Which plant milk is healthiest, and are the additives safe?

The objection

“Have you read the ingredients? Gums, emulsifiers, added vitamins, it’s a chemistry set. Cow’s milk is just milk.”

The answer

A carton of plant drink does list more than a plant and water. Three ingredient lists from US products, quoted as examples in a 2022 analysis, show the kinds of extras involved: a gum or two, such as locust bean, gellan or xanthan, sunflower lecithin, and calcium in the form of tricalcium phosphate or calcium carbonate, alongside added vitamins [1].

Cow’s milk isn’t always just milk either. Most milk sold in the US has added vitamin D [2], and Canadian regulations require 2 µg of it in every 100 ml of cow’s milk [3], although UK cow’s milk generally isn’t fortified [4]. The bigger difference lies in how each drink is made, since only one needs a cow to give birth and her calf to be taken from her, a trade recorded in Queensland in 2017 on a dairy farm, at a saleyard and inside a slaughterhouse.

Are the additives in plant milk safe?

Xanthan, guar, locust bean and gellan gum have all passed safety re-evaluations by the European Food Safety Authority (EFSA), which found no concern for the general population at the levels used in food. Its panels reviewed the first three in 2017 and gellan gum in 2018, and saw no need to set a numerical acceptable daily intake for any of them [5][6][7][8]. None is likely to be absorbed intact, and gut bacteria ferment xanthan, guar and locust bean gum [5][6][7][8]. Large amounts can unsettle the gut: adults who took up to 214 mg of xanthan gum per kilogram of body weight a day for ten days tolerated it, though some had abdominal discomfort, which EFSA called undesirable but not adverse [5].

The open question comes from France’s NutriNet-Santé study, which matches what volunteers eat against brand-level databases of additives [10]. Among 104,139 adults followed for an average of 6.8 years, each extra 500 mg a day of guar gum went with an 11% higher risk of type 2 diabetes, each extra 500 mg of xanthan gum with an 8% higher risk and each extra 500 mg of tripotassium phosphate (E340) with a 15% higher risk, alongside links for carrageenan, gum arabic and two other emulsifiers (Salame et al., 2024) [9]. In a 2024 cancer analysis of the same cohort, one group of emulsifiers, mono- and diglycerides of fatty acids (E471), was linked to higher risks of cancer overall, breast cancer and prostate cancer, and carrageenan to breast cancer, while other links did not hold up when the researchers tested them in different ways (Sellem et al., 2024) [10]. Both studies are observational and counted additives across the whole diet, and their authors call for replication and further research [9][10]. Anyone who would rather avoid gums or carrageenan can check the ingredient list, which names them.

Which plant milk is the healthiest?

Unsweetened soya or pea drink with added calcium, B12 and iodine comes closest to cow’s milk, because these are the only plant drinks with protein at levels comparable to milk’s [1]. In a 2022 analysis of 1,042 plant drinks in the US Department of Agriculture’s branded-food database, pea drinks averaged 3.5 g of protein per 100 g and soya drinks 2.8 g, against the 3.3 g typical of milk, while oat drinks averaged 1.4 g, almond 0.7 g and rice 0.5 g (Drewnowski, 2022) [1]. Soya drinks vary by brand. The department’s laboratory analysis of one unsweetened soya drink found 3.5 g [12], and a Swiss laboratory analysis of 27 plant drinks bought in 2019 found that only the soya drinks, like cow’s milk, had more than 3% protein, while most of the rest had 1% or less (Walther et al., 2022) [11]. The Swiss team still rated milk’s protein higher in quality than any plant drink’s, soya included, using the digestible indispensable amino acid score (DIAAS) [11].

Drink	Protein (g per 100 g)	Sugars, unsweetened (g per 100 g)	Iodine if fortified (µg per 100 ml)
Soya	2.8	0.6	24.9
Pea	3.5	no figure	26.8
Oat	1.4	2.3	22.5
Almond	0.7	0	24.8
Rice	0.5	5.3	none fortified
Cow’s milk	3.3	4.8	30.0

Protein is the average for each kind of plant drink, sweetened or not, in the 2022 US analysis, which covered 147 soya, 23 pea, 74 oat, 407 almond and 28 rice drinks [1], and the department’s laboratory figure for whole milk [16]. Sugars are the department’s laboratory figures for one unsweetened drink of each kind and for whole milk [12][13][14][15][16]. There is no sugar figure for pea, because the 2022 analysis gives only an average across sweetened and unsweetened pea drinks; about half of all the US plant drinks it covered had added sugars [1]. Iodine is the median among UK drinks with added iodine in a 2020 market survey, beside the UK food-table value for cow’s milk that the same study used (Nicol et al., 2023) [17]. Most drinks had none: only 8 of the 29 non-organic soya drinks had added iodine, 7 of 21 oat, 5 of 24 almond and neither of the 2 rice drinks, though 4 of the 6 pea drinks did [17]. Unfortified drinks have almost no B12 or iodine [11][17].

In UK supermarkets in December 2024, 88% of non-organic plant milks had added calcium, 71% added B12 and 48% added iodine, up from 28% with iodine in 2020 (Nicol et al., 2026) [18]. In the 2020 survey, plant drinks of all kinds with added calcium had a median of 120 mg per 100 ml on the label, close to cow’s milk’s 123 mg, while those with added B12 had 0.38 µg, less than half of milk’s 0.80 µg [17]. How much of the added calcium the body absorbs depends on its form, and the Swiss team cite a 2005 study in which calcium added to a soya drink as tricalcium phosphate was 25% less available than the calcium in milk [11]. In Great Britain organic drinks are usually unfortified, because the organic rules kept from EU law allow vitamins and minerals in organic food only where the law requires them, or in products such as infant formula [19]. In the 2020 survey, 41 of the 146 plant milks found were organic, products the authors note cannot be fortified [17].

The US government’s dietary guidelines for 2025 to 2030 list fortified dairy alternatives among the options in the dairy group [20], while the US Food and Drug Administration noted in 2023 that many plant drinks don’t match milk’s calcium and vitamin D and some may have much less protein [21]. The Swiss team concluded that even with fortification the drinks they tested were not real alternatives to milk in nutrient composition, and that replacing milk without adjusting the rest of the diet could leave people short of some nutrients over time. They called for better fortification, using the most soluble forms of each nutrient and those the body absorbs best [11].

Is oat milk bad for your blood sugar?

Unsweetened oat drink has less sugar than cow’s milk, but laboratory estimates suggest it raises blood sugar more, and rice drink more still. The US Department of Agriculture puts unsweetened oat drink at 2.3 g of sugars per 100 g against 4.8 g in whole milk [13][16]. In a 2017 study at University College Cork in Ireland, which estimated the glycaemic index of 17 plant drinks by digesting them with enzymes in the laboratory, cow’s milk scored 47, the one oat drink 60 and two rice drinks 98 and 100 (Jeske et al., 2017) [22]. Per 100 g, the oat drink’s glycaemic load was twice that of cow’s milk, 8.0 against 4.0, and the rice drinks’ more than four times as high [22]. The two soya drinks with no added sweetener scored 49 and 54, with glycaemic loads of 0.6 and 1.2, while the top of the soya range, 62, came from one sweetened with sugar [22].

Nearly all the oat drink’s sugar was maltose, which the authors attribute to the oat starch being broken down during processing, and they put its moderate glycaemic index, despite all that maltose, down to the beta-glucan in oats, a fibre known to lower it [22]. The figures come from a single oat drink tested in a laboratory, so treat them as a guide. How much fibre an oat drink keeps varies. The US Department of Agriculture’s analysis of one unsweetened oat drink found none [13], while Oatly says its Whole, Semi and No Sugars drinks carry 2 g of oat fibre per 290 ml glass, 1 g of it oat beta-glucan, which is a third of the 3 g a day linked to lower blood cholesterol [24]. Under rules kept from EU law in Great Britain, a food can claim that oat beta-glucan lowers blood cholesterol only if a portion provides at least 1 g, and buyers must be told that the benefit comes with 3 g a day [25].

Can toddlers drink plant milk?

In the UK, the NHS says unsweetened, calcium-fortified plant drinks such as soya, oat or almond can be given from the age of 1, but rice drinks shouldn’t take the place of milk for children under 5, because they may contain too much arsenic [23]. For the first 12 months, it calls infant formula the only suitable alternative to breast milk, and it advises talking to a health visitor or GP if a child has a milk allergy or intolerance [23]. Advice differs between countries. British Columbia’s health service says toddlers can have fortified plain soy drink as their main drink from age 2, and doesn’t recommend almond, rice, coconut or oat drinks for children under 2, because they have less fat, energy and protein than fortified soy; older children can have them if other foods supply enough of all three [26]. Oat and almond drinks average less than half of cow’s milk’s protein [1], and even soya protein scored lower for quality than milk’s for children aged 6 months to 3 years in the Swiss analysis, at 0.92 against 1.24 [11], so a toddler having a plant drink needs the rest of the diet to make up the difference [11][26]. An organic drink is unlikely to have added calcium, so check the carton before choosing one for a toddler [17][19].