Plant-based drinks and public health: a welcome step, but time for a stronger message
By Dr Shireen Kassam, Founder and Director of Plant-Based Health Professionals UK
The recent report by the Scientific Advisory Committee on Nutrition (SACN), in collaboration with the Committee on Toxicity (COT), assessing the health benefits and risks of consuming plant-based drinks, is a significant and timely contribution to public health discourse. The report focuses specifically on soya, oat and almond drinks, commonly used as an alternative to cows’ milk, and compares their nutritional and toxicological profiles to cows’ milk, with a special focus on children aged 1 to 5 years. It’s important to note that the nutrient profiles were based on purchasing data for products that were sold in the UK in 2019 to 2020 and nutritional composition data on these products that were obtained from manufacturer product descriptions on supermarket websites in January 2022. Since then, the market has continued to evolve, with more fortified and lower-sugar options now widely available. In that sense, the report is already slightly outdated, but its conclusions remain relevant.
We welcome its central message: cows’ milk is not a necessary component of the diet, for children or adults. This is a critical and overdue clarification. The report makes it clear that all essential nutrients provided by cows’ milk can be obtained through other dietary sources, including fortified plant-based milk alternatives. This gives welcome support to those following vegan or predominantly plant-based diets, as well as families with ethical, cultural or medical reasons to avoid dairy.
However, while the scientific content of the report is detailed and thoughtful, its overall tone remains overly cautious. From a public health messaging perspective, this caution may unintentionally discourage the use of plant-based milk alternatives, despite the report’s own findings that these drinks can be nutritionally appropriate for all age groups.
A missed opportunity to inspire confidence
Although the report rightly states that cows’ milk is not essential, the framing throughout is hesitant. For instance, rather than embracing the term “plant milks,” which is familiar to most consumers, the report refers instead to “plant-based drinks.” While this complies with EU and UK legal definitions of “milk,” (i.e. animal-derived products), it may be unclear to the public, many of whom don’t immediately connect the phrase “plant-based drinks” with soya or oat milk.
More significantly, the report omits one of the most compelling reasons many people choose plant-based alternatives: the environmental impact of dairy production. Cows’ milk has a far greater carbon, land and water footprint than all plant-based alternatives, whilst also contributing significantly to air and water pollution. If sustainability considerations had been included in this report, an aspect SACN explicitly excluded from its scope, the case for plant-based milks would have been even stronger. As we look to align dietary recommendations with climate goals, it is increasingly important that national nutrition guidance reflects environmental realities.
The report finds benefits and disadvantages of plant-based drinks and cows’ milk with the relevance of these considerations varying by age group. Yet, the tone of the report leaves the reader with the impression that cows’ milk is the preferred option. This is despite stating the relative benefits of plant drinks, including being lower in energy and saturated fat and higher in fibre and vitamin D. The disadvantages include the potential for higher intakes of free sugar and reduced intakes of certain micronutrients that are typically found in cows’ milk (vitamin A, vitamin B12, calcium, iodine and riboflavin), concerns easily addressed by choosing products wisely.
On nutrition, soya is the standout option
The report’s comparative nutritional modelling provides helpful guidance. Of the three plant-based drinks assessed, soya is nutritionally the closest to cows’ milk in both protein quantity and quality. Fortified soya milk can also deliver adequate levels of calcium, riboflavin, vitamin B12 and vitamin D, and increasingly includes iodine, making it a suitable and nutritionally complete replacement for cows’ milk at all ages from one year onwards.
Nonetheless, the report continues to express concern about isoflavones, plant compounds found in soya that have weak oestrogen-like activity. While it is right to consider all potential risks, the evidence-base for isoflavone harm in humans, particularly children, is extremely limited. Large population studies, particularly in Asia where soya intake is high from a young age, show no adverse reproductive or developmental effects. On the contrary, soya and isoflavone consumption has been associated with numerous benefits to health. Randomised studies have shown that soya drinks, when compared to cows’ milk, have benefits for cardiometabolic indicators of health, regardless of their sugar content. These potential benefits are briefly acknowledged in the report but are quickly overshadowed by speculative concerns drawn mostly from animal studies. This could unnecessarily deter families from choosing the most nutritionally robust plant milk available.
Clear guidance on fortification and free sugars
One of the strengths of the report is its practical advice on choosing appropriate products. It emphasises the importance of selecting unsweetened plant-based drinks that are fortified with key nutrients, especially calcium, iodine, vitamin D and B12, if these drinks are used to replace cows’ milk. This is essential guidance, and we strongly endorse it. The report also provides a helpful classification system for products as “typical,” “enhanced,” or “unfortified and/or sweetened,” based on their nutritional content. The report also makes useful recommendations to Government and the food industry, including the need to standardise the nutritional profile of plant-based drinks.
It’s worth highlighting that most of the “unfortified” products identified in the report were organic, which under current UK regulations cannot be fortified. Consumers often perceive organic products as healthier, but when it comes to plant-based milks for young children, unfortified organic options are not advisable. Health professionals must be aware of this and support families in making informed choices.
The report reiterates that plant-based drinks should not be given as the main milk drink to children under 12 months, a position we agree with. However, for children over 1 year of age, there is now strong evidence that appropriately fortified plant-based milks can support healthy growth and development.
Policy must catch up with the evidence
Despite the report’s clear scientific conclusions, UK government policy remains out of step. Schemes like Nursery Milk and Healthy Start still restrict reimbursement to cows’ milk, excluding plant-based alternatives even for children who follow a vegan diet or have dairy allergy or lactose intolerance. This approach is outdated, inequitable, and unsupported by the evidence in this report. The Scottish Government’s more inclusive approach, allowing fortified soya drinks to be reimbursed through its Healthy Snack Scheme, should become the standard across the UK. Don’t forget that dairy alternatives, such as soya, are already part of the UK dietary guidelines, the Eatwell Guide.
Conclusion: confidence, not caution
This SACN report offers a much-needed evidence base to support the safe use of plant-based milks, particularly soya, as a suitable alternative to cows’ milk from age one onwards. It confirms what we as plant-based health professionals have long known: that these drinks, when chosen wisely, can support optimal health at every life stage.
But the message must be clearer. With the right guidance on fortification and sugar content, plant-based milks, especially soya, are not just a viable alternative, but a positive choice for human and planetary health. Health professionals, parents, and policymakers should embrace this shift with confidence.
For more information on plant-based diets for children visit our dedicated website section. To ensure a well-planned plant-based diet, see our plant-based adaptation of Eatwell Guide.