Dairy and Plant-Based Milks: Implications for Nutrition and Planetary Health

PURPOSE OF REVIEW

Dairy milk products are dominant in the market; however, plant-based milks are gaining prominence among USA consumers. Many questions remain about how plant-based milk products compare to dairy milk from a nutrition, public health, and planetary health perspective. Here, we compare the retail sales, nutrient profiles, and known health and environmental impacts of the production and consumption of dairy and plant-based milks and identify knowledge gaps for future studies. For our plant-based milk comparisons, we reviewed almond, soy, oat, coconut, rice, pea, cashew, and other plant-based milks as data were available.

RECENT FINDINGS

The retail unit price of plant-based milks was generally higher than that of cow's milk, making it less accessible to lower-income groups. Many plant-based milks are fortified to match the micronutrient profile of dairy milk more closely. Notable differences remained, especially in protein, zinc, and potassium, depending on the base ingredient and individual product. Some plant-based milks contain added sugar to improve flavor. Plant-based milks were generally associated with lower environmental impacts (e.g., greenhouse gas emissions, water use) than cow's milk, with the notable exception of the higher water footprint of almond milk. This review of recent studies and consumer purchases confirmed that retail sales of plant-based milks are increasing and shifting among products. Further research is needed to better characterize the environmental impacts of newer plant-based milks, such as cashew, hemp, and pea milks; consumer attitudes and behavior towards plant-based milks; and the safety and potential health effects related to their long-term and more frequent consumption.

Perspectives from healthcare professionals on the nutritional adequacy of plant-based dairy alternatives: results of a mixed methods inquiry

BACKGROUND

Healthcare professionals are important sources of nutrition and health information for Americans. As plant-based (PB) dairy alternative products increase in popularity, concerns have been raised about their nutritional adequacy, and whether consumers understand nutritional differences to dairy. Healthcare professionals directly advise consumers on dietary choices, therefore we sought to examine their understanding and opinions of PB dairy alternatives.

METHODS

We analyzed comments submitted to the U.S. Food and Drug Administration (FDA) by health professionals (n = 191) in 2018-2019 in response to a request for public comment on the nutrition of PB dairy alternatives and the use of dairy terms like "milk", "cheese", and "yogurt" on their labels. Survey data from healthcare professionals (n = 417) was collected in 2020-2021. Comments and survey responses to open-ended questions were coded using template analysis and thematically analyzed. Logistic regression models examined perceptions across health professional characteristics for close-ended survey responses.

RESULTS

Three-fourths of health professionals believe consumers are confused about the nutritional differences between dairy and PB dairy alternatives. Over half (53%) do not believe either product is nutritionally superior to the other. Many believe dairy products have higher nutrient value, but also believe PB dairy alternatives can be part of a healthful diet. Compared to other types of health professionals, dietetics professionals demonstrated a more accurate understanding of the nutritional value of both products and were more likely to believe nutrients like protein (OR 2.02; 95% CI 1.22-3.34, p = 0.006) and vitamin D (OR 2.46; 95% CI 1.48-4.09, p = 0.001) may be nutrients of concern for PB dairy alternative consumers. They were also more likely to believe consumers are confused about these products (OR 3.44; 95% CI 1.65-7.21; p = 0.001). Health professionals who submitted comments to the FDA showed stronger opinions in favor of PB dairy alternatives.

CONCLUSIONS

Although PB dairy alternatives have nutritional value in certain diets, responses from health professionals suggest that changing their labeling to be different than dairy may reduce confusion. Improved nutrition education among health professionals may also be necessary.

Compatibility of pulse protein in the formulation of plant based yogurt: a review of nutri-functional properties and processing impact

With the increased environmental concerns and health awareness among consumers, there has been a notable interest in plant-based dairy alternatives. The plant-based yogurt market has experienced rapid expansion in recent years. Due to challenges related to cultivation, higher cost of production and lower protein content researchers have explored the viability of pulse-based yogurt which has arisen as an economically and nutritionally abundant solution. This review aims to examine the feasibility of utilizing pulse protein for yogurt production. The nutritional, antinutritional, and functional characteristics of various pulses were discussed in detail, alongside the modifications in these properties during the various stages of yogurt manufacturing. The review also sheds light on pivotal findings from existing literature and outlines challenges associated with the production of pulse-based yogurt. Pulses have emerged as promising base materials for yogurt manufacturing due to their favorable nutritional and functional characteristics. Further, the fermentation process can effectively reduce antinutritional components and enhance digestibility. Nonetheless, variations in sensorial and rheological properties were noted when different types of pulses were employed. This issue can be addressed by employing suitable combinations to achieve the desired properties in pulse-based yogurt.

Consumers' categorizations of dairy products and plant-based milk, yogurt, and cheese alternatives

Plant-based dairy alternatives have many benefits in terms of sustainability, animal welfare, and health, but they can only be successful in the market if consumers perceive them as suitable substitutes for conventional dairy. Consumers' expectations for new products are strongly influenced by the food categories into which they place these products. The present study aims to reveal consumers' categorizations of plant-based dairy products to gain insights into their potential as dairy substitutes. In a free sorting task, 100 participants from the German-speaking part of Switzerland sorted a variety of plant-based and conventional animal-based dairy products into groups, indicating their spontaneous similarity perceptions. Additionally, we assessed the participants' characteristics and attitudes toward plant-based dairy products to test potential differences in categorization strategies among consumer groups. Multidimensional scaling and cluster analysis showed that consumers' mental representations of plant-based dairy and conventional animal-based dairy were clearly separated across a wide range of product types. This pattern was even observed among consumers who ate less meat, had higher exposure to vegan dietary styles, and had less negative attitudes toward dairy alternatives. The results suggest that taxonomic distinctions based on plant or animal origin dominate consumers' perceptions and are likely to hinder the substitution of dairy with plant-based dairy. Nevertheless, they also imply that plant-based products that manage to emphasize shared goals and functional properties akin to conventional dairy products are more likely to form a common goal-derived category in consumers' minds and thus have better prospects as substitutes.

Plant-based beverages as milk alternatives? Nutritional and functional approach through food labelling

Plant-based beverages (PBB) market is largely growing. In this study, 136 beverages made of soy, oat, almond, rice, tigernut, and others (mixtures of various plant materials), from the Spanish market were evaluated through labelling information. Energy value and fat content were intermediate between skimmed and whole cow milk; while fatty acids profile was quite different. Carbohydrate content was usually higher than cow milk, and highly dependent on the addition of sugars. All products provided some dietary fibre. With the exception of soy-based drinks, samples presented lower protein and calcium content than milk (1/3 samples studied were Ca-fortified), and 23% were vitamin D enriched. The claim "No added sugars" was in more than 50% samples. A right labelling and nutritional education of consumers is essential to make adequate choices, since the appearing of many claims is not always indicative of a better-quality product. Plant-based beverages cannot be considered as an alternative to milk, but as a different product, with their own nutritional and functional entity. Their inclusion in a diversified balanced diet can provide interesting functional components, such as soluble fibre or unsaturated fatty acids (mainly soybean and almond drink), which can help improve the health status of the population.

Starter culture growth dynamics and sensory properties of fermented oat drink

In the present study, an oat drink, a plant-based alternative to dairy products, was developed by fermenting the oat base with different vegan starter cultures. The desired pH below 4.2 was achieved in 12 h, regardless of starter culture used. Metagenomic sequencing revealed that S. thermophilus was the dominating species, ranging from 38% to 99% of the total microbial consortia. At lower pH values, population of L. acidophilus, L. plantarum and L. paracasei continued to increase in fermented oat drinks. Lactic acid was produced between 1.6 and 2.8 g/L. The sensory panel showed that all fermented oat drinks had a sour odor and taste. The volatile compounds identified belonged to the ketone, alcohol, aldehyde, acids, and furan classes. The concentration of the most preferred volatile components, such as diacetyl and acetoin, increased during fermentation. However, sensory evaluation showed that all samples were associated with cereals and not dairy in terms of taste and odor. Rheological analysis showed the formation of weak gel-like structures in fermented oat drinks. Overall, fermentation improved flavor and texture of the product. This study provides a broad overview of the oat drink fermentation process from the perspectives of starter culture growth, microbial consortium dynamics, lactic acid bacteria metabolism, and sensory profile formation.