Milk and dairy products have long been promoted as the best way to get calcium in our diets. Recently, however, there has been a lot of scrutiny about dairy, and like most other trendy nutrition topics, it has become really confusing! In addition to the question about whether or not we should consume cow’s milk, an abundance of milk substitutes has flooded the market, all claiming to be better than cow’s milk. Should we avoid cow’s milk? If so, which substitute should we buy? Read on to learn about plant based milk vs cow’s milk!

Types of Cow’s Milk

There are different choices when purchasing cow’s milk, including various fat percentages, organic, lactose-free, flavored, and raw. Let’s take a look at the differences.

Whole Milk

3.25% milk fat by weight. 150 calories and 8 grams of fat per 1 cup.

Reduced-Fat Milk

2% milk fat by weight. 120 calories and 5 grams of fat per 1 cup.

Low-Fat Milk

1% milk fat by weight. 110 calories and 2.5 grams of fat per 1 cup.

Skim Milk

0% milk fat by weight. 80 calories, and 0 grams of fat per 1 cup.

Organic Milk

Comes from cows that have not been treated with antibiotics, have not been given hormones (for either reproduction or growth), and have been fed at least 30% of their diet on pasture.

Lactose-Free Milk

Free of lactose. Lactose is natural sugar (more specifically, a disaccharide composed of glucose and galactose) found in milk, which is broken down by an enzyme called lactase in our bodies. Some people do not produce any or enough lactase (i.e. lactose intolerance), so some manufacturers will add lactase to the milk to break it down outside of the body. Lactose-free milk tends to taste slightly sweeter than regular milk due to the presence of free glucose.

Flavored Milk

Includes additional ingredients to create flavors such as chocolate (the most popular flavor), strawberry, vanilla, and others. Flavored milks tend to be high in added sugars, so be sure to always read the nutrition facts label before purchasing.

Raw Milk

Raw milk is not pasteurized to kill harmful bacteria. There are safety concerns, so it is not widely available in grocery stores.

Is Milk Healthy?

Regardless of the type you select, milk is a nutrient-rich beverage, boasting 9 essential nutrients: calcium, vitamin D, potassium, phosphorus, protein, riboflavin, niacin, vitamin B12, vitamin A, and pantothenic acid. Vitamins A & D are added, but the others are naturally occurring. Essential nutrients are compounds that we must get from food, because our bodies are not capable of making them. 

Milk Benefits

Milk has long been associated with strong bones, and there is good reason for that correlation. The calcium in milk, along with vitamin D, vitamin K, phosphorus, protein, and magnesium help build and sustain strong bones and prevent osteoporosis later in life. (1, 2, 3, 4) Dairy is the number one source of calcium in the American diet. (5) Although it is possible to get calcium through plant sources such as leafy greens, beans, and nuts, most Americans simply do not eat enough of those foods. In fact, Americans don’t consume the recommended amount of dairy either. Calcium, vitamin D, and potassium are all nutrients of concern, meaning that the majority of Americans do not get enough of these nutrients. (6) 

Pouring a glass of milk is an easy way to add calcium and high quality protein to your diet – important nutrients for building strong bones and muscles!

Concerns with Cow’s Milk

Although milk appears to have numerous benefits, many people choose not to consume it for a variety of reasons.

• Allergies: it is estimated that 2-3% of infants are born with a milk allergy (7), although most outgrow it by age six. (8) Regardless, if you have a true milk allergy, you should not consume milk.
• Lactose intolerance: It is estimated 36% of Americans and 68% of the world’s population have some degree of lactose intolerance, meaning they lack the enzyme lactase that breaks down the natural lactose sugar found in milk. (9) For these individuals, consuming milk can lead to intestinal discomfort. Lactose-free milk is available, but some people prefer other alternatives.
• Environmental concerns: Dairy cattle produce more greenhouse gas emissions and require more land and resources than plants do. Research shows that producing milk alternatives is a more sustainable and environmentally-friendly practice. (10)
• Antibiotics and pesticides: While organic milk seems less likely to contain antibiotics and pesticides, not everyone can afford that option. Antibiotics and pesticides have been found to be prevalent in conventional (non-organic) milk, though the health consequences of these residues are not fully known. (11)
• Hormones: Cow’s milk contains estrogen and progesterone, so some fear that these hormones can cause cancer and/or lead to early puberty in girls. There is limited research to support these claims. (12, 13, 14)
• Prostate health: Research has shown that men that consume a lot of milk and dairy products are at higher risk of developing prostate cancer. (15, 16, 17)
• Mixed research on bone health: While there is ample evidence that milk can support bone health, there has been some recent research that suggests calcium in milk may not protect against osteoporosis and fractures. (18, 19, 20, 21)

Some people choose not to drink milk but still consume other dairy sources, such as cheese, yogurt, and/or kefir. Milk is not, in fact, a necessary component of a healthy diet. However, it is often the preferred source of dairy (and calcium) for growing children.

Plant Based Milk Alternatives

The milk alternative options seem to be growing almost daily; it’s hard to keep up with the different varieties! Let’s take a look at some of the more popular plant-based milk beverages.

Soy Milk

Soy milk is made by soaking soybeans in water. It contains as much protein as cow’s milk and is rich in disease-fighting isoflavones. Additionally, soy milk is fortified with calcium and other vitamins and minerals, making it comparable to cow’s milk. Some people express concern over soy intake and increased breast cancer risk, but research does not support this hypothesis. (22, 23)

Nut Milks

Nut milks are made by soaking nuts in water. There are a lot of varieties with different consistencies, calorie contents, and nutrients. Almond, cashew, macadamia, hazelnut, pecan, and walnut milks are all available on the market. There are some nut milk producers that use more nuts, avoid filler ingredients, and do not fortify their products with vitamins and minerals. The nutritional differences between the pure nut milks and the other formulas is quite significant, making it difficult to offer generalizations about the nutrient profile. Take a look at this comparison chart of pure almond milk versus almond milk with “extras”.

Pure Almond Milk vs. Almond Milk with Extras

8-ounce serving	Pure Almond Milk	Unsweetened Almond Milk + Extras
Calories	130 kcal	30 kcal
Total Fat	11 g	2.5 g
Saturated Fat	1 g	0 g
Trans Fat	0 g	0 g
Cholesterol	0 g	0 g
Sodium	5 mg	170 mg
Total Carbohydrate	3 g	1 g
Dietary Fiber	0 g	1 g
Total Sugars	1 g	0 g
Added Sugars	0 g	0 g
Protein	5 g	1 g
Vitamin D	0%	25%
Calcium	0%	35%
Iron	6%	4%
Potassium	4%	4%
Ingredients	Filtered water, almonds	Filtered water, almonds, calcium carbonate, sea salt, potassium citrate, sunflower lecitin, gellan gum, natural flavors, Vitamin A palmitate, Vitamin D2, D-alpha-tocopherol (natural Vitamin E)

The pure almond milk made with more almonds is higher in calories, healthy fats, and protein. The almond milk with “extras” is lower in calories, fat, and protein, but higher in sodium. Unlike the pure almond milk, it is fortified with calcium and vitamin D. So which one is better? That largely depends on its use.

Oat Milk

Oat milk is made by soaking oats in water then blending and straining. It is naturally creamy, high in carbohydrates, contains fiber, and maintains some of the vitamins and minerals found in oats.

Coconut Milk Beverage

Coconut milk is made by simmering shredded coconut in water then diluting with more water. Not to be confused with canned coconut milk, coconut milk beverage is low in calories, higher in saturated fat than other alternatives, and contains no protein.

Rice Milk

Rice milk is made from milled rice and water. It is naturally sweeter than other milk alternatives, high in carbohydrates, and contains almost no protein.

Hemp Milk

Hemp milk is made from soaking hemp seeds in water. It naturally contains calcium, protein, and heart-healthy omega-3 fatty acids.

Pea Milk

Pea milk is made from yellow split peas soaked in water. It is creamy and contains the same protein content as milk, but most options contain many additive ingredients.

Plant Milk Benefits

Plant milks offer both environmental and nutritional benefits. Plants used in alternative milk beverages require less land, water, fertilizer, and energy to produce than dairy cattle. (24)

For people seeking to follow plant-forward diets, plant milks offer a good alternative to cow’s milk, although they are not all completely nutritionally comparable. Plant milks are typically lower in saturated fat and calories than cow’s milk and provide some of the nutritional benefits of the whole plants themselves.

Plant milks are also a good option for those who have milk allergies or lactose intolerance.

Concerns with Plant-Based Milk

Just like with cow’s milk, there are concerns with plant-based milks. 

• Nutritional Gaps: nutritional contents vary between all of the plant-based milks, but soy milk is the only one that truly compares to cow’s milk. If cow’s milk is a normal part of your diet and you replace it with a plant-based milk (other than soy milk), you will not be getting the same quantity and types of nutrients as before. (25) This is very important to keep in mind when subbing plant-based milk for kids. 
• Price: Do a quick Google search or walk down the plant-based milk aisle of your grocery store, and you will quickly notice that plant-based milk prices can be significantly higher than cow’s milk. Some types are less expensive than others, so choose the one that works for your budget.
• Filler Ingredients: A lot of plant based milks have filler ingredients, thickeners, natural flavors, etc. That’s not to say that all of these are bad, but we recommend sticking to ingredients that you can recognize as much as possible. 
• Added Sugars: Sugar is added to a lot of plant-based milks to increase sweetness and improve palatability. Choose unsweetened versions for optimal health.

Plant Based Milk vs Cow’s Milk: Nutrient Comparison

Now that we have discussed the pros and cons of both cow’s milk and plant-based milks, let’s take a look at the different “milks” side-by-side. Nutrition information is based on 1 cup (8 ounces) and was pulled from USDA’s nutrient database and a few popular brands’ websites. Vitamins and minerals that were added during processing (vs. naturally occurring) are highlighted.

Nutrients	Whole Milk	Skim Milk	Soy Milk	Almond Milk	Oat Milk	Coconut Milk	Rice Milk	Hemp Milk	Pea Milk
Calories	150 kcal	80 kcal	80 kcal	30 kcal	90 kcal	40 kcal	120 kcal	60 kcal	70 kcal
Total Fat	8 g	0 g	4 g	2.5 g	1.5 g	4 g	2.5 g	4.5 g	4.5 g
Saturated Fat	5 g	0 g	.5 g	0 g	0 g	3 g	0 g	0 g	0 g
Sodium	120 mg	100 mg	75 mg	125 mg	120 mg	45 mg	100 mg	110 mg	110 mg
Carbohydrates	12 g	12 g	3 g	1 g	19 g	1 g	23 g	0 g	<1 g
Dietary Fiber	0 g	0 g	2 g	<1 g	2 g	0 g	0 g	0 g	<1 g
Total Sugars	12 g	12 g	1 g	0 g	4 g	0 g	10 g	0 g	0 g
Added Sugar	0 g	0 g	0 g	0 g	4 g	0 g	0 g	0 g	0 g
Protein	8 g	8 g	7 g	1 g	2 g	0 g	1 g	3 g	8 g
Calcium	28%	30%	20%	30%	25%	35%	30%	20%	35%
Folate	3%	3%	10%
Iron	1%	1%	6%	2%	2%	2%	4%	10%	0%
Magnesium	6%	7%	8%	2%				15%
Phosphorus	21%	25%	6%				15%
Potassium	9%	10%	7%	2%	8%	6%	1%	2%	10%
Riboflavin	24%	26%	30%		10%
Vitamin A	11%	10%	15%	15%	20%	20%	10%		10%
Vitamin B12	18%	20%	120%		10%	35%	25%		100%
Vitamin D	31%	29%	15%	10%	20%	10%	25%	10%	30%
Vitamin E				25%		20%

Things to Note:

• Cow’s milk, soy milk, and pea milk provide the most protein.
• Soy milk is the most comparable to cow’s milk.
• Coconut milk and almond milk are lowest in calories.
• Oat milk and rice milk are highest in carbohydrates.
• Cow’s milk contains the highest amount of natural sugars.
• Most plant based milks are fortified with nutrients to try to better match cow’s milk.

Which Milk is Best?

Sorry to say it, but there actually isn’t a clear winner! The answer totally depends on your individual dietary needs, restrictions, concerns, budget, and application. 

The biggest consideration is how you incorporate it in your diet. Remember that most plant based milks are not nutritionally comparable to cow’s milk, so if you drink milk daily as a primary source of protein and calcium, but you want to switch to a plant based option, choose one that is a good source of those nutrients. If you simply use milk with your cereal or a splash in your tea, the type of milk matters less. 

Although they both provide essential nutrients, cow’s milk and/or plant based milks are not actually essential in our diets. You can choose to drink either or neither! A varied diet rich in fruits, vegetables, nuts/seeds, legumes, whole grains, and lean protein (including dairy foods!) will provide the nutrition you need.

Which type of milk does a registered dietitian drink?

If you open my refrigerator, you will find an assortment of milks and milk alternatives. I have cow’s milk for cooking and as a drink option for my 19-month and 4-year-old boys, cashew milk for smoothies and overnight oats, and canned coconut milk for Indian/Pakistani and Thai curries. For many recipes, plant based milks just don’t substitute well for cow’s milk. Personally, I don’t actually drink any of these milks, except for a splash in my tea. However, I do consume kefir, yogurt, and cheese as sources of dairy and find that these leave me feeling nourished and satisfied.

Whatever your needs, preferences, and health goals, figure out what works best for you! 

To YOUR Taste!

Chef V