Running head: FLUID MILK CONSUMPTION
Beliefs, Attitudes and Decision-Making Tools of Fluid Milk Consumption
Sarah Heins
HHP 482: Senior Seminar in Health
Dr. Vicki Boye
19 December 2013
FLUID MILK CONSUMPTION
2
Introduction
Statement of the problem
Milk choices are not as simple as they once were. The consumer not only decides
between skim, 1%, 2% and whole milk, but also the bigger decision between organic, soy and
conventional milk. And then there is almond milk, coconut milk, rice milk, lactose-free milk and
rBST-free milk to add to the mix. The typical consumer is confronted with a host of decision
upon reaching the dairy section in the supermarket. However, this array of questions
accompanies neither a personal assessment tool to decipher which milk choice meets the
consumer’s personal beliefs, lifestyle choices and dietary needs, nor an educational brochure
explaining the differences. Instead, the typical consumer is left empty-handed to make the milk
choice and must rely on marketing, advertisement, personal experience and availability to decide
which milk choice is the best and why it is the best.
The Agricultural Marketing Service (AMS) of the United States Department of
Agriculture (USDA) published annual and monthly milk consumption statistics in the United
States from 2006-2012. According to this data, 1,062 million pounds of organic milk were
consumed in 2006, representing 1.92% of all fluid milk consumption. Over the span of these five
years, organic milk consumption increased by almost two percent to 3.86% (USDA, 2012).
Another sales report from the AMS reports the products sales from February 2013. The results
were as follows (in million pounds): whole milk – 1,031; 2% milk – 1,383; 1% milk – 567; skim
milk – 546; totaling 3,955 total conventional milk products; organic whole milk – 44; organic
reduced fat milk – 46; organic low fat milk – 32; organic fat-free milk – 33; totally 165 total
organic milk products. The total fluid milk products were 4,120 million pounds (USDA, 2013).
FLUID MILK CONSUMPTION
3
According to a survey from the Natural Marketing Institute, consumers rate the following
attributes in order of importance for using organic milk: contains no antibiotics, are from animals
that are fed organic feed, contains no hormones, are from animals that graze in a pasture,
contains no artificial flavors, colors, or preservatives, are from animals that have been treated
humanely, have more nutritional value than non-organic dairy products, and are from animals
that get regular exercise (Molyneaux, 2006).
The issue of organic versus conventional versus soy milk is new in the American society.
Therefore, little research has been performed on this topic. According to a report, Shopping for
Health 2005, by the Food Marketing Institute and Prevention magazine, more than 80% of
consumers who purchase organic products do so because of their perceived nutritional value.
Although there has been research done to examine the differences between milks, correlation
between milk and obesity, flavored milk in schools, and other issues, there has not been a study
performed that accounts for the reason why consumers choose the milk that they do.
Little research has been performed on milk consumption behaviors and milk consumption
beliefs, thus creating the need for such a study. With further research and more understanding,
educational programs can target their audience and educational components, and milk businesses
can market their product effectively.
Purpose of the study
The purpose of this study was to examine milk choice consumption and to identify for
such choices among students and faculty in a small Midwestern university.
Research questions
The research questions examined:
1. What is the prevalence of the different types of milk consumed by students, faculty and staff?
FLUID MILK CONSUMPTION
4
2. What are the factors that determine type of milk consumption?
Definition of terms
Almond milk – Almond milk is plant-sourced, not animal-sourced. Technically, it is not milk,
but a liquid made from almonds. It does not contain lactose, meaning it can be a substitute for
lactose intolerant people (Silk, 2013).
Coconut milk – Coconut milk is plant-sourced, not animal-sourced. Technically, it is not milk,
but a liquid made from coconuts. It does not contain lactose, meaning it can be a substitute for
lactose intolerant people (Silk, 2013).
Conventional milk – Conventional milk refers to a farm’s method of production, not the milk.
Conventional milk is as equally safe and nutritious as organic milk; the difference is how they
are produced on the farm. Both methods of production must meet the USDA’s standards to gain
certification. The National Dairy Council organization defines conventional milk as coming from
dairy producers who use “industry-accepted best management practices to ensure that dairy cows
are healthy by providing them with comfortable living conditions, nutritious diets, and good
medical care. They also protect the environment by implementing practices that conserve natural
resource and minimize the quantity of waste generated” (National Dairy Council, 2007).
Lactose intolerant – When a person is lactose intolerant, he lacks the lactase enzyme. This means
the body is not able to digest lactose which is a sugar found in milk and milk products (Ohio
State University Medical Center, 2013).
Lactose-free milk – Lactose-free milk is dairy milk without the lactose but still with the same
nutrients such as calcium, potassium and vitamin D (National Dairy Council, 2013).
Organic milk – Organic milk refers to a farm’s method of production, not the milk. Organic milk
is as equally safe and nutritious as organic milk; the difference is how they are produced on the
FLUID MILK CONSUMPTION
5
farm. Both methods of production must meet the USDA’s standards to gain certification. The
National Dairy Council organization defines organic milk with the same requirements as
conventional milk but meet the following additional criteria: “cows are exclusively given feed
grown without the use of pesticides or commercial fertilizers; cows are given periodic access to
pasture and direct sunlight; cows are not treated with supplemental hormones; and cows have not
been given certain medications to treat illness” (National Dairy Council, 2007).
rBST-free milk – rBST stands for recombinant bovine somatotropin and is also known as Bovine
Growth Hormone which increases milk production by 10-15%. rBST-free milk is milk produced
by cows that have not received this hormone (GRACE Communications Foundation, 2013).
Bovine somatotropin (bST) occurs naturally in cows, and a small amount is present in all milk.
bST is broken down by digestion like other proteins. rBST is the synthetic version of bST. About
15% of dairy farmers choose to use rBST with their herds (National Dairy Council, 2013).
Rice milk – Rice milk is plant-sourced, not animal-sourced. Technically, it is not milk, but a
liquid made from brown rice. It does not contain lactose, meaning it can be a substitute for
lactose intolerant people (Rice Milk, 2013).
Soy milk – Soy milk is plant-sourced, not animal-sourced. Technically, it is not milk, but a liquid
made from soybeans. It does not contain lactose, meaning it can be a substitute for lactose
intolerant people (Columbia Health, 2012).
Methodology
Population
The population that was studied consisted of 1152 undergraduate students and about 300
faculty and staff at a small Midwestern university of the 2013-2014 school year.
Procedures
FLUID MILK CONSUMPTION
6
A 12-question written questionnaire was distributed via email using Survey Monkey to
students, faculty and staff at a small Midwestern university of the 2013-2014 school year. All
items were multiple choice questions. The questionnaire was sent to 1152 undergraduate students
with 92 respondents for a response rate of 7.99%. It was also sent to about 300 faculty and staff
with 103 respondents for a response rate of 34.33%. Overall, this questionnaire was sent to about
1452 individuals with 197 respondents for a response rate of 13.57%. Of the 197 who started the
survey, 193 finished the survey, a rate of 98%. The cover letter email can be found in Appendix
A. The questionnaire can be found in Appendix B.
Data analysis
Data was collected and analyzed using simple descriptive statistics with some specific
cross tabulation.
Discussion of Results
This 12-item questionnaire was distributed to 1152 undergraduate students and about 300
faculty and staff at a small Midwestern university of the 2013-2014 school year. Ninety-two
students responded for a response rate of 7.99%, and 103 faculty and staff responded for a
response rate of 34.33%. Overall, this questionnaire was sent to about 1452 individuals with 197
respondents for a response rate of 13.57%. Of the 197 who started the survey, 193 finished the
survey, a rate of 98%. All items on this questionnaire were multiple choice.
The questionnaire was broken down into three sections. The first section included
demographic questions (gender, status in school, housing, and meals eaten in campus cafeteria).
The second question focused on milk consumption behaviors (milk consumed per day, types of
milk drank in last six months, type of milk drank most often, and digestive history with milk).
FLUID MILK CONSUMPTION
7
The last section examined milk beliefs (opinion on milk tastes, “healthiness” of milks, factors
influencing milk consumption, and most influential factor on milk consumption).
Of the respondents, 65% (127) were female and 35% (68) were male. The majority of the
respondents were faculty and freshmen. The classification of the respondents was as follows:
18% (35) freshmen, 9% (17) sophomores, 9% (18) juniors, 12% (23) seniors/super seniors, 23%
(45) faculty, 18% (36) technical staff and 11% (22) support staff.
Most of those who responded live off-campus but in the college town (39%, 75),
followed by on-campus (43%, 83) and lastly off-campus and not in the college town (19%, 37).
Almost half of the study group eats 0 meals in the campus cafeteria per week. Forty-nine
percent (95) answered 0 meals per week, 16% (30) answered 1-4 meals per week, 2% answered
(4) 5 meals per week, 3% (5) answered 6-11 meals per week, 4% (7) answered 12 meals per
week, and 27% (53) answered 12+ meals per week.
The majority of the respondents drink an average of 0-1 glasses of milk per day (based on
an 8 oz. glass). The responses were as follows: 43% (84) answered 0-1 glasses, 35% (68) drink
1-2 glasses, 11% (21) answered 2-3 glasses, 3% (5) answered 3-4 glasses, 5% (9) answered 4+
glasses, and 4% (8) answered that they do not drink milk.
To examine typical milk consumption, respondents were first asked to answer which
types of milk they have drank within the last six months. Next, they were asked to answer which
type of milk they drink most often. In the last six months, 91% (179) of the respondents have
drank conventional milk, 20% (39) have drank soy milk, 15% (29) have drank almond milk, 8%
(15) have drank organic milk, 5% (10) have drank coconut milk, 4% (8) have drank lactose-free
milk, 3% (5) have drank rice milk, and 3% (5) have drank rBST-free milk. Four percent (8)
responded that they do not drink milk. The most frequently consumed milk is conventional milk.
FLUID MILK CONSUMPTION
8
See Table 1 for responses. Eighty-four percent (165) drink conventional milk most often, 5% (9)
drink almond milk most often, 3% (5) drink organic milk most often, 2% (3) drink soy milk most
often, 2% (3) drink coconut milk most often, 1% (2) drink lactose-free milk most often, 0.5% (1)
drink rBST-free milk most often, and 0% drink rice milk most often. Four percent (8) said they
do not drink milk.
Seventy-eight percent (152) of the respondents said that they have never had any
digestive problems with milk and are not lactose-intolerant, 13% (26) said they have had a
couple digestive problems with milk but are not lactose-intolerant, 5% (9) said they have had a
lot of digestive problems with milk but are not lactose-intolerant, and 4% (8) said they are
lactose-intolerant.
Table 1 (n=196)
FLUID MILK CONSUMPTION
9
The respondents were asked to rate the following milks in order of taste: great, good,
decent, poor, repulsive, and N/A, do not know how this milk tastes. See Table 2 for responses.
The most popular response (66%, 126) for conventional milk was “Great – I really enjoy the
taste of this milk.” The most common responses for all the other milks (organic – 65%, soy –
43%, almond – 51%, coconut – 69%, rice – 78%, lactose-free – 81%, and rBST-free milk – 90%)
were “N/A – I don’t know how this milk tastes.”
When ranking the milks (conventional, organic, soy, almond, coconut, rice, lactose-free,
and rBST-free) compared to each other in order of “healthiness,” most responded “I don’t
know.” However, for those who did not respond, “I don’t know,” the consensus ranked the milks
in this order, starting with the healthiest: organic milk, conventional milk, soy milk, almond
milk, coconut milk, lactose-free milk, rice milk, and rBST-free milk. See Table 3 for these
responses.
Table 2 (n=190)
FLUID MILK CONSUMPTION
10
These values represent the average value of taste based on the system that great = 1, good = 2,
decent = 3, poor = 4, and repulsive = 5.
Table 3 (n=189)
These values represent the average value of “healthiness” with 1 being the healthiest.
Respondents were first asked to mark multiple factors that influenced their milk
consumption and then the most influential factor. For the multiple factors question, 64% (123)
answered taste, 42% (81) answered healthiness, 36% (69) answered cost, 35% (67) answered
availability in grocery stores, 33% (62) answered availability in campus cafeteria, 9% (17)
answered digestive reasons, and 6% (11) answered they don’t drink milk. For the most
influential factor, see Table 4 for responses. Thirty-four percent (64) responded taste as the most
FLUID MILK CONSUMPTION
11
influential factor, 22% (42) responded healthiness, 18% (34) responded availability in campus
cafeteria, 9% (17) responded cost, 7% (13) responded availability in grocery stores, 4% (8)
responded digestive reasons, and 6% (11) responded they don’t drink milk.
Table 4 (n=189)
Two cross tabs were examined. The first cross tab was for those who answered that their
most influential factor on their milk consumption is healthiness. This was 42 individuals, which
is 21% of all respondents. The majority of these were technical staff at 26% (11), 23% (1)
faculty, 19% (8) support staff, 14% (6) senior, 7% (3) freshmen, 5% (2) sophomore, and 5% (2)
junior. Of the 42 individuals, 79% (33) drink conventional milk most often, 10% (4) drink
FLUID MILK CONSUMPTION
12
organic milk most often, 5% (2) drink soy milk most often, 5% (2) drink almond milk most
often, 2% (1) drink rBST-free milk most often, and no one drinks coconut milk, rice milk,
lactose-free milk or no milk most often. When ranking the “healthiness” of milks, they rated
them in this order, starting with the healthiest: organic milk, conventional milk, almond milk,
coconut milk, r-BST free milk, rice milk, lactose-free milk.
The second cross tab was for those who ranked organic milk as the “healthiness” milk
compared to the other milks. This group is made up of 56 individuals, which is 28% of all
respondents. Of these, 27% (15) were faculty, 21% (12) were technical staff, 20% (11) were
freshmen, 11% (6) were juniors, 7% (4) were support staff, 7% (4) were sophomores, and 7% (4)
were seniors. Eighty-four percent (47) responded that they drink conventional milk most often,
7% (4) drink organic milk most often, 4% (2) drink almond milk most often, 2% (1) drink
coconut milk most often, 2% (1) drink rBST-free milk most often, 2% (1) don’t drink milk, and
0% drink soy milk, rice milk and lactose-free milk.
Conclusions and Recommendations
The students, faculty and staff being studied in this research are in a Midwestern,
agricultural area. Many have agricultural roots. Therefore, it makes sense that the results of this
study were fairly conservative. If this study were administered to students, faculty and staff at a
university on the coast or in a big city, the results would likely be very different. To gain more
accurate beliefs and behaviors of the average population, the study group should consist of a
more diverse population, including individuals from both agricultural and urban areas.
The cross tab of those who responded that their most influential factor on milk
consumption was healthiness was chosen because “healthiness” is a vague term. Many have a
FLUID MILK CONSUMPTION
13
different opinion on what is “healthy.” The author of this research study wanted to examine what
the respondents’ opinion on “healthiness” in relation to milk.
The cross tab of those who responded that organic milk is the “healthiness” milk
compared to the other milk choices was chosen because organic milk was the most popular
answer for the healthiest milk (excluding those who answered “I don’t know”).
The author of this research paper found it interesting that of those who responded that
organic milk is the healthiest milk compared to other milks, 84% drink conventional milk most
often and only 7% drink organic milk most often. It is interesting to note the cognitive
dissonance in consumers who believe organic milk is the healthiest but their action shows
otherwise as they choose to buy and drink conventional milk.
In conclusion, most students, faculty, and staff drink conventional milk most often and
like its taste the best but believe that organic milk is the healthiest. It is clear that the general
population needs more education on the differences between organic and conventional farming.
It is the author’s opinion that many who drink organic milk and believe it to be healthiest have
formed this opinion due to the marketing of organic products as fresh, whole, natural, etc. While
this is also true of conventional milk, conventional milk is not marketed in the same way. It is the
opinion of the author that the marketing of non-conventional milk is often deceitful, giving the
impression that conventional milk is unhealthy.
The author of this research study sought to examine consumers’ behaviors and beliefs
about milk consumption. Specifically, the author wanted to gain insight on non-conventional
milk drinkers’ behaviors and beliefs about milk consumption. However, the majority of the study
group drinks conventional milk most often. Since the university is located in the Midwest and an
agricultural area, it is logical that conventional milk is the most popular milk of choice.
FLUID MILK CONSUMPTION
14
However, this left a small focus group that does not drink conventional milk. This study could be
strengthened with a larger group of individuals who drink non-conventional milk. Future studies
should target only non-conventional milk drinkers to examine their milk consumption behaviors
and beliefs. After more research has been collected and analyzed, programs can be established to
educate the average consumer on milk blind spots to ensure solid knowledge on milk.
FLUID MILK CONSUMPTION
15
References
Columbia Health. (October 5, 2012). Nutritional differences between soy and cow’s milk.
Retrieved from http://goaskalice.columbia.edu/nutritional-differences-between-soy-andcows-milk.
Dairy Council Digest, Vol. 78, Num. 3. (May/June 2007). Modern dairy farming practices &
milk quality: Myths & facts. Retrieved from http://www.nationaldairycouncil.org/
SiteCollectionDocuments/footer/FAQ/food_safety/DairyCouncilDigest783.pdf.
Food Marketing Institute and Prevention Magazine. (2005). Shopping for health 2005.
Washington, D.C.
GRACE Communications Foundation. (2013). rBGH. Retrieved from
http://www.sustainabletable.org/797/rbgh.
Molyneaux, M. (April 18, 2006). Organic Dairy and the role of pasture. The Natural Marketing
Institute. Retrieved from http://www.ams.usda.gov/AMSv1.0/
getfile?dDocName=STELPRD3479242.
National Dairy Council. (August 21, 2013). Lactose intolerant? 5 things you need to know.
Retrieved from http://www.nationaldairycouncil.org/EducationMaterials/Health
ProfessionalsEducationKits/Pages/Lactose-Intolerant-5-Things-You-Need-to-Know.aspx.
National Dairy Council. (2013). Milk and hormones fact sheet. Retrieved from
http://www.nationaldairycouncil.org/SiteCollectionDocuments/footer/FAQ/food_safety/
MilkandHormonesFactSheetAugust2008.pdf.
Ohio State University Medical Center. (2013). Lactose intolerant. Retrieved from
http://medicalcenter.osu.edu/PATIENTCARE/healthcare_services/digestive_disorders/la
ctose_intolerance/Pages/index.aspx.
FLUID MILK CONSUMPTION
16
United States Department of Agriculture. (2012). Estimated U.S. sales of organic and total fluid
milk products, monthly and annual, 2006-2011. Retrieved from
http://www.ers.usda.gov/datafiles/Organic_Prices/AMS_Organic_Milk_Sales_Volume_E
stimates_20062011/amsmilksalesvolumeestimates20062011.xls.
United States Department of Agriculture. (April 26, 2013). Estimated fluid milk products sales
report. Retrieved from http://www.ams.usda.gov/AMSv1.0/getfile?d
DocName=STELPRDC5103645.
Rich Rice Milk. (2013). FAQs. Retrieved from http://www.richricemilk.com/faqs.html.
Silk. (2013). Almond milk. Retrieved from http://silk.com/products/learn-more/aboutalmondmilk.
Silk. (2013). Coconut milk. Retrieved from http://silk.com/products/learn-more/aboutcoconutmilk.
FLUID MILK CONSUMPTION
17
Appendix A
Students, Faculty and Staff,
My name is Sarah Heins, and I am a senior majoring in Community Health. For my Senior
Seminar in Health research study, I am examining milk consumption behaviors and beliefs
through the use of a questionnaire using Survey Monkey. I request your help by participating in
this 12-question survey, which will take about 5-7 minutes of your time.
Your specific responses will be kept confidential at all times and will be combined with others
for analysis. Your completion of the questionnaire implies your informed consent to be a part of
this research study. Email Sarah.Heins@cune.org or Vicki.Boye@cune.edu with questions or
concerns.
The following link will take you to the online questionnaire. Thank you for your willingness to
participate!
Sarah Heins
Link to online questionnaire:
https://www.surveymonkey.com/s/milkconsumption
FLUID MILK CONSUMPTION
18
Appendix B
FLUID MILK CONSUMPTION
19
FLUID MILK CONSUMPTION
20
FLUID MILK CONSUMPTION
21