Cow’s milk substitutes and bone health                     

            Cow’s milk has been the main source of calcium for generations but advertising hype and some legitimate health issues have encouraged the development of milk substitutes. It takes some careful digging to figure out what your best choice should be.

            Although calcium is clearly the most important nutrient for building a strong, healthy skeleton it won’t do the job by itself. In addition to the need for moderately intense physical activity during childhood, a partial list includes other factors such as vitamins C and D, omega-3 fats, protein and magnesium. Milk substitutes include most of these but not always in the required amounts.

            Why is there a need for milk substitutes? The primary reason is that many adults, including more than 70 percent of African-Americans and nearly all Asians have digestive problems that include bloating and diarrhea caused by lactose, or milk sugar. When the enzyme in the small intestine that digests lactose is absent or nearly so, bacteria within the gut ferment the sugar and cause symptoms. Persons who choose a vegan diet may like to have a milk-like beverage but they can usually fulfill their calcium needs with an ample amount of green leafy vegetables.

            Goat’s milk is probably the oldest cow’s milk substitute. It is popular in many parts of the world but not in the United States. Its nutrients are similar to those of cow’s milk, including its lactose content.

            Soy milk is the most popular plant-based milk substitute. Most manufacturers add calcium carbonate to bring the calcium content up to the level found in cow’s milk, approximately 300 milligrams per cup (240 ml.).

            Almond and rice milks are popular among vegans but they have only a fraction of the calcium of cow’s milk. Fortification with calcium carbonate, as in the case of soy milk, can make up for this deficiency. Both are plant products and therefore contain moderate amounts of vitamins, antioxidants and other nutrients.

            You may be surprised to find hemp milk on the shelf of your local supermarket. It is made from hemp seeds, not leaves, and it contains no marijuana-like chemicals. It doesn’t have much calcium either and its popularity probably comes from its unusual source, the seed of the marijuana plant.

            Some alternative milk is fortified with calcium but some is not. It pays to read the label. Look for “30 percent of Daily Value” for calcium.