Got milk choices?

By Niki Strealy, RD, LD, registered dietitian, Providence Nutrition Services

Have you been thinking about giving up your milk mustache? A lot of people have – so many, in fact, that the dairy industry just dumped its 20-year "Got Milk" campaign in February due to a continuing decline in the numbers who are getting it. Milk allergies, dairy-free diets and a huge new wave of milk alternatives have sent millions of former milk drinkers in search of something like milk, but not milk.

As a dietitian, I think that milk can be an important part of a healthy, well-balanced diet – the research behind its health benefits is solid and longstanding. That said, I don't drink it myself – I lost the taste for it as a lactose-intolerant child, before Lactaid, the lactose-free milk, was available. So I recognize that there are people out there who can't – or choose not to – drink milk. Today, there are plenty of alternatives, but keep in mind that none of the substitutes will give you the same nutrition as real milk. So before you go completely sour on good old-fashioned cow's milk, get the facts on both your dairy and nondairy options so you can make a smart, well-informed choice.

Got milk facts?

Here are 10 things to consider about cow's milk:

  • The Dietary Guidelines for Americans recommend three cups of dairy daily for adults and two cups for children. The American Heart Association adds that teens and older adults need four cups daily. Infants and toddlers especially need the essential fats in milk for brain development, and children, teens, and women before, during and after pregnancy need the calcium and vitamin D to build the bones that will carry them through life.
  • Milk packages nutrients in a way that your body absorbs best. For example, lactose, milk's natural form of sugar, enhances calcium absorption – you'll absorb more calcium from a glass of milk than you would from a supplement containing the same amount of calcium.
  • Milk also supplies protein, vitamin D and potassium, a blood-pressure-lowering nutrient that many people don't get enough of.
  • Studies show that people with higher intakes of dairy have lower risks of cardiovascular disease, diabetes and high blood pressure.
  • Drinking milk has been linked to lower body weight. Low-fat milk gives you positive nutrients and helps you feel full, which improves calorie control.
  • People who are lactose-intolerant can still drink milk: Lactaid is real milk – it's just had the lactose removed and replaced with a different form of sugar.
  • For people who are truly allergic to casein, a milk protein, nondairy alternatives are a better choice.
  • Despite its enthusiasts, raw unpasteurized milk is not advised due to the high risk of E. coli contamination. Children and people with weaker immune systems are at especially high risk of serious illness or death.
  • Organic milk is a good environmental choice. But if you're going organic just to avoid milk tainted with hormones and antibiotics, conventional milk may be pretty similar. No Pacific Northwest dairies use the rbST hormone, and a 2008 survey found "no meaningful differences" in hormones between conventional and organic milk. As far as antibiotics go, federal law requires that farmers test milk 72 to 92 hours after administering antibiotics to make sure they have cleared the cows' systems – so even conventional milk is essentially antibiotic free.
  • A 2013 study found that whole organic milk may reduce the risk of heart disease, due to the higher ratio of omega-3 fatty acids in grass-fed cows' milk. It's a balancing act, though: Go for whole organic, and you get more saturated fat; go for low-fat organic, and you get fewer of the beneficial fatty acids.

It's complicated, and we haven't even looked at the milk alternatives yet.

Got choices?

If you're considering a milk alternative, ask yourself, what am I really looking for? A nondairy beverage that's high in omega-3 fatty acids? Hemp milk is a good option. Something low in calories to pour on your cereal? Almond milk is a tasty low-calorie choice. A milk substitute for baking? Soy milk works well.

Once you've narrowed the field, compare labels carefully – protein, sugar content and nutrients vary wildly. Soy milk, for example, comes in sweetened and unsweetened styles, flavored and unflavored, regular and low-fat, and the amounts of added calcium, vitamin D and sugar are all over the map. In general, look for higher levels of protein, low or no added sugars, and added vitamins and minerals that compare well to cow's milk (about 30 percent daily value of calcium and 25 percent daily value of vitamin D per cup).

Here is a quick glance at some of the most common options:

Soy milk
  • Fortified brands have the closest nutritional profile to cow's milk, including about 7 grams of protein per cup (cow's milk has 8 grams).
  • It contains compounds called phytates, which can make calcium less absorbable.
  • You can use it in place of milk in baking.
Rice milk
  • This has a neutral flavor, but it's low in nutrition – look for supplemented vitamin D and calcium.
  • It's also very low in protein – usually 1 gram per cup.
Almond milk
  • It's mostly water; a cup contains only about 4 almonds.
  • Some brands have more calcium than cow's milk, others have close to zero.
  • It's lower in calories than cow's milk, but also low in protein – about 1 gram per cup.
Coconut milk
  • This is different than canned coconut milk – it's more creamy and sweet.
  • It contains vitamins D and B12, but very little calcium and protein (1 gram per cup).
  • It has antifungal and antiviral properties.
  • It contains about the same amount of saturated fat as whole cow's milk.
Hemp milk
  • This is made from filtered water and shelled hemp seeds – and it does not contain the THC found in marijuana.
  • It does contain calcium, vitamins D, A, E and B12, moderate protein (2 grams), omega-3 fatty acids, natural anti-inflammatory agents and other beneficial nutrients.
Oat milk
  • This is made from filtered water, oat groats and other grains and beans.
  • It's usually fortified with calcium and vitamin D.
  • It has 4 grams of protein per cup – about half as much as cow's milk.

I could tell you more – lots more – but I hope that you'll delve a little deeper into the labels yourself and really think about the choice that's best for you. Is dairy milk a good choice for growing children, adults who want to lose weight, or people who want an easy drink that delivers a great nutritional boost? Absolutely. Does milk do every body good? No – there are perfectly valid health, personal and ethical reasons for some people to avoid it – and plenty of great alternatives to choose from. Just steer clear of Internet rumors and dodgy claims, do your own homework, choose wisely and make sure you get the nutrition you need.