Introduction: Extant literature suggests consumption of sugar-sweetened beverages (SSB) is associated with unhealthy diets, while milk consumption is associated with healthy diets. However, few studies have compared both milk and SSB consumption in the same multi-ethnic population.

Methods: Parent-reported data of second grade children (mean age 7.5 years) were obtained from the 2015-2016 Texas School Physical Activity and Nutrition (SPAN) study. Foods and beverages consumed the day prior to the survey were recorded to assess dietary intake of 2,219 children. Possible beverage choices during the previous day included: 1) neither milk nor SSB, 2) SSB only, 3) milk only, and 4) both milk and SSB. Beverage choices were examined for their associations with diet patterns characterized using the SPAN Healthy Eating Index (SHEI) using linear regression.

Results: Over half of the children in the sample were Hispanic (65.7%) and female (53.6%). Most children drank milk only or both milk and SSB (32.5% and 44.5%, respectively). Mean SHEI (SD) for the population was 47.45 (11.10) out of 100 and was highest among children who consumed milk only. Compared to children who drank milk or milk and SSB, children who consumed SSB only had significantly lower SHEI (44.23, p<.0001), while those who drank milk only had significantly higher SHEI (53.60, p<.0001), controlling for gender and ethnicity.

Conclusion: Consumption of milk only and SSB only can serve as indicators of overall dietary patterns among second grade children. Parent provision of milk and no SSB is associated with healthier diets overall.