The Lowdown on Milk : Dairy, Non-Dairy, & More!

An overview on different milk types and how to make the best milk decision for your health & wellness! 

Milk -  "the first food" has been under scrutiny for a long time now. Even though years of research support the importance of milk for one's health, I get questions about milk very regularly so I am digging deeper into the world of milk - both dairy & non-dairy. The goal of this is post is provide a clear and concise evidence-based information on different milks in the market, clear common confusion/misconceptions about the milk industry, & help you make the best milk decision for your health & wellness. 

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Photo by Lidya Nada on Unsplash

Humans have been consuming milk for at least 9,000 years or longer and is considered a fundamental food for every age group. While I was growing up, dairy milk and soy milk were top two milk choices but these days supermarket is stocked with 10+ varieties of dairy and non-dairy milk for consumers to choose from. A survey found that in the US, dairy milk is a predominant choice for dairy and protein source but the number has steadily declined in the past years as more people are opting for non-dairy alternatives. I won't be surprised if non-dairy milk  consumption surpasses the dairy milk in the near future.

Facts on Dairy Milk Types

When it comes to dairy milk, you will most likely come across whole milk, 2%, fat-free, lactose-free, flavored milk, organic, ultra-pasteurized at the grocery store Do you usually grab a certain kind of milk out of habit, look at price, or nutrition? Nutritionally speaking, dairy milk is great source of protein, fat, calcium, and 18 other essential nutrients such phosphorous, calcium, vitamin A and vitamin D. Like most things, not all milk is created equal and here's what you need to know : 

  • Whole milk vs 2% vs fat-free : The main difference between these milk is the % of fat & calories per cup but otherwise, protein, carbohydrates, calcium, and other nutrients are pretty much the same. FDA mandates the milk fat percentage by weight which means whole milk should not fall below 3.25% and not to exceed more than 2% for reduced-fat, 1% for low-fat, and 0.2% for skim or fat-free milk. 

In addition to regular dairy milk, you will see flavored dairy milk such as chocolate, strawberry, coffee milk and so forth. These have flavorings as well added sugar so don't forget to check the nutritional label & ingredient list for more details. 

  • Lactose free : Milk contains sugar called 'lactose' and if you are lactose intolerant (when people don't produce enough lactase [enzyme that breaks down lactose] or do not digest lactose well), you will benefit from lactose-free milk. Lactose-free milk is made from cow (so obviously it's not dairy free) and manufacturers add small amounts of the enzyme lactase to milk so it is easily digested. Lactose-free milk does taste slightly sweeter than regular milk as it is broken down into glucose & galactose. Additionally, lactose free milk has a longer shelf life than regular milk because it is ultra-pasteurized where the milk is heated to at least 280 degree Fahrenheit for at least two seconds. It is done by manufacturers as lactose-free milk doesn't have as rapid a turnover on the store shelves as it doesn't have as much high demand. You can find lactose-free milk as whole, 2%, and skim as well.
     
  • A2 milk : 80% of protein in milk is called casein and there are different types of casein, one of which is called beta-casein - A1 & A2. Most of the milk available in the US and around the globe has A1 milk protein while old-fashioned cows such as Jersey, Charolais, Guernsey, and Limousin as well humans, goat, and sheep produce A2 milk. There is an emerging research suggesting that A2 milk may help with some digestive discomfort but based this systematic review,  a lot more work needs to be done in this area. A2 milk isn't lactose-free (it has the same amount of lactose as standard milk) but if you have symptoms of lactose-intolerance or you are sensitive to lactose, it might be worth giving A2 milk a shot.
     
  • Organic milk : According to the legal USDA guidelines, "organic milk must come from a cow that has not been treated with antibiotics, has not been given hormones ― for either reproduction or growth ― and has been fed at least 30 percent of its diet on pasture. (That’s the minimum ― farmers in more temperate regions are expected to let their cows graze on pasture for as long as possible.) The rest of the cows feed must be grown without chemical fertilizers, pesticides or genetically modified seeds. If for some reason, cows at an organic dairy farm does have to be treated with antibiotics, the farmer can no longer use the milk. 
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Photo by Tim Wright on Unsplash

Conventional milk farmers use antibiotics to treat sick cows and then use their milk but the cows are allowed back when they are determined to be healthy and the antibiotic's withholding time has passed. There are strict standards in place to ensure that milk you buy at the store is safe as it is tested at the farm, at the processing plant, and before it is transported for distribution.

Growth hormones are used in conventional milk as a way to improve milk production. Currently, Recombinant bovine growth hormone (rBGH) or recombinant bovine somatotropin (rBST) is approved by FDA to increase milk production in dairy cows. This drug is based on the somatrotropin, a protein hormone produced in the pituitary gland of animals, including humans, and is essential for normal growth, development, and health maintenance. Based on several studies, it has been determined that neither natural nor synthetic BGH has been found to affect human growth hormone receptors. Additionally, humans do not have receptors for bST and therefore it is passed through our body intact without being absorbed. As a result, there are no known side effects or health issues associated with consuming dairy from cows treated with bST.

  • Pasteurized vs. raw milk : Pasteurization is the process of heating milk up and then quickly cooling it down to eliminate the risk of bacteria and extend shelf-life. Most milk we see on the shelf is heated very quickly to at least 161.6° F for just a few seconds, which is known as High-temperature Short-Time (HTST) or flash pasteurization but other types of pasteurization exist to manipulate milk for different purposes. There is another type of pasteurization called Ultra-Heat Treatment (UHT), where milk is heated to 280 degrees Fahrenheit for a minimum of two seconds, which extends the shelf life a lot longer such as in shelf-stable milk. 

Raw milk is what you get straight from the cow without any pasteurization, which means it has a huge potential to carry bacteria that can cause multiple food borne illnesses. There is an increasing interest in raw milk as proponents believe that pasteurization kills "good" bacteria, enzymes, and nutrients that cannot survive the heating process. While pasteurization can slightly alter the nutrition profile of milk, studies have shown no meaningful difference in the nutritional values of pasteurized and unpasteurized milk. 

States make their own laws when it comes to the regulation of raw milk sales, however  federal law prohibits the distribution of the raw milk across state lines unless it is in transit to be pasteurized or used to make aged cheese. 

HEALTH BENEFITS & CONCERNS OF DAIRY MILK

Dairy milk is a nutritional power house for so many basic nutrients we need everyday - fats, carbohydrates, proteins, and many vitamins and minerals (except for iron). It's also a convenient, practical, and affordable option to get those essential nutrients on a daily basis. A large body of research suggests that dairy milk (and other products like cheese, yogurt) is an importance part of balanced diet as well as for the prevention of many health conditions. 

The only concern with dairy milk is if you have dairy/milk allergy or lactose intolerance, then  you should avoid dairy milk. 

 Facts on non-Dairy Milk Types

Non-dairy milk (or plant-based milk) market has grown significantly within the last 5 years and today you can pretty much find whatever plant-based or non-dairy milk you can imagine in the market. It's gaining popularity as people believe that plant-based products (regardless of what it is) are healthier, fear-mongering around dairy-milk and it's practices, and some people chose to practice veganism/plant-based lifestyle for personal, ethical, and environmental reasons. 

While almond, soy, and coconut are the staples in this category, I am starting to see plant-based milk such as pecan, pea, oats, quinoa, hazelnut, and flax milk to name a few. Plant based milk are made by blending nuts, water, and other add-ons and flavorings together. The nutrition profile of plant-based milk varies considerably for both macro & micronutrients based on how it was produced and what has been added. So when it comes to choosing plant-based milk, it really depends on your individual nutrition needs & flavor preference. 

  • Soy milk is probably the closest plant-based milk to cow's milk as it is higher in protein than any other commercially available milk, at around 8g per glass along with other nutrients. You can find soy milk fortified with calcium, B vitamins and vitamin D and don't forget to read the nutrition label for other additives, sweeteners etc.  
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Photo by rawpixel on Unsplash

  • Almond milk is the most popular milk choice for cereal, oatmeal, smoothies, lattes. It is lower in calories compared to dairy & soy milk, however a lot of people don't realize that almond milk is lower in protein and calcium compared to cow's milk. Store bought almond milk is generally fortified with calcium, vitamin D and vitamin B12. Almonds are rich in nutrients such as protein, fiber, vitamin E, magnesium, selenium, manganese, zinc, potassium, iron, phosphorus but when commercially made, nutritional value can vary significantly from one brand to another, how it is processed (ratio of almond to water), and I'd also carefully read labels for additives and sweeteners.  

There are other nut milks in the market such as cashew, macadamia, peanut, walnut, pecan, pistachio which are made by grinding nuts with water and straining out the pulp with strainer...or sometimes they add water to nut butter to thin out the consistency. Depending on the brand vs homemade, nut milks nutritional profile can vary significantly because it ultimately depends on the ratio of nuts to water and other added ingredients and fortified nutrients. 

  • Coconut milk is the go-to option for many people with nut, dairy, and soy allergy. When coconut meat is shredded and simmered in water to extract the coconut's flavor, the liquid separates into a fat-rich cream layer and a thin “skim” layer. Depending on how much water is used for simmering, it could result in coconut cream or coconut milk. Using a little water yields coconut cream: a thick, whipping cream-like substance skimmed off the top of the boiled liquid. And if larger amount of water is used, it will yield coconut milk which are commonly found at the grocery store. Canned coconut milk is the combination of two; it has more water than coconut cream, but less water than carton coconut milk. 

Coconut water is completely different than coconut milk because it is a clear liquid found in the center of a green, young coconut. 

Coconut is naturally high in fat (mostly saturated fats), fiber, and potassium. Just like other types of milk, the nutritional content of coconut milk will vary significantly from one brand to another, can vs. carton vs. cream. One of the biggest controversies surrounding coconut products like milk and oil is the type of fats and its effects on health, especially heart heart. The type of saturated fat found in coconut is called medium-chain fatty acids (MCFAs) which is believed to behave differently in the body than longer-chain saturated fats. Lauric acid, a medium-length chain fatty acid that makes about 50% of coconut oil is metabolized and sent directly to the liver, where it’s converted to energy rather than stored as fat. So, when compared with other saturated fats, lauric acid is believed to contribute the least to fat storage, possible weight loss, increased metabolism etc. In my personal opinion, coconut byproducts like milk, oil are great alternative but definitely not a magic cure. Nutrition and health is so much more than just one ingredient or a food group and also the research is still evolving on the effects of coconut oil on human health. 

  • Pea milk : For anyone with soy, nut, and dairy allergy - pea milk might be your answer. It is made from yellow split-peas, a great alternative to regular milk as it has same amount of protein as cow's milk : 8 grams per 8-oz. serving (1 cup) and 45% of daily value for calcium with 75 to 145 calories per cup. Personally, I haven't tried it but "Ripple Milk" and " "Bolthouse Farms" are two companies that currently makes pea milk in original, vanilla, unsweetened, and chocolate flavor. For flavored milk, I'd just check the added sugar as some do contain 12-17 grams of added sugar. Pea milk is marketed as environmental friendly and sustainable option than dairy and other plant-based milk because pea requires way less water, less carbon emission, and the packaging is made with recycled material. However, the idea of sustainability is far complex because it involves sourcing of raw material, distribution channels, production etc. 
     
  • Rice, oat, & hemp milk: These are additional non-dairy alternatives available that are not as popular but I am starting to see them more on the shelves. Rice milk is an option for anyone with allergies, however just be mindful that it is low in protein, fats, and high in carbohydrates. Oat milk does have more protein compared to other nut milk and highest in fiber when compared to dairy & non-dairy milk. It is also a good source of B vitamins (thiamine, folate), magnesium, manganese, phosphorus, zinc, and copper.  Hemp milk comes from the same plant as marijuana but when you eat hemp, you're not getting the "drug" part of the plant (THC (tetrahydrocannabinol)..instead hemp seeds are blended with water and then the mixture is filtered to make hemp milk. It has a subtle nutty flavor, slightly creamer than skim milk, and are rich in the plant-based omega-3 fatty acid - ALA. 
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Photo by Penchant Styled on Unsplash

HEALTH BENEFITS & CONCERNS OF NON-DAIRY MILK

Non-dairy milk is the only option for those with lactose-intolerance, milk-allergy, and for those who follow plant-based/vegan lifestyle. When compared with dairy milk, plant-based milk does fall short on protein, calcium, and vitamin D however, eating a wide-variety of food (& supplements if needed), one can certainly make up for the lost nutrients. Non-dairy milk does have a lot of nutrients, often fortified and enriched with vitamins and mineral, lower in calories, fats (esp saturated fats), and sugar (if chosen the unsweetened kind). 

Just like with most foods, I'd suggest reading the label and ingredient list when choosing the non-dairy milk that is right for your individual needs. 

BOTTOM LINE: 

Dairy & non-dairy milk have their own benefits and concerns but they both can be a part of your everyday lifestyle. Here are few questions I'd ask before ultimately making the decision on dairy & non-dairy milk: 

  • Can you tolerate dairy? How does your over-all diet look like? If you eat relatively healthy with not much saturated fat in your diet, perhaps full-fat milk is okay, otherwise, I'd stick with 2%. What is your cardiovascular health risk? 
  • If you feel strongly about organic milk, by all means go for it. Just remember that conventional milk is just as safe and nutritious! 
  • For plant-based/non-dairy milk, read the label and ingredients to find out the protein, added sugar, calories, and other nutrients such as calcium, vitamin D because it varies from one brand to another. Stick with the one that has higher protein, unsweetened/less amount of added sugar, and fortified with calcium, vitamin D. 
  • How are you using the milk? Not all milk taste and act same, especially for plant-based milk. Almond milk is great for smoothies, cereal, oatmeal, and baking but it doesn't hold up too well in cooking. Coconut milk is a great choice for cooking, especially in Thai curry but just be mindful of thickeners, binders etc. Hemp milk has a strong taste so it's definitely a personal taste and pricier. 
  • Don't blindly follow what others are drinking, instead consider your budget, be educated on nutritional benefits/risks, & most importantly your overall lifestyle that works for you. 

I'd love to hear your thoughts on milk - dairy vs. non-dairy. Do you prefer one vs. other? If so, I'd love to hear more.