (adjusted OR 1.57, p<0.05).
Conclusions
Consumption of 1%/skim milk is more common among overweight/obese preschoolers, potentially reflecting the choice of parents to give overweight/obese children low-fat milk to drink. Nevertheless, 1%/skim milk does not appear to restrain body weight gain between 2–4 years in this age range, emphasizing a need for weight-targeted recommendations with a greater evidence basis.