Cow’s milk still reigns supreme over plant-based alternatives

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An analysis of 200+ plant-based milk alternatives finds few contain the calcium, vitamin D, and protein of cow’s milk.

More and more people are turning to plant-based milk alternatives, with oats, soy, and almonds being popular choices. But there’s a question to consider: do these plant-based products offer the same nutritional benefits as cow’s milk? A recent study indicates that, in most cases, they do not.

Cow’s milk has long been a primary source of calcium and vitamin D. These nutrients are flagged by the 2020-2025 Dietary Guidelines for Americans as commonly underconsumed, putting public health at risk. Additionally, cow’s milk serves as a significant protein contributor to the American diet.

To assess how the nutritional content of plant-based milk alternatives compares to that of cow’s milk, scientists examined more than 200 plant-based milk alternative products being sold in the U.S. in 2023. This was far more products than were included in previous studies. Compared to cow’s milk, only 12% of the milk alternative products contained comparable or greater amounts of all three nutrients studied: calcium, vitamin D, and protein.

Abigail Johnson, assistant professor and associate director of the University of Minnesota School of Public Health Nutrition Coordinating Center, presented the findings at NUTRITION 2023, the annual flagship meeting of the American Society for Nutrition.

“Our results provide evidence that many plant-based milk alternatives are not nutritionally equivalent to cow’s milk,” said Johnson. “Based on these findings, consumers should look for plant-based milk alternative products that list calcium and vitamin D as ingredients. They may also want to consider adding other sources of calcium and vitamin D to their diets.”

The University of Minnesota’s Nutrition Coordinating Center maintains a database of approximately 19,000 foods for assessing dietary intake in human research. “We know from our dietary assessments for nutrition studies that consumers are choosing more plant-based milk alternatives,” said Johnson. “This project aimed to increase the number of these milk alternatives available in the Nutrition Coordinating Center’s database of foods.”

The study included nutrition information from nutrition facts labels and ingredient information for 233 plant-based milk alternative products from 23 different manufacturers. For each product, the researchers applied a nutrient calculation program to estimate full nutrient information. They then compared the nutritional content of different products within a category — for example, almond milk, oat milk, and soy milk — to each other and to cow’s milk. Compared to dairy milk, just 28 of the plant-based alternatives had similar or more calcium, vitamin D, and protein.

Almost two-thirds of the products included in the study were made from almonds, oats, or soy. The researchers found that 170 of the plant-based milk alternatives were fortified with both calcium and vitamin D and that the level of fortification tended to be similar to dairy milk.

Specifically, 76% of the oat-based products, 69% of soy-based, and 66% of almond-based alternatives were fortified with both calcium and vitamin D. The median protein content was 2.0 grams (g) of protein per 240 milliliters (ml) of liquid, with a large variability that ranged from 0 to 12 g. Only 38 (16%) of the milk alternatives studied had a protein level greater than or equal to the 8 g per 240 ml found in cow’s milk. Soy- and pea-based alternatives were more likely to have higher protein.

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