Are milk alternatives good for your bones?

What kind of mustache do you wear — dairy or nondairy? More and more people are going alternative with the nondairy, new "milk" type. If you've wheeled a cart down the grocery store aisles lately, you're sure to have noticed the growing availability of these products. So what's the deal with these trendy beverages?

Milk alternatives, or the new "milks," don't actually contain any milk. They're non-dairy beverages that many people consume instead of dairy milk. Others consume them in addition to dairy milk, as another beverage choice.

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Three popular alternatives are soy, rice and almond "milk." If you have an allergy to milk, are lactose intolerant, or simply prefer not to drink milk, then milk alternatives can be your healthful milk-replacement solution.

Each of these beverages has its own distinct texture, color and flavor. But make no mistake, they don't taste like milk; they have refreshing flavors of their own. There's plenty of variety — vanilla, chocolate, carob and cappuccino, for instance. Milk alternative lovers have actually been known to compare the taste to a milkshake! If you haven't tried these beverages lately, or perhaps ever, then try one. Better yet, experiment with several.

Cooking With Milk Alternatives

Often milk alternatives can be used in cooking or baking just like dairy milk. But, since some of them are sweet, you may need to reduce other sweet ingredients in a recipe. The next time you're in the mood to experiment in the kitchen, try to replace part or all of the dairy milk in a recipe with a non-flavored milk alternative instead.

They don't contain casein, the main protein found in milk, making them suitable for people with a cow's milk allergy. Milk alternatives are also naturally lactose free. Lactose is the sugar in cow's milk that many people are unable to digest. If you're not sure what the difference between a true milk allergy and lactose intolerance is, see the sidebar.

Even if you don't have an allergy and you currently consume milk or lactose-reduced dairy milk, don't think of milk alternatives as replacements. Rather, use milk alternatives as additional, nutritious beverages.

What is a milk allergy?

A true milk allergy involves an abnormal response of your immune system. An allergic reaction typically involves many parts of your body, such as swelling, hives, rash, nasal congestion, asthma, nausea, diarrhea or gas.

Lactose intolerance, often confused with an allergic reaction, doesn't involve the immune system. It occurs due to an inability to digest the milk sugar called lactose. Symptoms of lactose intolerance vary but generally include cramps, bloating, gas, diarrhea and nausea. Your healthcare provider can help evaluate and diagnose if you have an intolerance or allergy.

"Milk" and Bone Health

Many nutrients are required for the complex process of bone formation and bone maintenance. Calcium, vitamin D, magnesium and boron — to name just a few.

So, when eating — or drinking — for bone health, you need to start with a varied, balanced diet that's nutrient — dense, not calorie — dense. To top it off, you need to make sure you're meeting your minimum calcium needs every day: 1,000 mg (19 - 50; years) or 1,200 mg (51 years +).

Recommended Calcium Intakes*
Ages Amount (mg/day)
Birth - 6 months 210
6 months - 1 year 270
1 - 3 years 500
4 - 8 years 800
9 - 18 years 1300
19 - 50 years 1000
51 years and older 1200
Pregnant and Lactating 1000
14 - 18 years 1300
19 - 50 years 1000

*Source: National Academy of Sciences (NAS)

Nutritionally Similar to Milk

Just as with milk, there are varying fat and calorie contents for milk alternatives. Most are lower in protein than milk, but since they're all plant-based, no milk alternative contains cholesterol. Vitamins and minerals are added to many of the alternatives, making them nutritionally similar to milk.

A few have more calcium and vitamin D than milk! In particular, soy "milk" has the added advantage of isoflavones, known as phytoestrogens. Though the jury is still out on phytoestrogens, these substances may mimic estrogen and contribute to the slowing of bone loss due to decreasing estrogen levels associated with menopause.

Some "milks," however, lack several nutrients, such as the calcium and vitamin D, that are rich in dairy milk. These two nutrients are key players in the prevention of osteoporosis. What's more, the calcium in milk alternatives, namely soy "milk," is not as well absorbed as the calcium in dairy milk.

For instance, it takes about 500 milligrams of calcium (typically tri-calcium phosphate or TCP) in soy "milk" to equal a 1-cup (8 fluid ounce) serving of dairy milk containing 300 mg of calcium. You might need to consume 2 cups of fortified soy "milk" to obtain 500 mg calcium.

What do the milk critics say?

What are the "milk" critics saying? Some health professionals believe "milks" should be called "alternative calcium sources," not "milk." Linda McDonald, M.S., R.D., publisher and editor of Supermarket Savvy, agrees. She adds, "Dairy milk stands apart from the alternatives due to [a] unique nutrient package of calcium, protein, phosphorus, riboflavin, niacin, vitamins A, D, and B12, potassium and magnesium." Also, McDonald is concerned about the use of soy "milk" for babies in place of breast milk or whole milk formula.

Claudia Gonzalez, M.S., R.D., Miami area-based spokesperson for the American Dietetic Association, has similar concerns. She says, "Soy 'milk' is normally low in calcium (unless fortified) and is lower in protein, vitamin A and riboflavin. Therefore other foods may be needed to supply missing nutrients." Basically, the critics are saying, don't think of milk alternatives as milk's equal, but as distinctly different beverages.

The Bottom Line on Milk Alternatives

If you're an avid dairy milk drinker, don't give up your infamous milk mustache. Rather, consider adding nutrient — fortified milk alternatives (or "alternative calcium sources") to your beverage repertoire. If you're not drinking much or any dairy milk, and you're over the age of two, then drink up your fortified "milk" till the "cows come home." In either case, enjoy!

Make sure to check the nutrition facts labels before you buy. Compare the labels on milk alternatives to those on dairy milk cartons too.

Here's how they stack up on the basics:

(per 1 cup/8 fluid ounces
Calories (kcal) Total Fat (gm) Saturated Fat
Calcium (mg) Vitamin D
Fat-free milk (Skim or nonfat milk) 86 0 0 302 100
1% Lowfat milk (light milk) 102 2.5 1.5 300 100
2% Reduced-fat milk 121 5 3 297 100
Whole milk (3.25% fat) 150 8 5 291 100
Soy "milk" (fat-free/plain/fortified) 70 0 0 200 120
Soy "milk" (regular/plain/fortified) 110 2.5 0 300 120
Soy "milk" (regular/plain) 100 5 0 4 0
Rice "milk" - fat-free (plain/fortified) 80 0 0 150 120
Rick "milk" - lowfat (plain/fortified) 90 2 0 150 120
Almond "milk" (regular/plain) 70 2.5 0 2 0

*Nutritional information will vary due to brand, ingredient and fortification variables.

Related Articles


  • American Journal of Clinical Nutrition 2000; 71:1166-1169
  • The American Dietetic Association's Complete Food and Nutrition Guide, by Roberta Larson Duyff, M.S., R.D., (Chronimed, 1996)
  • National Osteoporosis Foundation
  • Bowes and Church's Food Values of Portions Commonly Used, by Jean Pennington, Ph.D., R.D. (Chronimed, 1996)
  • Pacific Foods (nutrition facts/product information only)


Jackie Newgent is a registered dietician in New York City.