As reported by DairyReporter, the World Health Organization (WHO) conducted a study on the link between decreased dairy consumption and its impact on children's health.

Compelling Arguments

The study's findings provide compelling arguments for policymakers, public health officials, and nutrition experts to prioritize context-specific dairy product development strategies based on the right combination of local dairy sector interventions and consumer-oriented trade policies.

According to the World Health Organization (WHO), a child is considered stunted if their growth has been affected due to malnutrition, making them too short for their age.

Stunted children fail to reach their physical and cognitive potential, and the condition is also a risk factor for infant mortality. The highest prevalence of stunting in children is found in parts of Africa, South Asia, Southeast Asia, and Central America, according to data from UNICEF, WHO, and the World Bank (https://ourworldindata.org/stuting-definition?tab=chart).

A group of researchers from the International Food Policy Research Institute conducted an analysis across several countries to demonstrate whether an increase in milk consumption was associated with significant reductions in stunting.

Their findings would be of interest to policymakers, especially in global regions where stunting rates are more prevalent.

Additional Variables

The researchers used WHO data on stunting prevalence, which they merged with FAO estimates of food balance sheets regarding domestic food supply, with milk being the main variable of interest.

To obtain more accurate estimates of milk consumption for children relative to FBS milk supply, the researchers also examined the association between the prevalence of dairy consumption in children aged 6 to 23 months from Demographic and Health Surveys and FBS milk supply; they found a strong correlation between milk supply and consumption.

The analysis also controlled for several additional variables, including nutrient-rich food groups such as non-dairy animal-source foods and fruits and vegetables; average income; access to improved sanitation facilities and drinking water, among others.

Areas of Impact

The highest prevalence of stunting was observed in Southeast Asia, South Asia, and Sub-Saharan Africa, while the lowest rate was recorded in East Asia.

While Southeast Asia and Sub-Saharan Africa had the lowest milk supply per capita, which could explain the high rates of child stunting, this was not the case for South Asia, where India, the largest milk producer in the world, is located.

The researchers noted, however, that other factors such as poor water quality, sanitation and hygiene conditions, and other dietary factors could explain the high rates of stunting in that region. "Furthermore, children consuming dairy products in countries like India are far from being universal: DHS 2015-2016 suggested that only half of the children consumed dairy in the past 24 hours," the paper stated.

Most regions, except Sub-Saharan Africa (SSA), experienced reductions in stunting prevalence, the study emphasized. All regions, except SSA, also witnessed an increase in milk supply since 1960, with the fastest growth in milk consumption occurring in Southeast Asia and China, as well as in Central Asia and South Asia. Higher income was also associated with lower stunting rates and increased milk supply.

Priority Evidence

Although this study has certain limitations, the authors argued that collectively, "this body of evidence justifies a much higher priority for dairy product development in national food and nutrition strategies."

"Dairy product development strategies need to be tailored to local circumstances, taking into account factors such as agro-ecological potential for dairy production (which is influenced by temperature and animal diseases), as well as whether a population has strong traditions or demand for dairy products. In countries with weaker traditions, there are important success stories in Southeast Asia from which other countries can learn," the authors reflected.

Low- and middle-income countries with strong traditions in dairy production and consumption, such as South Asia and East Africa, require modernization and commercialization, according to the paper. "In these countries, the total dairy cow populations are large but very small at the household level, often highly subsistence-oriented and very unspecialized, in the sense that the cattle are used to provide milk but also traction, transport, and other services," the authors wrote.

"Expanding production and consumption is certainly possible... but it requires a combination of expanding market access..., improving the genetic structure of the animal population, ensuring access to veterinary services, expanding processing and storage technologies, building a business environment conducive to commercial dairy products and firms, and ensuring appropriate regulation and monitoring of food safety, both for public health reasons and consumer confidence."

The researchers stated that "there is clearly enormous scope" for public policies and public-private partnerships to increase dairy consumption in regions with low milk consumption, such as Sub-Saharan Africa and Southeast Asia.

Important Concerns

The researchers also acknowledge important concerns related to dairy products. Cow's milk is a complement to breast milk, not a replacement, and they argued that nutritional education campaigns should promote exclusive breastfeeding in the first five months after birth, followed by an appropriate combination of breastfeeding and complementary feeding – including dairy products – from six months onwards.

"In terms of the impact of climate change, the dairy sector actually produces a lot of high-quality protein in relation to greenhouse gas emissions," said Beliyou Haile, former IFPRI researcher and one of the study's authors. "So, while there is a climate cost, there is also a significant nutritional benefit to dairy production."

The authors also noted that dairy farm emissions are much lower compared to beef, despite the two sectors often being lumped together in discussions on climate change. Furthermore, improving dairy production efficiency could simultaneously reduce emissions and make dairy products more accessible to the poor, the paper argues.

Lactose intolerance is another barrier they discussed, although it primarily affects only adult populations in countries without a history of dairy consumption rather than young children. "Vietnam has no dairy traditions at all, but it has managed to rapidly increase dairy consumption among young children and reduce stunting," noted Headey, "going from zero to hero in just a few decades."

In conclusion, the authors wrote, "We believe that this study, along with the existing body of evidence linking milk consumption to reduced stunting risks, justifies greater investments in dairy production – and potentially trade reforms – for reducing stunting risks as well as micronutrient deprivation in developing countries."

(Source: "Growth in milk consumption and reductions in child stunting: Historical evidence from cross-country panel data," Headey, D., Haile, B. Published: 20 June 2023; DOI 10.1016/j.foodpol.2023.102485)