Science & Research

Plant-Based Beverages

 

There has been an increased trend in families seeking alternatives to cow’s milk-based products for their children.  Healthcare professionals should be aware of the differences among available products as many traditional alternative milks are not nutritionally equivalent as a substitute for cow’s milk.  Professional organizations have taken various positions regarding this topic; thus, healthcare professionals should be aware of accompanying nutritional concerns.  The Academy of Nutrition and Dietetics (AND), the American Academy of Pediatric Dentistry (AAPD), the American Academy of Pediatrics (AAP), and the American Heart Association (AHA) published a consensus statement in 2019 addressing healthy beverage consumption in early childhood, heeding against plant-based cow’s milk alternatives due to the lack of nutritional equivalence.  NASPGHAN took a slightly different position on this topic and published a consensus statement recognizing the need for appropriate plant-based cow’s milk alternatives.  

Else products for toddlers and kids address concern of both consensus statements by providing complete nutrition supplements, plant-based with real minimally processed whole foods, meeting the highest standard for nutrition. 

 

 

Suggested readings: 

Yvan Vandenplas, Nele De Mulder, Elisabeth De Greef and Koen Huysentruyt. Plant-Based Formulas and Liquid Feedings for Infants and Toddlers. Nutrients 2021, 13(11), 4026

Plant based infant formulas have been evaluated extensively and have been shown to be nutritionally adequate, However, what about balanced feeding after the age of one or two years old? Market demand for plant-based solutions increases (whether if due to lifestyle, allergies and intolerances or sustainable preferences) and plant-based drinks have become available for toddlers. This paper discusses the use of planted-based toddler drinks, since they are a valuable and progressively more popular alternative for cow’s milk. Those plant-based solutions include Soy Based, Rice Based and Other Plant Based (such as almonds and buckwheat) Drinks and Formulas. The authors conclude that Plant-based drinks that are nutritionally adapted to the requirements of toddlers are a suitable alternative for cow’s milk to ensure a balanced dietary intake in toddlers.

Merritt RJ, Fleet SE, Fifi A, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition position paper: plant-based milks. J Pediatr Gastroenterol Nutr. 2020;71(2):276-81. This article reviews the evidence behind use of plant-based “milks” as alternatives to cow’s milk for infants and children, recognizing the risks of this rising trend.  NASPGHAN acknowledges that the protein of plain plant-based milk may be 2-8% that of cow’s milk, amongst other nutrients, and that those requiring a dairy-free diet may benefit from plant-based formula or drinks with nutritional composition containing sources of otherwise absent nutrients. NASPGHAN recommends only appropriate commercial infant formulas be used as substitute to human milk for the first year of life, and that a commercial formula be used thereafter for those following the restrictive dairy-free diet.
Lott M, Callahan E, Welker Duffy E, Story M, Daniels S. Healthy beverage consumption in early childhood: Recommendations from key national health and nutrition organizations. Consensus Statement. Health Eating Research; 2019. This report, coordinated by Healthy Eating Research (HER) of the Robert Wood Johnson foundation, was compiled by an expert group panel with representatives from the Academy of Nutrition and Dietetics (AND), the American Heart Association (AHA), the American Academy of Pediatric Dentistry (AAPD), and the American Academy of Pediatrics (AAP). It addresses beverage consumption in the interest of healthy eating behavior development and disease prevention. The panel notes that both infant formula and breast milk recommendations are beyond scope of the report and well-established. 
The panel provides recommendations against toddler milk, referring specifically to cow’s milk-based toddler formulas as they typically contain added caloric sweeteners, are expensive, and offer no further nutritional benefit compared to standard cow’s milk.  Of note, the panel did not address the need for plant-based toddler milk due to the gaps they identified as part of plant-based milk recommendations.  The panel noted that soy milk was not considered as a plant-based milk in their report, and that these milks should not be considered adequate alternatives to cow’s milk until nutrient quality and bioavailability are established.  Else Nutrition satisfies the gap in these recommendations as nutrient quality, composition, and bioavailability are considered during formulation
Bodnar LM, Jiminez EY, Baker SS. Plant-Based Beverages in the Diets of Infants and Young Children. JAMA Pediatrics. 2021;175(6):555-556.These authors emphasize what gaps identified by the aforementioned groups have yet to be addressed, including the lack of adequate plant-based cow's milk alternatives for non-breast fed toddlers ages 12-24 months.  They emphasize the need for clinicians to inquire about consumption of plant-based beverages, given the 61% overall increase in consumption, as well as the 5% of children in the FITS (Feeding Infants and Toddlers Study) study population.