Plant-based milks are more abundant than ever, and consumer demand for these products are at an all-time-high. These products were initially limited to soy, rice, and almond. However, improved technology and innovation has allowed the market to expand to cashew, coconut, flaxseed, oat, legumes, and other nut milk products. In fact, according to a 2021 consumer goods report, milk alternative sales were valued at 2.6 billion US dollars which exceeded the meat alternative sales value by 100%.1 The reasons why individuals are making the switch include intolerance to lactose, lifestyle and ethical matters (e.g., becoming vegetarian), and concerns about antibiotics and hormones. Despite this milk alternative craze, are they truly better for our health compared to cow’s milk?
Nutrient Composition of Plant-Based Milks
Let’s first examine the nutrient value of plant-based milks. We know that eating whole plants are full of vitamins, minerals, phytochemicals, and fiber – all of which influence our health in a positive manner. But converting whole plants into milk requires a lot of processing (which can be classified as “ultra-processed” as mentioned below). The extensive processing can drastically deplete the nutrient content of the milk. Using the USDA’s FoodData Central search engine, Table 1 highlights the average nutrient make-up of milk alternatives based on 8 ounces or 1 cup.
The nutrient value of milk alternatives varies and is primarily dependent on whether or not they were fortified with key vitamins and minerals. Based on Table 1, if you are concerned about optimizing protein intake, coconut and almond milk would not be wise choices. In contrast, flaxseed, pea, soy, and cow’s milk contain the most protein per 8 ounces. For bone health, calcium and vitamin D are essential, thus, cashew and oat milk would not be good choices. Vitamin B12, which is necessary for maintaining the integrity of our DNA and nerve function, is only found in animal products and must be fortified to milk alternatives.
Figure 2 also highlights differences in nutrient content among 8 types of products for vitamins A and D, calcium, and potassium. The longer the bar, the more variation was observed for that nutrient across same type (or variety) of plant products. For example, extreme variability in vitamin A and D concentrations were found across all rice milk products.
Concern in Growing Children
In February 2023, the Food and Drug Administration (FDA) announced recommendations for the labeling of plant-based milks. In that report, these products can be called “milks,” and the labels should include a voluntary nutrient statement on how the nutrients differ from cow’s milk. For example, “X milk contains less protein and Vitamin D than cow’s milk.” Growing children are at particular risk for consuming less-nutritious cow’s milk alternatives. Children up to 2 years of age have accelerated growth patterns that require adequate calories and protein. Drinking low-calorie / low-protein milk alternatives can lead to growth stunting. For example, one study found that every daily cup of milk alternative consumed lead to a 0.4 cm decrease in height, and 3 year old children drinking 3 cups per day were 1.5 cm shorter than those drinking cow’s milk.3 Height differences may be linked to insulin-like growth factor present in cow’s milk, which activates muscle growth and cartilage cells in bone.
Considerations for Selecting Plant-Based Milk
Other than taste and preference, what would be considered a healthy, nutrient-dense plant-based milk alternative? According to scientists at the University of Washington and Tufts University in Boston, the following should be considered when selecting milk alternatives (per 8 ounces):4
- No more than 240 calories
- At least 5 grams of high-quality protein
- Consistent fortification with calcium, Vitamins A, D, and B12 that matches cow’s milk
- Minimal added sugar (less than ~12 grams), saturated fat, and sodium
High-quality protein? What does that mean? We all have heard that the building blocks of protein are amino acids. We make 11 of the 20 amino acids in our body from other molecules. However, we must consume the remaining 9 through foods – and these “essential” amino acids must be present at the recommended levels for a particular life phase. For example, infants require higher amounts of these building blocks per pound of body weight compared to adults due to accelerated protein synthesis. Animal products contain all essential amino acids; plants (except soy) do not – or at least in appropriate amounts. Thus, fortification of high-quality proteins would allow for milk alternatives to be more nutritionally complete.
Plant-based milks can also be considered “ultra-processed.” In fact, over 90% of all plant-based milks were classified under “ultra-processed” because they were developed from components of foods with additives that are not usually used in the normal cooking process.4 Such components include added flavors, stabilizers, and preservatives.
The most effective way to identify the most “nutrient dense” milk alternatives to read the Nutrition Facts Label and focusing on the nutrients that provide the highest %Daily Value. The %Daily Value is the percentage of that specific nutrient that meets the recommended requirements. For example, if a product contains 10% of the Daily Value for protein, then it would contain 10 grams if the recommendation is 100 grams per day.
In conclusion, plant-based milk alternatives can be a healthy options, but nutrient composition and fortification should be highly considered. Care must be taken to ensure these products have adequate calories and protein which are necessary for the growth and development of children. Cow’s milk remains the gold standard for adequate nutrient composition.
References
1 https://www.statista.com/statistics/771457/plant-based-food-sales/
2 Pires VS, et al. Market basket survey of the micronutrients vitamin A, D, calcium, and potassium in 8 types of commercial plant based milk alternatives from US markets. ACS Food Sci Technol 2023 3(1):100-112.
3 Morency ME, et al. Association between noncow milk beverage consumption and childhood height. Am J Clin Nutr. 2017;106(2):597-602.
4 Drewnowski A, Henry CJ, & Dwyer JT. Proposed nutrient standards for plant-based beverages intended as milk alternatives. Front Nutr 2021;8:761442.
5 Drewnowski A. Perspective: Identifying ultra-processed plant-based milk alternatives in the USDA branded food products database. Adv Nutr 2021;12(6):2068-2075.