There are many different types of “milk” on the market today – it is easy to get confused as to which one might be the best choice. Our Weight Loss Surgery (WLS) patients ask me all the time: “What type of milk should I use?” Keep in mind, just because it says milk on the label, does not mean it has the same nutrition (calories, fat, protein or other vitamins or minerals) as cow’s milk. WLS patients need high protein, high nutrient, and low calorie foods to make sure they meet their daily protein goal, get in as much nutritional value as possible and promote weight loss or weight maintenance. Below is a brief overview of cow’s milk and many popular milk alternatives and some of the pros and cons of each.
Cow’s milk is high protein (8 grams per 8 ounce serving), low calorie (90 calories per 8 ounce serving for fat free/skim/nonfat*) and 0 grams of fat (if you choose skim/nonfat/fat free) and naturally high in calcium, potassium and other nutrients. (Vitamins A and D are also added in). There are also higher protein and calcium cow’s milk products on the market as well. Milk does contain lactose (milk sugar), but no added sugars. Fat free or 1% milk is an excellent choice to mix with protein powder, add to your cereal or pour an 8 ounce cup as a snack. If you are lactose intolerant, you can choose lactose free milk. If you have a milk allergy, cannot tolerate cow’s milk, or are vegan or vegetarian, a plant based milk alternative may be a better choice.
*Fat free, skim and nonfat are different names for the same type of cow’s milk.
Soy milk is made from soy beans and is similar to fat free cow’s milk in protein (7 grams per 8 ounce serving), calories (90 calories for unsweetened soy milk per 8 ounce serving) and calcium. Regular or flavored soy milk may have added sugars. For a lower calorie soy milk – get the unsweetened. If you have a milk allergy, lactose intolerant and/or vegan or vegetarian, soy milk may be a good option. WLS patients can use unsweetened soy milk in protein drinks, pour on cereal and as a substitute for cow’s milk in many recipes.
Nut Milk (almond or cashew)
Almond milk and cashew milks are becoming more popular. For WLS patients, regular unsweetened nut milks may not be the best choice as they are very low in protein – 1 gram per 8 ounce serving. However, there are higher protein nut milks on the market, which may help WLS patients reach their daily protein goal. The higher protein nut milks have around 130 calories and 10 grams of plant based protein per 8 ounce serving. Usually the protein added is pea and/or brown rice protein. Additionally, nut milk does have calcium and other nutrients added in to be similar to cow’s milk and also contain healthy fats. Unsweetened nut milk with added protein, may be a good alternative to cow or soy milk for WLS patients who cannot tolerate cow’s milk or soy, who are lactose intolerant, or vegan or vegetarian. Nut milks can be used to mix with protein powder, with hot or cold cereals and in some recipes. Nut milks are not to be used if you have allergy to nuts.
A milk alternative made from rice, it does have added calcium, vitamin D and other nutrients. Rice milk is low in protein and can be high in sugars, so it may be a poor choice for WLS patients.
Made from hemp seeds, this milk alternative has about 70 calories per 8 ounce serving and low in protein about 2-3 grams for the same serving size. Hemp milk is high in calcium, other minerals and is a good source of heart healthy omega 3 fatty acids. Hemp milk may not be the best way to get protein in for WLS patients, but can be a part of a healthy diet due to its high nutritional value. Hemp milk can be mixed with protein powders, used with cereal and in some recipes.
Coconut milk is made from coconuts, water and added vitamins (Vitamin D, A and B12) and minerals (mainly calcium). It is low in calories 45-90 per 8 ounce serving, but almost all the calories come from fat, mainly saturated fat. Coconut milk contains 1 gram or less of protein, which makes coconut milk a poor source of protein. (Do not confuse coconut milk for the coconut milk often used in cooking, which contains a lot more fat and calories). Coconut milk can be used in place of other types of milk, but not the best choice for bariatric patients due to its low protein count and high saturated fat content.
The Bottom Line
There are many milk and milk alternatives to choose from and nutrition may vary from brand to brand – some are flavored, some have added sugars, some have added protein and many have added vitamin and minerals. Read your Nutrition Facts labels and the list of ingredients carefully. Look for lower calories — no more than around 130 calories per serving, high protein (at least 5 grams protein per serving) and high vitamins and minerals (at least 10% Daily Value of most vitamins and minerals per serving). The first 3-4 ingredients should not be a form of sugar (corn syrups, cane sugar or syrups, etc.). Also look for the unsweetened version of plant-based milk alternatives to avoid added sugars and calories.
What kind of milk works for you? Tell us below.
Dietitian’s Corner is a monthly column for post-op and pre-op patients of bariatric surgery in NJ written by Prime Surgicare’s Lori Skurbe. Lori has been a dietitian for over 20 years with an extensive background in weight management, bariatric nutrition and diabetes education.