Proof Panel: Milk Substitutes
It wasn’t so long ago that milk was considered a healthy food and the best source of calcium – the more you drank, the stronger your teeth and bones would be. But nowadays, we know that a wide range of symptoms can be attributed to milk and dairy products and, for many, eliminating or restricting dairy in the diet may be healthier, provided that adequate calcium is still consumed.
There are two major problems associated with milk – lactose intolerance and milk allergy. It is important to identify which category you fall into.
Lactose intolerance
Lactase metabolises lactose (milk sugar) in the small intestine but, in people who don ‘t produce the enzyme, undigested lactose enters the large intestine, where it is fermented by bacteria into organic acids and gas, causing bloating, cramps and diarrhoea. To diagnose lactose intolerance, the individual takes a large amount of lactose in water and is then given a breath test to see if hydrogen is present.
Lactose intolerance is most common in those of African or Asian origin, and in other non-Europeans. One study estimated that 79 per cent of Native Americans, 75 per cent of blacks, 51 per cent of Hispanics and 21 per cent of Caucasians have this problem. However, there are indications that many people are either misdiagnosed or self-diagnosed, and may actually have irritable bowel syndrome or other digestive problems. When 30 people who reported severe lactose intolerance took part in a trial, their gastrointestinal symptoms were found to be not due to lactose intolerance after all (Am J Clin Nutr, 1988; 48 [4 suppl]: 1079-159).
Some dairy products are more easily digested by lactose ‘maldigesters’ than others – Swiss cheese, Mozzarella, Cheddar and butter have far lower lactose content than milk. Those who are particularly intolerant need to carefully scour the ingredients of processed foods to see if lactose has been added – powdered mixes, salad dressings, cakes, biscuits, medications, and even vitamins and minerals are common sources.
For many lactose-intolerant people, it’s a condition that can be carefully managed either by reducing the amount of dairy consumed or cutting them out altogether. Alternatively, lactase drops, capsules and tablets are available from reputable manufacturers that can be taken with milk products to enable digestion of lactose.
Milk allergy
Milk and dairy are the most likely foods to trigger allergic responses because some 20 substances in cow ‘s milk are human allergens (Clin Ecol, 1985; 3: 50-4). Nevertheless, the evidence suggests that the main milk protein, casein, is the chief cause of allergies to milk (Allergy, 1996; 51: 412-6).
Extreme milk sensitivity usually develops when cow’s milk is introduced to an infant (Allergy, 1990; 45: 587-96), which lends support to the ‘breast is best’ philosophy. There is often a family history of atopy (J R Soc Med, 1997; 90 [Suppl 30]: 34-9), and other conditions like hayfever and eczema.
In most infants, milk allergy is gone by the age of three. But, in some, it may lead to more serious symptoms and even prevent the child from thriving (Pediatr Allergy Immunol, 1994; 5 [5 Suppl]: 1-36).
Children fed artificial baby’s milk are seven times more likely to be allergic to cow’s milk (Lawrence R, Breastfeeding: A Guide for the Medical Profession, 4th edn. St Louis: Mosby, 1994) whereas those breastfed have fewer food allergies right through adolescence (Clin Pediatr, 1982; 21: 486-91). This is because breastmilk passes on antibodies from the mother, and means that babies are not exposed to potential allergens before their immune systems can cope.
Got calcium?
The recommended daily calcium allowance is 600 mg for a child and 800 mg for an adult (though these are conservative amounts intended simply to prevent a deficiency). In those who rely on milk and dairy for most of their calcium, excluding them can lead to deficiency, so it is advisable to take nutritional or medical advice before taking such action. Milk substitutes don ‘t always contain calcium or vitamin D, needed for calcium absorption. Those who truly cannot tolerate milk may wish to supplement with calcium that includes vitamin D.
The products
Soya and rice milks are now in most supermarkets, but milk substitutes made from hazelnuts, almonds and even peas are more likely to be found only in healthfood stores. Technically speaking, these aren ‘t milks at all because they’re not obtained by milking animals.
We selected eight typical dairy-free drinks from a wide variety of sources and asked 10 PROOF! Panel members to use them as they would regular milk. Products were judged on packaging presentation and information, ingredients, taste, look and smell, and whether they could be used in cooking, hot drinks or as drinks in their own right. Finally, Panel members were asked to note any health benefits from using these products.
Opinions varied widely, with no product scoring more than four points. Even with Provamel, the most highly rated product, two panellists expressed concerns regarding the overconsumption of unfermented soya and potential health risks (such as an underactive thyroid and too many plant oestrogens).
Rice Dream Original was described by one tester as “. . . an excellent substitute for milk in every way”. Another is now considering using Rice Dream instead of cow’s milk, but declared that she’d rather drink black tea, black coffee and nothing on cereal than use Provamel.
Oatly, EcoMil Almond and EcoMil Hazelnut also raised a range of opinions. Oatly was perceived as creamy by some, but thin by others (it needs a good shake). The various nut milks seemed less versatile than the others, perhaps because of their sweetness and strong taste, though some liked them on cereals. Comments ranged from “lovely” to “highly processed” and “thin and pale or grey”.
As for any health benefits, there were only one or two positive responses, but this may have been due to the short time that each product was being used.
Most products scored reasonably as far as packaging and information about ingredients were concerned. Some testers commented that White Sun ‘s packaging looked cheap, dull and dated, and some felt that the print needed to be bigger on many of the cartons. Rice & Rice was criticised for offering no comprehensive information while others suggested that, packaging-wise, EcoMil ‘s various milks were difficult to differentiate from each other.
Our testers were generally confident about the natural ingredients, but there were queries regarding the ‘natural’ sweeteners used, such as apple juice concentrate (White Sun), and agave syrup and maltodextrin (EcoMil ‘s milks). One parent, however, suggested that smaller cartons of the sweet nut milks might make a good juice substitute in children ‘s lunch boxes. Organic ingredients/certification (used by all except White Sun) inspired confidence.
Compared with whole milk, most of these dairy substitutes had a lower total fat content, though only soya milk had significantly fewer calories: 36/100 mL vs 63/100 mL. Likewise, except for Provamel and White Sun, these substitutes all had significantly more carbohydrates/100 mL than whole milk. Only White Sun mentioned calcium content on the label – 42 mg/100 mL – compared with 121 mg/100 mL in whole milk. However, many of our surveyed brands have calcium-enriched versions. All were much more expensive than a pint of regular organic milk.
Provamel
Distributor: Alpro Soya
Price: lb1.09 (1 L)
Rating: ****
The unsweetened version was used in our test, although a sweetened one is available. The pack clearly states that it is organic and GM-free. Ingredients include: hulled organic soybeans and filtered water. Half the testers really liked it in many different foods and drinks – tea, coffee, cereals, sauces and cooking – but others described it as “bland”, “powdery” and “artificial”, and only acceptable in porridge.
Concerns over unfermented soya and the potential health consequences influenced two panellists and, whereas one said it improved his catarrh, another said it made him feel nauseous.
Rice Dream Original
Distributor: Imagine Foods
Price: lb1.49 (1 L)
Rating: ****
The only product with Soil Association certification, this was highly popular with some panellists and disliked intensely by others. It is made from organically grown brown rice, filtered water, cold-pressed organically grown and produced sunflower oil, and sea salt. Because of its sweet taste, some people preferred using it in pancakes, cakes and custard, but not in savoury dishes, and several were critical of its thin, watery consistency.
Only one tester said it helped to reduce morning mucus, but another found it too processed and too sweet – “felt a bit low in blood sugar after trying it”.
EcoMil Almond
Distributor: Organico Realfoods
Price: lb2.48 (1 L)
Rating: ***
This is made of filtered water and organically farmed almonds, agave syrup and maltodextrin. Almond is an acquired taste and whether or not the panellist liked it tended to influence opinions. Even among those that did enjoy it, there were those who believed the taste might be too strong for children to accept.
Oatly
Distributor: Skane Dairy (UK)
Price: lb1.35 (1 L)
Rating: ***
Comprising filtered water, organic oats, organic rapeseed oil and sea salt, this also received mixed reviews. It was claimed to separate in tea and coffee, to be too thin and watery, and not pleasant in colour, whereas others described it as the best of the bunch. One panellist thought it was a great all-rounder.
EcoMil Hazelnut
Distributor: Organico Realfoods
Price: lb2.25 (1 L)
Rating: **
Certified organic, this contains filtered water, organically farmed hazelnuts, agave syrup and maltodextrin. Opinions ranged from “dreadful in tea”, “too sweet”, “awful nutty taste and smell” and “too strong for coffee” to “good for sweet things”, “wonderful in cocoa” and “a good all-rounder”. Again, these views seemed to very much depend on whether the tester liked the nutty flavour or not. One tester believed it increased mucus production.
EcoMil Sum
Distributor: Organico Realfoods
Price: lb2.21 (1 L)
Rating: **
This multigrain drink comprises filtered water, organically farmed almonds, soya, agave syrup, rice, barley, oats, amaranth, maltodextrin and natural vanilla flavouring. Although a few testers liked it, it was not popular. Most considered it to be too sweet, with a taste that was rather overwhelming in drinks; it curdled and separated in coffee and tasted odd in tea.
Rice & Rice
Distributor: Probios/ Organico Realfoods
Price: lb1.74 (1 L)
Rating: *
Like the other rice milks, this was praised by some and disliked by others. In particular, some found it too sweet, even though it uses no sweeteners. Unlike Rice Dream, it was criticised for tasting like rice, separating in tea, and curdling in hot drinks and cooking. For one panellist, though, it did cut down mucus production.
White Sun
Distributor: Plamil
Price: lb1.42 (1 L)
Rating: *
Made from water, sunflower oil, pea protein, apple-juice concentrate, tricalcium phosphate, sea salt, emulsifier, carob bean gum, vitamins B12, B2 and D2, and calcium, this carries the Vegan Society logo. It was described as “oily”, “synthetic”, “nothing like milk”, “disgusting” and “too horrible”; one complained about its “nasty scum on coffee”. Its packaging was considered cheap, dated, unappealing and dull, but the nutritional information was good.
This article first appeared in the November 2004 edition of Proof!.
