Plant-based drinks: which to choose and what to look for on the label

How do plant-based drinks differ from cow’s milk?

Plant-based drinks are made by blending pulses, grains or nuts with water and then filtering the mixture. Their nutritional content depends on the main ingredient and whether the manufacturer has fortified them.

Cow’s milk naturally contains around 3.2 g of protein and 120 mg of calcium per 100 ml. It also provides lactose, fat and phosphorus.

A study comparing plant-based drinks on the market with milk concluded that, as sold, they cannot be considered nutritionally equivalent to milk [1]. You will see them labelled as “drinks”, because European legislation reserves the word “milk” for animal products, with a few traditional exceptions. See “Soya drink”.

Which plant-based drink is best?

Soya is the best substitute for milk. In consultations, when a plan says “milk”, we suggest a plant-based drink with at least 3 g of protein per 100 ml; in practice, this is usually soya. The others have their place, but contain much less protein.

• Soya. Provides around 3 to 3.5 g of protein per 100 ml. It is the only common option close to the amount in milk, although its protein is slightly lower in quality [1]. It comfortably meets the criteria for a “source of protein” claim, which requires at least 12% of its energy to come from protein [3]. Its fats are mostly unsaturated, and it contains isoflavones.
• Oat. It has a creamy texture and some beta-glucans, the soluble fibre in oats, although there is little per glass. It is low in protein, at around 1 g or less per 100 ml, and contains more carbohydrates.
• Almond. With no added sugar, it is a light option with fewer than 25 kcal and 0.5 to 1 g of protein per 100 ml. It usually contains little almond, so it provides little from the nut itself.
• Rice. It is very mild but low in nutrients. It contains only 0.1 to 0.3 g of protein per 100 ml and quite a lot of carbohydrates, much of it in the form of sugars from the grain itself.
• Coconut. It is made from coconut flesh diluted with water. It has a distinctive flavour, but almost no protein (less than 0.5 g per 100 ml), and its fat is mostly saturated.

If you are allergic to soya or tree nuts such as almonds, check the allergen information before choosing.

How to read the label at the supermarket

There are two places to look: the ingredients list and the nutrition table. Both are required [4]. Ingredients are listed in descending order by weight [4]. The plant ingredient should appear just after water, and many cartons state its percentage. The higher the percentage, the more of the main ingredient is in the drink.

If sugars, oil or thickeners appear near the top of the list, the product provides less. In the nutrition table per 100 ml, check three rows.

• Sugars. Choose drinks with less than 2.5 g per 100 ml, the threshold given by the Agencia Española de Seguridad Alimentaria y Nutrición (AESAN) for children’s diets [5]. Unsweetened soya and nut drinks usually contain much less. A carton may only say “no added sugars” if no sugars or sweetening ingredients have been added [3].
• Calcium. Look for around 120 mg per 100 ml, the same as cow’s milk and 15% of the nutrient reference value [4].
• Vitamin D. Ideally, it should contain 0.75 to 1.5 µg per 100 ml, or 15% to 30% of the reference value [4]. It helps the body absorb calcium.

Calcium is needed for bones, muscles and nerves. If you do not eat dairy products, a fortified drink can help you meet your daily needs without changing your breakfast.

What mistakes do we see most often in consultations?

There are three things we often hear when someone switches from milk to a plant-based drink. Each one needs a closer look.

“It says no added sugars, but the table says it contains sugar”

This is the question we hear most often about oat and rice drinks, and there is an explanation. Enzymes are used to make the grain liquid; they break its starch down into simpler sugars such as maltose and glucose.

No sugar has been added, so it does not appear in the ingredients list. The nutrition table, however, must declare all sugars present, whether added or not [4]. That is why an oat drink’s table often shows 4 to 6 g of sugars per 100 ml. A rice drink contains 9 to 11 g of carbohydrates per 100 ml, much of it in the form of sugars.

AESAN recommends reducing drinks with sugars and choosing dairy products without added sugars [6]. If you have diabetes or do not want your breakfast to raise your blood glucose quickly, soya or unsweetened nut drinks are more stable options.

“It says it is a source of calcium, so that’s enough”

A drink needs only around 60 mg of calcium per 100 ml to claim that it is a “source of calcium” [3]. The 120 mg that matches milk qualifies as a “high calcium” claim [3]. Check the figure in the table rather than relying on the claim.

Added calcium is also not absorbed in quite the same way as calcium from milk. In a soya drink with tricalcium phosphate, calcium absorption was 25% lower than from milk [1].

“It already contains B12, so I don’t need a supplement”

A drink containing vitamin B12 does not replace the supplement, which is essential if you follow a vegan diet [2]. Your doctor or dietitian-nutritionist prescribes the supplement. Relying on fortified foods is one of the common mistakes in vegetarian diets.

Are plant-based drinks safe for babies and young children?

Extra care is needed in childhood. Before one year of age, plant-based drinks must not replace breast milk or infant formula and should be avoided [5]. If a vegan family is not breastfeeding, the alternative is infant formula based on soya protein [2]. See “Is soya harmful? Hormones, thyroid and breast cancer according to the evidence”.

These drinks do not provide the energy, protein, fats or micronutrients a baby needs. The Asociación Española de Pediatría warns that using unsuitable plant-based drinks has led to severe malnutrition, neurological problems and even deaths [2].

Recommendations for children between their first birthday and age 3 do not fully agree. Paediatricians advise using these drinks only occasionally, fortified with calcium and for cooking, and not as the main drink at least until age 2 or 3 [2].

The official guidance for early childhood education centres accepts them as a source of calcium for vegetarian children if they are fortified and unsweetened [5]. At this age, decide with your paediatrician. If a child follows a vegan diet, make sure they are monitored by a paediatrician and a dietitian-nutritionist.

Rice drinks deserve special mention. Rice and rice products are among the foods that contribute most inorganic arsenic to the diet, and exposure is highest in babies and young children [7]. For this reason, do not give rice drinks to children under 5 [5].

If you prefer to make it at home

It is easy to make at home. Soak the pulse, grain or nuts, blend with water, then strain through muslin or a filter bag. This saves packaging, lets you adjust the concentration and makes use of the leftover pulp, such as soya okara, in meatballs, doughs or creamy soups.

The limitation is that homemade drinks do not contain the calcium, vitamin D or B12 added to fortified commercial products. If a homemade drink replaces milk, you will need to get calcium from other sources. These include tofu set with calcium salts, ground sesame, pulses and low-oxalate vegetables such as broccoli or cabbage.

Our vegetarian diet guide explains how to plan this day to day.