MILKhuman nutritiondairy products inandMILKhuman nutritiondairy products inandEllen Muehlhoff Senior Officer Nutrition DivisionAnthony Bennett Livestock Industry Officer Rural Infrastructure and Agro-Industries DivisionDeirdre McMahon Consultant Nutrition DivisionTechnical EditorsFOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONSRome, 2013Cover photo credits front: EADD/Neil Thomas (top), FAO/A. Conti (bottom) back: ILRI/Apollo Habtamu (top), courtesy of Heifer International (mid), World Bank/Ray Witlin (bottom)The designations employed and the presentation of material in this information product do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations (FAO) concerning the legal or development status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by FAO in preference to others of a similar nature that are not mentioned.The views expressed in this information product are those of the author(s) and do not necessarily reflect the views or policies of FAO.ISBN 978-92-5-107863-1 (print) E-ISBN 978-92-5-107864-8 (PDF) FAO 2013FAO encourages the use, reproduction and dissemination of material in this information product. Except where otherwise indicated, material may be copied, downloaded and printed for private study, research and teaching purposes, or for use in non-commercial products or services, provided that appropriate acknowledgement of FAO as the source and copyright holder is given and that FAOs endorsement of users views, products or services is not implied in any way.All requests for translation and adaptation rights, and for resale and other commercial use rights should be made via www.fao.org/contact-us/licence- request or addressed to copyrightfao.org.FAO information products are available on the FAO website (www.fao.org/ publications) and can be purchased through publications-salesfao.org.iiiContentsPREFACE xiiFOREwORD xiiiACkNOwLEDGEmENTS xvAbbREvIATIONS AND ACRONymS xviiiCONTRIbUTORS xxiCHAPTER 1 Introduction 1 1.1 Nutrition and health 1 1.2 Progress in nutrition outcomes 1 1.2.1 Undernourishment 1 1.2.2 Childhood undernutrition 2 1.2.3 micronutrient malnutrition 2 1.2.4 The double burden of malnutrition 3 1.3 Linking agriculture and nutrition 4 1.3.1 The role of milk and dairy products 5 1.3.2 Dairy programmes affecting nutrition 7 1.3.3 Linking dairy agriculture and nutrition 7 References 9CHAPTER 2 Milk availability: Current production and demand and medium-term outlook 11 Abstract 11 2.1 Trends in food consumption patterns the role of livestock and dairy products 11 2.2 Drivers of increasing consumption of milk and livestock products 20 2.3 Trends in milk production patterns 22 2.4 Effects of technological changes on milk production and processing 26 2.5 Trends in international trade in livestock products 28 2.6 Future trends in production and consumption of dairy products 30iv2.7 Emerging issues and challenges 32 2.7.1 Impact on the environment 33 2.7.2 Impacts on animal and human health 34 2.7.3 Challenges for smallholder production and poverty alleviation 34 2.7.4 Conclusion 35 2.8 key messages 35 References 37CHAPTER 3 Milk and dairy product composition 41 Abstract 41 3.1 Introduction 41 3.2 milk composition 43 3.2.1 The role of milk as a source of macronutrients 43 3.2.2 Composition of milks consumed by humans 44 3.2.3 Factors affecting milk composition 59 3.2.4 Nutritional value of milk from various species 60 3.3 Treated liquid milks and dairy products 64 3.3.1 milk classifications 66 3.3.2 Heat treatments and microbiocidal measures 70 3.3.3 Fermented milk products 74 3.3.4 Cheese 78 3.3.5 butter and ghee 84 3.3.6 Cream 85 3.3.7 whey products 86 3.3.8 Casein 88 3.3.9 milk products from milk from underutilized species 88 3.4 key messages 89 3.5 Issues and challenges 90 References 90CHAPTER 4 Milk and dairy products as part of the diet 103 Abstract 103 4.1 Introduction 104 4.1.1 Limitations of studies reviewed 105 4.1.2 Interpreting study results 106 4.2 milk as a source of macro- and micronutrients 106 4.3 Dietary dairy in growth and development 111 4.3.1 Studies on the effect of milk and dairy products on linear growth in undernourished or socio-economically underprivileged children 113 4.3.2 The role of milk and dairy products in treatment of undernutrition 116 4.3.3 milk in the diets of well-nourished children 117 4.3.4 Secular trend of increasing adult height 119 4.3.5 Possible mechanisms for growth-stimulating effects of milk 120v4.4 Dietary dairy and bone health 121 4.4.1 bone growth 121 4.4.2 Dietary factors that affect bone health 122 4.4.3 milk and dairy foods and bone health 125 4.4.4 bone-remodelling tr