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With dozens of plant-based milk alternatives on the market, we asked Dr. Mark Hyman which one we should reach for.

There’s been a lot of mixed messaging about milk in the past decade or so. For years, it was taken as gospel that we all needed to drink milk every day to get strong bones. Remember those “Got Milk” campaigns? Then, we started hearing that maybe more people were lactose intolerant than anyone ever realized, and soy milk had a big moment. Now, there are about 100 different types of milk alternatives to choose from. So how do you know which milk is right for you? To figure this out, we enlisted some professional help from our favorite health expert, Pegan Diet author Dr. Mark Hyman. From which type of milk alternative he drinks himself to the issues with good old-fashioned cow’s milk, Dr. Hyman is here to make sure you never have to worry about feeling paralyzed with indecision in the dairy aisle again.

And before we get into that, why exactly have we been taught for years that dairy milk is the gold standard for our health? We explain it all in the video below, from how milk’s been marketed to why our conventional wisdom about it is wrong.

What is the best milk for you?

“At home, I like to make my own hemp, macadamia, and Brazil nut milk, which only require 2 to 3 ingredients (nuts/seeds, water, and an optional pinch of sea salt) and a high-speed blender. It doesn’t take much time and really is the best option. If I need a shortcut and have to buy something, or I’m at a coffee shop, I always look for an unsweetened one with the least amount of ingredients, all of which need to be real food. This can be a pretty big challenge depending on where you are. A couple of my favorites to buy are Malk Unsweetened Pure Almond Milk or a BPA-free can of organic coconut milk, without any added gums. Simplest is always best, and it’s important to read labels since so many milk alternatives come with artificial ingredients, additives, and sweeteners and are still advertised as ‘healthy.’”

If you’re not lactose intolerant, should you drink cow’s milk?

“An estimated 70 percent of the world’s adult population is lactose intolerant, many of which don’t know it. Clearly, these people need to be avoiding dairy, but many others benefit from eliminating it as well, like people who struggle with acne, digestive problems, or autoimmune conditions, among others. My general recommendation is that if you tolerate cow’s milk, it’s still best to enjoy it only occasionally and to always choose organic grass-fed whole milk.

“Cow’s milk contains many different kinds of proteins. One, in particular, called A1 beta-casein, has been linked to inflammation and harmful health outcomes. Organic grass-fed goat or sheep’s milk is a better alternative among animal milks, as they both contain little to no A1 beta-casein and higher amounts of A2 beta-casein, which does not elicit the same inflammatory problems. And of course, if you want to avoid animal milk altogether, there are plant-based alternatives.”

Do milk alternatives contain protein?

“You can get some protein from certain milk alternatives, but I wouldn’t suggest leaning on them as a protein source. Some almond milks have 5 grams of protein in 8 ounces, compared to 8 grams in an 8-ounce glass of grass-fed cow’s milk. Many soy milks have 8 grams per serving as well, but I generally don’t recommend those (for reasons I’ll address below). Even if they do have some protein, many milk alternatives won’t provide complete protein with all the essential amino acids, meaning you’ll still need to get protein from other places. Protein is a crucial macronutrient that a surprising amount of people struggle to get enough of, so I suggest eating a variety of foods like wild-caught fish, pasture-raised meats and eggs, and nuts and seeds every day to get a variety of high-quality protein in your diet.”

Is soy milk bad for you? Does it really contain estrogen?

“Soy contains what are called phytoestrogens, which are naturally occurring compounds that can bind to estrogen receptors and either block or mildly mimic estrogen. Some animal studies have shown negative effects of soy on rodents, like cancer, but humans metabolize soy differently and those same results haven’t been replicated in people. Other studies actually show soy can be protective against cancer.

“Estrogen aside, there are other things to think about before reaching for soy milk. The Asian cultures that have traditionally consumed soy typically ferment it first. This process breaks down the soy and makes it easier to digest. Plus, fermentation adds extra nutrients and probiotics to soy. Most soy milk you’ll find in the US isn’t fermented and will be highly processed. And if it’s not organic, it’s very likely genetically modified, so it’s never my first dairy-free choice. Soybeans — along with other beans, nuts, and seeds— also contain compounds called phytates, which bind to minerals inside your body and contain some potentially harmful compounds. Many people find it causes digestive upset as well.”

Does cow’s milk really help build strong bones?

“There is no biological requirement for cow’s milk — it’s the perfect food for calves, not humans. The evidence of its benefits is overstated, and the evidence of its harm to human populations is increasing. The enormous dairy lobby drives nutrition guidelines and false advertising initiatives to fool the public into believing their misinformation.

“I did a whole podcast episode called Why Most Everything We Were Told About Dairy Is Wrong with Dr. David Ludwig, who has led eye-opening research showing there is no data to support the claim that the consumption of dairy leads to better bones, weight loss, or improved health. His work has also found some serious risks tied to dairy consumption, including weight gain, increased cancer risk, and increased fracture risk. It turns out milk does not build strong bones! Plus, dairy can cause other problems like constipation, irritable bowel syndrome, bloating, gas, diarrhea, allergies, eczema, and acne.

“The belief has been that adults need 1,000 milligrams of calcium a day and that by drinking milk as children, we build up a calcium bank that helps us avoid osteoporosis and fracture later in life. Research shows us that’s actually not the case, and that dairy is not the ideal option for calcium intake and bone health. The current approach to introducing most allergenic foods to children, like dairy, is to do it around the same time you introduce other solids. Since most children will eventually be exposed to dairy, I see some merit in mindfully exposing them to small amounts of organic grass-fed dairy at the appropriate time, and carefully watching for signs of a reaction. But that does not mean dairy needs to be its own food group.”

Is it bad to drink coffee with cream?

“It comes down to quality and quantity. Many coffee creamers out there are made of junk dairy from conventional cows that have been pumped full of antibiotics, which is then added to artificial flavorings, inflammatory oils, and sweeteners. You absolutely want to avoid this. It’s the worst way to start your day and sets you up for a blood sugar roller coaster, cravings, weight gain, and mood swings. Real full-fat cream from grass-fed cows raised on pasture is a better option when it comes to using dairy in your coffee, but, again, I wouldn’t suggest using it daily due to the general inflammatory nature of cow’s milk. Non-dairy creamers are not necessarily better, though, and you still have to be very careful about reading labels.”

Do milk substitutes contain a high amount of sugar?

“Many of the milk substitutes out there have a lot of added sugar, but certain unsweetened ones can be high in natural sugars as well. Rice milk is one, which can contain up to 10 grams of sugar in 8 ounces even without any added sugar.

Oat milk has become the new favorite for many people. Making it requires oat starch to be broken down into simple sugars, so some brands labeled as ‘no added sugar’ are getting some heat for being misleading. If you look at the labels among different unsweetened oat milks, you’ll find anywhere from 2 grams to 17 grams in the same serving size. I usually recommend most people avoid eating oats because they have a high glycemic index, and in looking at data from people who monitor their blood glucose, oat milk is proving to be no different.”

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