Complete guide to milk: Lactose intolerance, dairy allergies, nut milks & more

Milk and dairy free milk substitute drinks and ingredients

Nut milk, cow’s milk, mylk vs. milk — the milk multiverse is very real.

But what’s the nutritional difference between nut milk and dairy? How do the options stack up when it comes to protein, calories and carbohydrates? And what the heck is hemp milk anyway?

“Today’s milk aisle is amazing, but it’s also overwhelming!” says Erica Fleming, registered dietitian at BlueCross BlueShield of Tennessee. “There’s definitely something for everyone. You just need to focus on your nutritional needs and then figure out which products meet them.”

What is mylk?

Fleming: Milk, in the traditional sense, is thought of as a nutrient-rich liquid obtained from a mammal. The variety of “milks” we find in grocery stores today may be similar in looks, taste or consistency. But, many actually come from nuts or plants rather than an animal.

Often, brands use the word “mylk” to show that their product is a non-dairy milk alternative. Yet, some non-dairy brands still use the word “milk” for their alternative products, so you have to read the label to be sure!

What’s the difference between cow’s milk and alternative milks?

Taste

Fleming: The biggest difference in cow’s milk and alternative milks are taste and appearance.

  • Cow’s milk has more fat, which gives it a creamier texture and mouthfeel.
  • To make up for that, some manufacturers add sugar or emulsifiers.
  • Since many of us grew up drinking cow’s milk, there might be an adjustment period when you switch to plant-based milk.

For example, it may take you a little while to get used to hemp milk’s earthier taste or chalky texture, or the way almond milk can separate when added to a hot beverage. That said, there are many options available and it’s highly likely that you’ll find one you and your kids enjoy.

Nutrition

Fleming: Nutritionally, the biggest difference between cow’s milk and plant-based alternatives is protein content.

  • Cow’s milk typically has 8-9 grams of protein per cup.
  • Plant-based milks may have as little as 1 gram and as much as 6 grams per cup.

The next difference is in carbohydrates. Cow’s milk is higher in carbs than almost all of the plant-based milks, with the exception of oat milk and rice milk. That’s why people with health conditions such as diabetes may choose plant-based alternatives.

Also, cow’s milk is naturally fortified with calcium and vitamin D, where plant sources often have these ingredients added.

Finally, cow’s milk tends to have more saturated fat. And plant-based milks have more healthy fats (monounsaturated, polyunsaturated). People managing their cholesterol or heart disease may opt for plant-based milks.

Fat facts: Decoding the difference between mono, poly, trans & saturated fats

Key Facts and Figures to Know

Fat in dairy

To understand dairy, it helps to understand fat. The milk that comes from a cow naturally separates into layers:

  • The top layers contain most of the fat (ex. cream)
  • The bottom layers contain almost none (ex. “skimmed” milk)

Dairy products like cream, for example, are made from the fat after it’s been extracted from milk. But all milk products contain varying amounts of fat. Since fat has more calories per serving, milks with higher fat content are higher in calories.

This doesn’t mean those milks aren’t still very nutritious. It just means you need to consider the fat and calories in them along with the rest of a balanced diet.

Dairy product % fat
Skim milk 0.5%
Low-fat milk 1%
Buttermilk 0.5-1.5%
2% milk 2%
Whole milk 3.5%
Half-and-half (half cream, half whole milk) 10.5% or higher
Sour cream 12-16%
Light cream 20%
Light whipping cream 33%
Heavy cream 36-38%
Crème fraîche 42%
Double cream 48%
Clotted cream 55-60%
Butter 80%

Key takeaways

  • Despite its consistency, sour cream is lower in fat content (12-16%) than light or heavy cream (20-38%).
  • The name “buttermilk” is deceiving from a nutritional standpoint. One cup of buttermilk contains less than 1.5% fat. The name is derived from an old practice dairy farmers had of mixing bacterial cultures into whole milk to increase shelf life. After a while, they’d skim off the cream to make butter, and the remaining liquid — which was thicker and slightly sour — was named “buttermilk.”

What is lactose-free milk?

Fleming: Lactose is a sugar (carbohydrate) in milk. Lactose-free milk is just what it sounds like: cow’s milk that has had lactose removed.

Lactose intolerance vs. lactose allergy

Fleming: Lactose intolerance is really a carbohydrate intolerance. If your body is unable to properly digest lactose, eating dairy (which includes lactose) will make you uncomfortable. You might experience symptoms including:

  • Nausea
  • Abdominal cramping
  • Gassiness
  • Diarrhea

If, however, you are allergic to lactose, you’ll have an immune response that’s dangerous rather than just uncomfortable. In addition to the gastrointestinal issues above, you might experience hives, itching or swelling around the nose or mouth that makes it hard to breathe.

What do people need to know about nut milks?

Fleming: In general, nut milks are made by mixing ground nuts with water. They’re typically lower in calories, protein and the unhealthy fat found in cow’s milk and more of the healthy fats. The main drawback, obviously, is that people with nut allergies must avoid them. And they can have widely varying nutritional value depending on brands. It’s also worth noting that many people get plenty of protein in their diets from other sources, so the low protein in nut milks may not be an issue.

Almond milk

Fleming: Naturally, almond milk has little to no calcium, so many brands add it. However, it may be difficult for some people to tolerate and absorb calcium-fortified products.

Cashew milk

Fleming: Cashew milk comes with the same added-calcium considerations as almond milk but may be creamier. Cashew milk and almond milk have similar nutritional profiles.

Other nut milks

Fleming: Other nut milk options include macadamia nut, hazelnut, walnut, and peanut.

Other milks

Coconut milk

Fleming: Despite its name, coconut isn’t actually a nut. That means coconut milk is safe for people with nut allergies to consumers.

Coconut milk is naturally low in protein and vitamins, so it’s often fortified. There are two types of coconut milk:

  1. the higher-fat version used for cooking (often in Asian cuisine)
  2. the low-calorie, unsweetened version.

The latter is a good vegan alternative to cow’s milk.

Soy milk

Fleming: Soy milk has the most protein of all the cow’s milk alternatives with 6-7 grams per cup. It has naturally occurring compounds that can hinder calcium absorption. But, when fortified with calcium, it is more readily absorbed by the body.

Hemp milk

Fleming: Although it’s made from shelled hemp seeds, hemp milk contains no THC. It is naturally rich in omega-3s, as well as vitamins and minerals including calcium and vitamin D. However, it may be an acquired taste for some.

Rice milk

Fleming: Rice milk is made by filtering the grain out of brown rice. It’s high in carbohydrates but a good alternative for those with nut allergies.

Oat milk

Fleming: Oat milk is a little higher in fiber and protein than nut-based milks. But, it should be avoided by people with celiac disease or gluten sensitivity.

Sesame milk

Fleming: One of the newer non-dairy milks is sesame milk. It’s high in healthy fats and vitamin E. Some — but not all — people with nut allergies are also allergic to sesame seeds. So, keep this in mind when serving sesame milk to children for the first time.

What do parents of young children need to know about milk?

Fleming: Cow’s milk offers a lot of nutrients that growing kids need, such as protein, calcium, vitamins A and D, and zinc.

The American Academy of Pediatrics recommends:

  • Whole milk for children under age 2 because the fat assists in absorption of nutrients as well as healthy brain development
  • Reduced-fat milk after age 2 to encourage absorption of nutrients without the extra saturated fat

Fleming: If your child is diagnosed with a milk allergy, know that it can go away altogether by the age of 6. Also, if your child has an intolerance, they may still be able to enjoy small amounts of milk, cheese, or other dairy without discomfort.

Related from WellTuned

Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).

More Posts - LinkedIn

BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also use tools and resources to help improve health and well-being by logging into BlueAccess and going to the in the Member Wellness Center under the Managing Your Health tab.