The next time you ask someone if they "got milk," the answer may surprise you. "Sure, we have soy, rice, almond, multigrain, oat, and potato. Would you like vanilla, carob, chocolate, strawberry, or plain?"
Milk sure has changed. And for many people, that change is welcome news. According to an article published in the American Family Physician, up to 100% of Asians and American Indians, 80% of blacks and Latinos, and 15% of people of northern European descent have trouble digesting lactose.
Lactose, a milk sugar found in dairy products, is digested in the intestines by an enzyme called lactase. If someone does not produce enough lactase, the result is a decreased ability to digest lactose, or lactose intolerance, which can result in bloating, gas, diarrhea, and stomach cramps. There are different degrees of lactose intolerance—some people may be able to handle moderate amounts of milk before feeling the effects of too little lactase, while others may only be able to handle a very small amount, or none at all.
Not everyone who shuns cow's milk is lactose intolerant. In its whole state, milk has both saturated fat and cholesterol. Some people are concerned about the environmental impact and animal abuse associated with milk production. Others have religious convictions or other personal reasons for avoiding cow's milk.
Fortunately, nondairy milks are abundant and now found in many supermarkets. Not only can you buy milk made from soybeans, rice, nuts, oats, potato, and combinations thereof, you also can pick your favorite flavor, fat content, and various levels of nutrient fortification. And with such a great selection, it is important to read the ingredient and nutrition information to help you select the best products for your needs.
Soy milk is the most common of the nondairy milk beverages. Each soy milk on the market has its own texture, taste, and consistency, and in general, is thicker and creamier than other nondairy milks.
Soybeans are the main ingredient in soy milk, followed by soy protein isolate—a concentrated soybean protein. Some soy milks contain tofu, but most soy milks are made from organic soybeans, although not all are free of genetically engineered beans. Soy milk is available in both liquid and powder forms. For the freshest soy milk, you can make your own (see Resources section).
Oat milk is made from oat kernels and filtered water. It may also include other grains, like barley or brown rice. The result is a neutral tasting, slightly sweet, highly stable beverage that is also an excellent substitute for cow's milk in cooking and baking. Oat milk contains vitamin E and folic acid and is low in fat and contains amino acids, vitamins, trace elements, and minerals. The extraction process allows much of the natural fiber to remain in the final product, which makes oat milk "oatmeal in a glass."
Rice milk is lighter and sweeter than soy milk. Some people say it tastes closer to cow's milk than the other nondairy choices. Almond milk is the number one nut milk, although people who make their own often use walnuts, hazelnuts, or cashews, along with almonds. Potato milk is the newest addition, and it is available in both liquid and powder form, although distribution is still limited. Combination beverages often contain oats, barley, soybeans, and brown rice.
Will you get enough calcium and other nutrients from nondairy milk? Yes, if you buy fortified products. The most common nutrients added to nondairy milks are the same ones either added to or found in cow's milk: calcium, riboflavin, and vitamins C, D, and B12. Buy brands that contain 20% to 30% of the US Recommended Daily Allowances (USRDA) for calcium, riboflavin, and vitamin B12, which makes them nutritionally similar to cow's milk. If for some reason you lack exposure to the sun, buy products fortified with vitamin D. Not all nondairy beverages are fortified, so check the labels. You can also get the calcium and nutrients you need from other food sources such as vegetables.
Nondairy milks are great in shakes and on cereal, but can you cook or bake with them?
Of course! The results will depend on the fat content, flavor, and consistency of the milk substitute you are using. Try different types of non-dairy milk and keep in mind that you may need to modify your recipe by adding or taking away other ingredients to get the same result.
Rice and nut milks are sweeter and lighter than soy milk, which makes them good for desserts and curries, but less suited for gravies and most entrees. Oat and potato milks are more neutral and complement soups and main dishes. Be aware that soy-based beverages or those containing a high amount of calcium carbonate can curdle at high temperatures, especially if the recipe uses acidic foods such as oranges or tomatoes.
Remember these guidelines when shopping for nondairy milk:
Dietitians of Canada
Health Canada Food and Nutrition
American Academy of Family Physicians. Information from your family doctor. Lactose intolerance: what you should know. Am Fam Physician. 2006;74(11):1927-1928.
Genkinger JM, Hunter DJ, Spiegelman D, et al. Cancer Epidemiol Biomarkers Prev. 2006;15(2):364-72.
Debunking dairy food myths. American Academy of Nutrition and Dietetics website. Available at: http://www.eatright.org/WorkArea/DownloadAsset.aspx?id=6442451312. Accessed October 15, 2013.
Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed October 15, 2013.
Goldberg JP, Folta SC, Must A. Milk: can a “good” food be so bad? Pediatrics. 2002;110(4):826-832.
How to substitute milk (skim, low fat, whole). Go Dairy Free website. Available at: http://www.godairyfree.org/dairy-substitutes/how-to-substitute-milk-skim-low-fat-whole. Updated July 2, 2012. Accessed October 15, 2013.
Lactose intolerance. National Digestive Disease Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance. Updated April 23, 2013. Accessed October 15, 2013.
Lactose intolerance in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated March 4, 2012. Accessed October 15, 2013.
Swagerty DL, Walling AD, Klein RM. Lactose intolerance. American Family Physician. 2002; 65(9):1845-1850.
Last reviewed October 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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