Global environmental costs of China's thirst for milk.

China has an ever-increasing thirst for milk, with a predicted 3.2-fold increase in demand by 2050 compared to the production level in 2010. What are the environmental implications of meeting this demand, and what is the preferred pathway? We addressed these questions by using a nexus approach, to examine the interdependencies of increasing milk consumption in China by 2050 and its global impacts, under different scenarios of domestic milk production and importation. Meeting China's milk demand in a business as usual scenario will increase global dairy-related (China and the leading milk exporting regions) greenhouse gas (GHG) emissions by 35% (from 565 to 764 Tg CO2eq ) and land use for dairy feed production by 32% (from 84 to 111 million ha) compared to 2010, while reactive nitrogen losses from the dairy sector will increase by 48% (from 3.6 to 5.4 Tg nitrogen). Producing all additional milk in China with current technology will greatly increase animal feed import; from 1.9 to 8.5 Tg for concentrates and from 1.0 to 6.2 Tg for forage (alfalfa). In addition, it will increase domestic dairy related GHG emissions by 2.2 times compared to 2010 levels. Importing the extra milk will transfer the environmental burden from China to milk exporting countries; current dairy exporting countries may be unable to produce all additional milk due to physical limitations or environmental preferences/legislation. For example, the farmland area for cattle-feed production in New Zealand would have to increase by more than 57% (1.3 million ha) and that in Europe by more than 39% (15 million ha), while GHG emissions and nitrogen losses would increase roughly proportionally with the increase of farmland in both regions. We propose that a more sustainable dairy future will rely on high milk demanding regions (such as China) improving their domestic milk and feed production efficiencies up to the level of leading milk producing countries. This will decrease the global dairy related GHG emissions and land use by 12% (90 Tg CO2eq reduction) and 30% (34 million ha land reduction) compared to the business as usual scenario, respectively. However, this still represents an increase in total GHG emissions of 19% whereas land use will decrease by 8% when compared with 2010 levels, respectively.

Considering milk price volatility for investment decisions on the farm level after European milk quota abolition.

After the abolition of the milk quota in the European Union, milk price volatility is expected to increase because of the liberalized market conditions. At the same time, investment appraisal methods have not been updated to capture the increased uncertainty. Therefore, the objective of this paper is to assess the effect of changing price volatility due to quota abolition on investment decisions at the dairy farm level. To contribute to the objective and to approximate milk price volatility after the European milk quota abolition, the risk-adjusted discount rate for risk-averse dairy farmers is derived based on the milk price volatility of a milk price series from New Zealand. New Zealand dairy farmers have faced liberalized market conditions for more than 3 decades. Afterward, the risk-adjusted discount rate is applied to appraise milking technology investments for an average German dairy farmer. The results show that it is still more reasonable to invest in a parlor system than an automated milking system, although the net present value of the parlor system investment varies between €191,723 for risk-neutral dairy farmers and €100,094 for modestly risk-averse dairy farmers. For the automated milking system investment, the same calculations lead to €132,702 for risk-neutral dairy farmers and €31,635 for risk-averse dairy farmers. According to higher levels of milk price volatility after milk quota abolition, the reduction of the expected utility of the underlying investment decision for modest risk-averse dairy farmers is almost similar to a milk price decrease of 5% for risk-neutral dairy farmers. Therefore, the findings urge finance providers and extension services to consider the change of increasing milk price volatility after dairy quota abolition when giving dairy farmers financial advice. The risk-adjusted discount rate is a flexible tool to do so.

Low milk supply and the pediatrician.

PURPOSE OF REVIEW: Human milk is the optimal food for human infants, and provides many diverse and well described benefits for both mother and infant. Low milk supply, whether perceived or actual, is one of the most common reasons why mothers stop breastfeeding. Breastfeeding mothers often seek out the guidance and support of their pediatrician in evaluating and resolving milk production concerns. RECENT FINDINGS: Recent evidence supports the importance of breastfeeding for maternal and child health in both developing and developed countries. Lack of knowledge regarding optimal breastfeeding management accounts for the large majority of low milk supply concerns, but there is emerging evidence that impaired glucose tolerance may contribute to intrinsic low milk supply. SUMMARY: Breastfeeding mother-infant dyads should be followed closely until lactation is well established and the infant is gaining well. Further research is needed to understand the physiologic contributors to low milk supply and to guide evidence-based interventions to optimize maternal success in reaching breastfeeding goals, particularly for women of poorer metabolic health.

Milking time and risk of over-milking can be decreased with early teat cup removal based on udder quarter milk flow without loss in milk yield.

Increasing the milk flow rate at which milking is terminated can shorten milking time and increase milking efficiency. The effects on milk yield and composition have not been fully investigated when the take-off is set at the udder quarter level and independent of feeding during milking. The objective of this study was to investigate the effect of 3 take-off levels at the udder quarter level (0.06, 0.3, and 0.48 kg/min) applied with or without feeding during milking on milking time, milk yield, the degree of udder emptying, milk composition, and free fatty acids. In this study, 30 cows were allocated into 6 groups, balanced by lactation number, lactation stage, and milk yield, and subjected to a 3 × 2 factorial arrangement of treatments using a Latin square design. Treatments were applied for 1 wk each. This study demonstrated milking time could be reduced by applying up to a take-off level of 0.48 kg/min on udder quarter level without losing milk yield or compromising milk composition or udder health.

[Effectiveness of the program "School Milk" for the prevention of iodine deficiency].

Republic of Bashkortostan refers to iodine-deficient regions of Russia. The incidence of endemic multinodular goiter in 2012 in the Republic amounted to 33.2 per 100 thousand of the population. The purpose of the study is to evaluate the effectiveness of group iodine prophylaxis of schoolchildren through the use of iodized milk. The study included 181 children of primary school (pre-pubertal) age (8-10 years), it has been carried out in accordance with the recommendations of the WHO and the International Council for Control of iodine deficiency disorders using a unified system of identification of iodine deficiency states. Level of physical development was assessed according to anthropometric measurements, which were conducted by centile distribution tables according to age and sex, and the individual assessment of physical development was determined by the level of feature by its position in a number of centile. Assessment of iodine deficiency was carried out by determining levels of iodine excretion in a single urine sample. Iodine concentration in urine was determined by ceric ion-arsenious acid method. Frequency of iodine deficiency varying degrees before the iodine prophylaxis among urban children was 57.0%, among rural-92.3%. Urban junior schoolchildren showed severe iodine deficiency in 12.7% and moderate one in 16.4% of the cases, while in the countryside their prevalence was higher--27.4 and 35.2%, respectively. It was revealed that the number of children whose body growth values are within the average values is 36% in urban children, and 48.4% in rural areas. It should be noted that the low and very low body height predominate in rural students, it makes up 16.1% (while in the town it makes-up 2.3%). Iodine prophylaxis contributed to a significant reduction of iodine deficiency in children. In the town the median urinary iodine exceeded 100 mg/L and amounted to 159.4 mg/L. After iodine prophylaxis 82.5% of urban children and 72.1% of rural showed normal urinary iodine. When comparing the results of clinical and laboratory studies before and after the group prevention of iodine deficiency there has been revealed a positive trend in terms of reflecting the tensions of thyroid status.

Changes in food and beverage environments after an urban corner store intervention.

OBJECTIVE: In response to the obesity epidemic, interventions to improve the food environment in corner stores have gained attention. This study evaluated the availability, quality, and price of foods in Philadelphia corner stores before and after a healthy corner store intervention with two levels of intervention intensity ("basic" and "conversion"). METHODS: Observational measures of the food environment were completed in 2011 and again in 2012 in corner stores participating in the intervention, using the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS). Main analyses included the 211 stores evaluated at both time-points. A time-by-treatment interaction analysis was used to evaluate the changes in NEMS-CS scores by intervention level over time. RESULTS: Availability of fresh fruit increased significantly in conversion stores over time. Specifically, there were significant increases in the availability of apples, oranges, grapes, and broccoli in conversion stores over time. Conversion stores showed a trend toward a significantly larger increase in the availability score compared to basic stores over time. CONCLUSION: Interventions aimed at increasing healthy food availability are associated with improvements in the availability of low-fat milk, fruits, and some vegetables, especially when infrastructure changes, such as refrigeration and shelving enhancements, are offered.

A comprehensive dairy valorization model.

Dairy processors face numerous challenges resulting from both unsteady dairy markets and some specific characteristics of dairy supply chains. To maintain a competitive position on the market, companies must look beyond standard solutions currently used in practice. This paper presents a comprehensive dairy valorization model that serves as a decision support tool for mid-term allocation of raw milk to end products and production planning. The developed model was used to identify the optimal product portfolio composition. The model allocates raw milk to the most profitable dairy products while accounting for important constraints (i.e., recipes, composition variations, dairy production interdependencies, seasonality, demand, supply, capacities, and transportation flows). The inclusion of all relevant constraints and the ease of understanding dairy production dynamics make the model comprehensive. The developed model was tested at the international dairy processor FrieslandCampina (Amersfoort, the Netherlands). The structure of the model and its output were discussed in multiple sessions with and approved by relevant FrieslandCampina employees. The elements included in the model were considered necessary to optimally valorize raw milk. To illustrate the comprehensiveness and functionality of the model, we analyzed the effect of seasonality on milk valorization. A large difference in profit and a shift in the allocation of milk showed that seasonality has a considerable impact on the valorization of raw milk.

Development of a community-sensitive strategy to increase availability of fresh fruits and vegetables in Nashville's urban food deserts, 2010-2012.

BACKGROUND: Food deserts, areas that lack full-service grocery stores, may contribute to rising rates of obesity and chronic diseases among low-income and racial/ethnic minority residents. Our corner store project, part of the Centers for Disease Control and Prevention's Communities Putting Prevention to Work initiative, aimed to increase availability of healthful foods in food deserts in Nashville, Tennessee. COMMUNITY CONTEXT: We identified 4 food deserts in which most residents are low-income and racially and ethnically diverse. Our objectives were to develop an approach to increase availability of fresh fruits and vegetables, low-fat or nonfat milk, and 100% whole-wheat bread in Nashville's food deserts and to engage community members to inform our strategy. METHODS: Five corner stores located in food deserts met inclusion criteria for our intervention. We then conducted community listening sessions, proprietor surveys, store audits, and customer-intercept surveys to identify needs, challenges to retailing the products, and potential intervention strategies. OUTCOME: Few stores offered fresh fruits, fresh vegetables, low-fat or nonfat milk, or 100% whole-wheat bread, and none stocked items from all 4 categories. Major barriers to retailing healthful options identified by community members are mistrust of store owners, history of poor-quality produce, and limited familiarity with healthful options. Store owners identified neighborhood crime as the major barrier. We used community input to develop strategies. INTERPRETATION: Engaging community residents and understanding neighborhood context is critical to developing strategies that increase access to healthful foods in corner stores.

Farm technical efficiency under a tradable milk quota system.

This paper incorporates the milk quota system into technical efficiency analysis of dairy farms in England and Wales. Our approach accounts for milk quota trade, allowing an investigation of the relationship between the way in which milk quota market is used by farmers and technical efficiency. In addition, several explanatory variables for inefficiency were used. Results obtained from a Bayesian stochastic frontier analysis show that the way in which farmers use the milk quota market is linked to farm efficiency. Other aspects such as environmental payments received by the farmer are linked to inefficiency.

Got low-fat milk? How a community-based coalition changed school milk policy in New York City.

In 2006, New York City, the largest school district in the country, eliminated whole milk and reduced the availability of sweetened milk in 1,579 schools. Despite pressure from the American Dairy Council, skepticism from school food administrators and elected officials, and the difficulties inherent in changing a system that serves 120,000,000 containers of milk per year, a community-led coalition prevailed. This article describes how parents, educational leaders, advocates, and health professionals collaborated to educate school children and their families to choose low-fat milk, and created change at a system, policy, and environmental level to promote health in the community.

Recent Trends in Dietary Habits of the Italian Population: Potential Impact on Health and the Environment.

Population growth, globalization, urbanization, and economic pressures are causing changes in food consumption all over the world. The study's aims are (1) to evaluate trends in food habits in Italy to highlight deviations from the traditional Mediterranean diet, (2) to analyze the features of the present Italian diet that should be modified to meet evidence-based global scientific targets for a healthy and sustainable diet proposed by the EAT-Lancet Commission. Trends in food availability for human consumption during the period 2000-2017 were assessed using the food balance sheets (FBSs). Greenhouse gas (GHG) emission was estimated according to life cycle assessment (LCA) analyses. During the study period, the availability of animal fat and beef meat greatly declined (-58% and -32%, respectively), followed by fruit, potatoes, vegetables, milk, and non-tropical oils (-20%, -15%, -13%, -14%, and -11%, respectively). A substantial increase has occurred for tropical oils, fish, and nuts (+156, +26%, and +21%, respectively). In order to meet the targets of consumption proposed by the EAT-Lancet Commission, the consumption of legumes and nuts should be almost doubled, whereas the consumption of meat, eggs, dairy products, animal fat, tropical oils, and sugars should be reduced by proportions ranging from 60% to 90%. If implemented, these changes would reduce the diet-related greenhouse gas emission by nearly 50%. In conclusion, these data call for nutritional education programs and interventions on the food system aimed at promoting a healthier and more environmentally sustainable diet. To this end, the availability and affordability of products with a better impact on human health and the environment should be promoted.

Advances and Perspectives in the Application of CRISPR-Cas9 in Livestock.

The sophistication and revolution in genome editing and manipulation have revolutionized livestock by harvesting essential biotechnological products such as drugs, proteins, and serum. It laid down areas for the large production of transgenic food, resistance against certain diseases such as mastitis, and large production of milk and leaner meat. Nowadays, the increasing demand for animal food and protein is fulfilled using genome-editing technologies. The recent genome-editing techniques have overcome the earlier methods of animal reproduction, such as cloning and artificial embryo transfer. The genome of animals now is modified using the recent alteration techniques such as ZFNs, TALENS technique, and clustered regularly interspaced short palindromic repeats/Cas9 (CRISPR-Cas9) system. The literature was illustrated for identifying the researchers to address the advances and perspectives in the application of Cas9 in Livestock. Cas9 is considered better than the previously identified techniques in livestock because of the production of resilience against diseases, improvement of reproductive traits, and animal production to act as a model biomedical research.

Milk utilisation patterns in the low-input production systems in South Africa.

Understanding the utilisation patterns of milk assists in designing appropriate dairy development schemes in rural communities. The objective of the study was to determine milk utilisation patterns in different smallholder farming systems in the Eastern Cape Province of South Africa. Data were collected through the administration of recording sheets to 130 randomly selected households in Alice, Fort Beaufort and Queenstown districts. Amounts of milk produced per household ranged from 9 to 21 l per household per day. Milk consumption/household/day was similar among the three districts. Milk consumption in the early lactation doubled the amount consumed in late lactation (P < 0.05). Milk in the communal areas was largely utilised as fresh or sour milk. Fresh milk was mostly used in tea/coffee or to make porridge for children. Sour milk was consumed with thick boiled maize meal. Fort Beaufort (10.2 +/- 1.37 l/day) had the highest sour milk sales whilst Queenstown had the highest fresh milk sales (9.7 +/- 5.57 l/day). It was concluded that quantities of milk consumed or sold as fresh or sour were generally low and varied across smallholder farming systems.

FACTORS ASSOCIATED WITH INADEQUATE MILK CONSUMPTION AMONG ADOLESCENTS: NATIONAL SCHOOL HEALTH SURVEY - PENSE 2012.

OBJECTIVE: To identify the prevalence and factors associated with inadequate milk consumption among adolescents. METHODS: This was a cross-sectional study based on secondary data from the National School Health Survey (2012), a Brazilian survey carried out using a self-administered questionnaire in a representative sample of 9th-grade students from public and private schools. The frequency of milk intake and its association with socio-demographic characteristics, food consumption and physical activity were estimated. A descriptive and inferential analysis of factors associated with inadequate milk consumption (no consumption at least one of the seven days of the week) was performed. A multiple logistic model was adjusted to control confounders. RESULTS: The sample included 108,828 adolescents and inadequate milk consumption ocurred in 58.9%. The final model included nine variables independently associated with inadequate milk intake: breakfast frequency less than 4 days per week (odds ratio [OR]=2.40; p<0.001), unprocessed or minimally processed foods intake less than 5 days per week (OR=1.93; p<0.001), living in the northeast region (OR=1.39; p<0.001), less maternal schooling (OR=1.35; p<0.001), physical inactivity (OR=1.33; p<0.001), attending public school (OR=1.26; p<0.001), not being white (OR=1.14; p<0.001), being older than 14 years old (OR=1.13; p<0.001) and having a habit of eating meals while watching TV or studying (OR=1.04; p=0.036). CONCLUSIONS: Inadequate milk consumption is prevalent among Brazilian adolescents. The identification of associated factors suggests the need to develop nutritional guidance strategies for the prevention of diseases that result from low calcium intake.

Chinese Consumers' Preferences for Attributes of Fresh Milk: A Best-Worst Approach.

Fresh milk represents a major type of dairy product in China, while it remains at a low level in terms of consumption. Consumers' preferences are a crucial factor determining consumers' attitudes and behavior towards fresh milk consumption. However, little is known about what drives consumers' preferences for fresh milk. This study intends to fill this gap based on a survey with a sample of 1248 respondents in ten cities in China. The best-worst scaling (BWS) method was employed to measure the importance of different attributes that consumers consider when selecting fresh milk. The BWS result indicates that safety certification, shelf-life, and nutrition were ranked as the most important attributes of fresh milk, whereas origin, purchasing location, and package were found to be the least preferred attributes. Furthermore, the study also explored heterogeneities by dividing all samples into a developed area and a less developed area, and a latent class model (LCM) was then applied to classify consumers based on their preferences and demographics in these two areas, respectively. In developed areas, consumers were divided into "Safety First" and "Taste Sensitive", and Gender and Age were significant determinants of class membership. In less developed areas, consumers were classified as "Quality Sensitive" and "Brand Sensitive", while Education, Pregnancy, and Health condition were significant determinants of class membership. The findings might be useful for the government in terms of encouraging dairy companies to implement safety management certification, and suggest that companies should design differentiated strategies in different areas.

Brucellosis in dairy herds: A public health concern in the milk supply chains of West and Central Africa.

Ten herd-level cross-sectional studies were conducted in peri-urban dairy production areas of seven West and Central African countries (Burkina Faso, Burundi, Cameroon, Mali, Niger, Senegal and Togo). The objectives were to estimate herd level Brucella spp. seroprevalence and identify risk factors for seropositivity. In each of the ten study areas, herds (between 52 and 142 per area, total = 965) were selected probabilistically and a structured questionnaire was administered to gather information on their structure and management. A bulk milk sample from each herd was tested by indirect ELISA for Brucella spp. For each area, herd seroprevalence estimates were obtained after adjusting for the assumed performance of the diagnostic test. Herd level risk factors for Brucella spp. seropositivity were identified by means of stratified logistic regression, with each peri-urban zone as a stratum. Area-specific models were also explored. Estimated herd seroprevalences were: Lomé (Togo) 62.0% (95% CI:55.0-69.0), Bamako (Mali) 32.5% (95% CI:28.0-37.0), Bujumbura (Burundi) 14.7% (95%CI:9.4-20.8), Bamenda (Cameroon) 12.6% (95% CI:7.6-21.9), Ouagadougou (Burkina Faso) 3.0% (95% CI:1.0-9.1), Ngaoundere (Cameroon) 2.3% (95% CI:1.0-7.0), Thies (Senegal) 1.3% (95% CI:0.1, 5.3), Niamey (Niger) 1.2% (95% CI:0.08-5.3), Dakar (Senegal) 0.2% (95% CI:0.01-1.7) and Niakhar (Senegal) <0.04%. Logistic regression modelling revealed transhumant herds to be at lower risk of infection (adjusted OR: 0.25, 95% CI: 0.13 - 0.5) and in one of the areas (Bamenda), regular purchase of new animals was found to be strongly associated with Brucella spp. seropositivity (adjusted OR = 5.3, 95% CI: 1.4-25.9). Our findings confirm that Brucella spp. circulates among dairy cattle supplying milk to urban consumers in West and Central Africa, posing a serious public health concern. Control programs are urgently needed in areas such as Lomé or Bamako, where more than 30% of the herds show evidence of infection.

Value chain analysis and sanitary risks of the camel milk system supplying Nairobi city, Kenya.

The camel milk trade in Kenya has evolved significantly from a small-scale business undertaken in local villages to its current status involving a large number of different stakeholders supplying urban towns, particularly Nairobi City. Despite the evident growth pattern, the supply of camel milk to Nairobi has largely remained informal, with minimal enforcement of regulations. The aim of this study was to characterise the camel milk system supplying Nairobi and assess its governance, main challenges and the potential food safety risk practices. A value chain analysis framework was used to carry out data collection between August 2014 and July 2015. Qualitative and quantitative data were collected through focus group discussions and key informant interviews with stakeholders operating in different nodes of the value chains. Three milk value chains supplying Nairobi were identified and mapped: the Isiolo chain, the Kajiado chain and the camel milk processing company chain. Overall, the results indicate that 94% of the milk supplied to Nairobi city is informally traded (traded without any effective regulation), while 6% originates from a formal milk processing company. In the informal chains, milk traders (mostly women) were reported to play a pivotal role in the organisation and daily functioning of the chains. The processing company had partly integrated activities and reported exporting 5% of their products to regional and international markets. Food safety themes identified were associated with i) lack of cold chain, ii) gaps in hygiene practices, particularly at farm and market levels, iii) consumption of raw camel milk, and iv) lack of food safety training, among other issues. Low level involvement by government agencies in enforcing stipulated food safety measures were reported in the informal chains, as these concentrate efforts in the regulation of dairy milk chains. Isiolo milk traders were identified as the dominant group, setting milk prices and providing sanctions. The framework and findings obtained can help future research and policy makers to reach informed decision about what to regulate, where to target and importantly how to make the camel milk value chain more efficient and safer.

Forecasting fluid milk and cheese demands for the next decade.

Predictions of future market demands and farm prices for dairy products are important determinants in developing marketing strategies and farm-production planning decisions. The objective of this report was to use current aggregate forecast data, combined with existing econometric models of demand and supply, to forecast retail demands for fluid milk and cheese and the supply and price of farm milk over the next decade. In doing so, we can investigate whether projections of population and consumer food-spending patterns will extend or alter current consumption trends and examine the implications of future generic advertising strategies for dairy products. To conduct the forecast simulations and appropriately allocate the farm milk supply to various uses, we used a partial equilibrium model of the US domestic dairy sector that segmented the industry into retail, wholesale, and farm markets. Model simulation results indicated that declines in retail per capita demand would persist but at a reduced rate from years past and that retail per capita demand for cheese would continue to grow and strengthen over the next decade. These predictions rely on expected changes in the size of populations of various ages, races, and ethnicities and on existing patterns of spending on food at home and away from home. The combined effect of these forecasted changes in demand levels was reflected in annualized growth in the total farm-milk supply that was similar to growth realized during the past few years. Although we expect nominal farm milk prices to increase over the next decade, we expect real prices (relative to assumed growth in feed costs) to remain relatively stable and show no increase until the end of the forecast period. Supplemental industry model simulations also suggested that net losses in producer revenues would result if only nominal levels of generic advertising spending were maintained in forthcoming years. In fact, if real generic advertising expenditures are increased relative to 2005 levels, returns to the investment in generic advertising can be improved. Specifically, each additional real dollar invested in generic advertising for fluid milk and cheese products over the forecast period would result in an additional 5.61 dollars in producer revenues.

Disparities in the Availability and Price of Low-Fat and Higher-Fat Milk in US Food Stores by Community Characteristics.

BACKGROUND: National surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics. OBJECTIVE: Our aim was to assess the availability and price of low-fat and higher-fat milk in food stores throughout the United States and examine associations with community characteristics. DESIGN: We conducted a cross-sectional study involving observational data collection in 2010, 2011, and 2012. PARTICIPANTS/SETTINGS: The study included 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided. MAIN OUTCOME MEASURES: We studied the availability and price of whole, 2%, 1%, and skim milk. STATISTICAL ANALYSES PERFORMED: Multivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, US Census division, and year of data collection. RESULTS: Less than half of all stores carried 1% and skim milk, and more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31% to 67% lower in stores in majority black and 26% to 45% lower in other/mixed race compared with majority white communities. The odds of carrying specifically low-fat milk were 50% to 58% lower in majority Hispanic compared with majority white communities, and 32% to 44% lower in low-income compared with high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited-service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared with such stores in majority white and urban communities. CONCLUSIONS: This is the first nationwide study to examine the availability and price of low-fat and higher-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in nonwhite and low-income communities.