School Milk Program Research Articles

School Milk Programs and Child Nutrition: Leveraging Local Governments and Markets

School Milk Programs and Child Nutrition: Leveraging Local Governments and Markets

The Welfare Effects of School Milk Program

The Welfare Effects of School Milk Program

Cost‐effectiveness of probiotics and fluoride varnish in caries prevention in preschool children

AbstractObjectivesThe purpose of this study was to evaluate the cost‐effectiveness of two preventive interventions aimed at increasing the proportion of caries‐free preschool children of low socioeconomic status using a decision analytic model.MethodsTwo scenarios were tested, one with a school milk program (SMP) and one without (non‐SMP). Fluoride varnish (FV) and a probiotic (PB) were compared to a do‐nothing alternative among children in public nurseries/schools over a 4‐year period. FV was applied biannually and a PB (Lactobacillus rhamnosus) added to milk powder prepared daily. A Markov decision tree model was utilized. Several sources of data were used to populate the model. Probabilistic and deterministic sensitivity analyses were performed, and a public provider perspective was used.ResultsIn the SMP scenario, PB was more effective and less costly than FV and, compared with do‐nothing, increased the proportion of caries‐free children by 14.5%, with a cost of USD 12.5 per child (June 2018). PB presented an incremental cost‐effectiveness ratio (ICER) or cost per extra caries‐free child of USD 86.2. In the non‐SMP scenario, both interventions were cost‐effective. FV (compared with do‐nothing) increased the percentage of caries‐free children by 8.3% with an ICER of USD 338.3 and PB (compared with FV) increased the effect by 6.2% with an ICER of USD 1400.2.ConclusionsThe findings showed that PB was most effective and less costly than FV in the SMP scenario only. This type of analysis and its results provide essential information for decision‐makers to improve the oral health of preschool children.

INFLUENCE OF SCHOOL FEEDING PROGRAM ON THE RETENTION OF LEARNERS IN PUBLIC PRIMARY SCHOOLS IN KENYA; A CASE OF MOMBASA COUNTY

Purpose: The purpose of the study was to establish the influence of school feeding program on the retention of learners in public primary schools.Methodology: This study was conducted through a descriptive survey research design. A descriptive survey is a present oriented methodology used to investigate populations by selecting samples to analyze and discover occurrences. The survey focused on 60 out of the 188 head teachers and teachers who are beneficiaries of school milk program in all the six sub counties in Mombasa i.e. Mvita, Kisauni, Likoni, Nyali, Jomvu and Changamwe.This gives 31.9 % of the total number of participants in this project. To obtain the study sample for descriptive studies 10% of the accessible population is enough. Simple random and purposive sampling procedures were used in this research.Results: School feeding program influences retention of learners in public primary schools with a reliability value of 0.8 which is considered minimal acceptable thus rejecting null hypothesis therefore meaning that school feeding program has a significant effect on retention of learners in pubic primary schools.Unique contribution to theory, practice and policy: School feeding programmes are often designed to enhance academic performance and cognitive development. Improved nutritional status of school-age children leads to better attention and cognition, and thus, better educational outcome. School feeding can improve attentiveness in class by reducing short-term hunger many children come to school on an empty stomach, yet they remain surrounded by the distracting and disturbing facets of the crisis. The study recommends that the ministry of education should review the School feeding Programme and extend it upper primary classes. They should prioritize supply of food to ensure continuous provision and adequate supply of food for pupils.

The physical activity and nutrition-related corporate social responsibility initiatives of food and beverage companies in Canada and implications for public health

BackgroundAs diet-related diseases have increased over the past decades, large food companies have come under scrutiny for contributing to this public health crisis. In response, the food industry has implemented Corporate Social Responsibility (CSR) initiatives related to nutrition and physical activity to emphasize their concern for consumers. This study sought to describe the nature and targeted demographic of physical activity and nutrition-related CSR initiatives of large food companies in Canada and to compare companies who participate in the Canadian Children’s Food and Beverage Advertising Initiative (CAI), a self-regulatory initiative aimed at reducing unhealthy food advertising to children, with non-participating companies.MethodsA cross-sectional study was conducted in 2016. Thirty-nine large food companies, including 18 participating in the CAI, were included in the study. The webpages, Facebook pages and corporate reports of these companies were surveyed to identify CSR initiatives related to nutrition and physical activity. Initiatives were then classified by type (as either philanthropic, education-oriented, research-oriented or other) and by targeted demographic (i.e. targeted at children under 18 years or the general population). Differences between CAI and non-CAI companies were tested using chi-square and Mann-Whitney U tests.ResultsOverall, 63 CSR initiatives were identified; 39 were nutrition-related while 24 were physical activity-related. Most (70%) initiatives were considered philanthropic activities, followed by education-oriented (20%), research-oriented (8%) and other (2%). Almost half (47%; n = 29) of initiatives targeted children. Examples of child-targeted initiatives included support of school milk programs (n = 2), the sponsorship of children’s sports programs (n = 2) and the development of educational resources for teachers (n = 1). There were no statistically significant differences in the number of CSR initiatives per company (CAI: Mdn = 1, IQR = 3; non-CAI: Mdn = 0, IQR = 2; p = .183) or the proportion of child-targeted initiatives (CAI: 42%; non-CAI: 54%; p = .343) between CAI and non-CAI companies.ConclusionFood companies, including many that largely sell and market unhealthy products, are heavily involved in physical activity and nutrition-related initiatives in Canada, many of which are targeted to children. Government policies aimed at protecting children from unhealthy food marketing should consider including CSR initiatives that expose children to food company branding.

Participation in the School Milk Program Contributes to Increased Milk Consumption and Dietary Nutrient Intake by Middle School Students in South Korea.

Milk is considered to be one of the main food sources of calcium for promoting growth and bone health in children and adolescents. This study investigated whether or not participation in a school milk program affected milk consumption and nutrient intake by middle school students in South Korea. In total, 692 middle school students aged 13–16 years old were enrolled in two groups: the school milk program participant group (n = 346) and the non-participant group (n = 346). The survey examined normal milk consumption status in both groups. The diet record method was applied to analyze the amount of nutrient intake levels. Milk/dairy product consumption was significantly higher in the school milk program participant group for both boys and girls (p < 0.001). The school milk program participant group also generally showed higher energy and dietary nutrient intake levels as compared to the non-participant group for both genders (p < 0.05). No differences were observed in milk consumption at home or outside school, and calcium intake from animal-derived foods was higher in the school milk program participant group (p < 0.001). Therefore, it can be assumed that participating in the school milk program directly resulted in higher calcium intake. Hence, we can report that participating in the school milk program contributes to increased milk consumption and improved the overall nutrient intake.

The consumption pattern of milk and calcium sources of the middle school students depending on the participation of school milk program in Gyeonggi, Korea

The consumption pattern of milk and calcium sources of the middle school students depending on the participation of school milk program in Gyeonggi, Korea

Evaluation of Small and Medium-Sized Enterprises Operating in Short Supply Chains Within Slovak School Programmes

Abstract Despite of reduction of its share on the gross domestic product, agriculture remains a branch generating job opportunities in rural areas. However, through more intensive farming procedures, it puts a pressure on environment and sustainability of agricultural production and prolongs the distance of distributed goods. Reduction of the mentioned impacts is possible through shortening the food supply chain subsequently resulting in increase of local sale, demand for local services and increase of labour market, putting an emphasis on support of small and medium – sized enterprises and their economic viability improvement. This paper evaluates the performance of small and medium enterprises and micro-enterprises which applied for the support and supplied and distributed fruits, vegetables, milk and milk products to kindergartens and primary schools within the School Fruits and Vegetables and the School Milk programme. We suppose that through supplying local schools they contributed to the food supply chain shortening.

OKUL SÜTÜ PROGRAMINA YÖNELİK VELİLERİN YAKLAŞIMI: ISPARTA İLİ ÖRNEĞİ

Bu araştırmada Isparta ilinde okul sütü programına katılan ilkokul öğrenci velilerinin bu programa yönelik yaklaşımlarının tespit edilmesi amaçlanmıştır.&#x0D; Çalışmada, araştırma bölgesinde okul sütü programına dahil olan 359 öğrenci velisinden anket yöntemi ile elde edilen veriler kullanılmıştır. Araştırma bölgesinde ele alınan tüketiciler hane gelirlerine göre dört gruba ayrılarak incelenmiştir. Araştırma bulgularına göre ailelerin daha çok pastörize sütü tükettiği belirlenmiştir. Görüşme yapılan bireylerin yaş ortalamaları 37.14 yıldır. Ailelerin %36.21‘i lise mezunudur. Ailelerin %53.48‘i, 50 TL‘den az süt harcaması yapmaktadır. Hane genişliği 4.05 kişidir. %21.84‘ü sütü sıcak olarak tüketmektedir. Velilerin okul sütü programına bakışı genel itibariyle olumludur (%82.17‘si). Okul sütü programı süt tüketme alışkanlığı kazandırdığını, olumsuz düşünen velilerin %33.33‘ü dağıtılan içme sütünün içeriğine güvenmedikleri için olumsuz baktıkları tespit edilmiştir. Velilerin %49.30‘u okul sütü programının çocuklarında süt tüketim alışkanlığını artırdığını düşünmektedir. Velilerin %67.97‘si dağıtılan içme sütünün arz fazlası olmadığını düşünmektedir. Bu düşüncelerinde ise Devlete ve Milli Eğitim Bakanlığı‘na olan güvenlerinden kaynaklandığı tespit edilmiştir. Arz fazlası olduğunu düşünen veliler (%30.95) ise firmalara yardım düşüncesinde oldukları tespit edilmiştir. Okul sütü uygulamasının amacına dair velilerin %48.75‘i sütü sevdirmek ve alışkanlık kazandırmak olduğu yargısına sahiptir. Velilerin (%62.40) günlük süt tercihi söz konusudur. %44‘ü de içme sütlerinin analiz edildiğine inanmaktadır. Milli Eğitim ve Sağlık Bakanlığının, ailelere sütün önemi ve okul sütü programın yararları konusunda bilgilendirme çalışmaları yapması önerilmektedir.

The Perception of School Milk Program and Consumption of Calcium Source of Middle School Students in Gyeonggi, Korea

In order to develop the strategies to increase the participation of school milk program (SMP), 300 middle school students were surveyed. The information regarding the perception of SMP and intakes of milk and other calcium sources as well as general characteristics was obtained by self‐administered questionnaire. The data were compared between the subjects who wanted the SMP (wanting‐SMP) and those who did not (not‐wanting‐SMP). More of not‐wanting‐SMP group graduated from the elementary schools without SMP (10.9% vs. 4.5%, p&lt;0.05) and drank milk usually along with other foods such as cereals (32.4% vs. 26.1%) or snacks (26.1% vs. 19.8%), while less of them drank milk alone (33.3% vs. 42.3%, p&lt;0.05), compared to wanting‐SMP group. Compared to wanting‐SMP group, more of not‐wanting‐SMP group drank milk less often than once a week (19.6% vs. 52.2%, p&lt;0.05), while the intakes of dairy foods and calcium supplements were not different between groups. Without significant differences between groups, 65.6% of subjects drank the flavored milks when they had a choice to purchase, while 82.6% drank unflavored milk when they did not have a choice home. Conclusively, the results suggested that the adolescents who are reluctant to participate school milk program may have inadequate calcium intake and provided the rationale to urge them to participate SMP not only for the adequate calcium intakes currently, but also for the good dietary habits regarding drinking milk regularly from healthier type, which will favor their health in the future.

The impact of tap water fluoridation on human health

The purpose of this review is to describe the osteological, neurological, endocrine and dermatological effects of fluoride ingestion. Additional aims are to evaluate whether the Chilean tap water fluoridation program has had any impact on dental health, and analyze the basis for the Chilean elementary school milk fluoridation program, which is targeted at children living in places where tap water has a fluoride concentration less than 0.3 mg/L, without any artificial fluoridation process. We discuss the finding that both public measures have no direct or remarkable effect on dental health, since topical dental hygiene products are the main and most effective contributors to the prevention of dental decay. We also suggest that the permanent and systematic ingestion of fluorides imposes health risks on the population. Therefore, we recommend reevaluating the national fluoridation program for public tap water and the elementary school milk program.

우리나라 초·중·고 학생들의 학교우유급식 참여 실태 및 인식 조사

This study was designed to examine the level of milk consumption and perception of the school milk programs among elementary, middle and high school students, which provides the information to improve the school milk program. Using a self-administered questionnaire survey, the data collected from 1,725 students nationwide were analyzed. The results showed that whole milk was the type of milk most frequently drunk by the students, although flavored milk and yogurt products were also highly preferred. When asked whether they wanted the school milk program or not, approximately 30% of the students in the schools presently participating in the school milk program and 50% of the students in the schools not participating the school milk program answered "yes". However, all of the respondents preferred to have a choice for the school milk program. The elementary school students showed a higher level of satisfaction with the school milk program than the middle and high school students. Especially, the level of satisfaction with the taste and flavor of the milk was the lowest among the various satisfaction items. However, the students were reported to believe that milk is highly nutritious and good for their health in the present study. Our results suggest that providing a choice of dairy products would improve the students' satisfaction with the school milk program, and that continuous education about the benefits of drinking milk would also encourage them to participate in the school milk program.

우리나라 학교우유급식 관리현황 및 영양사들의 인식 조사

This study was aimed to investigate management conditions and dietitians' perception for improvement of school milk programs. Using an online sampling method, collected data from 1,723 dietitians nationwide were analyzed. The results show that 44.4% of respondents carried out the cyclic school milk program, providing various types of dairy products either weekly or monthly. Further, 80.3% of respondents answered that preference survey results were a determining factor in their choice of school milk provider, and 55.9% said that a school steering committee made the decision on relevant facts of the school milk program. For diversification of school milk type, 60.5% of respondents wanted to maintain the current system, and 39.5% answered that milk type needed to be diversified. The respondents preferred fermented milk products, functional milk, and processed milk, in order, if school milk type is diversified. To improve perception and knowledge about milk, 66.0% of respondents thought that nutrition education by a nutrition teacher would be the most effective, and parent's letters or a nutrition newsletter would be helpful. More than half of respondents (55.0%) disagreed with a merged program for school foodservice and milk.

Impact of the removal of chocolate milk from school milk programs for children in Saskatoon, Canada

Studies in the United States report inclusion of flavoured milk in the diets of children and youth improves nutrient intakes. No research has investigated the contribution of flavoured milk to overall milk intake or the milk preferences of Canadian children. The objective of the study was to measure milk consumption (plain milk and flavoured milk) by children in an elementary school environment and investigate factors contributing to milk choice. A mixed-method research design was applied across 6 schools for 12 weeks. Milk waste was measured in grades 1-8 for 12 weeks. Weeks 1-4 (phase 1) and 9-12 (phase 3) provided both plain milk and flavoured milk as chocolate milk while weeks 5-8 (phase 2) provided plain milk only. Beverage Frequency Questionnaires were used in each phase (in grades 5-8 only) to assess usual beverage consumption. Statistical nutrient modelling was conducted to determine the effects of removing chocolate milk during phase 2 as a milk choice. Later, focus groups were conducted with students in grades 5-8 to determine what influences them to choose/not choose to drink milk. Total milk intake decreased by 12.3% when chocolate milk was removed from the schools (26.6% ± 5.2% to 14.31% ± 1.6%, p < 0.001). Milk choice was influenced by environmental factors as well as taste, cost, convenience, and variety. Total milk intake was associated with location (p = 0.035) and cost (p < 0.001), with rural students and/or those students receiving free milk drinking the greatest amount of milk. Nutrient modelling revealed chocolate milk is more cost-efficient and convenient at providing nutrients than alternative food/drink combinations.

Milk fluoridation for the prevention

The aim of this review is to give an overview of 55 years experience of milk fluoridation and draw conclusions about the applicability of the method. Fluoridated milk was first investigated in the early 1950s, almost simultaneously in Switzerland, the USA and Japan. Stimulated by the favourable results obtained from these early studies, the establishment of The Borrow Dental Milk Foundation (subsequently The Borrow Foundation) in England gave an excellent opportunity for further research, both clinical and non-clinical, and a productive collaboration with the World Health Organization which began in the early 1980s. Numerous peer-reviewed publications in international journals showed clearly the bioavailability of fluoride in various types of milk. Clinical trials were initiated in the 1980s - some of these can be classed as randomised controlled trials, while most of the clinical studies were community preventive programmes. These evaluations showed clearly that the optimal daily intake of fluoride in milk is effective in preventing dental caries. The amount of fluoride added to milk depends on background fluoride exposure and age of the children: commonly in the range 0.5 to 1.0 mg per day. An advantage of the method is that a precise amount of fluoride can be delivered under controlled conditions. The cost of milk fluoridation programmes is low, about € 2 to 3 per child per year. Fluoridation of milk can be recommended as a caries preventive measure where the fluoride concentration in drinking water is suboptimal, caries experience in children is significant, and there is an existing school milk programme.

Extruded Rice Grains Fortified with Zinc, Iron, and Vitamin A Increase Zinc Status of Thai School Children When Incorporated into a School Lunch Program

Iron (Fe), zinc (Zn), and vitamin A (VA) deficiencies are common among children in developing countries and often occur in the same individual. Rice is widely consumed in the developing countries of Asia and the low phytate in polished rice makes it ideal for Zn and Fe fortification. Triple-fortified rice grains with Zn, Fe, and VA were produced using hot extrusion technology. The main objective of the present study was to determine the impact of triple-fortified extruded rice on Zn status in school children in Southern Thailand. Although serum zinc was the main outcome indicator, Fe and VA status were also assessed. School children with low serum zinc (n = 203) were randomized to receive either triple-fortified rice (n = 101) or natural control rice (n = 102) as a component of school lunch meals for 5 mo. Serum Zn, hemoglobin, serum ferritin, serum retinol, and C-reactive protein were measured at baseline and at the end of the study. After the intervention, serum Zn increased (P < 0.05) in both the fortification (11.3 ± 1.3 μmol/L) and control (10.6 ± 1.4 μmol/L) groups, most likely due to the proper implementation of the school lunch and school milk programs, with the increase greater in the group receiving the triple-fortified rice (P < 0.05). Because the children were not Fe or VA deficient at baseline, there was no change in Fe or VA status. We conclude that Zn fortification of extruded rice grains is efficacious and can be used to improve Zn status in school children.

울산시 초등학교 우유급식 만족도 및 기호도 분석

This study examined the satisfaction of a school milk program as well as the preference of school milk and flavored milk. The subjects of this study were 4<SUP>th</SUP>, 5<SUP>th</SUP> and 6<SUP>th</SUP> grade students in 4 different elementary schools, who were attending the school milk program in Ulsan. The survey was conducted from April 10, 2009 to April 30, 2009. Of the 403 questionnaires distributed, 347 responded and analyzed (usage rate: 86%). The results were as follows. Of the 347 respondents, 53.9% were boys and 46.1% were girls. 34%, 31.1% and 34.9% of the students were 4<SUP>th</SUP>, 5<SUP>th</SUP> and 6<SUP>th</SUP> graders, respectively. Second, 80.1% of the students reported ‘have milk everyday’, and 89.9% of the students reported ‘have milk as it is’. Third, the overall satisfaction with the school milk program was 3.32 based on a 5-point likert scale, the ‘guidance of nutrition teachers and class teacher’ was 3.21 and ‘taste of school milk’ was 3.37. There were significant positive correlations between the school milk satisfaction variables and overall satisfaction (p＜0.01). Fourth, the preference for school milk was 3.33. The preference for flavored-milk were 3.63 (coffee milk), 4.44 (chocolate milk), 4.16 (strawberry milk), 4.26 (banana milk) and 3.53 (black bean milk). Fifth, to improve the school milk program, 85.9% of students wanted a provision for flavored milk. In conclusion, schools need to find a way to increase the satisfaction of the school milk program and the preference of school milk to increase the milk intake of students. Nutrition education for students and parents should be conducted systematically and choices for various kinds of milk and milk products should be given to the students.

Distributions and Incidences of Elementary School Children with Lactose Intolerance Symptoms after Drinking Milk in Korea

Milk contains a number of nutrients required for human growth and development, such as disaccharide lactose which is significantly contained in milk and dairy products. About two thirds of world populations are reportedly suffering from lactose intolerance after drinking milk. Lactose intolerance is defined as a maldigestion of lactose in the human intestine with typical symptoms of abdominal pains, bloating, and diarrhea. In this study, incidence of lactose intolerance has been investigated for the elementary school children for 1 year from July, 2010 to June, 2011. It is found that about 70% of the total elementary students have joined the school milk program. Out of 636 total students that participated in this study, 449 were from the metropolis, 85 from middle-sized city, and 102 from the small town including rural areas (small town/rural areas). For distributions of lactose intolerance, 154 students (24.2%) were found to be positive among the total 636 subjects. Based on the size of the city, the symptoms were the most prevalent for the students in the small town/rural areas at 31.4% (32/102), followed by 30.6% (26/85) in middle-sized city, and 21.4% (96/449) in the metropolis. On the other hand, gender had no significant effect on the incidence of lactose intolerance, shown those for boys and girls were 24.8% (77/310), 23.6% (77/326), respectively. Further research is needed to confirm the correct incidence of lactose intolerance symptoms as the frequency is significantly affected by subject's digestive functions including irritable bowel syndrome.

Implementation of CAP programs aimed at increasing the consumption of fruit, vegetable and milk products in Polish schools

The Common Agriculture Policy’s Fruit Scheme and School Milk Program are EU-wide institutional attempts to encourage consumption of selected food products among children by increasing their availability in schools. The number of pupils participating in both schemes in Poland has reached more than 67% and 38% of the appropriate target groups. Pilot studies, carried out in 2010 and 2011, indicate what products are most preferred by Polish schoolchildren from among those made available to them through the schemes. Circa 86% of the surveyed children living in cities would like to obtain more milk products in schools, especially yogurts. In order to make both CAP schemes more nutrition-oriented the education component should be strengthened since the availability and the price are important, but not exclusive determinants of food choice

A Study on a School Milk Program for Elementary School Students in Seoul

A Study on a School Milk Program for Elementary School Students in Seoul