Over the past decade there has been an explosion in dairy free milk options popping up on our grocery store shelves. In the not so recent past the only other alternative to cow's milk was soy milk for those with lactose intolerance or a milk protein allergy. Now there are dozens of dairy free milks ranging from coconut, almond, hemp, flax, cashew, quinoa, rice, oat and pea. Plus there are a few blends such as almond and coconut. Phew! So which is the best? Or should we just drink cow's milk if we can tolerate it? Unfortunately the answer is not so easy.
First let's take a look at cow's milk. Cow's milk contains protein, calcium, potassium, phosphorus, vitamin A, vitamin D, vitamin B-12, riboflavin and niacin. Grass fed and organic milk contain more antioxidants, CLA and Omega 3 which have an anti inflammatory effect making it a healthier option. Organic milk has a better ratio of omega-6 to omega-3 fatty acids compared to conventional milk.
It is important to remember that the fat soluble vitamins in milk, Vitamin A and D needs to be consumed with a fat source in order be absorbed; therefore, I recommend 2% or whole milk. For example if your breakfast was skim milk and corn flakes you will absorb little to none of the vitamin A or D. (Just to be clear this is not a breakfast I would recommend). More recent research suggests that the saturated fat in dairy products has similar effects on our HDL cholesterol, inflammation, and glucose metabolism as unsaturated fats, however, it can increase LDL cholesterol. From my experience most of us do not drink copious amounts of milk, a few splashes in our coffee or hot cereal are unlikely to be of concern.
Lactose free organic milk would be a great option for those with a lactose intolerance or on a low FODMAP diet. This milk is pretreated with a lactase enzyme breaking down the milk sugars prior to ingestion, making it easier to digest.
Soy milk and the new pea based milks have similar protein and calorie counts as cow’s milk and are often fortified with vitamin D and calcium and contain potassium. Soy milk contains isoflavones which may have some cardio protective advantages. These are both high protein vegan milks. Pea protein found in milks such as Ripple and Good Karma Flaxmilk+ Protein has not been officially tested by the Monash University, so we are uncertain of the FODMAP content . However per this blog post on A Little Bit Yummy, small servings 20grams or less which is ~3/4 of a large scoop of pea protein is considered low FODMAP. Kate Watson, registered dietitian and founder of Nicer Foods (they make low FODMAP protein bars), has had pea protein independently tested via the Australian based FODMAP Friendly Food Certification program. Larger servings contain moderate to high FODMAPS loads. Good Karma Flax plus protein uses pea protein. A word of caution for those with thyroid disorders, high intake of soy is not recommended and best to separate from thyroid medication by 4 hours
Nut, flax, coconut and hemp milks contain very little protein and carbohydrates. These may be a good option for those watching their carbohydrate intake and sugar. Most nut milks use only 4-5 nuts to produce 4 cups of milk, water and thickeners added for that creamy mouth feel. Carrageen has been recently under fire and pulled from many brands. Now gellan gum, xanthan gum, cellulose gum, locust bean gum, and agar are more commonly used. These milks are often fortified with vitamin D and calcium, however, brands differ, so be sure to compare labels. Cashew milk is considered a high FODMAP milk. Flax and hemp milk contain plant based ALA omega 3s which are anti inflammatory and heart healthy. Flax, hemp, and almond milk are all low FODMAP options, but double check the ingredients and use caution with pea protein, inulin, and chicory root. From a sustainable approach almond and cow milk require a lot more water and energy in their production. However only a few nuts are used in every carton of almond milk which may help offset some of these environmental effects.
Coconut milk is low in carbohydrate and low FODMAP option in servings of 1/2 cup or less. The saturated fat in coconut milk is high in lauric acid, which is thought to have a beneficial effect on our healthy HDL cholesterol. Coconut also has MCT oils which may help with weight management. If you have a strong history of heart disease, it would be wise to be mindful of your saturated fat intake which is found in full fat cow's milk and coconut milk. Coconut, hemp, pea, and flax are more sustainable low carbohydrate dairy free options.
Rice milk is not high on my list since this contains more carbohydrates which is a nutrient most of us do not need to increase in our diet. This is a however a low FODMAP option.
With all of the above, watch out for ADDED SUGAR. It is best to choose an unsweetened milk or milk alternative since sugar can cause weight gain, high blood sugars, and promote carbohydrate craving. Read the ingredient lists to see if sugar was added. The 12 grams of sugar in 8 ounces of cow's milk are from lactose which is a naturally occurring sugar and not added sugar.
My tops low FODMAP + Paleo "milks" are unsweetened coconut, almond milk, and flax. These are great options for use in coffee, smoothies, hot cereals, soups, and baked goods. I am a fan of whole organic milk for my family however, I cannot tolerate lactose and feel better avoiding dairy. Eliminating dairy has actually improved my IBS and skin. There is good research to support a strong correlation between dairy and acne.
So did I answer the question or just confuse you more? Rarely is the answer black and white in the world of nutrition.