Cow’s Milk Fat and Child Growth, Development and Nutrition

Background: Health Canada and the Canadian Paediatric Society suggest that children over age 2 years transition from whole (3.25%) to reduced fat (0.1-2%) milk in effort to lower dietary fat intake and reduce the risk of overweight and obesity. However, observational studies have demonstrated that higher milk fat intake is associated with lower child adiposity. The optimal milk fat for child growth, development and nutrition is unknown. Objectives: 1) Determine the relationship between milk fat and child adiposity among existing literature, 2) Understand parent and physician perspectives about milk fat for children, 3) Evaluate the relationship between milk fat and child zBMI among children aged 9 months-8 years in the TARGet Kids! cohort, and 4) Design and launch a randomized controlled trial (RCT) to determine the effect of recommendations for whole vs. reduced fat milk on zBMI among children aged 2-4 years. Methods: 1) A systematic review and meta-analysis was conducted, 2) A qualitative study which sought to understand current practice, attitudes and preferences about milk fat for children aged 2-5 years, 3) A prospective cohort study was conducted using linear mixed effects models, and 4) A RCT protocol (Cow’s Milk Fat Obesity pRevention Trial or CoMFORT) was developed to be embedded in TARGet Kids!. Results: Among 20,897 children aged 9 months-18 years, those who consumed whole milk had 0.61 (95% CI 0.52-0.72, pPh.D