Glasses of various kinds of milk sit on a table next to bowls of nuts.
The definition of milk continues to evolve to include new blends and fresh flavors. But is it better? (For Spectrum Health Beat)

Moooove over, Bessie. Cow’s milk has lots of competition.

You can fill your glass with a milk-like beverage made from hemp, coconut, cashews, macadamia nuts, oats, peas, flax, sunflower seeds or quinoa.

And the longtime favorites―soy, rice and almond milks―occupy more and more space on store shelves.

In the past few decades, the growth in milk alternatives has cut into Americans’ dairy milk consumption. Cow’s milk sales have dropped to half the level of the 1980s, according to the Dairy Reporter. Meanwhile, the milk alternatives market is expected to double by the end of 2019.

With more options popping up, picking the right milk to pour on your cereal can be a bit overwhelming for consumers.

Making that choice depends on an individual’s health needs―and taste preference, says Kristi Veltkamp, MS, RD, a Spectrum Health dietitian.

“If you have allergies, that’s obviously a big driving force,” she says.

For those allergic to cow’s milk, nuts or soy, the growing alternatives market offers some welcome options.

Aside from allergies, nutritional goals should guide your choice, she says.

From the cow

When it comes to nutrition, the old standby rules.

“Cow’s milk by far has the most nutrition in it,” Veltkamp says. “It has protein in it. It has carbohydrates. It has fats. It has a good combination of all three macronutrients. …It’s also a good source of calcium. It has phosphorus and potassium.”

Nutritional guidelines call for whole milk for children from ages 1 to 2. Veltkamp recommends organic milk, free of growth hormones.

Consumers also should consider pastured or grass-fed cow’s milks, she adds, because in consuming an animal product, “you eat what it eats.”

Once children turn 2, they generally can switch to a lower fat milk.

Although adults have long been advised to drink low-fat milk to limit calorie and fat consumption, Veltkamp says recent research casts doubt on that practice. A study in the journal Circulation, for example, found people who consumed full-fat milk and dairy products had lower diabetes rates.

Sugars and protein

People opt for an alternative to cow’s milk for a variety of reasons―they may be lactose intolerant, allergic to milk or following a plant-based diet.

Typically, the plant-based alternatives are created by blending up the main ingredient with water and straining out the pieces.

“Then, they add a thickener. Otherwise, it would be very watery,” Veltkamp says, “Then they add vitamins. Essentially, it’s flavored water.”

Many plant-based milks “are a nice low-calorie option if you are trying to watch your calories or your carbs,” Veltkamp says.

But stick with an unsweetened version, she advises. The flavored versions of popular drinks, like soy and almond milk, can deliver more sugar and calories than cow’s milk.

And remember to check the nutrition facts. Rice milks typically are relatively high in carbs.

Milk produced by cows does contain lactose, a naturally occurring sugar. But that differs from the sugar added to sweetened milk alternatives.

“It is processed differently in the body,” Veltkamp says.

Most of the alternatives have little protein―just a gram or 2 per serving. For those looking for a higher protein content, soy milk and pea milk are good alternatives. They contain 7 or 8 grams of protein in a cup.

Calcium and cooking

Most of the plant-based milks are calcium fortified and deliver 30 to 50 percent of the recommended daily allowance for adults.

If lactose intolerance poses a problem, consumers can buy lactose-free milk.

“They add an enzyme called lactase, and it breaks down the lactose in milk,” Veltkamp says. “It’s kind of like it’s predigested.”

Despite the thinner consistency, Veltkamp says milk alternatives work well in recipes.

“I use almond milk in any recipe that calls for milk, and I don’t have any issues,” she says.