Invited review: Maintaining and growing fluid milk consumption by children in school lunch programs in the United States

Abstract

Fluid milk consumption among children has declined for decades. Adequate consumption of milk and dairy products, especially during childhood, has beneficial health outcomes for growth, development, and reduced risk of osteoporosis, hypertension, obesity, and cancer during adulthood. Satisfaction with milk flavor, perceived health benefits derived from milk, and habit are primary drivers of lifelong milk consumption. Child preferences and attitudes for milk may differ from those of adults, and as such, understanding and fulfilling the needs of children is crucial to reverse the decline in milk consumption. School meal programs make fluid milk accessible to millions of children each day; however, regulations and school lunch procurement systems in the United States sometimes make it difficult to provide novel or value-added milk products in these programs. Total consumption of all milk types in US schools declined by 14.2% from 2008 to 2017, and the percentage of children participating in the school lunch program has also declined. This decline has also been driven by declining average daily participation in the school meal program and may also reflect children's dissatisfaction with the sensory characteristics and the form of milk offered in schools. The change in form of milk offered in schools to lower fat and lower added sugar content in the United States has been driven by government-mandated school lunch calorie and fat requirements. This review describes the current milk consumption trends among children; the structure and basic requirements of the school lunch program in total and for milk; and the intrinsic, extrinsic, and environmental factors that influence child perception, preference, and consumption of fluid milk in the US school system.