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Release claiming chocolate milk improves concussion symptoms in student athletes is out-of-bounds

COLLEGE PARK, Md., Dec. 22, 2015 /PRNewswire-USNewswire/ — Fifth Quarter Fresh, a new, high-protein chocolate milk, helped high school football players improve their cognitive and motor function over the course of a season, even after experiencing concussions, a new preliminary University of Maryland study shows.

The study, funded through the Maryland Industrial Partnerships program and conducted by Jae Kun Shim, a professor of kinesiology in the School of Public Health, followed 474 football players from seven high schools in Western Maryland throughout the fall 2014 season.

“High school football players, regardless of concussions, who drank Fifth Quarter Fresh chocolate milk during the season, showed positive results overall,” said Shim. “Athletes who drank the milk, compared to those who did not, scored higher after the season than before it started, specifically in the areas of verbal and visual memory.”

Football players were tested before the season, after concussions and post-season using Immediate Post-concussion Assessment and Cognitive Testing, also called ImPACT™, a widely used computer-based evaluation for concussions. Overall, 36 variables for attention span, working memory, sustained and selective attention time, response variability, non-verbal problem solving and reaction time were measured in the study.

Experimental groups drank Fifth Quarter Fresh after each practice and game, sometimes six days a week, while control groups did not consume the chocolate milk. Analysis was performed on two separate groups: athletes who experienced concussions during the season and those who did not. Both non-concussed and concussed groups showed positive effects from the chocolate milk.

Non-concussed athletes who drank Maryland-produced Fifth Quarter Fresh showed better cognitive and motor scores over nine test measures after the season as compared to the control group.

Concussed athletes drinking the milk improved cognitive and motor scores in four measures after the season as compared to those who did not.

The remaining test scores did not show a statistically significant difference between the experimental and control groups over the season, according to Shim.

He suggested that the naturally occurring high levels of specific nutrients in Fifth Quarter Fresh likely contributed to the results.

“Branched chain amino acids (BCAAs) are important for energy metabolism and neurotransmitter synthesis in the brain,” said Shim. “Previous studies have shown that BCAA supplementation has resulted in improved cognition in mice with brain injuries.”

Shim also cited carbohydrates, calcium and electrolytes, all of which he says are likely to be critical for the recovery process after brain injuries.

While the study’s results indicate a strong link between milk and the reduction of concussion-related symptoms, researchers caution that more in-depth studies are necessary to be conclusive.

Fifth Quarter Fresh is a fat-free chocolate milk made by combining nutrient-rich milk (yielding 40 percent more protein, calcium and electrolytes than conventional milk) with the benefits of a pasteurization process that preserves proteins and makes them easier for the body to absorb, according to the company.

Fifth Quarter Fresh has a balance of fast-absorbed whey and sustained-release casein proteins that provide a quick burst of amino acids followed by a continuous supply over several more hours, according to Richard Doak, co-founder of Fifth Quarter Fresh.

The company maintains that protecting student athletes and helping them perform at a higher level was the reason they created Fifth Quarter Fresh in the first place.

“We believe there is a real need to improve nutrition for young athletes. Fifth Quarter Fresh may help them prevent injuries by providing their bodies with the nutrients they need to heal and repair. This study suggests that,” said Doak. “Our milk provides 20 grams of protein and five grams of undamaged BCAAs per 14-ounce serving—naturally. We use no supplements and no preservatives—it is fresh chocolate milk.”

Officials in Washington County, Md., home to all seven high schools participating in the study, are now considering the broad adoption of Fifth Quarter Fresh in sports programs throughout its school system.

“There is nothing more important than protecting our student-athletes,” said Clayton Wilcox, superintendent of Washington CountyPublic Schools. “Now that we understand the findings of this study, we are determined to provide Fifth Quarter Fresh to all of our athletes.”

Earlier this year, UMD released the preliminary results of a study showing that Fifth Quarter Fresh outperformed leading commercial workout recovery drinks for endurance recovery by 13-17 percent.

Fifth Quarter Fresh is produced through the Hagerstown-based Lanco-Pennland Quality Milk Producers, a farmer-owned, farmer-run cooperative with nearly 650 members that spans the U.S. East Coast. Frederick-based Dairy Maid Dairy bottles it.

The University of Maryland study was made possible by the Maryland Industrial Partnerships (MIPS) program, which jointly funds commercial product development projects teaming Maryland companies with University of Maryland faculty.

For photos and videos, visit http://go.umd.edu/concussions.

About the Maryland Industrial Partnerships (MIPS) Program

MIPS, a program of the Maryland Technology Enterprise Institute (Mtech) in the A. James Clark School of Engineering at theUniversity of Maryland, supports university-based research projects to help Maryland companies develop technology-based products. Commercial products benefiting from MIPS projects have generated more than $30.2 billion in revenue, added thousands of jobs to the region, and contributed to successful products such as Martek Biosciences’ nutritional oils, Hughes Communications’ HughesNet™, MedImmune’s Synagis®, and Black & Decker’s Bullet® Speed Tip Masonry Drill Bit.

Concussion-Related Measures Improved in High School Football Players Who Drank New Chocolate Milk, UMD Study Shows

Our Review Summary

5th Quarter Milk LabelGot facts?

They are almost absent from this boastful release touting vague neurological benefits of a specific chocolate milk. The release says high school football players, including some who suffered concussions, who drank the milk improved their scores on a computer-based concussion evaluation, but the release not only doesn’t say how much improvement was seen, it doesn’t even say which of the 36 measurements in the test improved. The release highlights the protein, calcium and electrolyte content of the milk, without ever mentioning each serving also contains the equivalent of eight teaspoons of sugar. Perhaps the most worrisome aspect of this case is the status of the “study” it is based on. The study does not appear to have been independently reviewed or published.

This review and a related blog post calling attention to the issues raised within have sparked much news coverage and led to a University of Maryland investigation into policies surrounding research quality, conflict of interest, and public relations. More links to our coverage can be found here.

 

Why This Matters

This quote from the release eloquently demonstrates why it matters:

“There is nothing more important than protecting our student-athletes,” said Clayton Wilcox, superintendent of Washington County Public Schools. “Now that we understand the findings of this study, we are determined to provide Fifth Quarter Fresh to all of our athletes.”

There are real consequences to PR spin of health research.

If this story were to gain traction, it may further the health haloing of a beverage that drop per drop has more calories and nearly as much sugar as Coca-Cola.

[Editor’s note: This review initially stated, incorrectly, that 5th Quarter Fresh has more sugar, drop per drop, than Coca-Cola. This milk in fact has 3 g of sugar per ounce, compared with 3.25 g per ounce for Coca Cola. However, children would ingest more total sugar from a bottle of the chocolate milk compared with a can of Coke because of the larger serving size (14 oz vs. 12 oz).]

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

The price of the chocolate milk product used in this study is not mentioned, even though it is being sold to schools.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The release says that high school football players who drank the chocolate milk had higher scores after the season on nine of 36 measures in a computer-based concussion evaluation, and that among the players who suffered a concussion, those who were drinking the milk had improved scores on four measures compared to those who didn’t drink the milk. But the release doesn’t say how much difference there was or even which measures showed positive changes.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

Potential harms are not mentioned. While a chocolate milk product may seem benign, the release could have referred to the fact that each serving of this product contains as much sugar as the total daily intake of added sugar recommended for an adult man (and almost twice the amount recommended for women) by the American Heart Association. The release, which touts the protein, calcium and electrolyte content of the product, and notes that it is “fat-free”, should not have hidden the sugar content.

Then there is the harm of believing that downing chocolate milk could protect a teenager’s brain from harmful effects of a concussion. Concussions in high school football games and practices are especially dangerous, sometimes even fatal, when a player gets hit a second time within a few days after an initial concussion. If a belief in protective effects of chocolate milk lead to teenagers being put back in the game too soon after a hard hit, the consequences could be devastating.

Product label: http://dairymaiddairy.com/products/fifth-quarter-fresh/

AHA “Sugar 101” information sheet: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar-101_UCM_306024_Article.jsp

CDC Sports Concussion Policies and Laws: http://www.cdc.gov/headsup/policy/

Does the news release seem to grasp the quality of the evidence?

Not Satisfactory

The news release not only fails to explain the quality of the evidence, it misleads readers by highlighting claims that were not tested. For example, readers are led to believe that this chocolate milk product is somehow superior to other varieties of milk, but the study did not measure intake of other milk. The release does not even say whether the study included a placebo control. And about that “study”… according to a representative Maryland Industrial Partnerships (MIPS) program, the research has not been peer-reviewed or published, so it has not been examined by any independent experts.

Does the news release commit disease-mongering?

Satisfactory

This release might be the opposite of disease-mongering. As mentioned in the “harms” section, promoting belief in a protective effect of chocolate milk could lead someone to minimize the danger of a concussion.

Does the news release identify funding sources & disclose conflicts of interest?

Not Satisfactory

It’s safe to assume that the Fifth Quarter Fresh company was closely involved, but the release does not explain the nature of the relationship. The release says the study was made possible by the Maryland Industrial Partnerships program, but it does not say whether Fifth Quarter Fresh provided any additional funding or free product. There are no disclosures about any relationships between the researchers and the company, including whether they could profit from any sales boost following the use of research results in marketing campaigns. Also, did the company have any involvement in the design, conduct or reporting of the study and its results? The release doesn’t say.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

The release promotes the belief that this chocolate milk product provides benefits that other products do not… yet the study did not actually compare this product to any others. The release mentions an earlier study that compared this product to “commercial workout recovery drinks”, but those drinks apparently did not include any other types of milk.

Does the news release establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The release says the product is bottled by Dairy Maid Dairy, but there is no information about whether it is available in stores. Other news reports indicate that it is sold only to schools.

Does the news release establish the true novelty of the approach?

Not Satisfactory

There are other studies listed on www.PubMed.gov that look into the potential effects of chocolate milk on athletic performance. None of this background is mentioned in the release.

Even so, we fail to see how other athletic performance studies (conflicted as many are) and the lone study linked which looked at the effect of dietary branched chain amino acids on mice cognition, bolsters the claims of a study purportedly designed to look at concussion recovery in high school athletes.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Not Satisfactory

The release paints a picture of benefits that goes far beyond any specific research results that are provided. The most troubling comment comes from a local school official who says that based on this study the school district plans to provide this commercial milk product to all athletes, because “There is nothing more important than protecting our student-athletes”.

Total Score: 1 of 10 Satisfactory

Comments (2)

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.

Gary Schwitzer

January 13, 2016 at 2:20 pm

On January 13, just eight days after we published this review, and after we published two more blog posts on the issue, which were followed by at least a dozen news stories across the US based on our work, the University of Maryland announced an institutional review of the “the conduct and administration of the project, the dissemination of the results and recommendations for institutional actions, according to a university spokeswoman.” http://www.bizjournals.com/baltimore/news/2016/01/13/university-of-maryland-launches-review-of.html.
Links to some of the news coverage so far appear at the end of this blog post:
https://www.healthnewsreview.org/2016/01/why-wont-the-university-of-maryland-talk-about-the-chocolate-milkconcussion-study-it-was-so-eager-to-promote/

Reply

jimmy

January 18, 2016 at 8:55 am

ALL questionnaires wrt to food or nutrition are BUNK – full stop
The Harvard School of Public Health needs to stop the proliferation of these non-science associations for disease disguised as casual for disease – shame on them for obfuscating nutritional science (and wasting so much granted money for these erroneous conclusions).
http://fivethirtyeight.com/features/you-cant-trust-what-you-read-about-nutrition/

Reply