Cow’s milk is considered a complete food, providing high-quality protein and essential micronutrients, including vitamins and minerals. For medical reasons or as a lifestyle choice, consumers are replacing cow’s milk with plant-based milk alternatives (PBMA); some perceive them as healthier alternatives to cow’s milk due to their low saturated fatty acid content and no cholesterol content. However, the nutritional composition of PBMA is quite variable between different types and even within, which makes a comparison with cow’s milk a complex issue. Furthermore, the consumption of PBMA has been associated with the development of some diseases in infants and children. Meanwhile, the consumption of cow’s milk in human health is a controversial issue since it has been associated with a favorable effect in some diseases (such as obesity, type 2 diabetes, and Alzheimer’s) and a negative effect in others (such as prostate cancer risk and Parkinson’s disease); while in some diseases, there is no consensus in the cow’s milk consumption effect. The aim of this review is to make a nutritional comparison of cow’s milk with PBMA and to clarify the potential health issues related to their consumption.

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Some consumers are replacing cow's milk with plant-based milk alternatives (PBMAs). The present study aimed to characterize the lipid profiles of cow's milk (n = 60) and PBMA types (soya, oat, rice, almond, coconut, and hazelnut; n = 10 per type). Significant differences were found in the fatty acid (FA) profiles of PBMAs and milk, particularly in FA diversity (15 FAs in PBMAs vs 54 FAs in milk) and the proportion of prime FA groups. The FA profile of coconut was dominated by saturated FAs (SFA), whereas monounsaturated FAs (MUFA) or polyunsaturated FAs (PUFA) were dominant in the remaining PBMA types. Cholesterol was not detected in any PBMA type. The FA profile of milk FAs was dominated by SFA; however, different individual SFA have varying health outcomes. Additionally, milk contains some FA groups with health-promoting properties, such as methyl-branched-chain FAs (BCFA) and conjugated linoleic acid (CLA), both of which are absent in PBMAs.

The prevalence of lactose intolerance is one of the factors driving consumers toward plant-based milk alternatives (PBMA). This study aimed to analyze the carbohydrate profile of cows' milk (regular and lactose-free from both pasteurized and UHT milks; n = 80) and PBMA (n = 60) by HPLC. The study revealed that no significant difference was present in the energy content and total carbohydrate content between regular milk and lactose-free milk. Although milk and PBMA are entirely different food matrices, some PBMA types, as soya and coconut, may have energy contents and total carbohydrate contents comparable to those of milk. Furthermore, the variability observed in total carbohydrate content, as well as in carbohydrate profile, both between PBMA types and within samples of the same type, arises not only from variations in raw materials but also from the number of dilutions of the vegetable extract and the addition of different types and levels of carbohydrates, such as sucrose, fructose, or sorbitol, during PBMA manufacture. Although, milk presents a regular carbohydrate composition, differing solely between presentations (regular/lactose-free), the PBMA differs significantly between types and among the same type, not being for that reason regarded as a milk substitute.

Some consumers are replacing cow's milk by plant-based milk alternatives (PBMA), however the current knowledge regarding the mineral profile of PBMA is limited. This study aimed to characterize the mineral profile of commercial milk (n = 80) and PBMA types (n = 60; soya, rice, oat, almond, coconut, and hazelnut) by Inductively Coupled Plasma - Optical Emission Spectroscopy, along with a modification of the Sandell-Kolthoff reaction (iodine determination). A single fixed effect statistical model considering the type of beverage as an independent variable was applied. Soya PBMA presented higher contents of Ca, Mg, Cu, and Mg than commercial milk, and similar contents of K and P. On the other hand, commercial milk had higher contents of S, Zn, and Se, with the latter being below the limit of quantification (10 µg/kg) in all PBMA types. Both almond and hazelnut PBMA displayed I contents like those of commercial milk. In terms of mineral ratios, PBMA types presented a higher Ca/P compared with commercial milk, being aligned with dietary guidelines, while commercial milk and soya PBMA showing lower Na/K values, which are beneficial for cardiovascular health. Due to their variability, it is difficult to say with certainty that PBMA can reliably substitute milk as a source of minerals.

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