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Submitted by Content Loader on 16 October 2014

Who needs to drink milk, how much and what kind? Paediatrician and family practitioner Dr Gita Mathai has all the facts.

There’s nothing like mother’s milk

Newborns, infants and children definitely require milk until the age of one. Mother’s breast milk is the ideal food for newborns as it is easily digestible, free from bacteria and available on demand at the right temperature. 

Despite our evolution and our technological leaps, no scientist has been able to perfectly replicate human milk. They are unable to formulate and add some of the micronutrients, probiotics and immunoglobulins present in breast milk.

It remains unique and the best food for newborns and infants.

The traditional age of weaning is two to three years. Most people stop breast-feeding by one year or when teeth start to appear.

Other animals do not drink milk after they are weaned but we do continue the practice of drinking milk into adult life under the mistaken impression that we still need it, even after the rest of our body (and our intestines) has matured and we can eat a varied diet, which can provide us with all the nutrients needed. We drink milk of animals like cow, goat, buffalo or camel or reconstitute it from powders, but it remains food meant for another species.

Why drink milk of other species?

Milk is nutritious. Fat-free milk provides 80 calories (approximately) per 100ml. This compares with 40 calories provided by 100ml of colas and other carbonated beverages. But whereas sodas provide empty calories, milk contains healthy nutrients. 

 

Nutrient Milk (1 cup)
Fat-free
Low-fat
1%
Reduced
2%
Whole 1%
Choc
Kilocalories 83 102 122 149 158
Protein (g) 8 8 8 8 8
Carbohydrate (g) 12 12 12 12 26
Sugars (g) 12 13 12 12 25
Fiber (g) 0 0 0 0 1
Total Fat (g) 0 2.4 4.8 7.9 2.5
Calories from Fat 0 22 43 71 23
Saturated Fat (g) 0 1.5 3.1 4.6 1.5
Cholesterol 5 12 20 24 8
Cholesterol (%DV) 2% 4% 7% 8% 3%
Sodium (mg) 103 107 115 105 152
Sodium (%DV) 4% 5% 5% 4% 6%
Potassium (mg) 382 366 342 322 425
Potassium (%DV) 11% 11% 10% 9% 12%
Vitamin A (IU) 500 478 464 395 490
Vitamin A (%DV) 10% 10% 13% 11% 14%
Vitamin B12 (ug) 1.2 1 1.3 1.1 0.8
Vitamin B12 (DV) 20% 17% 22% 18% 13%
Vitamin C (mg) 0 0 1 0 2.2
Vitamin C (%DV) 0% 0% 2% 0% 4%
Vitamin D (IU) 115 117 120 124 108
Vitamin D (DV) 29% 30% 30% 31% 27%
Calcium (mg) 299 305 293 276 290
Calcium (%DV) 30% 31% 29% 28% 29%
Folate (ug) 12 12 12 12 12
Folate (%DV) 3% 3% 3% 3% 3%
Iron (mg) 0.1 0.1 0.1 0.1 0.7
Iron (%DV) 1% 1% 1% 1% 4%
Magnesium (mg) 27 27 27 24 32
Magnesium (% DV) 7% 7% 7% 6% 8%
Phosphorus (mg) 247 232 224 205 258
Phosphorus (%DV) 25% 23% 22% 21% 26%
Thiamin (mg) 0.1/td> 0.1 0.1 0.1 0.1
Thiamin (%DV) 7% 7% 7% 7% 7%
Riboflavin (mg) 0.45 0.45 0.45 0.41 0.42
Riboflavin (%DV) 26% 26% 26% 24% 25%
Niacin (mg) 0.2 0.2 0.2 0.2 0.3
Niacin (%DV) 1% 1% 1% 1% 2%
           

Reproduced from US Dairy Export Council

What’s the problem then?
65% of the world and 90% of the Asian population cannot tolerate milk. They either have milk allergy or total lactose intolerance (lactose is the sugar present in milk). They cannot drink milk or consume milk products at all. Others have partial or relative lactose intolerance. They can tolerate small amounts of milk in their coffee or tea, but cannot consume the recommended three eight-ounce glasses of milk a day. Partially digested and processed milk, as in yoghurt or cheese, weight for weight, has health benefits equal to milk, but is more easily digested and often better tolerated.

What about milk alternatives from non-animal sources?
You can try almond milk. This is made by soaking almonds overnight or for at least 6-8 hours and then grinding them either manually or in a blender. Flavoured and unflavoured almond milk is available commercially as well. It contains probiotics, vitamins and micronutrients.  A cup of unsweetened almond milk made from 20-24 nuts contains 1gm of fibre, 6 grams protein, 2.5-3g of fat, 163 calories. The protein content of almond milk is not sufficient for children under the age of two years. The calorie and nutrient count for regular milk is shown above.

Soya milk, either flavoured, sweetened or unsweetened is also available commercially. Soya milk can easily be made at home by soaking the soya beans for 8 hours or overnight in water and then grinding them in a blender. The liquid obtained is then strained and boiled. Milk made from 100g of soya beans contains 54 calories, 1.8g of fat, 3.3g of protein and 0.6g of fibre. Children brought up on soya milk should have their thyroid function tests monitored yearly.

In adults both substitutes work well and can be used.

Is milk essential for calcium and vitamin D?
Deficiency of calcium and vitamin D can result in weak and brittle bones that fracture easily. Drinking milk was widely toted as a remedy for vitamin D and calcium deficiency.

A cup of milk provides only 30% of the daily requirement of vitamin D and calcium. This means that three eight-ounce (250ml) cups have to be drunk per day to get all the calcium and vitamin D from natural sources. Very few adults can tolerate that much of milk. It also adds significantly to the total calorie content of the diet.

Where else can you get calcium and vitamin D?
Calcium and vitamin D are present in oily fish like mackerel and sardines, green leafy vegetables, almonds, flaxseed, custard apples, sesame seeds and tofu.

As an adult, consuming a calcium tablet daily is probably the best way to get the required calcium. The body can absorb calcium in this form. Vitamin D is present in sunlight. An hour of exposure a day with minimal clothing will offset and prevent any deficiency. Few people enjoy sunshine and have the time to consistently spend an hour a day basking in it. There is also the danger of skin cancer. Vitamin D levels can be tested in the blood. If deficiency is present, taking supplements under medical supervision is probably the best option.

Low fat vs full fat milk
Low fat milk was widely touted as healthier because it reduced the total calorie consumption and the amount of saturated fat consumed. The calcium and vitamin D content of both types of milk is the same.

But low fat milk may not be as effective as believed earlier, firstly, as it leaves the person less satiated. This (especially in children) often leads to cravings and consumption of high calorie food for satiety. Secondly, since low fat milk is not as tasty, flavouring and sweetening agents may be added for taste. This defeats the purpose as these agents add to the calories.

So what’s the verdict?
The recommended intake of milk is three eight-ounce helpings. That is almost 750ml. Even if low-fat milk is consumed, it adds around 300 calories a day, without taking into account calories from any flavouring or sweetening agent that may be added.

It is better to remember that as an adult you do not really need, probably cannot tolerate or work off the calories from that much milk. Why not enjoy a warm spinach salad topped with almonds and tofu followed by some grilled mackerel?