by Jen Rawson, RD
Navigating milk choices has become infinitely more complicated over the past decade. It used to be a decision of what fat percentage milk to buy: skim, 1% or 2%. Now, there are many questions, such as: should I be buying cow’s milk at all? Should I consider alternatives such as almond, cashew, hemp or coconut milk? Are all the options healthy?
Dairy’s reputation has taken a hit as some publications have linked it to certain types of cancers and challenged the long-established notion that drinking milk prevents osteoporosis. During the recent review of Canada’s Food Guide, many voiced the opinion that dairy should be removed as a food group. Based on the draft that was released in July, it appears those opinions have been heard. So where does that leave us when choosing milk in a traditional or alternative form?
The research surrounding dairy and cancer is conflicting. While there have been associations between high calcium diets and increased risk of prostate cancer, there are also associations between increased milk intake and decreased risk of colorectal cancer, bladder cancer, gastric cancer, and breast cancer. It’s also important to point out that the research is all based on associations and does not prove causality, meaning that even if a high calcium diet is associated with prostate cancer, that does not mean it causes prostate cancer. There could be any number of other factors that cause that result.
When it comes to preventing osteoporosis, it appears that while milk and dairy products increase bone mineral density and play a critical role in bone development in childhood and adolescence, increased intake does not necessarily prevent fractures in older adults. However, dairy is still a valuable source of calcium to the diet, which has multiple vital body functions beyond osteoporosis prevention. And while most milk alternatives are fortified with calcium, supplemental calcium has been associated with increased risk of cardiovascular disease.
The conflicting nature of dairy research reinforces an important point about nutrition studies: we do not eat food or nutrients in isolation. We have to consider the entire diet and environment when looking at risk factors for disease. Milk and dairy products fit into a healthy, balanced diet. The key factors for choosing milk alternatives would be an allergy, lactose intolerance, taste preference and/or ethical concerns. With this in mind, here are some key factors to consider when it comes to milk alternatives.
Dairy milk has the highest proportion of protein compared to milk alternatives. Soy milk is comparable but other alternatives such as rice, almond, coconut, and hemp have a very low protein content. For example, almond milk contains 1 gram of protein per 250 mL, compared to 9 grams in a 250 mL glass of dairy milk.
It is a recommended healthy practice to reduce saturated fat in one’s diet. Dairy milk contains 3 grams of saturated fat per 250 mL serving, whereas most plant-based milk products (except coconut milk) contain little to no saturated fat.
Calcium and Vitamin D
Dairy products are one of the richest sources of naturally occurring calcium, and all dairy milk in Canada is fortified with vitamin D. While many milk alternatives are now fortified with similar amounts of calcium and vitamin D, not all are and labels should be checked. Preparing milk alternatives at home has become increasingly popular (see recipe on the next page) but if one chooses to do this, alternative sources of calcium and vitamin D must be considered. Other sources of calcium include: dark, leafy green vegetables, broccoli, beans and lentils, tofu, almonds, and salmon. Vitamin D is found in foods such as fish, eggs, fortified cereals and fortified orange juice.
Appropriateness for Children
Milk alternatives are sometimes used as a method to reduce caloric denseness. While substitutions of this nature are okay for an adult, it’s important to be aware that children require adequate calories, protein and fat for proper growth and development. Switching from dairy milk to a milk alternative without consideration for the rest of the child’s diet can lead to malnutrition. Parents choosing milk alternatives for their children are advised to speak with a dietitian to ensure their child receives adequate nutrition.
When it comes to choosing milk or a milk alternative, there is no best choice. Dairy milk, soy milk, coconut milk and almond milk can all be part of a healthy and balanced diet. The best milk is the one that’s right for an individual’s tolerance, taste preference, ethical values, and budget. Bottom line: be an informed consumer and choose the milk or alternative that feels right for you.
Make-your-own almond milk
1 cup (250 mL) raw almonds, soaked overnight in cool water (or 1-2 hours in very hot water)
5 cups (1.25 L) filtered water (less to thicken, more to thin)
Pinch sea salt
2 dates, pitted, or other sweetener of choice (omit for unsweetened)
1 tsp. vanilla extract or 1 vanilla bean, scraped (omit for plain)
2 tbsp. (30 mL) cocoa powder for “chocolate milk”
1/2 cup (125 mL) berries for “berry milk”
Add the soaked almonds, water, salt, and any optional ingredients to a high-speed blender and blend until creamy and smooth (1-2 minutes). Strain using a nut milk bag or a thin dish towel*. Transfer milk to a jar or covered bottle and
refrigerate. Will keep for up to a few days, though it is best when fresh. Shake well before drinking, as it tends to separate. Makes 5 cups (1.25 L).
*Dish towel straining method: lay a clean dish towel over a mixing bowl, pour over the almond milk, carefully gather the corners, and lift up. Hold over bowl and squeeze until all the liquid is extracted. Discard pulp or save for adding to
Adapted from minimalistbaker.com
Jen Rawson is a Registered Dietitian from Calgary who works in a private practice specializing in intuitive eating, sports nutrition and gut health. She is passionate about running and travelling, often combining the two at destination races.