Dairy milk: There are alternatives but no equivalents.

Dairy milk is a core food in many food-based guides to healthy eating. However, plant-based milk alternatives are becoming increasingly available as substitutes. While these products serve a subset of the population unable or unwilling to consume milk, plant-based milk alternatives can be perceived by consumers as direct equivalents, or even more healthful alternatives to dairy milk. This commentary addresses the significant differences in nutrient content that may have implications for the intake of key nutrients in the case of direct substitutions. Furthermore, while there is a significant body of knowledge demonstrating the significant health benefits associated with dairy milk consumption and a small number of potentially negative associations, there is a paucity of data on the health benefits of plant-based milk alternatives directly. A "health halo" may exist based on matching individual nutrients through fortification, lower energy levels, and the health properties of the unprocessed raw characterizing ingredients of plant-based milk alternatives. This may mislead consumers regarding healthfulness. Similarly, environmental attributes based on volumes of production, without considering contribution to nutrients, may also skew consumer perception. Positioning of plant-based milk alternatives in food-based dietary guidelines, marketing, and personal recommendations should acknowledge the differences in nutritional, bioactive, and health properties between plant-based milk alternatives and dairy milk to ensure appropriate adaptations are made to account for shortfalls in nutrients.