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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

House Call: Milk, alternatives are tasty, nutritious

By Dr. Bob Riggs For The Spokesman-Review

My last column on building and maintaining healthy bones leads me to a discussion of milk and milk alternatives. Cow’s milk, the source most common here in the United States, is a convenient source of calcium and protein. However, 8 ounces of whole cow’s milk contains a considerable amount of fat, which packs quite a few calories and can make maintaining a healthy weight a challenge.

We all need a healthy mix of nutrients in our diets, including fat, so I recommend a balance of foods, some of which contain healthy unsaturated fats and some that contain no fat. It is best to base your milk choice on your overall diet. Whether you choose whole cow’s milk, fat-free milk or something in between, the amounts of protein, calcium and vitamin D are nearly the same. The same can be said for other dairy products made from cow’s milk such as yogurt and cheese.

If you are lactose intolerant, allergic to milk, vegan or avoiding cow’s milk for some other reason, there is good news. There are many lactose-free and plant-sourced milk alternatives available that are quite tasty.

Lactose intolerant people make no or very little lactase in their guts, unlike the rest of us. Lactase is the enzyme that breaks milk sugar (lactose) down into simple sugars that we can absorb. When lactose is not broken down, it passes into the large intestine intact and the bacteria there have a party with it, making gas and compounds that pull water into the stool resulting in loose stools. That causes them to experience bloating, gas, diarrhea, intestinal cramps and other discomfort. Lactose-free cow’s milk products have been treated with the enzyme lactase to convert the lactose into digestible sugars. These products typically have the same amounts of protein, calcium and vitamin D in them as their untreated counterparts. Taking a lactase supplement when eating anything that contains or is made from cow’s milk will reduce lactose intolerance symptoms.

If you don’t consume cow’s milk and dairy products because of an allergy (typically to a protein in the milk) or as a personal choice, you can find milk alternatives made from soy, almonds, cashews, coconut, rice and hemp. They come sweetened or unsweetened in original, vanilla and chocolate favors. I recommend reading ingredient labels carefully if you have food allergies to ensure you are purchasing a product that is right for you. As I have talked about before, a diet rich in fruits and vegetables and greens, with moderate amounts of lean proteins, beans and grains will supply you with the nutrition that you need. Milk and milk-alternative products are tasty and good sources of nutrients when they are part of a varied and colorful diet. We don’t need milk after the newborn and early childhood period of life, but most of us have gotten used to drinking it and like it.

The amounts of protein, calcium and vitamin D in these alternatives varies, so when choosing, be sure to read nutrition labels carefully. For example, soy-based milks tend to have similar amounts of protein, calcium and vitamin D in them when compared to cow’s milk and most of the other alternatives have similar amounts of calcium and vitamin D. There have been some limited studies that indicate that the vitamins and minerals in milk alternatives may not be absorbed by your body quite as well as they are from cow’s milk, so you may need to consume a bit more in some cases to get an equivalent amount of nutrients.

Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.