Got milk? What kind?

The dairy case has ballooned in grocery stores, thanks to a surge in nondairy milk alternatives. Consumers torn simply between 1 percent and 2 percent cow’s milk in the past now have soy, almond, coconut, rice and other plant-based milk substitutes vying for space in the shopping cart.

That’s because of people like Jordan Anderson of Mount Pleasant. The 37-year-old aerial yoga instructor switched from cow’s to soy to almond milk, and now buys it regularly.

Anderson says she eats vegetarian most of the time and has moved away from products containing antibiotics and hormones. But for her, the choice was more about taste and texture than anything else.

“I don’t like regular milk. I don’t like the creaminess of it or the way that it makes me feel ... kind of heavy and gross.”

And while she has tried the gamut of alternative milks, she has settled on unflavored, unsweetened almond as her top choice.

“It’s the most delicious and I feel like the one that gives me the most energy,” she says.

As for the nutritional profile, Anderson says she doesn’t pay that much attention.

“Partly because they’re fortified and partly because I eat pretty healthy. I eat a lot of leafy greens and things like that. I do a lot of yoga and I’m pretty in touch with my body.”

Better for you?

But the promise of health benefits is the reason that many Americans are giving the alternatives a try. Wellness expert Dr. Ann Kulze of Mount Pleasant calls it the “halo” effect, yet several of the plant-derived milks aren’t the angels they are made out to be.

“People perceive them to be healthier than they really are,” she says, particularly when the products are sweetened and flavored with chocolate or vanilla. “So you can really get hidden sugars if you’re not careful.”

Medical University of South Carolina registered dietitian Debbie Petitpain applauds the expansion of milk choices, including those that are lactose free or lower in calories. But she, too, has the same caveat.

“Probably the biggest caution is watching that added sugar. Chocolate milk is chocolate milk, whether it’s cow milk, almond milk or soy milk.”

Regular cow’s milk remains the mainstream preference, and for good reasons, they say.

It’s rich in protein, calcium and vitamin D and is a good source of fluid. Consumption is linked to lower risks for metabolic syndrome and high blood pressure, and protection from colon polyps and osteoporosis, Kulze says.

On the negative side, she says, “There’s a pretty consistent relationship between men consuming the most dairy foods and a higher risk of prostate cancer.” A few studies show a higher risk of Parkinson’s disease for men and ovarian cancer in women.

The saturated fat content of cow’s milk is the bigger concern, especially for people at risk of heart disease or those who are overweight. Skim always is the best choice, both Kulze and Petitpain say.

Bullish on soy

Another component of animal milk growing in recognition is lactose, a sugar that causes digestion problems for many. Lactose intolerance is very common, particularly among African-Americans and Hispanics, Petitpain says.

“It’s a real phenomenon,” echoes Kulze, and people are affected to various degrees.

Soy milk, which is naturally lactose free, can be an excellent substitute. Because it doesn’t offer the same natural calcium or vitamin D as cow’s milk, make sure it’s fortified, and reach for the plain, unsweetened version, they say.

Kulze is bullish on whole soy foods, including soy milk. Neither she nor Petitpain has deep concerns about soy, which has stirred debate for years over fears about breast cancer and reproductive effects.

People don’t know the real data, Kulze says.

“Whole soy foods have an exemplary nutritional profile. ... When consumed regularly, soy provides a benefit for cardiovascular risk reduction. We think it’s because the proteins in soy can very modestly lower bad cholesterol. It’s not a big effect, but we see it consistently.

“The other thing we observe, the regular consumption of soy foods is associated with lower rates for lots of cancers.”

She points out that Asian populations have 10 to 15 times the intake of soy foods and a “fraction of the cancers” of the Western world.

She also questions reproductive risks. “Don’t you think we would see it in populations consuming 10 to 15 times more?”

Petitpain says she does get more concerned about concentrated sources, such as soy protein powders, that are added to foods. But eating soy in food forms is “safe and beneficial.”

Beyond cows and soy

So where do the other nut, seed and grain milks fit in?

Petitpain and Kulze don’t paint them with one brush. Those milks have their place in a good diet, they say.

Unsweetened versions can work well for people watching calories. They’re lactose-free. They appeal to vegans or vegetarians. And they can offer comparable nutrients if fortified. Still, the amount of protein will be less than either cow’s or soy milk.

“The nutritional profile is just not up to snuff, especially in regards to their protein,” Kulze says.

Both women are proponents of organic milk, free of hormones and antibiotics, if the purse permits.

“When I have the extra money in my budget, I will buy the organic for my children,” Petitpain says.

Knowledge is the milk shopper’s best ally, they advise.

“The big thing I tell my patients a lot,” says Petitpain, “when you look at these buzzwords while shopping, (companies) aren’t out there to educate you on health, they’re out to sell a product. So you still have to be an informed consumer.”

Cow's milk

Touted as "Nature's Perfect Food," calcium- and protein-rich cow's milk became a household staple in the 20th century. Advances in dairy science, such as pasteurization and homogenization, and in farming and processing, made large-scale commercial production possible. Today we have many choices in cow's milk, mainly according to fat content. As a baseline, per 1 cup:

Variants:

Lactose-free milk: Made for those who can't digest lactose, a milk sugar. A deficiency in the digestive enzyme lactase causes the intolerance. Compares nutritionally to regular milk.

Raw: Unpasteurized milk, and it's controversial. Proponents say it offers better nutrition because vitamins and natural enzymes aren't destroyed by heat, and it is as safe as the dairy is hygienic. However, the Centers for Disease Control and Prevention and other public health agencies warn that raw milk can carry harmful pathogens such as E. coli and salmonella that can make one sick, even prove fatal.

Retail sales of raw milk are legal in South Carolina, but not in neighboring North Carolina or Georgia.

Organic: Cows that eat organic feed or graze on pesticide-free grass. Animals are not given synthetic growth hormones or antibiotics. Commercial organic milk is pasteurized.

Goat's milk

It has slightly lower lactose than cow's milk and contains proteins and fats that make it more digestible. Goat's milk is naturally creamy -- no need to homogenize -- because its smaller fat globules remain suspended and don't separate. Some find it sweet while others detect a bit of tang or saltiness.

It's a good source of calcium, protein and the amino acid tryptophan, which is beneficial for sleep and depression.

Rice milk

Slightly sweet and naturally thinner than some of the others, rice milk is produced from brown rice. It often is commercially thickened, sweetened more and flavored. Rice milk contains double or more the carbs in cow's milk. It does not contain a significant amount of calcium without enriching, and is low in protein. However, it has no lactose and is low in fat and calories.

Soy milk

Pressed from soaked, ground soybeans, the milky liquid is cholesterol- and lactose-free, and its protein is comparable to cow's milk. Often fortified with calcium and vitamins and is low in calories, it remains the most popular alternative milk, though sales are losing a bit of ground. The flip side: Soy has been a lightning rod over health concerns.

Almond milk

The fastest-growing nondairy milk is made from roasted, ground almonds and water, so it tastes somewhat nutty. Like most of the alternatives, it is found in vanilla and chocolate flavors in addition to plain. It has no saturated fat, cholesterol or lactose, but is relatively low in protein. Unsweetened, it can have as few as 35 calories per cup. Add in those flavors and sugars, and the calorie and carb count can quadruple.

Coconut milk

Coconut milk is not the liquid substance found inside a cracked coconut -- that's coconut water. And the canned coconut milk used for cooking is not the same as the cartons of coconut milk "beverage" found in the dairy and nondairy case.

Both of the "milks" are made from ground coconut meat and water, but the canned may run a whopping 500 calories per cup and 40-plus grams of saturated fat, albeit the "good" kind.

The beverage has been made lighter, running 50-80 calories and 5 grams of fat per unsweetened cup. Coconut milk is plentiful in lauric acid, which boasts anti-viral and anti-bacterial properties.

Still on the fringe

Milks are available that are made from oats, hemp, flaxseed, hazelnuts and cashew. Combinations such as almond-coconut and soy-rice also are out there.