Soy, oat, almond, coconut? How to find the healthiest milk for your needs

While cow's milk has been a controversial staple in the American diet for generations, it didn't have any serious competition until the past decade, which has seen a remarkable rise in the number of plant-based alternatives.

This increase in nondairy "milks" makes sense for many reasons: 65 percent of the adult population has difficulty digesting lactose, the sugar in cow's milk; our diet has become more varied in general; more consumers are vegan; and people worldwide are more aware of the environmental toll the dairy industry is taking on the planet.

For years, soy milk was the main alternative. But even those who welcome more choice might find the options out there daunting: pea milk, hemp milk, coconut milk, etc. How to decide? "Think about your big-picture needs versus what's trendy," says Jessica Cording, a dietitian and integrative health coach. Consider your nutritional needs, how you plan to use the milk and whether it's a taste you enjoy.

And keep in mind that cow's milk alternatives have drawbacks of their own. "Many of these milks, like oat, rice, and almond milk, require things to be added to make them smoother, emulsified, so they're more even [in consistency] and more like the milks you're used to," says Ilene Fennoy, a pediatric endocrinologist and specialist in nutrition.

To approach the nutritional punch of cow's milk, they also need to be fortified with calcium, vitamins and minerals, as commercial versions are. But beware: "While fortified with calcium, this calcium may not be as well-absorbed by the body," says Natalie Allen, a registered dietitian and clinical instructor of biomedical sciences for Missouri State University. "The calcium can also settle in the container; thus, consumers are not getting as many bone-building nutrients as they think."

Allen suggests you consider a milk's protein content (better if high), sugar level (better if low) and fortification (it should have it). "Consider any additives in the ingredient list, too," she says, including emulsifiers and stabilizers such as xanthum gum, carrageenan or sunflower lecithin.

Some of these may irritate the gut or cause inflammation. And remember that plant milks need these additives because they tend to separate, so make sure to shake them well before serving. "Some of the vitamins and minerals may settle to the bottom," says Allen.

With the above advice in mind, let's look at the specifics of cow's milk and some of its easily obtainable alternatives (calorie, protein, fat and sugar content differ by brand and type of milk; these are general figures).

• Cow's milk: high in calcium, protein and fat

Creamy, cool cow's milk, with about 8 grams of protein per serving, is often considered the "gold standard" of milks in terms of taste and nutrients. "Dairy milk is best for bone health," says Allen. "The calcium in all cow's milk is well-absorbed, and dietitians recommend three or four servings a day, particularly for children and pregnant women. From ages 1 to 2, we recommend whole milk."

One cup of whole milk has 150 calories, with 4.5 grams of saturated fat and 12 grams of sugar (lactose). In the United States, most dairy milks are fortified with extra vitamins and minerals, and are notably good sources of phosphorus, potassium, and vitamins A and D, says Allen.

While not ideal for adults, the dairy fat is necessary for infants. "Fat is important for brain development," Fennoy says. Experts commonly recommend switching to skim, 1 percent or 2 percent after age 2. "The fats in cow's milk are saturated fats, which are not the best for cholesterol or triglyceride levels," she explains. "We encourage a switch to lower fat as individuals get older."

If you prefer milk from animal sources because of their protein but have a lactose sensitivity, you may want to try lower-lactose goat's or sheep's milk. "The flavor is different, more tangy and gamy, but not a big change in calories or fat grams," Cording says. Sheep's and goat's milk also provide calcium.

• Legume-based milk: packed with protein

Soy milk has been on the grid for a long time. It's on the creamier side among dairy alternatives (although some find it chalky), and dietitians typically laud the milk for its protein, when most milk alternatives do not compare to dairy, says Cording. (It clocks in at about seven to 12 grams per cup.) "For a long time, most of the nondairy milks were very low protein, which set soy milk apart in another category." At 80 calories per cup, soy milk contains around 3 grams of fat (just 0.5 grams of saturated fat) and 1 gram of sugar. There have been concerns about the effect of soy on thyroid function and hormone levels, which may be why there's been a small consumer shift away from this plant-based staple.

A more recent legume option is pea milk, with a mild, somewhat earthy taste. "I like it a lot because it actually has seven to 10 grams of protein per cup," Cording says. On top of that, she says it's "versatile," and typically well-received among most palates. Allen says pea milk has many advantages. "It's free of dairy, soy, nuts and gluten," she says. "The protein is equal to dairy milk.

It's also lower in sugar and contains all nine essential amino acids." Typically, pea milk contains 4.5 grams of fat and 5 grams of sugar. However, anyone allergic to soy or nuts should check brand labels to make sure the milk is not produced in a plant that also produces items with those ingredients.

• Seed-based: healthy fats Hemp milk is a popular alternative in coffee shops because it's creamy and thick and does well in latte art. "Hemp milk is a good option for those who cannot consume nuts, dairy, soy or gluten," says Allen. If you're looking for a dose of healthy fat, then it might be the right option for you: Allen notes hemp milk is an excellent source of healthy fats and magnesium but lacks the calcium and vitamins D and B12 of other options.

There's a little bit more protein at 5 grams per cup, around 100 calories and relatively high sugar (9 or 10 grams). Its shining point: Cording says hemp milk, which has a slightly nutty flavor, also "has that ideal omega-6 to omega-3 ratio of 3:1, which is beneficial for brain and heart health."

Flax is another nutty-tasting option worth considering, at about 25 to 60 calories per cup, just about 2.5 grams of fat (negligible saturated fat) and minimal sugar (zero grams if you buy unsweetened). This alternative is "generally similar in nutrition to nut-based milks," according to Sharon Collison, a registered dietitian and instructor of nutrition at the University of Delaware, but creamier.

While flax milk is not a great source of protein on its own, there are now versions on the market that are enriched with pea protein and "provide eight grams of protein per cup," says Collison, along with those heart-healthy omega-3s. "Even with the protein added, it is lower in calories at 60 calories per cup, so it is a good alternative to cow's milk for those wanting a plant-based milk," she says.

• Grain-based milk: allergen-friendly Collison says rich, creamy oat milk has a widely enjoyed texture and is a decent all-around alternative to dairy milk that's very allergen-friendly. However, it only has 3 grams of protein per cup, along with 120 calories, 2.5 grams of fat and 7 grams of sugar.

Because oat milk is generally flavored, Allen says it's higher in carbs and sugars, which is a con. "But oat milk has no cholesterol and is low in fat, so it's good for heart health," she says. "Additionally, it has more fiber than many other types of milk. It's a good alternative in cooking, particularly in sweeter items that call for milk, such as muffins and quick breads."

Rice milk, another grain-based option, is on a similar plane. Some may like its sweeter taste, containing around 120 calories, 13 grams of sugar, 2 grams of fat and less than 1 gram of protein. "It is naturally sweeter than other types of milk, but low in protein and high in carbs," Allen says. "People with diabetes should avoid it."

"The biggest problem is the very low protein, and concern over the arsenic in rice," Cording says. "If it is your day-to-day diet, it could potentially add up over time, so a lot [of consumers] have moved away."

• Nut-based milk: versatile Milks made from almonds and coconuts (which are technically drupes) are a couple of the most common, versatile dairy alternatives out there. People tend to find their slight almond or coconut flavor fairly pleasant compared with other plant-derived options, as well - but they aren't exactly nutritional powerhouses.

Collison, for instance, sees almond milk more as a solid beverage choice, coffee additive or smoothie ingredient if you're trying to keep your calorie count in check. "It's best as a low-calorie beverage - unsweetened almond milk has about 30 calories per cup," she says. "It is much too low in protein to be a true substitute" for dairy milk, at 1 gram of protein.

Among its pros, unsweetened almond milk is lower in carbs and sugar than a lot of other options, and is a good source of polyunsaturated fats and vitamins A and E. Unsweetened varieties have no sugar and just 2.5 grams of fat.

Coconut milk is great for cooking and easy to enjoy with its sweet taste, but you may want to limit it overall. "Coconut milk is generally higher in calories and saturated fat than other milks," says Allen. Canned coconut milk has roughly 150 calories per cup, with 12 grams of fat (10 of which are saturated) and a gram of sugar. Unsweetened coconut milk is about 50 calories per cup, 4 grams of fat and 1 gram. "Think of it as a substitute for cream, not necessarily the best option for drinking. Better for cooking."

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