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Published in Print: April 1, 2000, as The Dairy Dilemma

The Dairy Dilemma

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Over the years, Arkansas principal Alfred Carroll has heard more than a few of his middle school students complain of stomachaches after breakfast or lunch. Carroll always figured many of the kids were scamming him to get out of class. Now, he's not so sure.

Over the years, Arkansas principal Alfred Carroll has heard more than a few of his middle school students complain of stomachaches after breakfast or lunch. Carroll always figured many of the kids were scamming him to get out of class. Now, he's not so sure.

Recent research indicates that many minorities may have difficulty digesting lactose, a natural sugar found in milk. Estimates suggest about 90 percent of Asian Americans are lactose intolerant. The figure is 70 percent for African Americans and Native Americans, 50 percent for Hispanics.

Though these findings are disputed, Carroll has concluded that he may have misjudged the complaints of his students at the Sam Taylor Computer Technology Magnet School in Pine Bluff. For students who are lactose intolerant, consuming dairy products can lead to gas, diarrhea, cramps, and bloating—symptoms many of his kids described. So these days, Carroll's staff documents stomach problems at the 270- student, majority-black school. They also plan to hold a public health forum soon to inform the community about lactose intolerance.

Still, one solution to the problem—eliminate milk from public school meals—is something that Carroll can't do. That's because milk and its products— yogurt, cheese, and ice cream—are staples of the federal school lunch and breakfast program. According to the U.S. Department of Agriculture, milk is one of the five essential food groups and must be given to students participating in the program unless they have a doctor's exemption. About 93,000 schools get the federal subsidy to serve lunch and breakfast to students from low-income families; any that don't follow the milk mandate risk losing funding for the program.

That policy is being challenged in a lawsuit filed recently by the Physicians Committee for Responsible Medicine, a Washington, D.C.-based advocacy group. The suit claims that the USDA and the U.S. Department of Health and Human Services are promoting foods that have an adverse effect on disproportionate numbers of minorities. (Only 15 percent of whites are lactose intolerant.) With the legal action, the physicians' group hopes to influence a five-year review of federal dietary guidelines that's under way. "School meals should promote grains, vegetables, fruit, and legumes, and everything else, including meats and milk, should be optional," says Dr. Neal Barnard, president of the committee. "At the very least, alternatives such as soy milk or calcium-fortified orange juice should be available."

As it stands now, "schools are dumping grounds for beef and dairy products," Barnard charges. "The changes we're calling for are simple: We need balance in the guidelines."

The Congressional Black Caucus and the League of United Latin American Citizens are among dozens of minority organizations and individuals that have endorsed the group's proposals for changing the guidelines.

But milk supporters and some nutritionists question the lawsuit's claims. Many people with lactose intolerance can drink at least one glass of milk with a meal, experts say. More can eat yogurt and cheese, foods that are easier to digest because they have less lactose. Greg Miller, vice president of nutrition research for the National Dairy Council, decries what he sees as the physicians' group using "race card" tactics. "Minorities can benefit greatly by consuming dairy products, and there are strategies that will allow them to tolerate dairy products," says Miller, whose organization provides education and research on dairy products.

"Milk is a very important component of a meal plan for children," says Phyllis Griffith, president of the American School Food Service Association and the food-service director for the Columbus, Ohio, school system. "It is a major provider of calcium in children's diets."

Nutrition experts agree that calcium is important for children; they need two to four times as much as adults. But with substantial changes in diet, children could get the calcium they need from nondairy products. "It is more difficult, but it can be done," says Wahida Karmally, a spokeswoman for the American Dietetic Association and an associate research scientist at Columbia University. Calcium is found in foods such as sardines and salmon with bones, dried beans, tofu, broccoli, kale, collard greens, and breads and cereals, and a wide variety of calcium- fortified foods are available, including juices, fruit drinks, cereals, and carbonated beverages.

Griffith, however, cautions that schools would be hard-pressed to come up with enough of these foods—some of which are costly. "We could offer other beverages," she says, "but when you begin to analyze the nutritional content of them or alternative meals, it would be a real challenge to meet the recommended daily allowances."

While the lawsuit awaits trial and the review of federal dietary guidelines continues, the USDA has urged state agencies to work with school districts to offer such alter- natives as lactose-free milk. "Schools have a fair amount of authority to plug in alternative kinds of milk or anything they feel a demand for," says Phil Stanholtzer, a USDA spokesman.

The Sacramento, California, school district does not offer reduced-lactose milk, but it does accommodate students who cannot drink milk. Students who need a special diet must provide a doctor's note. Although nearly 75 percent of the district's 54,000 students are minorities, only a handful have sought the exemption, says Nancy Alexander, the district's nutrition supervisor. One possible reason: Under the district's "offer vs. serve" policy, students choose three out of five items served at any meal. That allows a student to select foods other than milk that fulfill the USDA's calcium requirement, Alexander says.

Miller of the National Dairy Council doubts that the physicians' group will succeed in changing the federal dietary guidelines. But he suggests that the lawsuit may increase awareness of minority health issues.

"The right thing to do is to help people understand how they can keep this calcium-rich product in their diet," Miller says. "We must do better in terms of talking to consumers, especially minority groups."

—Adrienne D. Coles

Vol. 11, Issue 7, Pages 16-17

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