Milk Powder Added to a School Meal Increases Cognitive Test Scores in Ghanaian Children

Reginald Lee, Lauren Singh, Danielle van Liefde, Meghan Callaghan-Gillespie, Matilda Steiner-Asiedu, Kwesi Saalia, Carly Edwards, Anja Serena, Tamara Hershey, Mark J. Manary

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: The inclusion of milk in school feeding is accepted as good nutritional practice, but specific benefits remain uncertain. Objective: The objective was to determine whether consumption of 8.8 g milk protein/d given as milk powder with a multiple micronutrient–enriched porridge resulted in greater increases in linear growth and Cambridge Neuropsychological Test Automated Battery (CANTAB) scores in Ghanaian schoolchildren when compared with 1 of 3 control groups. Methods: A randomized, double-blind, placebo-controlled clinical trial in healthy children aged 6–9 y was conducted comparing 8.8 g milk protein/d with 4.4 g milk protein/d or 4.4 g milk protein + 4.4 g rice protein/d (isonitrogenous, half of the protein from milk and half from rice) or a non-nitrogenous placebo. Primary outcomes were changes in length after 9 mo and CANTAB scores after 4.5 mo; secondary outcomes were body-composition measures. Supplements were added to porridge each school day and consumed for 9 mo. Anthropometric and body-composition measures and CANTAB tests were completed upon enrollment and after 4.5 and 9 mo. Group results were compared by using ANCOVA for anthropometric measures and the Kruskal-Wallis test for CANTAB scores. Results: Children receiving 8.8 g milk protein/d showed greater increases on percentage correct in Pattern Recognition Memory (mean ± SD: 5.5% ± 16.8%; P < 0.05) and Intra/Extradimensional Set Shift completed stages compared with all other food groups (0.6 ± 2.3; P < 0.05). No differences were seen in linear growth between the groups. The children receiving either 4.4 or 8.8 g milk protein/d had a higher fat-free body mass index than those who received no milk, with an effect size of 0.34 kg/m2. Conclusion: Among schoolchildren, the consumption of 8.8 g milk protein/d improved executive cognitive function compared with other supplements and led to the accretion of more lean body mass, but not more linear growth. This trial was registered at"> as NCT02757508.

Original languageEnglish
Pages (from-to)1177-1184
Number of pages8
JournalJournal of Nutrition
Issue number7
StatePublished - Jul 2018


  • Ghana
  • cognition
  • linear growth
  • milk
  • school feeding


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