The effects of whole milk compared to skim milk and apple juice consumption in breakfast on appetite and energy intake in obese children: a three-way randomized crossover clinical trial

Abstract

Background: A limited number of studies have examined the effect of dairy on satiety and short-term energy intake among children; furthermore we are not aware of any study comparing high and low-fat dairy products regarding their effect on appetite and short-term energy intake. Our objective was to assess the effect skim milk (SM) compared to whole milk (WM) and apple juice (AJ) on satiety and energy intake at lunch among 10-12 y children with obesity. Methods: Fifty children with obesity who aged 10-12 y were randomized to consume a fixed content breakfast with 240 ml of SM, AJ, or WM for two consecutive days. The study was a three-way randomized crossover study; therefore each participant served as his/her own control. The total appetite, hunger, fullness, desire to eat and prospective consumption were measured using a visual analogue scale (VAS) before breakfast and every one hour after breakfast until a freely consumed lunch. VAS scores and energy intakes were compared using repeated measures procedure. Results: Forty-eight participants (24 girls and 24 boys) completed the study. The energy intake was not different between SM, AJ and WM periods (adjusted mean ± standard error (SE) of energy intake: SM = 831.27 ± 30.64 Kcal, AJ = 794.92 ± 28.72 Kcal, WM = 798.87 ± 24.09 Kcal; P = 0.56). The effect was the same for either gender. Children reported higher satiety score 4 h after drinking WM with breakfast compared with SM (P < 0.05). The same association was found only in girls. Furthermore, SM significantly reduced appetite compared to AJ, 2 h after preloads in girls (P < 0.05). Conclusions: Full-fat milk may have favorable effects on satiety but not energy intake in subsequent meal compared to skim milk among the children with obesity. Future studies with longer follow-up periods are needed to confirm these results. Trial registration: The study protocol was registered with the Iranian registry of clinical trials on 9th October 2016 (registration ID: IRCT2016072012571N5).

Whole-Fat or Reduced-Fat Dairy Product Intake, Adiposity, and Cardiometabolic Health in Children: A Systematic Review

“…Consumption of whole-fat dairy products rather than reduced-fat varieties could result in increased feelings of satiety. In a randomized crossover trial, 48 Iranian children consumed a breakfast with either skim milk or whole-fat milk for 2 d ( 80 ). Children reported a higher satiety score 4 h after drinking whole-fat milk with breakfast compared with skim milk.…”

The potential nutrition-, physical- and health-related benefits of cow’s milk for primary-school-aged children

“…In another study comprising 48 obese children (mean age 11 years), girls reported higher satiety scores 4 h after drinking whole cow's milk compared with skimmed milk, and low-fat cow's milk significantly reduced appetite compared with apple juice 2 h after consumption. These differences, however, did not translate to changes in energy intake at an ad libitum lunchtime meal across all conditions in girls, boys and the group as a whole (108) . As mentioned, only one investigation (comprising two experiments) has sought to establish the effect of cow's milk (and other dairy products) on appetite and feeding behaviour in normal weight and overweight/obese children (mean age 11.5 years), where subjective appetite and appetite-related analytes were measured (112) .…”

“…From the available studies (108)(109)(110)(111)(112) , cow's milk has principally been given as a mid-morning snack or alongside breakfast, with the volume of cow's milk offered to children ranging from 160 ml to 250 ml. Based on these studies, the evidence concerning cow's milk and appetite regulation is inconclusive.…”

Added Sugar Consumption in Spanish Children (7–12 y) and Nutrient Density of Foods Contributing to Such Consumption: An Observational Study

“…It contains high nutritional quality protein and other naturally present high bioavailable bioactive components, minerals (mainly calcium), and fat-soluble vitamins (mainly vitamins D and A) [ 23 ]. Evidence consistently shows that daily cow’s milk consumption improves the intake of energy, protein, vitamins, and minerals [ 28 ], hydration, dental and bone health, and growth; furthermore, there is increasing evidence of the effect of cow’s milk on appetite regulation and satiety that may reduce energy intake in overweight or obese children [ 29 , 30 , 31 , 32 , 33 ]. Therefore, it is advisable to promote the consumption of cow’s milk by children to improve their health.…”