Which Milks are Best for Diabetes?

Almond milk, soy milk, oat milk…the list of alternative milks goes on and on. If you can name a seed, nut, or legume, there’s probably a non-dairy milk being developed with that ingredient. And, of course, that doesn’t even include actual dairy milk from cows.

If you have diabetes, is one better than another?

Each milk has different nutritional content based on the ingredients and brand, so we’ll break down what’s in some of the most popular milk types and offer tips for how to choose from among them. 

Dairy Milk, Yes or No?

Cow’s milk is hands down the most popular milk — and it’s common for people to choose non-dairy milk after rejecting traditional cow’s milk — so let’s start with that first.

Public health authorities like the USDA recommend consuming dairy as part of a healthy diet, including for people with diabetes. Of course, there are many exceptions: you may be allergic to milk or lactose intolerant, you may dislike the flavor of cow’s milk, or you could be following a vegan diet.

Milk is extremely nutrient-dense. Milk, along with other dairy products like yogurt and cheese, is filled with nutrients like calcium, protein, iodine, vitamin A, vitamin D, riboflavin, B12, and zinc. It also, however, does have carbohydrates. One cup of whole milk contains 11 grams, which may require a dose of insulin for people using fast-acting insulin before meals.

Milk offers other potential benefits for people with diabetes. For example, the protein in low-fat dairy, especially whey, is associated with stimulating the release of insulin and lowering hyperglycemia after eating.

Registered dietician Lori Zanini told our partner site Everyday Health that dairy from grass-fed cows adds another benefit: alpha-linolenic acid, an important omega-3 fatty acid associated with many benefits for diabetes.

Cow’s milk has no added sugar, unlike several plant-based milks — as long as it’s not flavored or sweetened like chocolate milk or condensed milk.  Lactose, the naturally occurring sugar in dairy milk, actually helps your body absorb the nutrients in milk. It has other health benefits as well. Lactose has a low glycemic index, helps shape intestinal microbiota, and supports the immune system. 

If you’re choosing to drink dairy milk, the American Diabetes Association advises fat-free or 1 percent low-fat milk.

If you’re lactose intolerant, there are, of course, lactose-free milks. But it’s important to find another way to take in key nutrients to help avoid conditions like osteoporosis, osteopenia, and even malnutrition.

Non-Dairy Options

Plant-based milks vary widely in nutritional content. If you’re concerned with the amount of carbs, protein, fat, added sugar, or calcium in your milk, you need to read the nutrition label on the packaging.

The following chart summarizes the nutritional content of the most popular plant-based milks. To source these numbers, we used the nutritional data from one popular and widely-available brand in each milk category. These numbers may differ, perhaps very significantly, between brands. Always check the label to be sure.

CaloriesProteinFatTotal CarbsSugarCalcium

Cow Milk Full Fat146881112295

Cow Milk 2%120851212302

Cow Milk Skim82801212317

Oat Milk130242113289

Almond40132<150

Cashew50142040

Soy70743<1300

Rice700311<1361

Hemp603500260

Coconut50035344

Important note: All of these milk products were labeled as unsweetened. If you’re looking for an alternative milk without added sugar, be sure to double-check the packaging.

Here’s some more detail on these milks’ most prominent qualities:

Almond milk:

Here’s a milk that can be purchased or made at home. It is a natural source of vitamin E and high in omega-3 fatty acids. Commercial almond milk is fortified with calcium and vitamins A and D. Because it is plant-based, it has neither cholesterol nor saturated fat. And it’s lower in carbs than cow’s milk. But it’s low in protein, with only 1 gram per serving and lower in potassium than cow’s milk. It can be found both sweetened and unsweetened, as well as flavored, so check the label for extra ingredients that can impact calorie count and added carbs.

Cashew milk:

Another nut milk (which can also be made at home), cashew milk is known for its thick and creamy texture. It is low in calories, cholesterol, and sugar, and generally fortified with vitamin D and calcium. Different brands can have very different compositions, and some cashew milk can have as much as 13 grams of carbohydrates in a one-cup serving. 

Soy milk:

Soy milk is derived from soybeans, and often fortified with vitamins and minerals including vitamin D, calcium, omega-3 fatty acids, and flavonoids. Nutritionally, it’s the most similar to low-fat cow’s milk compared to other plant milks. Among those similarities is that it is also a good source of protein. There are scads of brands available, some of which may add sugar, so it’s best to search out unsugared varieties. 

Oat milk:

Made from oats, oat milk is an option for people not only looking for a dairy alternative, that doesn’t contain nuts or soy. It’s generally fortified with calcium, vitamin D, vitamin A, and riboflavin, and has some protein but lower than dairy or soy milk. With two grams of fiber per cup, oat milk has more fiber than cow’s milk, but it also has about twice the amount of carbs. And, according to the Harvard School of Public Health, processing the oats to make oat milk creates some sugars. These two factors might not make it the best plant-based milk for people with type 2 diabetes.

Rice milk:

Rice milk is made with brown rice, and while it is an alternative for those who have lactose intolerance and allergies to soy and nuts, it is fundamentally a carbohydrate. The processing alone breaks down the carbohydrates into sugars, making it naturally sweet but without much in the way of nutrition, unless it’s fortified.  

Coconut milk beverage:

Coconut milk beverage is the unsweetened, ready-to-drink dairy alternative found in cartons, not the thick, sweet canned milk commonly used in soups, curries, and sauces. The beverage version of coconut milk can be low in calories, but it tends to have several grams per serving of saturated fat and no protein. The good news for people with diabetes is that unsweetened coconut milk is very low in carbohydrates. As with other plant-based milks, select those fortified with calcium, and other nutrients. 

Read the Label!

Plant-based “milks” can be healthy alternatives to cow’s milk, but they are not uniform from brand or product to another. There can be a difference in everything from the type and amount of nutrients they are fortified with to added sugars and calorie and carbohydrate ranges. It’s critical to read labels and know what to look for: 

Fat: Look at both the type of fat (“bad” saturated fats versus “good” unsaturated, monounsaturated, or polyunsaturated fats) and the amount per serving.
Protein: The gold standard is dairy milk, which has just over 8 grams per cup. Soy milk has about 7 grams per cup, but almond milk has only 1 gram per cup.
Calcium: You’ll likely find added calcium in soy and almond milk equal to what is in cow’s milk — about 300 milligrams a cup — but keep in mind that calcium added to foods is not the same as natural sources of calcium and may not be absorbed as well by the body. You may need to up your calcium by taking supplements if you’re not eating dairy, since not even foods like dark green leafy vegetables provide optimal calcium absorption.
Carbohydrates: People with diabetes are always concerned with carbohydrate intake, so be sure you check out the number of carbs per serving of the non-dairy milks you’re contemplating. 
Added sugars: Some people find the natural taste of soy or almond milk unpleasant. For that reason, they and other plant-based milks may be sweetened with added sugars. Read the label to look for those milks with the minimum of added sugars. 
Added nutrients: Because these non-dairy milks are generally lacking many of the natural nutrients of dairy milks, you may want to be sure to choose products fortified with calcium, protein, and other vitamins and minerals like potassium, vitamin B12, and iodine.

The Bottom Line

Dairy milk is a natural source of protein and calcium, and it probably still provides the most nutrition of all of today’s milks. It’s high-calorie, though, so it’s probably best to have low- or nonfat versions if you are watching your weight.

Non-dairy plant-based alternative milk can be a terrific option for those who cannot or prefer not to have milk from cows. Most of these products are lower calorie than dairy milk (even skim milk). With some exceptions, they are usually lower in carbs, too. If you are prioritizing protein intake, soy milk might be your best bet. Keep in mind that nutritional content varies significantly from one brand to another — always check the label and see how your milk fulfills your nutritional requirements.

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