(P16-015-25) Associations Between Milk and the Consumption of Fruits and Vegetables in Elementary, Middle, and High School Students Using Objective Measurements

Objectives: Most youth ( >90%) do not meet recommended intake of milk or fruits and vegetables (FV). While milk consumption is linked to healthy behaviors, the relationship between milk type (flavored vs unflavored) and FV intake in school-aged children remains unclear. We examined how selection and consumption of different milk types relate to objective FV intake.

Methods: This secondary analysis used cross-sectional data from a cluster-randomized intervention of students grades 1-12 in Arizona (2017-2021; n=4009, 52% Hispanic/Latino, 47% female; 36% elementary, 30% middle, and 33% high school). Data included demographics, milk selection/type, milk consumption, and objective FV consumption (post- vs. pre-lunch difference in weight of FV items). Milk type (none, unflavored milk, flavored milk) selected and consumed (opened, unopened) were assessed via onsite tray images. Mixed effects zero-inflated negative binomial models examined the association of milk selection/consumption with FV intake, adjusting for race/ethnicity, gender, grade, priced lunch status and school-level clustering.

Results: Most students (n=2762; 68.9%) selected milk, 79.2% of whom selected flavored milk, and 83.9% opened their milk. Flavored milk (85.5%) was opened more than white (77.7%). Adjusted mean FV intake was highest for opened white milk (49.6 g) and lowest for selected but unopened flavored milk (41.1 g). Among those consuming any FV, consumption was 20.9% higher when white milk was open than when flavored milk was unopened (p=.02). The odds of consuming any FV were 1.4 times higher when students opened white milk than opened flavored milk (p=.03), 1.8 times higher than unopened white milk (p=.03), and 1.4 times higher than when no milk was selected (p=.04).

Conclusions: Results suggest students who select and consume white milk may consume more FV relative to other behaviors. Promoting white milk consumption during school lunch may help increase FV intake among school-aged students.

Funding Sources: National Dairy Council