On High Fructose Corn Syrup and Flavored Milk, for James Rippe

James Rippe wants school nutrition directors to know flavored milk is not the enemy.

Dr. James Rippe, founder of Rippe Lifestyle Institute, cardiologist and professor of biomedical sciences at the University of Florida, spoke earlier this week at the School Nutrition Association’s conference about high fructose corn syrup (HFCS). Rippe says the sweetener has been unfairly vilified and warns child nutrition directors not to eliminate flavored milk.

Q. Let’s start with flavored milk. What’s your opinion of schools eliminating flavored milk?

Some schools unfortunately have made the decision to ban flavored milk. The rationale for people arguing that that’s a good thing to do is the added sugar that typically accompanies flavored milk. The reason that they are concerned about that is because these individuals think that limiting added sugars is a positive thing that can be done to help with a very significant issue that we have in our country of childhood obesity.

It’s a laudable goal to try to do something about childhood obesity, but this is a big mistake. The reason for that is this about two-thirds of milk that is consumed at school is flavored milk. The Dietary Guidelines for Americans have a lot of recommendations in this area. They listed four nutrients of particular concern: calcium, vitamin D, potassium and fiber. Milk is the main source of three of those. Right now less than half of children meet the recommended daily guideline for milk. We are falling way, way short of the recommendations.

There are data available for what happens when you eliminate flavored milk in schools. The first thing that happens is that total milk consumption plummets. It goes down by about a third. You basically lose a third of the calcium, vitamin D, potassium and fiber that are in milk. There is some sugar in flavored milk, although that has decreased a lot in the last five years. People said they are used to chocolate milk and the next year they will come back when they’re not used to that sweetened milk. That has also been shown to not be the case. Once they leave they don’t come back. It gets even worse in the second year.

There have been studies that show that if you want to replace the nutrients in chocolate milk you need to add three or four other foods, which are going to have calories in them too. You may have to revamp your entire menu and there are cost implications I’ve seen estimates between $2,200 and $4,600 for every 100 students per year to do that. It would be one thing if there were a nutritional reason to do it and not simply to pander to people.  

Q. What about the HFCS in flavored milk?

Some schools have said we’ll allow schools to have chocolate milk, but it can’t have HFCS. It can have sucrose but not HFCS. It’s also important to know that added sugar is the concern here, flavored milk represents about 3% of added sugars in children’s diets. It’s a trivial amount of added sugars in the first place.

We do need to do something about childhood obesity. But to do this, is a mistake. I think this is an example of where the vocal minority of people in school systems has won the day. A survey of parents said that over 50% of parents said they don’t think it’s a good idea. Ninety-three percent of school nutrition directors think it’s a bad idea to eliminate flavored milk. But some school systems have contemplated this and some have already done it. I think its been driven by a politically correct but nutritionally incorrect idea. 

HFCS has been around for about 40 years. It was pretty much an anonymous ingredient for most of that time. The modern interest in this started in 2004, when two very senior people—friends of mine—published this article basically saying isn’t it interesting that in the last 40 years we’ve had HFCS in our diet and obesity has risen? It isn’t cause and effect. They were pretty careful about saying that the fact that these two things happened at the same time doesn’t mean one caused the other. But isn’t it interesting? They have both now publicly withdrawn that comment. It is the most downloaded article in history from the American Journal of Clinical Nutrition. It got a lot of play. Once it took off on the Internet, it seems to have gathered a life of its own.

Q. Nutritionally, how does HFCS rank?

Many people don’t even know what HFCS is. It’s unfortunate that the name says HFCS because it kind of suggests that it’s high in fructose, but it isn’t. HFCS was developed as an alternative to replace sucrose in certain food and beverage applications. There are two forms of it. They are basically about half fructose and half glucose. Sucrose in contrast is 50% fructose and 50% glucose. They are virtually interchangeable. They have the same number of calories, the same number of sweetness. They are absorbed identically in the human GI tract.

Over the last five years we’ve done a lot of research of this area in adults, but there is no reason to doubt that the same holds true for kids. We’ve found that by every parameter that we have measured, HFCS and sucrose are identical.  

Q. How can child nutrition directors explain to parents that HFCS is not a bad thing in milk?

It’s very hard to turn around someone who is a zealot in this area. The only thing you can do is say here’s the published literature in this area. They can direct parents to resources, like sweetsurprise.com. All you can do is say there is a literature on this and a consensus in the scientific community and if you care to become informed on this, here are places I can direct you. 

Q. Why are dairies working with school districts to formulate HFCS-free milks?

I think sometimes this is the next step that a school system says if you don’t have sucrose in it we’re not going to buy it. The dairy says OK. Then they will accede to that because they want the business. I attended the School Nutrition Association conference last year and over and over again nutrition directors came up to me and said, ‘thank you for being here, but you don’t understand the pressure that we’re under.’ A number of them said that once a group of parents gets it in their head that this is going to happen, no matter what I do it’s very hard to convince them. There is no debate in the scientific community now.

What parents really aught to be doing is thinking about the totality of their children’s diets and how much physical activity they are getting.