I grew up in Holland, a country where children drink a lot of milk. The milk came from a cow and other types of milk were rare. Nowadays there are many different types of “milk” on the market; all with health claims and some even with performance claims. When traveling with professional athletes I often see the old fashioned cow milk is replaced by “fancy” new versions of milk like almond milk, soy milk and coconut milk. When I ask athletes “why?”, they tell me it is “better” or “healthier”. But exactly what does that mean and what is the evidence for that?

First, it is important to realize that most of these drinks aren’t actually “milk”, even though they may look a bit like milk. They can also vary significantly from a nutritional point of view. We should refer to these drinks as milk beverages or milk-like drinks because they are not technically milk. We also read about the benefits of cow milk, and the superior effects of whey protein (one of the constituents of cow milk) for recovery? So which is better? Is there evidence?

Cow milk

Cow milk has been the milk of choice for humans for many years. We have been drinking cow milk for more than 10,000 years. We can buy different versions of cow milk: Full fat, 2% fat, 1%fat, and fat free milk. We can also choose organic versions of milk which means that it comes from cows raised without the use of growth stimulants and other artificial ways to boost milk production. These cows also eat organic food. In terms of composition, organic milk is not too different from other milk, same amount of protein and other nutrients, maybe a little more of the essential fat alpha-linolenic acid.

The long term health effects of cow milk will be discussed in a future blog, including the effects on bone density, cardiovascular disease and so on. For some individuals, the lactose found in animal milks can cause gastro-intestinal discomfort. Those who are lactose-intolerant can choose lactose-free version of cow milk.

Differences between whole milk, skim milk, reduced-fat (2 percent), low-fat (1 percent), and fat-free milks is their fat content (and as a result their energy content (kcal)). (Table 1)

Goat

This is real milk from goats. Goat milk has the same protein and calcium content than cow milk. It also has slightly less lactose than cow milk, but still enough to cause problems for individuals who are lactose-intolerant. Goat milk contains more calcium, more magnesium and more vitamin C than cow milk.

Sheep

Sheep milk is higher in protein than cow and goat milk (almost 15 grams of protein per glass), and also offers a little more calcium, vitamin B12, and folate. Although not as readily available, this seems a good alternative to cow milk. Again those with lactose intolerance may want to avoid this type of milk.

Milk-like drinks

These options are non-dairy but often called “milk” because they look so similar to the real thing. But when it comes to nutrition these beverages are quite different. All non-dairy beverages that come from seeds are lactose-free, giving plenty of options to those who are lactose-intolerant or choose to forego animal products.

Soy milk

Soy milk, made from ground soybeans and water, comes in plain and flavored, which tend to be a lot higher in added sugars. Each glass provides about 6 grams of protein, which supplies all of the essential amino acids. Soy milk also comes fortified with calcium, and vitamins D and B12 (which does not occur naturally in soy). This makes soy milk a good lactose- and animal-free substitute.

Rice milk

Much lower in protein, rice milk provides only one gram per glass but in some countries it may come fortified with calcium, and vitamins D and B12. Check the label because nutrients may vary significantly depending on the brand with some brands containing hardly any nutrients. Rice milk is often sold as a sweetened version. If this is the case sugar has been added and the drink will contain more calories.

Oat milk

Like rice milk, oat milk is naturally sweet and are more palatable non-dairy milk options. Often sugar is added and this beverage contains very little protein (less than 1 gram per glass).

Almond milk

This beverage is made out of ground almonds with water. This non-dairy drink is also very low in protein with just one gram per glass. Check the label for added sugar, calcium, and vitamin D, since it can be hit or miss on which brands carry these nutrients.

Hemp milk

This drink is made of ground hemp seeds. These seeds are rich in omega-3 and omega-6 essential fats, about four grams per glass and contains some vitamin E as well. Hemp milk contains about 0-5 grams of protein per glass.

Coconut milk

The composition of this non-dairy milk drink can very a lot, and therefore it is very important to check the label. The canned milk can contain a lot of fat or no fat at all. Sometimes coconut milk is fortified with Vitamin D but it really is predominantly fat and water.It has zero protein and little calcium.

Summary

In conclusion, although several milk like beverages are often used by athletes to replace cow milk, they are really no replacement at all. Cow’s milk and plant-based drinks are not nutritionally comparable foods. Soy milk may be the drink that is somewhat similar but most other milk-like drinks have very different compositions. Most of these milk-like drinks contain very little protein and sometimes these drinks can be loaded with sugar.

Milk is often used for recovery because it is a good protein source. Milk-like beverages like almond, coconut and hemp milk are no milk replacements as they contain little or no protein. Soy is the milk like drink with the highest protein content and would be a better replacement of milk especially for those who are lactose intolerant. For those interested mainly in recovery, the amino acid composition is important too and studies seems to indicate that this composition is somewhat favourable in cow milk.

Finally, it is always important to check the labels for the exact composition and to keep asking questions.