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Are the alternatives just milking it?

From nuts to soy, and oats to rice - there is no shortage of 'milk' substitutes on the market. But are they just skimming the surface when it comes to nutrition? Our resident dietitian has the answers


There is now a flurry of milk alternatives on offer

There is now a flurry of milk alternatives on offer

There is now a flurry of milk alternatives on offer

Milk used to mean cow's milk. Although low-fat milk and skimmed milk have been popular for some time now, there is now a flurry of milk alternatives on offer that are growing in popularity. As many people are now incorporating these milk alternatives in their diet, their sales have more than doubled between 2009 and 2015. This trend is predicted to continue to grow by about 8pc to 12pc in the next four years.

Often people trade one type of 'milk' for another with minimal thought. However, this may not be advisable, as all 'milks' differ nutritionally. Each has their own plus point, so perhaps by learning the pros and cons you'll be better able to decide when to include them into your daily routine.

* Calories

First thing to note when looking at all the 'milks' is that they differ in terms of calories. Milk from an animal is the highest in calories per 100ml. Surprisingly to some, there is a very small caloric difference between low-fat and skimmed milk. Although none of the 'milks' are exceptionally high in calories, the likes of unsweetened almond 'milk', cashew 'milk' or coconut 'milk' are generally the lowest in calories. The calorie count from these milk alternatives comes from the carbohydrate and fat they contain. The extra calories found in animal milk and soy 'milk' is mainly due to their higher protein content, but for some, their higher fat content.

* Protein

If you're looking for protein, milk from an animal is the front runner. The only alternative with a meaningful amount of protein is soy 'milk'. Nonetheless, although soy contains high quality protein, the building blocks of protein called amino acids differ to cows' milk. Soy protein tends to have lower levels of amino acids methionine and cysteine. Therefore when each milk is rated for protein quality, milk protein has a slightly higher score than soy protein.

As each meal requires a protein source, milk at meal times may need to be animal or soy 'milk'. For example, if you're making porridge on oats and almond milk, there would be inadequate protein within your bowl. If you make your porridge on cows' milk, there would be sufficient protein within your meal.

However, if you already have a protein source at your mealtime, such as eggs, the other milk alternatives can be nice tasty option. For example, hazelnut milk makes a lovely latte which could be enjoyed alongside your toast and eggs.

* Fat

As you can see from the table above right, the fat content of each of the 'milks' varies a little bit. The fat in animal milk is naturally occurring. The fat within the milk alternatives is sometimes added to the milk. For example, oat 'milk' may have vegetable oil added. Nutritionally speaking this isn't regarded as a big deal. Nevertheless, to check if and what fats have been added to your 'milk', look at the ingredients label.

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It's important to note that none of these 'milks' are high in fat. When you talk about solid food, high fat is greater than 17.5 grams of fat per 100 grams and low fat is less than 3 grams of fat per 100 grams. When you talk about liquids, low fat is less than 1.5 grams of fat per 100 grams. As you can see, none of the 'milks' are high in fat. In fact, most are low in fat or close to being low in fat.

A pet peeve of mine is that people call regular cows' milk 'full fat milk'. Firstly, we don't call bread 'full gluten bread' just because there is an alternative called gluten-free bread. Secondly, as mentioned above, 'full fat milk' isn't all that high in fat. If you were to switch from milk to low fat milk, you would be reducing your fat intake by approximately 10g of fat for every pint of milk you drink. If you made the change from low fat to skimmed milk you would be cutting your fat intake by less than 4 grams of fat per pint. This isn't a big save. A more dramatic way to cut down on animal fats, if that is something that you wish to do, would be to use an alternative to butter when cooking and on your bread. For example, in cooking you may choose to use olive or rapeseed oil and on your bread you may consider putting the likes of peanut butter, hummus, guacamole or avocado instead.

* Carbohydrate

The carbohydrate found in animal milk is natural, it has not been added. This carbohydrate found in milk is called lactose and is considered a Low GI (slow release) carbohydrate. Some people find that lactose can make them bloat, have loose stools or become windy. For those people who are lactose intolerant, lacto-free cows' milk is available, as well as the naturally lactose free 'milk' alternatives.

Although lactose is a simple sugar, it is considered to be different to other simple sugars as it is naturally occurring within the milk rather than added to the milk. The guidelines encourage us to lower our 'added sugar' intake, which doesn't include the sugar naturally found in milk. To check if sugar has been added to your milk or milk alternative, read the list of ingredients.

If words like sugar, fruit juice, syrup or honey appear on the ingredients list, you know that sugar has been added. Grain-based milk alternatives such as rice and oat 'milk' have slightly more carbohydrate within them as they are a starch. Nonetheless, some milk alternatives may have 30 grams of sugar added to each carton, which is nearly eight teaspoons of sugar. In fact, as the ingredients are listed in order of quantity, it's clear from checking the labels that there may be more sugar than nut within the drink!

Flavoured versions, for example chocolate almond milk, may have 70 grams of sugar or nearly 18 tsp of sugar added to each carton. Considering the aim is to consume less than 6 tsp of added sugar each day, this can really mount up. So do choose the unsweetened varieties.

* Micronutrients

Although the macronutrients are important to consider, so too are the micronutrients. As the milk alternatives do not contain as many different vitamins and minerals as animal milks, many alternatives are fortified with micronutrients during production. It is common for vitamin B2, B12 and D2 to be added to the milk alternatives as well as calcium, salts, emulsifiers/ thickeners and stabilisers.

Cows' milk naturally contains calcium, vitamin B2, B5, B6 and B12 as well as phosphorus, iodine and potassium. Certain brands of cows' milks have other additional vitamins added to them such as vitamin D, folic acid, vitamin E, vitamin C and iron. Although the nutrient content of animal milks and fortified milk alternatives is great, it is important to note that the content on the nutritional label does not necessarily guarantee equivalent nutritional value. We know that different sources of nutrients are absorbed and used by the body differently.

For example, dairy calcium is considered to have a high bioavailability with natural components found within the milk and the mineral playing a role in enhancing its absorption. In milk alternatives, calcium can be added in the form of calcium carbonate or tricalcium phosphate. Tricalcium phosphate has been shown to be less well absorbed when compared to calcium carbonate. The calcium absorbed from calcium carbonate is considered to be on a par with the calcium from diary, while the tricalcium phosphate has been shown to be absorbed with 75pc efficiency.

Additionally, many milk alternatives do not contain the mineral iodine. Iodine is another nutrient often linked to cows' milk as it has been shown to provide 45pc of if the iodine within Irish diets. Nearly four out of five Irish women of child-bearing age are not meeting the recommendations for iodine during pregnancy. This is worrying, as it contributes to the normal cognitive function and thyroid function. Poor intake during pregnancy has been associated with lower IQ and may impair cognition for the baby. For this reason, if you have removed milk from your diet, you may need to be focusing on eating more fish or seaweed for iodine.

Milk substitutes

• Almond

A popular choice but be warned, some 'milks' contain more sugar than almond! One of the more popular brands is about 3pc sugar and only 2pc almond. A healthier choice is the unsweetened varieties.

• Hazelnut

It's more challenging to come across unsweetened hazelnut 'milks'. The more popular brands contain nearly a tsp of sugar per 100ml. Nevertheless, if you like a hazelnut shot in your coffee, you may wish to try coffee made on hazelnut 'milk'.

• Coconut

Although each brand is different, coconut 'milk' can contain a comparable amount of saturated fat to cows' milk. Although there is research to show that the saturated fat in cows' milk may be good for us, there is less solid evidence in favour of the fat from coconuts. The sugar it contains tends to be naturally occurring rather than added.

• Cashew

Cashew 'milk' is less common. Nonetheless, the more popular brand is unique as it is more nut than sugar (3pc nut and 2pc sugar). Unfortunately, it's fortified with tri-calcium phosphate rather than calcium carbonate. Nevertheless, it still counts towards your calcium intake.

• Rice

With 9.5 grams of naturally occurring carbohydrate per 100ml, rice 'milk' is a tasty carbohydrate-based drink. As it's naturally low in lactose and easy to digest, it's an option for those with upset stomachs or athletes trying to stay fuelled during long bouts of exercise.

The fat within the milk is often added. Therefore you may see the likes of sunflower oil within the list of ingredients.

• Oat

Oat 'milk', as well as almond 'milk', is a milk alternative on offer in many coffee shops. It's unique in that it provides 1 to 1.5 grams of fibre per 100ml, depending on the brand. Oat 'milk' is about 10pc oat and usually has fats like sunflower or rapeseed oil added to it.

• Soy milk

Similar to milk from an animal, a pint of soy 'milk' provides just under 20 grams of protein. Soy milk is part of a cholesterol-lowering diet. Reductions of 3pc to 10pc are commonly seen when 25 grams of soy protein are added to the diet.


• Lactose intolerance implies that a person is unable to digest lactose, the naturally-occurring sugar in milk and milk-containing products like yoghurt. Lactase is the enzyme or chemical that our body produces to break down lactose.

• Lactose intolerance is when there is little or no lactase being produced in the body. When someone is lactose intolerant, they generally start to feel unwell within two hours of eating or drinking lactose. The severity of symptoms differs but usually includes diarrhoea, bloating, and cramping. Some people feel nauseous and gaseous. Often when people have lactose intolerance they can still tolerate a small amount of milk and yoghurt. It's important to find your tolerance level. Usually those with lactose intolerance can tolerate cheese.

• The prevalence of cow's milk protein allergy varies from 2pc to 7.5pc. It's estimated that 75pc to 90pc of people with cow's milk protein allergy no longer have an allergy by the age of five or six years. Therefore allergy to the protein in cow's milk is rather uncommon in adults, though it still exists.


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