To ask the Scottish Executive, further to the answer to question S2O-4899 by Mr Euan Robson on 13 January 2005, whether it will provide details of the evidence that the nutritional value of milk is "equivocal" and place any research material on the issue in the Scottish Parliament Information Centre.
I must clarify that my previous answer stated that nutritional opinion on the merits of increasing milk consumption, other than low fat milk, is equivocal, rather than the nutritional value of milk is equivocal. Milk does have a clear nutritional value on many counts; it is a nutrient rich food, and a rich source of protein, fat, carbohydrates and various micronutrients especially calcium, riboflavin and vitamin A. We consider it should be seen as part of a varied diet.
The evidence is held in various documents, but can be summarised as follows:
The amount of calcium required to maintain a healthy skeleton varies with age and gender. There are also differences in the recommendations relating to calcium intakes. The Department of Health's subgroup on Bone Health, the Working Group on the Nutritional Status of the Population of the Committee on Medical Aspects of Food and Nutrition Policy (COMA), recommended that the dietary reference nutrient intake (RNI) of calcium for children aged seven to 10 years is 550 mg per day and for children aged 11 to 18 years, 1,000mg and 800mg respectively for boys and girls (Department of Health. Nutrition and Bone Health: with particular reference to calcium and vitamin D. 1998 and Department of Health. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects: 41 London: HMSO, 1991).
However the National Osteoporosis Society (NOS) recommendations are in line with the USA National Institute of Health (NIH) Consensus Panel 4. (National Institute of Health Consensus Development Panel. Optimal Calcium Intake. JAMA 1994;272:1942-1948) and differ from COMA recommendations. NOS/NIH recommend an intake of 800 mg per day for children aged 7 to 12 years and 1,000 for teenagers aged 13 to 19 years. COMA reviewed the evidence presented by the NIH Consensus Panel and could find no scientific justification to adopt its recommendations at this stage.
Calcium intakes in primary children currently meet recommended levels (using COMA RNIs), however, intake drops off as children, and particularly girls, enter their teenage years. This is related to the increase in their consumption of other drinks at this age. It also relates to changes in their food choices - intake of dairy products of all types falls at this age also. Hungry for Success, (Hungry for Success: A whole school approach to school meals in Scotland) and subsequently the Scottish Nutrient Standards for School Lunches recognise the importance of milk in the diet of children and young people and recommend that plain or flavoured drinking milk should be available as an option every day. Semi-skimmed and skimmed milks have the same amount of calcium as whole milk and should be provided for drinking as well as cooking.
Fizzy, sugary soft drinks should not be served as part of school lunch in primary schools and should not be encouraged in secondary schools. Carbonated water, plain water, milk and fruit juices are considered appropriate drinks. Milk is a good alternative to sugary, fizzy drinks, and semi-skimmed milk provides less fat than whole milk. The use of semi-skimmed milk is in line with existing recommendations, e.g. the Scottish Diet Action Plan. There is a desirability to gradually wean Scottish children away from a predilection for sweet flavours. Semi-skimmed plain and flavoured milk drinks are to be encouraged as an immediate alternative to fizzy, sugary soft drinks as they can be a valuable source of protein and calcium. Therefore no nutrient specifications for flavoured milk have been set. However, any added sugar should be kept to a minimum in order to assist in meeting the Nutrient Standards for NME sugars (Scottish Executive (2003). Nutrition in Schools: Scottish Nutrient Standards for Manufactured Products. Edinburgh: Scottish Executive).
In addition, some local authorities are actively working with suppliers to source low fat flavoured milk [personal communication: Direct and Care Services, Glasgow]. In many areas, money received as part of the Hungry for Success initiative is being used to subsidise milk as part of school lunches. Water is recognised as being necessary, particularly in children and young people, for hydration and to facilitate concentration and learning. However, when it is not available children will often meet their hydration needs with fizzy, sugary soft drinks, which will often be more readily available and cheaper than bottled water (Alexander L, Currie C, Todd J and Smith R (2004) HBSC Briefing Paper 7 : How are Scotland's young people doing? A cross-national perspective on physical activity, TV viewing, eating habits, body image and oral hygiene Edinburgh: Child Adolescent Health Research Unit.) However, in recent years significant attempts have been made to improve access to drinking water, and especially tap water, in schools. This is especially important outside of lunchtimes when other sources of hydration are not available.