Got Mylk? The Emerging Role of Australian Plant-Based Milk Alternatives as A Cow's Milk Substitute

Mapping the evidence of novel plant-based foods: a systematic review of nutritional, health, and environmental impacts in high-income countries

CONTEXT

Shifting from current dietary patterns to diets rich in plant-based (PB) foods and lower in animal-based foods (ABFs) is generally regarded as a suitable strategy to improve nutritional health and reduce environmental impacts. Despite the recent growth in supply of and demand for novel plant-based foods (NPBFs), a comprehensive overview is lacking.

OBJECTIVES

This review provides a synthesis of available evidence, highlights challenges, and informs public health and environmental strategies for purposeful political decision-making by systematically searching, analyzing, and summarizing the available literature.

DATA SOURCES

Five peer-reviewed databases and grey literature sources were rigorously searched for publications.

DATA EXTRACTION

Study characteristics meeting the inclusion criteria regarding NPBF nutrient composition and health and environmental outcomes in high-income countries were extracted.

DATA ANALYSIS

Fifty-seven peer-reviewed and 36 grey literature sources were identified; these were published in 2016-2022. NPBFs typically have substantially lower environmental impacts than ABFs, but the nutritional contents are complex and vary considerably across brands, product type, and main primary ingredient. In the limited evidence on the health impacts, shifts from ABFs to PB meats were associated with positive health outcomes. However, results were mixed for PB drinks, with links to micronutrient deficiencies.

CONCLUSION

If carefully selected, certain NPBFs have the potential to be healthier and nutrient-rich alternatives to ABFs and typically have smaller environmental footprints. More disaggregated categorization of various types of NPBFs would be a helpful step in guiding consumers and key stakeholders to make informed decisions. To enable informed policymaking on the inclusion of NPBFs in dietary transitions as part of a wider net-zero and health strategy, future priorities should include nutritional food standards, labelling, and subdivisions or categorizations of NPBFs, as well as short- and long-term health studies evaluating dietary shifts from ABFs to NPBFs and standardized environmental impact assessments, ideally from independent funders.

Nutritional profile of plant-based dairy alternatives in the Swedish market

The market for plant-based dairy alternatives is growing; therefore, focusing on the nutritional quality of these products is important. This study evaluates the nutritional profile of plant-based alternatives to milk, yoghurt, cheese, cream, ice cream and fat spread in the Swedish market and compares them to corresponding dairy products. The nutritional quality of organic vs non-organic and plain vs flavoured plant-based milk and yoghurt alternatives was also assessed. Nutritional data for 222 plant-based dairy alternatives were collected from the manufacturers' websites, and data for corresponding dairy products were obtained from the Swedish Food Composition Database. Plant-based dairy alternatives had higher fibre content than dairy products, while their protein content was lower, except for soy-based products. The saturated fat content of plant-based dairy alternatives was similar to or lower than dairy products, except for coconut-based yoghurt and plant-fat-based cheese. Their energy content was also similar to or lower than dairy products, except for coconut-based yoghurt, plant-based fat spread and plant-based ice cream, which contained higher energy than yoghurt, blended margarine, and ice cream, respectively. The micronutrient fortification was mainly in plant-based milk, yoghurt, and cheese alternatives; thus, compared to dairy, they had similar or higher vitamins D, B2, and B12 (except in plant-based milk alternatives), calcium and iodine content. Furthermore, organic plant-based milk and yoghurt alternatives had a lower micronutrient content (e.g., vitamins B2 and B12, iodine and calcium) except for vitamin D than non-organic varieties. Flavoured plant-based milk and yoghurt alternatives were higher in energy and total sugar than plain varieties. In summary, plant-based dairy alternatives have nutritional strengths and weaknesses compared to dairy products that should be considered when replacing dairy.

Contribution of plant-based dairy and fish alternatives to iodine nutrition in the Swiss diet: a Swiss Market Survey

PURPOSE

With dairy products and fish being major sources of iodine in Switzerland, the growing popularity of plant-based alternatives may impact iodine nutrition. This study aimed to assess the iodine content in plant-based dairy and fish alternatives available in the Swiss market and compare them with conventional products.

METHODS

In 2022, a market survey was conducted in Zurich, Switzerland, to identify the plant-based dairy and fish alternatives available and assess their iodine content. To evaluate the impact of plant-based alternatives on iodine consumption in Switzerland, we modeled dietary scenarios by substituting the intake of dairy and fish items with plant-based alternatives. In addition, we investigated fortification with calcium, vitamins B2, B12, and D.

RESULTS

Out of 477 identified products, only four milk-alternative products were iodine fortified (median iodine concentration: 22.5 μg/100 ml). The median iodine concentration in unfortified plant-based alternatives was negligible compared to conventional dairy and fish products (milk: 0.21 vs 9.5 μg/100 ml; yogurt 0.36 vs 6.1 μg/100 g; cheese: 0.10 vs 20 μg/100 g; fish 0.50 vs 44 μg/100 g). Three portions of dairy per day as recommended by the Swiss Food Pyramid provide 25% of the RDA for iodine (150 μg/day), whereas substituting those with unfortified alternatives provides only 0.7% of the RDA.

CONCLUSION

Only four out of 477 plant-based alternative products are iodine fortified in the Swiss market. Thus, the risk for consumers to miss out on the ca. 25% of the RDA for iodine by consuming plant-based alternatives is high, placing them at a risk for inadequate iodine intake.

The impact of replacing milk with plant-based alternatives on iodine intake: a dietary modelling study

PURPOSE

Cow's milk is the primary source of iodine in the UK, but consumption of plant-based milk alternatives (PBMA) is increasing and these products are often not fortified with iodine. We evaluated the impact that replacing current milk consumption with PBMA would have on iodine intake.

METHODS

We used data from the National Diet and Nutrition Survey (2016-2019) for children (1.5-10 years), girls 11-18 years, and women of reproductive age (WRA). We used a dietary modelling approach with scenarios using brand-level iodine-fortification data (0, 13, 22.5, 27.4 and 45 µg/100 mL). Relative to usual diet, we calculated change in iodine intake, and the proportion with intake below the Lower Reference Nutrient Intake (LRNI) or above the upper limit.

RESULTS

For all groups, replacement with PBMA, either unfortified or fortified at the lowest concentration, resulted in a meaningful decrease in iodine intake, and increased the proportion with intake < LRNI; compared to usual diet, iodine intake reduced by 58% in children 1.5-3 years (127 vs. 53 µg/day) and the proportion with intake < LRNI increased in girls (11-18 years; 20% to 48%) and WRA (13% to 33%) if an unfortified PBMA was used. Replacement of milk with PBMA fortified at 27.4 µg/100 mL had the lowest impact.

CONCLUSION

Replacing milk with commercially available PBMAs has potential to reduce population iodine intake, depending on the fortification level. PBMAs fortified with ≥ 22.5 and < 45 µg iodine/100 mL would be required to minimize the impact on iodine intake. Research is needed on the impact of total dairy replacement.

Sensory characteristics of plant-based milk alternatives: Product characterisation by consumers and drivers of liking

Like other plant-based (PB) product categories, PB milk alternatives (PBMA) are in ascendency as part of the green consumer transition and a greater focus on personal health. However, consumption remains far below that for cow's milk, and among multiple barriers to uptake, inferior sensory properties is one problem, nutritional inadequacies another. While exceptions exist in both instances, a general need for improved products remains. The present research is situated in this nexus, and its primary aim was to contribute new consumer-centric insight regarding the sensory drivers of liking/disliking in the PBMA category. This was achieved through a central location study with adult New Zealanders (n = 143, not regular PBMA consumers) who tasted 18 different PBMA samples spanning a broad range of PB ingredients (soy, oat, coconut, almond, rice, cashew, peanut, macadamia, lentil, hemp, sesame) in different product types (single PB source, blends, barista style) with varying nutritional profiles. The most liked sample (6.5/9), which was made from soy, had the nutritional profile that most approximated cow's milk (3 g/100 mL protein), as well as a milky appearance and taste. Its mouthfeel was smooth, and this sensory characteristic was also paramount for barista-style PBMAs being well-liked (>5.9/9) regardless of their constituent PB ingredient (oat, almond, coconut). Opportunities for product innovation within this type of PBMA was identified including for using barista-style beyond hot beverages, as these samples received positive liking scores on average. The same applied to blends as multiple-source PBMAs can facilitate improved nutritional composition, and significant scope seemed to exist to identify more liked vs less liked PB ingredient combinations (e.g., almond/rice vs coconut/sesame). By identifying, through penalty/lift analysis that positive sensory drivers of PBMA liking span all sensory modalities (appearance, taste, flavour, texture and mouthfeel), it becomes easier to appreciate that products in this category are complex and challenging to optimise. A second minor research aim was focused on the modulating influence of PBMA consumption frequency on product liking and the sensory drivers of liking. The key result was a positive association between liking and higher consumption frequency, and greater appreciation of sweet, coconut, nutty and cereal/oaty characteristics of PBMAs.

A comparison of the nutritional content and price between dairy and non-dairy milks and cheeses in UK supermarkets: A cross sectional analysis

Background: Non-Dairy (ND) food consumption is rapidly increasing in the UK and for many consumers plant-based diets are presumed to be healthier than standard diets. ND alternatives have different nutritional compositions, and their consumption could present challenges on a public-health level. Aim: To compare the price and nutritional composition of dairy and ND milks and cheeses in UK supermarkets. Methods: Macro and micronutrient data was recorded from Alpro's website and the 6 leading UK grocers for their own-label ND milks and cheeses. For missing micronutrient values the McCance & Widdowson's dataset was used. 99 total products were extracted: 57 ND milks, 7 dairy milks, 10 dairy cheeses and 25 ND cheeses. Dairy milk and cheese were used as control against which all ND products were compared. Results: Soya and coconut milks had lower values of carbohydrates, sugars, calcium, iodine, and potassium (p < 0.01) than dairy. Almond milk had lower values of carbohydrates (p = 0.01), sugars, calcium, iodine, and potassium (p < 0.01) compared to dairy milk. Protein was significantly (p < 0.01) lower for all ND except soya. Dairy cheeses had higher values for energy, protein, iodine, potassium, riboflavin, vitamin B12 and calcium (p < 0.01) than ND. Median prices were similar between dairy and ND milks, whereas ND cheeses were significantly more expensive compared to dairy (p < 0.01). Conclusions: ND alternatives fall short in several key nutrients compared to dairy. Fortification, accurate labelling and nutrition education are needed to help consumers make healthy and informed choices.

Enhancing the functionality of plant-based Yogurt: Integration of lycopene through dual-stage fermentation of soymilk

Well-defined compositional assemblies of plant-based yogurt are of fast-growing awareness for world population concerning environmental sustainability, economic burdens and health risks. Soybean is an attractive candidate for plant yogurt, suffering from poor flavor, limited nutrition, and undesired allergens to offer healthy-functional segments. Herein, we deciphered a novel lycopene-soy yogurt by efficient two-stage fermentation of engineered B. subtilis and LAB. The fortified sogurt was ensured with redundant lycopene of 22.67 ± 2.95 mg/g DCW by engineered B. subtilis and enriched soy isoflavone from synergistic effects of engineered B. subtilis and LAB, possessing strong antioxidant capacity for upgrading functionality. Moreover, the desired pH, accelerated protein hydrolysis, enhanced amino acid availability, and expected sensory attributes cooperatively conferred lycopene-soy yogurt as healthy functional food. High potential is firstly ascribed to sequential dual culture of engineered B. subtilis and LAB in lycopene-soy yogurt, in which flavorful, hypoallergenic and antioxidative ingredients enabled functionalities for plant-based yogurt.

Nutrient composition of milk and plant-based milk alternatives: A cross-sectional study of products sold in Australia and Singapore

Dairy and non-dairy (plant-based) alternatives are promoted as an essential component of a healthy diet. The purpose of this study was to evaluate the range of dairy milks and plant-based milk alternatives in supermarkets in Australia and Singapore, and to explore nutritional differences within the category, and between countries. Product information was collected in store from packaging. Products were sorted into dairy milks and plant-based milk alternatives, and further categorised as (i) breakfast drinks (12 % of products); (ii) plain milks (62 %); or (iii) flavoured milks (26 %). The nutrient profiles of products were tested for differences using Kruskal Wallis and Mann-Whitney U tests. Flavoured products contained almost double the median sugar content of plain products (8.3 g v. 4.6 g, p = 0.005). Two-thirds of the product range were dairy milks, which contained nearly four times the median saturated fat content (1.1 g v. 0.3 v, p < 0.0001) and more than double the amount of sugar (5.1 g v. 2.6 g, p < 0.0001) of plant-based milk alternatives, but three times more protein (3.3 g v. 1.0 g, p < 0.0001). Between countries, generally, calcium contents were similar across products, likely due to fortification of plant-based milk alternatives. Compared to Singapore, dairy milk and plant-based milk alternative products sold in Australia were generally higher in energy, protein and fat, but lower in carbohydrate content. Food supply differences between Singapore and Australia may be cultural and have nutritional implications.

Effects of Plant-Based Protein Interventions, with and without an Exercise Component, on Body Composition, Strength and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Maintaining muscle mass, strength, and function is crucial for our aging population. Exercise and dietary protein intake are recommended strategies; however, animal proteins have been the most studied. Plant-based protein sources have lower digestibility and incomplete amino acid profiles. However new innovative plant-based proteins and products may have overcome these issues. Therefore, this systematic review aimed to synthesize the current research and evaluate the effects of plant-based protein interventions compared to placebo on body composition, strength, and physical function in older adults (≥60 years old). The secondary aim was whether exercise improved the effectiveness of plant-based protein on these outcomes. Randomized controlled trials up to January 2023 were identified through Medline, EMBASE, CINAHL, and Cochrane Library databases. Studies contained a plant-protein intervention, and assessed body composition, strength, and/or physical function. Thirteen articles were included, all using soy protein (0.6-60 g daily), from 12 weeks to 1 year. Narrative summary reported positive effects on muscle mass over time, with no significant differences compared to controls (no intervention, exercise only, animal protein, or exercise + animal protein interventions). There was limited impact on strength and function. Meta-analysis showed that plant-protein interventions were comparable to controls, in all outcomes. In conclusion, plant-protein interventions improved muscle mass over time, and were comparable to other interventions, warranting further investigation as an anabolic stimulus in this vulnerable population.

Impact of a Switch to Plant-Based Foods That Visually and Functionally Mimic Animal-Source Meat and Dairy Milk for the Australian Population-A Dietary Modelling Study

Sales of plant-based 'meat' and 'milk'-products that mimic the visual and functional characteristics of animal-source foods-have increased rapidly during the past decade and are predicted to continue to increase. As plant-based 'meat' and 'milk' are nutritionally dissimilar to the animal-source originals, this study aimed to estimate the nutritional implications for the Australian population of substituting 'Easily Swappable' animal-source meat and dairy milk with plant-based imitation products. Computer simulation modelling was undertaken using dietary intake data collected in 2011-12 from a nationally representative survey sample. Conservative and Accelerated dietary transition scenarios were modelled in which various amounts of dairy milk and animal-source meat were replaced with plant-based 'milk' and plant-based 'meat', for the entire population and for various sub-populations. The scenarios were based on sales reports and economic projections. Modelling revealed that the intake of nutrients already at risk of inadequate intake, such as iodine and vitamin B12 (particularly for females), zinc (particularly for males) and n-3 long-chain fatty acids (for adults), would likely be adversely impacted in an Accelerated scenario. In conclusion, widespread replacement of dairy milk and animal-source meat with plant-based 'milk' and 'meat' may increase the risk of nutritional inadequacies in the Australian population. Messages and policy actions promoting the transition to more environmentally sustainable diets should be designed to avoid such adverse nutritional impacts.

Plant-Based Milk Alternatives in Child Nutrition

Plant-based milk alternatives can be distinguished in two main categories, differing in production processes and regulation: plant-based formulas and plant-based drinks. They are now a widely accepted class of products on the international market. The various plant-based milk alternatives differ in nutritional characteristics due to their origin and manufacturing; more importantly, whereas formulas from plant and cow origin can be used interchangeably, plant-based drinks are nutritionally different from cow's milk and can be consumed by children subsequently to the use of formula. Several scientific organizations have expressed differing opinions on the use of these products in the diets of children. In the face of unanimous conclusions regarding the use of these products during the first year of life, in subsequent ages there were conflicting opinions regarding the timing, quantities, and type of product to be used. From the viewpoint of the child's overall diet and health, it could be suggested that these foods be considered not as simple substitutes for cow's milk, but as part of a varied diet, within individual advice of use. We suggest accepting the presence of these products in a baby's diet (omnivores included), planning their use correctly in the context of a balanced diet, according to the specific product and the needs of the individual.

Iodine fortification of plant-based dairy and fish alternatives: the effect of substitution on iodine intake based on a market survey in the UK

Milk, dairy products, and fish are the main sources of iodine in the UK. Plant-based products are increasingly popular, especially with young women, which may affect iodine intake as they are naturally low in iodine; this is concerning as iodine is required for fetal brain development. We, aimed to (i) assess the iodine fortification of products sold as alternatives to milk, yoghurt, cheese and fish through a cross-sectional survey of UK retail outlets in 2020, and (ii) model the impact of substitution with such products on iodine intake, using portion-based scenarios. We identified 300 products, including plant-based alternatives to: (i) milk (n 146); (ii) yoghurt (n 76); (iii) cheese (n 67) and (iv) fish (n 11). After excluding organic products (n 48), which cannot be fortified, only 28 % (n 29) of milk alternatives and 6 % (n 4) of yoghurt alternatives were fortified with iodine, compared with 88 % (n 92) and 73 % (n 51), respectively, with Ca. No cheese alternative was fortified with iodine, but 55 % were fortified with Ca. None of the fish alternatives were iodine fortified. Substitution of three portions of dairy product (milk/yoghurt/cheese) per day with unfortified alternatives would reduce the iodine provided by 97·9 % (124 v. 2·6 µg) and substantially reduce the contribution to the adult intake recommendation (150 µg/d; 83 v. 1·8 %). Our study highlights that the majority of plant-based alternatives are not iodine fortified and that the use of unfortified alternatives put consumers at risk of iodine deficiency.

Vegan milk and egg alternatives commercialized in Brazil: A study of the nutritional composition and main ingredients

Worldwide, there is an increasing demand for plant-based food due to sustainable, health, ethical, religious, philosophical, and economic reasons. In Brazil, 14% of the population declares themselves vegetarians, and a noticeable increase in the consumption of vegan products is also noted. Substitution of animal dairy and egg is challenging from both sensory and nutritional aspects. Yet, there are no data regarding the nutritional value and ingredients of Brazilian commercial dairy and egg substitutes. Therefore, this study aimed to analyze the nutritional composition and used ingredients in Brazilian commercial vegan alternatives to dairy and eggs to provide information for Brazilian consumers of these products. A cross-sectional quantitative study was carried out in three steps: (i) sample mapping. (ii) data collection, and (iii) statistical analysis. A total of 152 samples were included. No differences were found between the energy value and total fat of vegan products and their animal counterparts. Vegan products showed higher amounts of carbohydrates and dietary fiber, and only the vegan versions of beverages and cheeses showed less protein than their counterparts. Cashews, rice, coconut, and soy were the most used ingredients in dairy substitutes. Emulsions of oil, starch, and isolated protein were used in vegan egg products. Most vegan beverages presented sugar in their composition. Vegan alternatives of dairy and eggs might be suitable for substituting their animal counterparts, but given that traditional versions of cheeses and milk are sources of protein in omnivorous diets, for equivalent nutritional replacement in vegan products, it is necessary to improve the protein content of their vegan counterparts.

Quality and health dimensions of pulse-based dairy alternatives with chickpeas, lupins and mung beans

Health and environmental issues regarding dairy consumption have been highlighted in recent years leading to tremendous consumer demand for plant-based substitutes. In this review, we focused on quality and health dimensions of pulse-based dairy alternatives (PuBDA) using chickpeas, lupins and mung beans. Appraisal of existing documents show that there is limited information on PuBDA with the said pulses compared to similar materials such as soy and pea. Most of the studies focused on milk or fermented milks, either in full or partial substitution of the dairy ingredients with the pulses. Issues on stability, sensory properties, shelf life and nutritional quality were underlined by existing literature. Although it was emphasized in some reports the health potential through the bioactive components, there is scarce data on clinical studies showing actual health benefits of the featured PuBDA in this paper. There is also a scant number of these PuBDA that are currently available in the market and in general, these products have inferior nutritional quality compared to the animal-based counterparts. Technological innovations involving physical, biological and chemical techniques can potentially address the quality problems in the use of chickpeas, lupins, and mung beans as raw materials in dairy alternatives.

Nutritional Profiles of Non-Dairy Plant-Based Cheese Alternatives

With the growing interest in non-dairy products, there has been a surge of interest in consumers seeking plant-based cheese alternatives spurred by a desire to improve individual health and achieve a more sustainable food supply. The aim of this study was to conduct a cross-sectional survey of non-dairy cheese alternatives available in the United States and to evaluate their nutritional content. A total of 245 non-dairy plant-based cheese alternatives were analyzed using their nutritional facts labels. The various cheese alternatives were based upon coconut oil (n = 106), cashews and coconut (n = 61), cashews (n = 35), oats (n = 16), almonds (n = 7), soy (n = 6), palm fruit oil (n = 5), and other blends (n = 9). Only 3% of these cheese alternatives had 5 g or more of protein, while 19%, 14%, and 1% were fortified with calcium, vitamin B12, and vitamin D, respectively. Almost 60% had high levels of saturated fat, while 15% had low sodium levels. The products based on cashews alone more commonly had the highest protein levels and the lowest sodium and saturated fat levels. Those containing coconut oil more commonly had higher saturated fat and sodium levels and were most frequently fortified with vitamin B12. Few of these products could be considered good dietary sources of either protein or calcium.

Nutritional content, protein quantity, protein quality and carbon footprint of plant-based drinks and semi-skimmed milk in the Netherlands and Europe

OBJECTIVE

To compare the nutritional composition of bovine milk and several plant-based drinks with a focus on protein and essential amino acid content and to determine the ratio of essential amino acids to greenhouse gas emission.

DESIGN

Nutritional information on the label was extracted for semi-skimmed milk, soy, oat, almond, coconut and rice drink from the Innova database between January 2017 and March 2020 for the Netherlands, Belgium, Germany, Spain, Italy, and Sweden. Protein and amino acids were measured and carbon footprint was calculated for a selection of Dutch products. Protein quality was determined by calculating the contribution to the WHO essential amino acids requirements.

SETTING

The bovine milk and plant-based drinks market in Netherlands, Belgium, Germany, Spain, Italy, and Sweden.

PARTICIPATING PRODUCTS

Semi-skimmed bovine milk and soy-, oat-, almond-, coconut- and rice drink.

RESULTS

Nutritional label information was collected for 399 products. Milk naturally contains many micronutrients, e.g. vitamin B2, B12, and calcium. Approximately 50% of the regular plant-based drinks was fortified with calcium, whereas the organic plant-based drinks were mostly unfortified. Protein quantity and quality were highest in milk. Soy drink had the best protein quality to carbon footprint ratio and milk came second.

CONCLUSIONS

The nutrition - climate change balance presented in this study, is in line with previous literature, which shows that semi-skimmed bovine milk and fortified soy drink deserve a place in a sustainable diet.

Perspective: Identifying Ultra-Processed Plant-Based Milk Alternatives in the USDA Branded Food Products Database

This study explored the characteristics of plant-based beverages (PBBs) that are marketed as "milks" in the United States. First, machine searches of product names and ingredients in the USDA Branded Food Products Database (BFPDB) yielded 641 nondairy PBBs that included almond, soy, coconut, cashew, other tree nut, flax/hemp, pea, and quinoa and rice "milks." The products varied in energy density and the majority of PBBs contained added salt (69%) and added sugar (53%). Scores on nutrient density metrics [Nutri-Score, Choices, and the Nutrient Rich Food index 7.3 (NRF7.3)] were higher for almond and pea products and lower for coconut PBBs, which contained saturated fat. Ingredient lists were searched further for added flavors, stabilizers, or preservatives said to be characteristic of the NOVA food classification system's ultra-processed group. Most PBBs (90.1%) and 95% of almond milks met the NOVA criteria for ultra-processed foods, because they were created from food components and contained multiple substances not used in normal cooking. Replacing milk and dairy products with plant-based alternatives will necessarily involve the use of ultra-processed foods.

Proposed Nutrient Standards for Plant-Based Beverages Intended as Milk Alternatives

Background: Plant-based beverages (PBB) that are marketed as alternatives to cow milk are gaining in popularity worldwide. Nutrient quality of PBB can be highly variable. Objective: To develop a set of voluntary or mandatory nutrient standards for the PBB product category in order to assist innovation and guide product development and reformulation. Methods: The present goal was to develop standards for PBB energy content, minimum protein content and quality, maximum content for added fat, sugar, and salt, and to suggest fortification levels for selected vitamins and minerals. The standards were based on dietary recommendations and guidelines and current practices of federal agencies in the US. Results: The proposed energy and nutrient content for PBB milk alternatives are maximum 85-100 kcal energy per 100 g; a minimum for 2.2/100 g of high-quality protein, low content of saturated fat (<0.75/100 g) and added sugar (5.3-6.25/100 g) and consistent fortification with calcium, vitamins A, D, B-2, and B-12 at levels comparable to those found in cow milk (1%). Ideally, the protein content ought to be increased (2.8/100 g) and added sugar content reduced even further (2.7-3.1/100 g) for "best of class" products. These proposed standards were applied to the 641 existing PBB products listed in the 2018 version of the USDA Branded Food Products Database (BFPDB). The standards were met by <5% of the PBB on the US market. Conclusion: Often viewed as equivalent to milk in nutritional value, many PBB are often low in protein and are fortified with varying amounts of calcium, and vitamins A and D. Nutrient standards for this category should be adopted by the food industry, by public health regulatory authorities, and by standardization bodies such as the Codex Alimentarius.

Plant-based milk alternatives in the USDA Branded Food Products Database would benefit from nutrient density standards

Many plant-based beverages (PBBs) in the US Department of Agriculture Branded Food Products Database serve as milk alternatives or replacements. Their collective nutrient content and fortification patterns need to be evaluated more fully. Listed ingredients for 641 PBBs were machine-searched for added vitamins, minerals, sugar and salt. The Nutrient Rich Food index NRF5.3 measured nutrient density. Except for soy milks, there was little consistency in nutrient density and micronutrient content across and within PBB product types. Industry-wide voluntary nutrient standards are one mechanism to bring more consistency to the expanding PBB category.

Carotenoids in Milk and the Potential for Dairy Based Functional Foods

Carotenoids are a family of over 1100 known natural pigments synthesized by plants, algae, fungi and bacteria. Dietary intake of carotenoids is necessary for mammals as they cannot be synthesized in the body. In cows, the nature of the diet consumed strongly influences the composition of milk produced and this includes carotenoid concentration and profile. Fresh forage is the richest source of carotenoids for cows. The main carotenoids identified in forages are lutein, β-carotene, zeaxanthin and epilutein. Manipulating cow feed via carotenoid supplementation increases the carotenoid content of bovine milk. In humans, carotenoids have anti-oxidant, anti-inflammatory and provitamin A activity. Lutein is a major carotenoid in human milk and the brain tissue of adults and infants. Lutein and zeaxanthin are linked to improved eye health and cognitive function. Traditionally for humans, fruit and vegetables have been the main source of carotenoid intake. Functional foods present an opportunity to incorporate these naturally occurring compounds into milk products for added health benefits, widening the range of dietary sources of carotenoids. We offer an overview of the literature to date on carotenoid-fortified dairy products and infant formula. This review will describe and summarize the key mechanisms by which the carotenoid profile of bovine milk can be manipulated. We present findings on the origin and role of carotenoids in bovine and human milk, outline factors that impact the carotenoid content of milk, evaluate carotenoid-fortified milk products and discuss the associated challenges, such as bioaccessibility and stability.

International Analysis of the Nutritional Content and a Review of Health Benefits of Non-Dairy Plant-Based Beverages

Concerns about environmental impact and sustainability, animal welfare, and personal health issues have fueled consumer demand for dairy alternatives. The aim of this study was to conduct a cross-sectional survey of plant-based non-dairy beverages from three different continents (USA, Australia, and Western Europe) to assess their nutritional content and health profile. A total of 148 non-dairy beverages were analyzed from the nutrition label and ingredients listed on the commercial package or from the information located on the website of the manufacturer or retailer. The different types of beverages were extracts of nuts or seeds (n = 49), grains (n = 38), legumes (n = 36), coconut (n = 10), and mixed blends (n = 15). On average, the plant-based beverages generally scored well in terms of not containing high levels of sodium, saturated fat, or calories. Over half of the beverages were fortified with calcium to levels equal to or greater than that of dairy milk. The protein content varied from 0 to 10 g/serving. Levels of vitamin D and B12 fortification were quite low. Consumers should be informed of the nutritional profile and potential health benefits of plant-based dairy alternatives as the nutritional content can vary greatly between the different types of beverages.

An Application of the Theory of Planned Behaviour to Predict Intention to Consume Plant-Based Yogurt Alternatives

This study attempts to predict plant-based yogurt consumers’ intention to consume plant-based yogurt alternatives in Denmark employing Ajzen’s theory of planned behaviour as a theoretical framework. An online survey was conducted among 265 consumers recruited through convenience (snowball) sampling. The results from structural equation modelling analysis show that attitude (β = 0.216, p < 0.001), perceived behavioural control (self-efficacy) (β = 0.229, p < 0.001) and perceived sensory attributes (β = 0.324, p < 0.001) positively and significantly influenced consumers’ intention to consume plant-based yogurt alternatives. However, subjective norms (β = 0.106, p = 0.087) and perceived barriers (β = −0.051, p = 0.414) did not influence consumers’ intention to consume plant-based yogurt alternatives. Further, objective knowledge showed no significant influence on attitudes (β = 0.077, p = 0.242) and intention (β = −0.029, p = 0.603) towards plant-based yogurt alternatives. The intention (β = 0.677, p < 0.001) to consume plant-based yogurt alternatives showed a strong positive correlation with the behaviour to consume plant-based yogurt alternatives. The results from logistic regression indicated that socio-demographic characteristics, gender, education, income and region of residence were significantly associated with consumption of plant-based yogurt alternatives. Thus, focusing on consumers’ attitudes and self-efficacy and improving the organoleptic characteristics might promote the consumption of plant-based yogurt alternatives in Denmark and similar countries.

Nutritional Quality of Plant-Based Drinks Sold in Italy: The Food Labelling of Italian Products (FLIP) Study

Plant-based drinks represent a heterogeneous class of beverages, made from several vegetal sources, with a market rapidly expanding around the world. These beverages are mainly drunk in the replacement of milk. Thus, aims of the present study were to: (i) evaluate the nutritional declaration of 330 plant-based drinks currently available on the Italian market; (ii) compare their nutrition facts based on type, presence or not of organic certification and nutrition (NC) or health claims (HC), and of specific claims ("no added sugars" and "source of calcium"); (iii) compare their nutrition composition with cow's milk. A high variability in terms of nutrient profile among products was observed. Limited difference was found between products belonging to both organic and NC categories, while products carrying HC showed lower energy, carbohydrates, sugar, and higher protein contents than the related counterparts. Compared to cow's milk, plant-based drinks showed differences in terms of nutrient profile, mostly regarding the lower protein content (except for soy drinks). Overall, due to the variability, findings from the present survey show that plant-based drinks sold in Italy cannot be considered tout court as milk substitutes and support the importance of improving knowledge towards food labeling to make conscious food choices.