The risks of consuming pasteurized cow's milk are pronounced when consuming in the long term, especially for women. Not only does pasteurized milk create imbalances in the ratios of crucial minerals, but it influences progression and rates of osteoporosis. So which alternatives to milk are there and which ones are actually healthy?

The most heavily consumed processed milks in the world all carry significant problems if we assess their toxic/nutrient balance. Cow's milk is is essentially a dead liquid, devoid of any real nutritional value.

Pasteurized dairy contains too little magnesium needed at the proper ratio to absorb the calcium. Most would agree that a minimum amount of Cal. to Mag Ratio is 2 to 1 and preferably 1 to 1. So milk, at a Cal/Mag ratio of 10 to 1, has a problem. You may put 1200 mg of dairy calcium in your mouth, but you will be lucky to actually absorb a third of it into your system. 

Over 99% of the body's calcium is in the skeleton, where it provides mechanical rigidity. Pasteurized dairy forces a calcium intake lower than normal and the skeleton is used as a reserve to meet needs. Long-term use of skeletal calcium to meet these needs leads to osteoporosis.

Along with almond milk, soy milk has been one of the most popular dairy milk alternatives. It's considered higher in protein and fiber than almost any milk on the market, but these benefits are generously outweighed by the health risks which are numerous.

The old alternatives -- soy, rice and coconut milk -- are now joined on grocery shelves by alt-milks made from almonds, cashews, macadamia nuts, oats, peas, flax, hemp -- the list goes on and on. You can even buy milk made from potatoes or bananas.

Since 2012, non-dairy milk sales in the US have risen 61 per cent, according to market research by Mintel. There is a similar trend in the UK, with plant-milk sales up a third since 2015. More than half of that is almond milk, with soy and coconut milks making up another quarter of the market.

As you might expect for the latest food trend, these milks are mostly bought by millennials, or adults younger than 35. Manufacturers appeal to that generation's values by positioning the products as a healthy alternative, both for the body and the planet. But is that really true?

Nutritionally, it depends on which milk replacement you consider. In general, they are made by grinding up plants and soaking them in water, then adding emulsifiers and stabilisers to thicken the liquid and keep it from separating, but they have a lot of variety.

Almond and cashew milks have less than half the calories found in cow's milk, but are lower in protein. Coconut and hemp milk have a rich texture owing to their high fat content and they also include a small amount of dietary fibre not found in cow's milk. Oat and rice milks are higher in carbohydrates than both cow's milk and other plant-based alternatives.

Milks made from legumes, such as peas, soya beans and peanuts, also offer amino acids not found in cereal crops. Each type of alternative milk has its nutritional benefits and limitations. Any one of them can be considered healthy only when combined with a rounded diet, though the same can be said for dairy milk.

"Almost all of these products are fortified," says P. K. Newby, a nutrition and sustainability scientist at Harvard University. Many non-dairy milks have vitamin D, vitamin B12 and calcium added to make them more similar to cow's milk.

"Milk alternatives are only healthy if combined with a rounded diet, though the same is true of dairy milk"

Few of them have added iodine, though, which helps make thyroid hormones that regulate our metabolism. A 2017 study of iodine levels in seven types of plant-based milks available in the UK found average iodine concentrations of just 1.7 per cent that seen in cow's milk. The authors found that only three of 47 alt-milks on the market were fortified with iodine, and the concentration in those was just a bit over half that seen in cow's milk.

Still, Newby says people who use milk in their coffee or just for cereal could easily switch to a non-dairy alternative without much dietary impact (see "Where to start with alt-milk").

"It's not like most people are drinking this for the nutrients, as such," she says. "They tend to meet their nutrient needs with other foods."

Glass Half-Full

There are some alt-milks it makes little sense to produce in bulk. Rice milk is an option for those with dairy, nut, gluten and soy allergies, but it has far less protein than cow's milk and often has significant amounts of sweeteners added to improve the flavour.

It is also one of the most environmentally costly alt-milks to produce. When rice paddies are flooded to stimulate plant growth, submerged biomass decomposes without oxygen, producing the potent greenhouse gas methane.

"Rice has a much greater carbon footprint than other cereals," says Elin Roos, who studies the environmental impacts of food production at the Swedish University of Agricultural Sciences. "It's very low in nutrition. I don't see why you should use it."

Of course, cows are notoriously bad for the environment as well. The carbon footprint of producing cow's milk varies from place to place, but in Western countries, it is typically around twice as big as that of making plant-based alternatives, says Roos.

A 2010 report by the Food and Agriculture Organization of the United Nations found that the production, packaging and transportation of cow's milk emits 4 per cent of all human-caused greenhouse gas emissions.

In fact, lactating cattle are the main source of greenhouse gases among all livestock and poultry. These emissions include methane that builds up in a cow's digestive tract and is then burped out or emitted from its manure. Carbon dioxide and nitrous oxide are also released from any land cleared for feed crops. Fertilisers used to grow feed further add to the greenhouse gas emissions.

"You need to produce a lot of feed for the animals," says Roos. "Most of the energy in that feed is lost in the process of feeding animals, so in general, all the resource use is much bigger for animal products than for plant-based milks."

Land management plays a role in the environmental impact of every kind of milk. Some cattle graze on grassland, which stores more carbon than land that has crops turned over each year. But a 2017 study by the Food Climate Research Network at the University of Oxford found that the carbon sequestered in the soil would only offset up to 11 per cent of the animals' emissions.

Carbon isn't the only environmental concern to consider. Nuts are notorious water sinks, with some requiring nearly as much water to produce as cow's milk. "We made a calculation that came to a water footprint of 917 litres per litre of almond milk, the same order of magnitude as cow milk, 1000 litres per litre," says Arjen Hoekstra at the University of Twente in the Netherlands.

He also found that producing 1 litre of soy milk requires 297 litres of water. That includes water that ends up in the milk itself, water that evaporates during production and water polluted by those processes. It also accounts for the water used to make the sugars and starches that flavour and stabilise the milk.

In a 2010 report, the UNESCO Institute for Water Education assessed the water footprint of global food crops. It found that of the plants used for alt-milks, water usage was highest for nuts, flax and soy, and lowest for coconut, oats, rice and hemp.

"You also have to take into account the water scarcity situation in a region," says Roos. There are places where you need to irrigate to produce any crops, so they will have higher water usage. And there are places like Sweden, she says, that rely more on rain stored in the soil -- but that also adds to a water footprint.

On the whole, it is clear that alt-milks are friendlier to the environment than traditional dairy, but their growing popularity may cause problems. As more people jump on the bandwagon, manufacturers are starting to compete to introduce new flavours and new types of plant-based milks. Roos warns that this trend may cause unintended environmental harm.

If demand for coconut milk skyrockets, for example, it will become more profitable to grow coconut trees, which could lead to deforestation as farms expand. To avoid that, it is best to have several non-dairy options to choose from. So maybe the proliferation of alt-milks is a saving grace.

"Alt-milks are better for the environment than dairy, but their growing appeal may cause problems"

All that said, sometimes the impacts on the food system may not be worth the end product, says Roos, as with rice milk. Or take banana milk, which involves blending bananas, usually adding some sugar and spice for flavour, and straining the mixture. Then it must be packaged, stored and transported. "Is it worth it? Or is it best to just eat the banana?" asks Roos.

Where To Start With Alt-milk

Each non-dairy milk option has its pros and cons. Decide what is most important to you -- nutrition, sustainability, allergies -- and then get tasting. Here are a few brief reviews of some of the most popular alt-milks.

Rice: For those with allergies to nuts, soy, dairy and gluten, rice milk is the way to go. It is a bit thin on flavour and texture.

Banana: Another allergy-free option, with a bit more substance than rice milk, but it can be difficult to find.

Almond (or other nuts): The flavour is nutty, as you might expect, and stronger than some other non-dairy milks. Try these if you want something with a bit more taste.

Coconut: The flavour here is one of the strongest of the alt-milks, so you will really have to be a fan of the tropical taste.

Pea: Nutritionally strong and very close to cow's milk in texture, pea milk is a nice alternative if you aren't looking for a strong flavour and you want to avoid products with a large water footprint.

Oat: This is relatively easy on the environment. It has an earthy flavour and enough body to use with coffee or cereal.

Brazil nuts, almonds, hazelnuts, walnuts, pecans, and hemp seeds all make nutrient dense, great tasting milks and they're all essentially made the same way. 

WHAT YOU NEED

• Organic nuts or seeds. A general rule is a ratio of at least 2:1. Two parts water to 1 part nuts or seeds.
• Half-gallon mason jar or glass pitcher. Use this for soaking the nuts and storing your final product.
• Blender of food processor. You don’t need a high-speed blender or anything fancy to make nut milk.
• Nut milk bag, cheesecloth or fine-meshed sieve (optional). Use if you like your milk smooth instead of pulpy.

SOAK nuts, seeds, or grains by placing in a bowl with filtered water and a pinch of sea salt. Different foods require different soak times.

• Place the desired nuts or seeds in a glass bowl and cover them with warm distilled, purified or filtered water with a teaspoon of Celtic Sea Salt dissolved in it.
• You will want to use a ratio of at least 2:1. Two parts water to 1 part nuts or seeds.
• Keep the bowl at room temperature and cover with a flour sac cloth or thin tea towel that breathes, and then drain and rinse every few hours to remove the nasties.
• The soaking water will contain all of the toxic enzyme inhibitors which we are trying to remove to improve digestibility and nutrient bioavailability, and helps everything blend more easily. So proper rinsing is really important. Make sure you do a final rinse until the water comes out clear. Some people recommend doing a final rinse with a diluted solution of apple cider vinegar in order to remove any remaining bacteria.
• You want to try and soak the nuts for the recommended amount of time to make them as digestible as possible.
• As a general rule with nuts: the harder the nut, the longer you need to soak. Long soak nuts such as almonds, pistachios and hazelnuts are best soaked for about 12 hours. Common medium soak nuts are walnuts, brazil nuts and pecans. They require less soaking time as they swell more quickly as they are oilier. Short soak nuts are cashews, macadamias and pine nuts. They require the least amount of soaking as they do not contain inner skins, and therefore not as many enzyme inhibitors. 

BLEND with filtered water. A high-speed machine like a Vitamix is preferable to really pulverize the mixture. A 1:3 ration of nuts/seeds/grains to water generally yields good results. I start with 2 cups of water and gradually add more water until I get the taste and consistency I like. Blend for about 1 minute. This can warm the mixture. Chill in the fridge, or blend with ice to consume immediately.

SWEETEN the milk to taste with pitted dates, stevia, maple syrup, honey, coconut sugar, etc. You can also add 1 teaspoon of vanilla extract to boost flavors, and 1 tablespoon of coconut butter to emulsify ingredients. You can also jazz up your milks with raw cacao, fruit, cinnamon, nutmeg, or anything else that tickles your fancy.

STRAIN Some foods like cashews, macadamias, and pecans yield smooth milks. However, with most other foods, like almonds, you will get some texture. You can enjoy this fibrous milk, or strain it for a smoother, more commercial-style blend. Place a nut milk bag over a large container, pour the milk in, and gently squeeze the bag until all liquid has passed through. You can repurpose the pulp as a body scrub by mixing with some coconut oil, or dehydrate it for use in cookies, crusts, and crackers.

Here are five ideas for your pulp (if you don’t want it in your milk):

1. Nut Flour. The pulp can be dehydrated or placed in a 200 degree oven until dried. Grind the dried pulp in a spice grinder or high-speed blender until fine.
2. Raw cookies. Blend the pulp with some dates, nut butter, shredded coconut and sweet spices. Roll into balls and roll in shredded coconut or raw cocoa powder.
3. Soft, raw cheese. Blend the pulp in a food processor with a little nutritional yeast, garlic, lemon juice, fresh herbs, and salt. Serve with crackers.
4. Cereal. Combine the pulp with your fresh nut milk, dried fruits, nuts and sweet spices for a porridge-like cereal.
5. ENJOY Most milks will keep in the fridge in a sealed container for two or three days. Freeze any leftovers in ice cube trays for use later. Homemade milks can separate when stored. Just shake or blend again before drinking.