Are milk alternatives healthy?

If you can’t, or choose not to, drink cow’s milk, your options include almond, coconut and oat milk. But are they good for you?

Helen Foster
April 2018

Walk into any coffee shop and you’ll be offered a choice of dairy-free milk for your flat white.

Reasons for choosing dairy alternatives range from allergies or intolerance, claims that symptoms like bloating, loose bowels or skin complaints are linked to consuming dairy and dietary preference.

Alternatives to traditional milk come in 2 main forms – plant-based and modified dairy.

Dairy allergy

Let’s start with allergies. “Dairy allergy is a reaction to the proteins in cow’s milk. It usually develops in childhood and most children grow out of it. The incidence in adults is less than 1% of the population,” says Ingrid Roche, chair of the Australasian Society of Clinical Immunology and Allergy Dietitians Committee.

Symptoms of dairy allergy can include hives, a rash, vomiting, diarrhoea, coughing or eczema. In serious cases it can lead to anaphylaxis, with symptoms including difficulty breathing, swelling of the tongue and throat and dizziness. In the case of a severe allergic reaction, call 000 for an ambulance straight away.

If dairy allergy is diagnosed by an immunologist or allergist, you should avoid milk, as well as dairy products like cheese, butter, ice cream and yoghurt, and use plant alternatives.

An issue of intolerance

The other reason people may give up dairy is they believe, or know, it’s responsible for health concerns like digestive problems. It might not be an allergy but an intolerance, where the body reacts badly to an ingredient in milk.

The most common of these is intolerance to lactose, one of the sugars in milk. “Lactose intolerance is caused by a deficiency of the enzyme lactase needed to digest lactose,” says Roche. “This is more common in people with Aboriginal, Asian, African, Middle Eastern or Mediterranean ancestry, and while you would usually have this from childhood, it can develop in adulthood.”

Symptoms of lactose intolerance include diarrhoea, abdominal pain, flatulence and bloating.

See a doctor if you think you might have lactose intolerance. They may recommend you have a hydrogen breath test or to try a dairy-free diet to see if you actually have an intolerance.

You don’t need to give up milk if you have lactose intolerance as there are several milk products available that have lactose removed.

Drinking A2 milk might be another option. “Milk normally contains two proteins named A1 and A2; some people can’t tolerate the A1 type and mistake this reaction for lactose intolerance,” says Lisa Renn, spokesperson for the Dietitians Association of Australia.

Dietary choice

If you’re on a vegan diet, where you avoid animal products, or if you simply don’t like the taste of traditional dairy, you may also want to swap to plant milks. But whatever your reasons, it’s important to consider the nutritional balance of your diet.

Are milk alternatives healthy?

“Plant-based milks have developed a reputation as being healthier than traditional dairy, but that’s not necessarily true,” says Roche. “They can contain lower levels of calcium, less protein and often have more sugar than traditional dairy milks.

“This doesn’t mean you shouldn’t use them, but you must ensure the rest of your diet makes up for these differences.”

Check for the amount of sugar and protein in the nutritional panel on the carton.

Dairy is a good source of calcium. The recommended adult intake of this is 1000mg (increasing slightly as we age) which is about 3 serves of dairy a day. “The easiest way to ensure you get enough of this with plant milks is to choose brands fortified with calcium,” says Roche.

For example, a 250ml glass of almond milk fortified with calcium (i.e. calcium is added) can provide 300mg of calcium compared to 367mg in the same amount of reduced-fat cow’s milk. Calcium-fortified cereals and fish with soft bones, like tinned salmon, are also good sources of calcium.

Another consideration is sugar intake. Some plant-based milks are sweetened, for example that glass of almond milk providing the calcium example above contains 12.2g of sugar. The same amount of skimmed milk contains 12.5g but sugar in milk is the natural sugar lactose, while plant-based milks use added sugars.

“And these are a type we should be trying to cut down on,” says Renn. Ideally pick unsweetened brands of milk alternatives to keep your sugar content down.