Each week we investigate the nutrition and diet topics making the headlines. This week, the Daily Mail discussed the health profiles of non-dairy milk alternatives.

The article was based on a study in the Journal of Food Science and Technology titled ‘How well do plant-based alternatives fare nutritionally compared to cow’s milk’?

The four most consumed non-dairy milk drinks were studied: almond, soy, rice and coconut milk (all unsweetened varieties). Nutritional values were obtained from the food packaging and the USDA database.

The review discussed the pros and cons of each milks, with the aim to help make consumers be able to make a more informed decision. Their main findings were as follows:

Coconut milk	Almond milk	Rice milk	Soya milk
Pros Low calories Taste Cons No proteins Rich in saturated fats	Pros Balanced diet Low calories Taste Cons Almond allergy	Pros Comparable caloriesCons Rich in sugar Unbalanced diet	Pros Rich in protein Balanced dietCons Taste Soy allergy

The headlines point to soya is the best alternative to cow’s milk, with researchers concluding that, ‘among alternative milks only soy milk contains comparable amounts of nutrients’.

More detailed findings and rationale for each of the points above are all discussed in the original study, alongside nutritional values for each of the milks.

Behind the headlines: the Nutrilicious dietetic view

The study is especially relevant because of the increasing popularity of non-dairy alternatives to milk and the increasing recognition of the health benefits of plant-based diets, and plant foods being more environmentally sustainable. Indeed, the latest ‘Eatwell Guide’ from Public Health England updated the name of one of the food groups from ‘Milk and Dairy Foods‘ to ‘Dairy and Alternatives’, highlighting the growing role of such foods in our diets. Plant food sources of protein were listed ahead of animal food sources of protein for the first time: the protein food group is now called ‘beans, pulses, fish, eggs, meat and other proteins’.
See our blog on the new Eatwell Guide

There are many reasons why people are choosing such products, including health, environment, allergies and intolerances, and veganism.

Our assessment of the study

• A good amount of data was analysed. For a non-dairy milk to be included within this study, at least four examples had to be available for each type of milk.
• The study uses American data. We cannot be sure findings will be the same for the UK and Irish products, although they are likely to bear many similarities. Opinions were also gathered regarding taste of the different milks and the UK population may react differently.
• Due to missing data, the research did not cover all the vitamins as intended.

One of the main conclusions from the study was that soya milk contained more protein than other alternatives. We did our own analysis of the four unsweetened* milks, alongside two other unsweetened milks available for reference. Here are our findings:

	Cow’s milk (Semi skimmed)	Coconut milk	Almond milk	Rice milk	Soya milk	Oat Milk	Cashew milk
	Per 100ml (mean values)
Energy, kcal	47	36	13	47	29	40	26
Fat g	1.8	1.5	1.1	1.0	1.5	1.0	1.0
Sat fat g	1.1	1.4	0.1	0.2	0.3	0.1	0.2
Sugars g	4.8	3.3	0.1	6.2	0.5	3.7	1.7
Protein g	3.6	0.2	0.5	0.1	2.7	0.7	0.5
Calcium mg	123	120	120	120	120	120	120
Vitamin D2 ug	0.00	0.75	0.89	0.89	0.75	0.75	0.75
B12 ug	0.91	0.38	0.38	0.38	0.38	0.38	0.38

Values from Forestfield Dietplan 7, National Dairy Council – the nutritional composition of dairy and plant-based drinks nutritional information: a range of current products on the market. *There are also sweetened versions of these products on the market.

Is soya milk the best non-dairy alternative?

1. Protein The most notable similarity between cow’s milk and soya milk compared to the other non-dairy milks is the higher protein levels, as highlighted in the original study. While this has grabbed the headlines as being highly beneficial, for the majority of the UK population protein intakes are in fact in excess of requirements. The UK National Diet and Nutrition Survey shows that only 7–8% of protein for those aged 11–65+ comes from cow’s milk. Calling one milk ‘healthier’ than the other based on this alone is generally not useful or appropriate. Single food measures of protein content or indeed quality do not reflect the scale of impact across the total diet and not enough attention is given to this key consideration.
2. Calcium Cow’s milk is known to be a great provider of the UK’s calcium intake, providing from 26% in 4–10 year olds to 18% in 11–18 year olds and in 19% in adults aged 19–64. We can see that all of the non-dairy alternatives to cow’s milk closely match this. They are also fortified with vitamin D, which aids in calcium absorption and is beneficial for bone health. Cow’s milk in the UK does not have vitamin D.
3. Saturated fat One benefit of all the non-dairy milks is that they are generally lower in saturated fat than cow’s milk, providing 0.1–0.6%. Coconut milk is the exception, with levels higher at 0.9–1.9%. One 200ml glass of coconut milk provides 2.8g saturated fat on average, whereas the other non-diary milks average at 0.4g saturated fat. The coconut milk ranks ‘medium’ for saturated fat under the drinks traffic light labelling system, the others are ‘low’.
4. Cholesterol Looking more specifically into soya and the advantages it can have for health, one point not discussed in this study is that soya can also help reduce cholesterol levels. This forms part of the Ultimate Cholesterol Lowering Plan from HEART UK.
5. Iodine This essential trace element is an important component of the thyroid hormones. A recent study from the University of Surrey investigated 14 non-diary milks in the UK and found that iodine levels were only 2% that of in cow’s milk. Women of childbearing age and pregnant women are most at risk of deficiency. Information on alternative sources of iodine are discussed on a British Dietetic Association (BDA) iodine factsheet.
6. Is soya ok? Soya products such as soya milk alternatives often hit the news, with suggestions they can be bad for our health. However, many of these claims are untrue, as discussed on the BDA Fact Sheet for Soya. Soya forms part of a healthy balanced diet. The British Heart Foundation also discusses the role of soya milk as a replacement for cow’s milk. A very recent review of plant food sources of protein for optimum health by Dietitian Vanessa Clarkson can be found on this plant protein fact sheet

Conclusions

A healthy alternative for adults
For those looking to replace cow’s milk in the diet with a plant-based milk, fortified soya milk bears the most nutritional similarities to cow’s milk. However, the other plant-based drinks analysed also provide many of the nutrients. Its crucial to consider them in the context of the whole diet and we feel confident that these products can contribute to a healthy balanced more plant-based diet for adults.

Which non-dairy milk is considered the ‘best’ will depend on individual needs, with personal taste playing an important role. Faced with so much choice, here are some points to consider when buying a non-dairy alternative to milk:

• Choose non-dairy milks that have been fortified with calcium and vitamin D for bone health. Organic varieties and homemade milks may not contain high enough levels – read the label.
• For vegans in particular, choose a milk that has been fortified with vitamin B12 – often found to be low in the vegan diet. Other groups at risk of low vitamin B12 including vegetarians, the elderly and individuals with gastrointestinal disorders.
• Choose unsweetened varieties where possible to minimise intake of free sugars.
• Soya milk is higher in protein than other non-dairy alternatives, although lower protein milks should not pose an issue for the general adult population.
• Soya milk can help as part of a cholesterol-lowering diet.
• Coconut milks will be higher in saturated fats, which can raise ‘bad’ LDL cholesterol levels.
• Swapping cow’s milk for non-dairy alternatives could result in a lower iodine intake unless the milk has been fortified with iodine. Some may be fortified – read the label if there is a concern.
• As with any food or drink product, don’t just treat it in isolation: it’s the total dietary intake that’s important. Whether having dairy milk or a substitute, we need to make sure that our overall food intake is healthy and nutritionally balanced.

Non-dairy milks for children
Parents of children wishing or needing to avoid cow’s milk should seek dietetic advice to ensure their diet is balanced at every age. See the British Dietetic Association factsheet for more information

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