Green Bay Packers quarterback Aaron Rodgers promotes milk’s health benefits to kids in an advertisement sponsored by the National Dairy Council. The Wisconsin Milk Marketing Board has cited such promotions during presentations to elementary students.

Part One of Two

What do scientists say about the Wisconsin Milk Marketing Board’s health claims about dairy? A two-day series produced in collaboration with a University of Wisconsin-Madison journalism class taught by Professor Deborah Blum.

• Today: Marketing dairy to children
• Monday: A claim that dairy aids weight loss
• Tuesday: Milk board retreats from weight loss claim

Fact-checking the milk board’s health claims

Some statements checked out. But the Center also found some claims unsupported by science, and some where most evidence came from industry-funded studies. Click the image above to view a pop-up gallery.

Table: Nature’s sports drink?

See the Center’s review of findings and funding sources from eight studies on milk as a sports beverage.

Board defends its conduct, says claims are science-based

By Amy Karon, Catherine Martin and Jessica Gressa
Wisconsin Center for Investigative Journalism

LODI — “How many of you have seen the ‘Got milk?’ ads with Aaron Rodgers and Greg Jennings?” Angie Edge of the Wisconsin Milk Marketing Board asked a roomful of elementary school students, invoking the names of two Green Bay Packers stars.

Hands shot up.

In Wisconsin — the nation’s top cheese producer, with more dairy cows per square mile than any other state — it’s hard to miss the message that milk does a body good. Especially if you’re a child.

That’s because the nonprofit milk board, funded by dairy farmers, spends about $950,000 a year on talks, concerts, posters and a website promoting dairy’s health benefits to school children. The group has challenged others’ claims, such as a recent Wisconsin billboard — sponsored by a national physicians group that promotes veganism — that featured the Grim Reaper to suggest eating cheese can be unhealthy.

But the state-supervised milk board sometimes overstates dairy’s health benefits, public records and interviews suggest.

An investigation by the Wisconsin Center for Investigative Journalism and a University of Wisconsin-Madison journalism class found that the milk board promotes chocolate milk as a sports recovery beverage for children and teenagers, although related studies have mostly focused on adult athletes.

In some materials, the milk board also recommends children consume three to four servings of dairy a day, although the U.S. Department of Agriculture recommends just three servings for teenagers and children over age 9, and less for those 8 and younger. Nutrition experts from Harvard University, New York University and the Mayo Clinic said three to four servings aren’t necessary.

A milk board spokesman defended the group’s conduct.

“Dairy’s role in a healthy diet for all Americans has long been established by the science and nutrition community,” said Patrick Geoghegan, the board’s senior vice president of corporate communications. “All the dietary guidance provided to students and consumers by the Wisconsin Milk Marketing Board… is based on sound, often peer-reviewed research that’s continually updated.”

A boy poses with a standup poster of Green Bay Packers player Greg Jennings holding a glass of chocolate milk. The Wisconsin Milk Marketing Board promotes the drink to children as a “natural sports beverage.” Photo: Wisconsin Dairy News

Chocolate milk: Health food or junk food?

The milk board touts chocolate milk as a natural sports drink for children and teenagers. “Muscles fueled with chocolate milk are muscles fueled with nutritious energy,” states a brochure for parents.

According to the board’s most recent annual report, during the 2009-10 school year, it sent 90 percent of Wisconsin schools promotional materials such as a stand-up poster of Jennings, the Green Bay Packers wide receiver, holding a glass of chocolate milk, and planned to give six high schools chocolate milk for the 2010 football season.

The group reinforces the messages during school visits. “Have you heard the research that chocolate milk is the ultimate sports beverage?” Edge asked students last April at Lodi Elementary School, 25 miles north of Madison.

Several small studies — mostly funded by dairy groups — have found that drinking chocolate milk can enhance recovery after exercising. But they focused on adult athletes with higher calorie needs, not children. Almost 28 percent of Wisconsin children were obese in 2007, according to the most recently available data from the National Survey of Children’s Health.

The topic of flavored milks in schools has taken central stage in recent childhood obesity debates. Last June, the Los Angeles Unified School District became the largest in the nation to ban them from school menus. And this fall, Madison schools cut chocolate milk from the breakfast menu for elementary and middle students.

Researchers haven’t tried to pinpoint flavored milk’s role in obesity, partly because few children drink it exclusively, Yale University children’s obesity expert Marlene Schwartz wrote in an email interview.

But Jennifer Nelson, director of clinical dietetics at the Mayo Clinic, said offering children too many sugary foods can foster long-term preferences for sweets.

“My preference is taking the longer view of establishing dietary patterns,” she added. “Maybe we have chocolate milk Wednesdays, but why do we need chocolate milk every day?”

Dale Schoeller, UW-Madison nutritional sciences professor.

Dale Schoeller, an obesity expert and nutritional sciences professor at the University of Wisconsin-Madison, said there’s no way to pinpoint a single food as a culprit in the obesity epidemic.

“Milk is a highly nutritious food,” Schoeller added. “It is one of the major sources of calcium in a child’s diet and a good source of protein.”

Schoeller said he wasn’t overly concerned about the frequency of chocolate milk served in schools, especially in light of new, lower-sugar chocolate milk formulas.

This fall, Dean Foods Company, which supplies milk to about 120 of Wisconsin’s 424 public school districts, switched to a reduced-calorie chocolate milk formula that’s 1-percent or fat-free with no high-fructose corn syrup, Dean spokesman Jamaison Schuler wrote in an email interview. A cup of the fat-free version has 130 calories and 22 grams of sugar — 40 calories and 10 grams of sugar more than plain milk.

When asked the reason for the new recipe, Schuler said that over the past decade, consumers have increasingly preferred less sugar, fewer calories and no high-fructose corn syrup.

Salud Garcia of Madison wasn’t impressed with the change, adding last spring that she was “dumbstruck” when she learned her daughter’s school, Gompers Elementary, had offered chocolate milk twice daily. “I couldn’t believe the schools would be serving so much sugar to kids,” said Garcia, founder of Madison Families for Better Nutrition, a small group that promotes healthier school district menus.

Ken Syke, Madison school district spokesman, said some parents had complained about chocolate milk, but the district hadn’t recorded how many. He said the district responded by telling parents that children need the nutrients in milk, and that some research has shown they drink less when flavored milk isn’t offered.

The milk board cites a 2009 study, funded by the dairy group that runs the “Got milk?” advertising campaign, that found school children drank 35 percent less milk when flavored milk was off the menu.

Marketers need to “stop sending the message that children will only eat healthy foods that have been reformulated with added sugar,” Yale’s Schwartz responded. “Sugared cereals, highly sugared yogurts and flavored milks are all examples of otherwise healthy foods that now have ‘kids’ versions’ heavily marketed to children and their parents.”

The state Department of Public Instruction doesn’t track chocolate milk sales, but spokesman Patrick Gasper said menu analyses suggest about 75 percent of milk sold in Wisconsin schools is chocolate.

“I have 24 kids in my classroom and at snack time, 23 have chocolate milk and one has plain,” said Tricia Kuluvar, who teaches sixth grade at Waunakee Intermediate School.  “And that’s consistent every year.”

Three to four servings a day?

The milk board website states that “increased dairy consumption” leads to higher bone density later in life and a lower risk of osteoporosis, or weak, fracture-prone bones.

At Lodi, Edge told students they should drink three to four glasses of milk “every single day” for strong bones, while the board’s poster for students recommends “three-four glasses a day for a healthy and hard-working body.”

Milk board representatives gave similar presentations to 30,865 elementary students during the 2009-10 school year, and sponsored “iRock with Milk” concerts for more than 6,000 middle schoolers, according to the board’s annual report.

The milk board’s Geoghegan said dozens of groups and individuals support its recommendations, including the National Osteoporosis Foundation, the U.S. Surgeon General, and the American Medical Association.

In fact, these groups mostly frame their guidance in terms of amounts of calcium to consume, not a preferred source. For example, the Osteoporosis Foundation recommends children and teenagers get 500 to 1,300 milligrams of calcium daily, depending on their age. (A cup of milk contains about 300 milligrams.)

The federal Centers for Disease Control and Prevention makes similar recommendations for calcium consumption and notes that good sources of the mineral include dairy products, dark green leafy vegetables, almonds and calcium-fortified orange juice, soy beverages and cereal.

The USDA’s 2010 Dietary Guidelines for Americans recommends adults and children ages 9 and older consume three cups per day of fat-free or low-fat “milk and milk products” — including fortified soy milk. The USDA recommends two-and-a-half cups daily for 4- to 8-year-olds and two cups daily for younger children.

Some research supports the milk board’s recommendations. A 2003 study on 28 teenage male weight lifters found that boys who drank three servings of milk a day for 12 weeks produced more bone mass than those who drank juice.

But several leading experts said so much milk isn’t needed.

“The so-called calcium requirement in the United States is based on very short-term studies (that are) irrelevant to long-term calcium needs,” Dr. Walter Willett, who chairs the nutrition department at the Harvard School of Public Health, wrote in an email interview about the federal government’s recommended dietary calcium levels.

Long-term studies show consuming more than one serving of dairy a day doesn’t further decrease the risk of weak bones or fractures, Willett added.

And the Mayo Clinic’s Nelson said even being vegan doesn’t increase that risk.

“We know that those individuals who avoid milk and animal products that contain calcium do just fine in terms of their growth, their development, and their bone health,” she said.

Nelson said that’s because vegan diets can be rich in other foods that are good calcium sources.

“The profile of the vegan diet also helps you conserve calcium,” she added. “The person who eats a lot of meat or a high animal-protein diet has a tendency to lose more calcium … it’s a metabolic process that’s quite complex.”

Marion Nestle, nutrition professor at New York University and author of six books on food politics, criticized the milk board’s claims.

She wrote in an email interview: “I wonder how the marketing board explains why the highest rates of osteoporosis are found in countries that drink the most milk, or how cows manage to make huge bones that support their weight while eating mostly grass?”

“It’s hard not to be sarcastic about this kind of marketing,” Nestle added. “Milk is a fine food if you like it, but it is not an essential nutrient.”

Amy Karon is a reporter for the Wisconsin Center for Investigative Journalism. Catherine Martin, Jessica Gressa, Andrew Golden and Eric Skvirsky contributed reporting in a UW-Madison journalism class taught by Professor Deborah Blum, in collaboration with the nonprofit, nonpartisan Center (www.wisconsinwatch.org). The Center also collaborates with Wisconsin Public Television, Wisconsin Public Radio and other news media.

All works created, published, posted or disseminated by the Center do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.

DHS Secretary Dennis Smith. Photo courtesy of Wisconsin Department of Health Services.

Health chief defends approach, says system should be nationwide

By Bill Lueders
Wisconsin Center for Investigative Journalism

Advocates for Wisconsin’s Women, Infants and Children nutrition program want the state to reconsider its decision not to seek nearly $9 million in federal grants to make the benefits more convenient and less open to fraud.

The decision by Dennis Smith, secretary of the Wisconsin Department of Health Services, will  “diminish the capacity to serve the 120,663 participants currently enrolled,” Barbara Sheldon, chairwoman of the Wisconsin WIC Association, said in a letter sent Aug. 12 to Smith.

Earlier this year, Smith rejected a proposal from Patti Hauser, who directs the state WIC program, to submit an $8.9 million grant application to the U.S. Department of Agriculture to convert to an Electronic Benefit Transfer (EBT) system — a swipe card — as all states are required by federal mandate to do by 2020.

The WIC program is for low-income women who are pregnant, nursing or who have children up to age 5. For example, a family of three earning up to $34,281 a year is eligible.

Program recipients in Wisconsin receive paper checks that they present at the grocery store to obtain staples including milk, cheese, eggs, cereal and peanut butter. The new system, already in place in several other states, would allow these purchases to be made using a swipe card.

Unlike paper checks, which can be traded or sold for non-eligible purchases, the cards create an electronic record for each transaction, making fraud easier to detect, according to the USDA.

A sample WIC check, made out to Jane Doe.

Smith, an appointee of Republican Gov. Scott Walker, said he rejected the grant request because there are still too many technological and policy problems that the USDA needs to work out. He added that “the most cost-efficient, best way to do this procurement is at the national level.”

“People want to boil it down to, we turned away money,” said Smith, adding that the funds would not have gone to Wisconsin but to “one of the vendors who do EBT benefits.” He said the decision would have no impact on the current state budget.

But Sheldon, whose association represents the state’s 71 county and tribal WIC programs, sees the state’s failure to seek the $8.9 million as a potential lost opportunity.

“This money is available now,” said Sheldon, who works with the WIC program in Winnebago County. “It may not be available in the future. It may have to fall to the state to pay for this.”

A spokeswoman for the USDA said the agency is making $13 million in grants available this year to help states convert WIC programs to the technology. The awards are expected to be completed by mid-September.

Last year, USDA awarded $30 million to help 23 states begin or continue their conversion to the electronic system.

Sheldon’s letter to Smith says prompt filing of the state’s grant application “puts Wisconsin in the line-up for implementation funding. Once the line-up is full, the federal funding will no longer be available.”

Hauser’s grant proposal summary, obtained by the Wisconsin Center for Investigative Journalism through an open records request, said that “with one or two other states applying,” the full $8.9 million would not likely be awarded at one time. She indicated that if Wisconsin were to receive initial funding, however, it would be in a better position to compete if additional money becomes available.

According to Hauser, the new system could be operational for WIC recipients by 2014. Smith said he considers that timeline “optimistic,” and that his priority as secretary is “doing things that help people today.”

Sheldon said switching to an EBT card, which is already used in Wisconsin for food stamps, would improve program efficiency, “be less cumbersome for grocery stores” and make the program more appealing to participants.

“It’s more in step with how people shop these days, and there would be less stigma to using a swipe card than the paper checks,” she said.

Suzanne Oehlke, advocacy chairwoman for the Wisconsin WIC Association, said some program participants are uncomfortable using the paper checks. They feel stereotyped as poor by cashiers and other shoppers — a reaction she’s also encountered while doing compliance buys in Portage County, where she works. “We know that keeps people from using the WIC program,” she said.

This is not the only federal grant that Smith, a former senior fellow at the conservative Heritage Foundation think tank, has declined to pursue. He also initially refused to support applications by agencies including the Milwaukee Health Department and University Health Services for about $30 million in federal grants over five years to promote healthier lifestyles and prevent disease.

After Smith’s decision was widely criticized, the department changed its stance and sent letters in support of several agencies seeking these grants.

Sheldon’s letter to Smith asks for a meeting to discuss how the state can meet the 2020 deadline to convert to the swipe cards. Smith, through a spokeswoman, said he would be “happy to meet” with the WIC organization.

Bill Lueders can be reached at blueders@wisconsinwatch.org. The nonprofit and nonpartisan Wisconsin Center for Investigative Journalism (www.WisconsinWatch.org) collaborates with Wisconsin Public Television, Wisconsin Public Radio and the UW-Madison School of Journalism and Mass Communication and other news media. All works created, published, posted or disseminated by the Center do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.

For a list of local WIC programs in Wisconsin, see: http://www.dhs.wisconsin.gov/wic/localproject/localprojects.htm

One night last September, Dantwon Gray went fishing with a friend in a rowboat on Friess Lake in Richfield, 25 miles northwest of Milwaukee. When he got a bite, the 26-year-old Milwaukee man stood up, causing the rented boat to capsize.

Bystanders pulled his companion to safety, but Gray drowned. His body was recovered the next day. Gray, who didn’t know how to swim, wasn’t wearing a life jacket, and alcohol wasn’t a factor, the Washington County Sheriff’s Office concluded.

The tragedy that claimed Gray’s life was typical among the boating accidents that killed 20 people in Wisconsin in 2008, according to accident reports analyzed by the Wisconsin Center for Investigative Journalism.

Eight of the 20 people who died last year were in non-motorized boats, most of which capsized. Of the 17 who drowned, 15 weren’t wearing life jackets. And the percentage of boating accidents in which alcohol was involved declined sharply last year, accounting for just one in five accidents. Experts credit stricter law enforcement and a growing public awareness of the dangers of drunken boating.

The Center analyzed accidents reported to the Wisconsin Department of Natural Resources and the U.S. Coast Guard. The Center found:

– Over the past 10 years, 193 people died in 1,311 boating accidents in Wisconsin. In the 110 accidents involving non-motorized boats, 56 people lost their lives.

– July is the most dangerous month of the year, with more than a third of all accidents occurring in that month during the past decade.

– In 2008, there were 110 reported boating accidents, well below the state’s annual average of 131 accidents over the past 10 years. That continued a fairly steady downward trend in accidents since 1999.

– The proportion of accidents involving alcohol dropped sharply last year to the lowest in at least a decade. In four of the past 10 years, alcohol was a factor in at least 85 percent of the boating accidents, compared to 21 percent last year.

– Accidents involving non-motorized boats continue to be a lethal contributor to annual boating fatalities. Only 16 of the 110 accidents last year involved non-motorized watercraft, but half of them resulted in fatalities. Since 1999, 51 percent of all reported non-motorized boating accidents resulted in deaths, compared to just 11 percent of accidents involving motorized watercraft, including jet skis.

A bill before the Legislature would attempt to add another layer of safety. It would require Wisconsin to join 48 other states in requiring that children under age 13 wear life jackets while boating.

In Wisconsin, children under 13 accounted for eight of the 193 boating deaths in the past 10 years, the Center found. Four of the five children who drowned during that time weren’t wearing life jackets. Two others died of trauma, and the cause of death for one child was listed as unknown.

None of the fatalities last year involved children under 13. Among those who died in 2008 was a 17-year-old and his father, neither of them wearing life jackets. They drowned after their motorboat was swamped by the cascade from a dam on the Wisconsin River in Marathon County. Nearly 90 percent of drowning victims in boating accidents statewide and nationally weren’t wearing life jackets.

Wisconsin law requires boat operators to have a life jacket for each person on board, but doesn’t mandate that they be used. Wisconsin and Virginia are the remaining two states that don’t require life jacket use for children.

Senate Bill 162, introduced in April by Sen. Jim Sullivan, D-Wauwatosa, would require life jacket use for children when traveling in a boat less than 26 feet long.

The son of a U.S. Coast Guard officer who patrolled Lake Michigan, Sullivan grew up learning about the importance of personal flotation devices.

“When you look at the harm that befalls children in boating accidents, most of it does come down to the wearing of a life preserver,” Sullivan said. “When you’re out there on the water on a boat, it’s not a matter of your judgment, it’s not a matter of how good a swimmer you are. Things go bad, and they go bad immediately.”

Unstable watercraft contribute to danger

Among the eight deaths that occurred in non-motorized boating accidents last year, six, including the Sept. 25 accident that claimed Gray’s life, involved canoes or rowboats that capsized. Two victims were presumed to have fallen overboard.

Dane County Sheriff’s Deputy Matthew Gueldner, who patrols Madison-area lakes and rivers, said boaters often underestimate the hazards of non-motorized boats.

“If you tip them over, they’re very difficult to right,” Gueldner said. “They’re very difficult to get back into. People on non-motorized boats need to be extra careful before they head out.”

Wisconsin has 613,000 registered motorized boats, fifth highest in the nation, and tens of thousands more canoes, kayaks, sailboats and rowboats that keep the state’s outdoor tourism industry afloat. The state is home to some 15,000 lakes, major rivers including the Mississippi and Wisconsin and hundreds of miles of Great Lakes shoreline on lakes Michigan and Superior.

In 2007, Wisconsin was the seventh safest state for boating in accidents per 100,000 registered boats, the Center found. Minnesota was the third safest, preceded by Vermont and Indiana. Nevada was the least safe, with Arizona and Alaska rounding out the bottom three. The analysis doesn’t account for the difference in time that boats were actually in use, as some waterways in colder states aren’t accessible for boating during winter months. No data were provided for California.

Despite a favorable safety record, Wisconsin boaters still face a variety of hazards. On June 28, a storm caused a 19-foot motorized bass boat to take on water on Madison’s Lake Mendota, dumping seven passengers into the the lake. Three were rescued while four others swam 100 yards to shore. Dane County Sheriff’s spokeswoman Elise Schaefer said alcohol did not appear to be a factor in the incident. Information on life jacket use wasn’t available, she said.

Life jackets save lives

Of the 20 people who died in Wisconsin in 2008, three boating deaths were attributed to trauma. The other 17 victims drowned. Fifteen of them weren’t wearing life jackets — a safety device costing around $30. The Center found that statewide and nationally, nearly 90 percent of boat-related drowning victims weren’t using a flotation device.

“If any of the other drowning victims had been wearing a life jacket, it is likely their deaths may have been prevented,” the Department of Natural Resources said in its 2008 Wisconsin Boating Program Report.

Steve Zowin, co-owner of Lake Delton Water Sports in Lake Delton, has been renting canoes and kayaks for more than 30 years. Although he’s not required by state law to do so, he instructs customers on how to boat safely and urges all of them to wear life jackets — advice that few act on, he said. Zowin recalls an accident one April more than 30 years ago in which a canoeist drowned in the cold water of the nearby Upper Dells. He believes a life jacket would have saved that man’s life.

“We make sure they have (life jackets) when they rent something,” Zowin said, but “most people do not wear them.”

Dantwon Gray wasn’t wearing a life jacket the night he rented a boat on Friess Lake. His father, Darin Gray, wants people to learn from his son’s tragedy by wearing life jackets when they go boating.

Dantwon didn’t know how to swim, just like more than half of the people who drowned while boating in Wisconsin during the past decade.  In honor of his son, Darin Gray’s employer, Pro Health Care Medical Associates, sponsored a scholarship  to fund swimming lessons at a Menomonee Falls YMCA.

Dantwon “was a very outgoing person,” said Darin Gray of his son. “He was real good with people. He loved to fish, so he went out the right way.”

Mandatory training still new to Wisconsin

A year ago, Wisconsin implemented a law requiring motorized boat operators born after Jan. 1, 1989 who are at least 16 years old to complete a boater safety training course. The law requires operators younger than 16 to either be safety certified or supervised by an adult. Officials say it’s still too early to know for sure whether the required training, offered both in classes and online, has been effective in saving lives.

Jack Von Rutenberg of Waunakee, a lifelong boater, is a strong believer in boater safety education. He took his first course as a child and has repeated it with his wife, son, stepson — and now his 11-year-old daughter, aptly named Marina. Last month, father and daughter joined about three dozen other students in a three-session boating course in Verona taught by Deputy Gueldner.

“When you’re out there, you have to know (what to do) right away,” said Von Rutenberg, who runs a restaurant on Lake Mendota.

He credits the state’s “phenomenally low” accident rate to classes like the one he took at the Verona Public Library. But such training is only required of operators of motorboats, not the lighter watercraft involved in many of Wisconsin’s boating deaths.

A top safety expert at the state Department of Natural Resources believes boater education, along with tighter enforcement of drunken-boating laws and growing public awareness of the dangers of drinking while driving a boat, have all contributed to safer boating in Wisconsin.

“As a society, we’ve become more aware of alcohol and the impacts,” said  Todd Schaller, DNR’s director of recreational safety. “We do more enforcement with alcohol than we did 10 or 15 years ago. People are more conscious of it, and they’re more conscious of that enforcement.”

A searchable database of Wisconsin boating accidents since 1999 is available at www.WisconsinWatch.org.

This story was reported and written by Jacob Kushner and Kryssy Pease of the Wisconsin Center for Investigative Journalism. Pease analyzed the data, obtained from the Wisconsin DNR and the National Institute for Computer-Assisted Reporting.

The Wisconsin Center for Investigative Journalism is a nonprofit organization producing investigative journalism in the public interest with its partners — the University of Wisconsin-Madison School of Journalism & Mass Communication, Wisconsin Public Radio and Wisconsin Public Television. See us at www.WisconsinWatch.org.

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