“My grandson was switched to almond milk after he was weaned at eight months. He eats no dairy. He is now four-and-a-half years old. He has no medical reason for not consuming dairy. What will be his development challenges for not consuming dairy?”

With the growing popularity of plant-based drinks, many parents, grandparents and caregivers are likely considering similar questions. We reached out to Dr. Dennis Savaiano, professor in the Department of Nutrition Science, Purdue University.

He explained that it depends on a person’s overall diet.

“Dairy foods are a great source of nutrients, especially calcium, protein and other vitamins and minerals. Not eating dairy makes eating a nutritious diet more difficult, but not impossible,” he said.

As with many nutrition issues, it is important to read labels of plant-based milk products.

“Many almond milks have poor nutrient composition. Be careful in reading labels to ensure that the products contain good nutrition and not simply empty/sugar calories,” Dr. Savaiano added.

In our article about plant-based milks, Dr. Ann Macrina, Penn State University, explained that all cow’s milk is relatively consistent in protein and mineral content. The amount of fat varies in the different types such as whole milk, skim milk, etc. That is not the case with plant-based milks, which include drinks made from almonds, soy, rice or other plants.

“Plant-based milks are quite variable. Some have as much fat as cow’s milk. Some have a higher sugar content. The big difference is protein. The quality of plant protein generally is not as high as animal protein. Cow’s milk has more of the building block proteins that humans need in their diet,” she said.

It is possible for children and adults to get necessary nutrients without consuming dairy; however, it is essential to read labels and make sure the overall diet has adequate vitamins, minerals and protein.

You can get all necessary nutrients without dairy, but be sure your diet has vitamins, protein.
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While traditional milk from a cow is still far and away the leader in the dairy case, plant-based products such as soy milk and almond milk are gaining popularity. They’re also a point of contention. Some feel we shouldn’t be able to call a drink “milk” just because it’s a white liquid. The Food and Drug Administration has been asked to make a determination.

We asked a panel of nutrition experts to weigh in on the issue:
Dr. Ann Macrina, Penn State University
Dr. Dennis Savaiano, Purdue University
Dr. Connie Weaver, Purdue University
Dr. J. Bruce German, University of California Davis

The bottom line:

The issue is far from settled, with strong feelings on both sides. Read labels to know for sure what you are buying and to know if the milks or drinks meet your expectations for nutrients, fat and calorie content.

What’s the debate all about?

Dr. Macrina: The USDA’s legal definition of milk is, “The lacteal secretion from a cow.” In theory, anything that does not meet that definition should not be called milk. So, the controversy is whether plant-based products should be allowed to be called milk.

Dr. Savaiano: If you asked people what milk is, I think most would say it is cows’ lactate that we put into containers and sell. Soy, almond and rice-based products aren’t milks – they’re drinks. They may look like milk but their nutrient composition can be quite different. Some of them can have a lot of added sugar. Some contain no calcium. It is possible to mimic the composition of cow’s milk but the consumer needs to be aware and the label will give the them the information they need.

Can you give us an example of how consumers should interpret what they see on the label?

Dr. Savaiano: Well, I’m looking at the label of an almond-based drink as we speak and I see it has no added sugar but calcium and Vitamin D have been added. You can see this beverage has been designed to be low in calories and high in calcium and vitamin D. It’s high in sodium compared to potassium, so it’s not a perfect blend compared to what cow’s milk contains. I also have a rice-based beverage label in front of me. It is low-fat and has added sugar. It has quite a bit of carbohydrate, a little bit of sodium and no calcium. There doesn’t appear to be a lot of nutrition in this drink.

Consumers should read the label very carefully. Plant-based drinks certainly can be a healthy choice but it depends on how they’re formulated.

From a nutritionist’s perspective, do you think plant-based drinks should be allowed to use the term “milk?”

Dr. Savaiano: I would prefer that we call them “drinks” because to call them milk implies they have the same nutrient composition as milk. This is going to be an interesting policy debate.

Dr. Macrina: I’m undecided. How about peanut butter? Butter is a dairy product but peanut butter is not. There are all kinds of spreads that we call butter. I think the consumer understands peanut butter doesn’t come from a cow. By the same token, I think consumers understand that soy milk comes from soybeans. I also understand that using the term “milk” might imply a certain nutritional profile so … I guess I’m not really sure where I stand on this.

Dr. German: I have a scientific conviction that vocabulary matters and that the imperative to develop accurate terminology for our understanding of the world around us is as vital as making scientific discoveries in the first place. I won’t dwell on the political implications of over-simplifying agriculture, food and health but certainly it is troubling that we conflate all “white liquids” as “milk.” So, in direct answer to the question, I feel strongly there need to be specific terms for human milk, bovine milk, sheep’s milk AND almond juice, soy juice, etc.

When it comes to making healthy food choices, whether it be dairy products or any other food, what’s your advice to consumers?

Dr. Weaver: Nutrition advice is mixed and comes at consumers in too frequent and complex doses. The best advice is for consumers to follow the Dietary Guidelines for Americans. This is the national policy with the most careful approach. Mandated by Congress, the U.S. Department of Agriculture and the Department of Health and Human Services convene experts every 5 years to review all related peer-reviewed evidence for the previous five years to give dietary guidance.

Related topics have been extensively gleaned from the literature, graded for quality and consistency, and summarized. The experts review the evidence and come to a consensus vote for each and every recommendation that is made. Using this information, laws are created that all government-funded nutrition programs must follow, such as the school lunch program.

No other process matches this extensive evaluation. But some scientists express their own opinions and media cover individual studies. This can be confusing to the public if the message doesn’t agree with the Dietary Guidelines. So, some choose to ignore them.

Dr. German: In my professional opinion, the failure to educate students through K-12 about diet, food and health has been a major mistake and stands as one of modern society’s great blunders. As a result, some consumers today have a discouraging misunderstanding of how diet relates to health. Individual foods are not the secret to health. Diet in its totality is what matters. Many consumers have been led to the impression that individual foods have almost magical properties and can cure all of the ills of the rest of their diet and lifestyle. We can debate how this impression developed, nonetheless it is just wrong. Hence, any beverage option should be viewed as a part of an overall diet for each individual in the context of their overall health, taking age, activity, tolerances and allergies into consideration.

Read Related Article: Plant-Based Milk vs. Cow’s Milk: What’s the Difference?

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While traditional cow’s milk still dominates the market, research shows U.S. non-dairy milk sales are growing while cow’s milk sales have declined. One need only look at the refrigerator case at a grocery store to see that retailers are increasingly stocking more plant-based dairy alternatives.

Consumers shopping for healthy alternatives have a lot of questions. How do you get milk from a nut, bean or seed? Is almond milk healthy? Is soy milk dairy? What is the nutrient profile of plant-based dairy alternatives compared to cow’s milk? Are the plant-based alternatives really milk?

We posed these questions to a panel of nutrition experts: Dr. Ann Macrina, Penn State University, Dr. Dennis Savaiano, Purdue University, and Dr. Connie Weaver, Purdue University.

What we learned

Plant-based milks are made by grinding a bean or nut, then adding water, flavors, vitamins and minerals. The nutrients and amount of sugar in plant-based milk varies considerably based on how it was produced and what has been added. Cow’s milk contains protein, calcium, riboflavin and potassium. The nutrients are consistent in all products, but the amount of fat varies from no fat, low-fat and full-fat.  Calcium-fortified soy milk is the closest to cow’s milk, but it is lower in other nutrients than cow’s milk. Some plant-based milks are very low in protein, which can be a matter of concern for children and elderly. Plant-based milks are becoming more popular because some people prefer the taste and the variety of flavors. It is also preferred by people who are allergic or intolerant to milk. The experts urge milk drinkers to read the labels and make the choice based on nutrition, price and preferences.

From the experts

Read the in-depth interview to discover more about plant-based milk, nutrients and trends in the dairy aisle.

Why have sales of cow’s milk been declining?

Dr. Macrina: There are several reasons. Back in the day when most people were home for dinner in the evening, it was part of our routine for kids, and even adults, to drink milk. People today are on the go and often aren’t home for dinner. And, for a long time, milk wasn’t as portable as other beverages. Portable milk packaging has come a long way but I don’t think many people are fully aware of it.

Dr. Weaver: Also, some people avoid cow’s milk because of expected lactose intolerance or protein allergies, or dislike of the taste without making the effort to find products or strategies to incorporate them into their diet.

Dr. Savaiano: Over the last 30 years or so soft drink consumption has increased significantly and for some people, soft drinks have replaced milk as the drink of choice. This is concerning. If you look at the nutrient intake profile of Americans over the last 30 years, we are far away from recommendations. We don’t eat enough fruits or vegetables. We probably do get enough calcium. We’re on the edge of getting the right amount of riboflavin. The sodium/potassium ratios of what we eat are not great – less sodium and more potassium would be good.

Low-fat dairy can be a key component in an ideal diet. Soft drinks tend to contribute calories instead of nutrients and most Americans get more than enough calories.

Dr. Macrina: Some people think milk costs too much. If you can buy a two-liter bottle of soda for a $1.50, some will choose it over milk. People sometimes don’t think about the nutritional issue when they’re making purchasing decisions. If you ask a kid if they want milk or soda, which one do you think they’re going to choose? Also, kids used to drink a lot of milk at school, but schools have switched to very low-fat or no-fat milk which simply doesn’t taste that good to kids.

Market research shows plant-based milk substitutes are gaining popularity. Why?

Dr. Savaiano: It’s a very small part of the market, but yes, sales of plant-based beverages are increasing. It reflects that some people feel vegetable-based products are healthier. Some consumers also question modern milk production practices which also has had a negative impact on milk consumption. Depending on their composition, some of these plant-based drinks fall into the category of sweetened beverages. Some do, some don’t. It just depends on how much sugar is added.

Dr. Macrina: It’s interesting to note that while fluid milk consumption has decreased, overall dairy consumption has increased. People today are eating a lot of cheese and yogurt. But, some people perceive plant products as healthier than those from animals. Whether or not they actually are, some people believe they are allergic or intolerant to milk. A lot of the plant-based milks are flavored while there aren’t a lot of flavored cow’s milk products, other than chocolate, in many retail outlets. The plant-based products also tend to be sweeter, which is attractive to some.

How are plant-based milks made?

Dr. Macrina: Generally speaking, they grind a bean or nut then add water. The amount of water determines the consistency. Flavors, vitamins, minerals, etc. are added.

Dr. Savaiano: I’m not a food technologist, but if you look at the label you can see the ingredients. They contain components extracted from almonds, rice, soy, etc. The taste depends on what they’re flavored with and how they’re formulated.

Dr. Weaver: Soy milk, for example, is extracted from soybeans and if calcium fortified, a calcium salt is added. Similar for other plants.

What is the nutritional profile of regular milk vs almond milk and the other plant-based alternatives?

Dr. Savaiano: This is an important question because it can vary a lot. Consumers need to look at the label. Milk has lots of positive nutrients – protein, calcium, riboflavin, potassium. Milk’s nutrient profile isn’t perfect, but it’s a very nutritious food and, of course, it comes in no-fat, low-fat and full-fat varieties. The plant-based drinks can have a positive nutrient profile, too. It depends on the manufacturer.

Dr. Weaver: None of the plant-based options match cow’s milk entirely. Calcium-fortified soy milk is the closest to cow’s milk but still lower in potassium and some other nutrients. Some plant-based beverages are very low in protein as well (like almond milk) which can be a problem for kids and the elderly.

Dr. Macrina: The most variable component of cow’s milk is fat. The rest of it is relatively consistent – the protein and mineral content is going to be about the same regardless of the fat level in the milk you buy. Plant-based milks are quite variable. Some have as much fat as cow’s milk. Some have a higher sugar content. The big difference is protein. The quality of plant protein generally is not as high as animal protein. Cow’s milk has more of the building block proteins that humans need in their diet.

What’s your advice to consumers on milk replacements?

Dr. Macrina: Plant-based milks are quite variable in what they contain while cow’s milk is pretty standard. We know where cow’s milk comes from. Plant-based milks are manufactured and can have a variety of additives. I urge consumers to read the label to determine what’s best for them.

Dr. Savaiano: Yes, consumers should read the label very carefully. Plant-based drinks certainly can be a healthy choice depending on how they’re formulated.

Dr. Weaver: The plant-based beverages all cost a good deal more than cow’s milk. So, one needs to determine how much they want to pay for the nutrients and determine which nutrients you need to get from other foods. A main nutrient expected from milk is calcium. Only soy milk has been tested for calcium bioavailability (by my lab) which was determined to be as good as from cow’s milk. But none of the other plant beverages have been tested and they should be.

MilkPEP (Milk Processor Education Program) has created an interactive site comparing plant-based milk and cow’s milk  on factors such as calories and nutrients.

Some members of Congress have asked FDA to step in and determine whether plant-based drink products should be allowed to be called “milk.” Find out in the second part of this series Debate in the Dairy Aisle: Are Plant-Based Drinks “Milk”?

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