Milk has long been debated as a healthy food choice; cow, soy, almond, rice, even coconut and cashew milks are vying for your attention on the supermarket shelves. The obvious features of milk include high calcium and vitamin D content. Good for the bones, right? But, with so many choices, how do you know which is the healthier one?

I’ve been surprised by the number of patients I’ve seen lately proudly reporting their switch from cow’s milk to a non-dairy alternative. “What prompted the switch?”, I ask. Most of them aren’t sure, but recall a helpful loved one tout the virtues of non-dairy milks as healthier or better for the heart. All this had me wondering about the nutritional specifics of various milks when lining them up side by side. 

We generally understand that cow’s milk contains a certain amount of animal fat (saturated fat) in some varieties (1%, 2%, 3.25% homogenized) and that plant-based milks (soy, almond, coconut) don’t. What’s prompted more competition with cow’s milk is the fact that most non-dairy milks are fortified with calcium and vitamin D (& also some B vitamins), making them nutritionally similar to cow’s milk. 

Where things get sticky are with the flavoured milks, regardless of the milk’s origins. Got added sugar? You’ll definitely find them here. So what’s the breakdown? Let’s start with cow’s milk, which contains naturally occurring milk sugar, or lactose. In 1 cup, there’s roughly 12-13g of sugar. We normally don’t get too fussed about naturally occurring sugars in foods because they’re generally combined with other nutrients like vitamins, minerals and sometimes antioxidants (as in fruit & veg). The flavoured milks such as chocolate or strawberry cow’s milks have about double the sugar (25-26 grams), so you can figure about half is added sugar (12-14g). Not ideal. (Trick to downgrade the sugar: pour half a glass of low-fat milk and top it up with, say chocolate milk, and enjoy a treat while controlling the sugar).   

Almond milk is up next. I was surprised to read the ingredient list on the original almond milk to find cane sugar the second ingredient in the listing, second only to water! Almonds are third on the listing. What?!  That brings our sugar count to 7 grams in 1 cup. The vanilla rings in at 12 grams of sugar. Lo and behold we do have an unsweetened almond milk which bumps almonds from third place to second in the ingredient list, having nixed the added cane sugar. What’s disappointing to me is that the protein is ridiculously low, yes, only a measly 1 gram/cup. Interestingly, a handful of almonds contains about 6 grams. It looks like eating your almonds will give more nutrition bang for your buck.

Soy milk, you’re next. As non-dairy milks go, soy milk was the belle of the ball for many years, until a handful of studies showed a possible relationship between excessive soy intake and  increased breast cancer risk. But no follow-up, large scale studies have been able to consistently replicate these results. So while many breast cancer patients and survivors may choose to avoid soy, much of the rest of the population do not. But I digress…original soy milk contains slightly more fat (4g) than 1% milk (2.5g) and regular almond milk (2.5g) but has substantially more protein (7g) than almond (1g) and slightly less than cow’s (9g). The sugar amounts vary 6-8 grams in original and vanilla varieties but the unsweetened version only clocks in at 1 gram. 

Next in line, rice milk. Original rice milk will run you 120 calories, 2.5g of fat, 10g sugar and only 1g protein. Unsweetened rice milk has the same fat and protein as the original but less than 1 gram of sugar. Again, unsweetened versions provide a better nutritional breakdown than many original or regular versions.

Of the newer and novel milks, we have coconut and cashew as options. Coconut is very on-trend right now, from using coconut oil on your hair, nails or in a stir fry. It seems there’s not much coconut can’t do. When it comes to coconut milks, however, it runs 5g fat, 6g sugar and only 1g protein. This is pretty similar to almond milk with the exception of fat, which is higher in coconut milk. 

Cashew milk is a lesser known milk alternative but gaining ground in the mainstream market. The overall calories are relatively low (60 kcals) compared to coconut (80 kcals), cow (90 kcals) and soy (100 kcals). The fat is low at 2.5 grams per cup, but the sugar is high (8 g) and the protein almost non-existent (0.5 g). How it differs from the rest of field is its sodium content at 160 milligrams (mg), which is high in comparison to the others and nearing the cut-off for sodium (aiming for less than 200mg/serving or less than 5-10% of the Daily Value).

There is no definitive evidence highlighting one type of milk as nutritionally superior to others. It is interesting though to see how they compare in this mini experiment lining them up side by side. I was particularly surprised by the minimal protein in the nut-based milks given that nuts themselves are an excellent source of protein. The added sugar issue, while ever present in most foods, is easily dealt with by choosing unsweetened versions more often. In cow’s milk, minimizing animal fat is controlled by your choice of milk fat percentage. 

Keeping in mind what is important to your health will help determine the healthiest choice for you. That is, there is no one-size-fits-all easy answer to the question of what is the best, most nutritious milk. It really boils down to what matters to you (i.e. minimizing added sugar, animal fat, sodium, calories) and your health, your personal preference in taste since that (& maybe price) will dictate whether you keep buying and drinking your milk choice.   Drink up and enjoy.