Danielle Dunnagan, MS, RD, LD Nutrition Care Division Eisenhower Army Medical CenterGone are the days where the milkman delivered milk to our doorstep without having to choose which type, brand or flavor. Today, grocery stores are lined with an unbelievable assortment of milk and milk beverages, each looking or tasting different from the next. The convenience of so many brands and flavors provides us with a popular public predicament: Are all milks created equal?According to the Dietary Guidelines for Americans, children and adults ages 9 and older should include three servings of dairy such as milk, cheese or yogurt in their daily food intake. A serving of dairy should provide about 6 to 9 grams of protein and ample amounts of calcium, a naturally occurring mineral needed for optimal bone health.Dairy milk in particular provides a number of essential nutrients including potassium, phosphorus, vitamin A, vitamin D, vitamin B12, riboflavin and niacin. It also packs 8 grams of protein per eight-ounce serving, and provides around one-third of our daily calcium needs. Calories and fat content are what differentiates whole milk from low fat and fat-free milks.Most labels will list calories per 8-ounce (1 cup) serving, and fluctuate between 149 and 86 calories per serving. The higher the calories, the higher the fat content.Flavorings such as chocolate, strawberry or vanilla are added sugars and increase total calories and carbohydrates per serving.Nevertheless, dairy milk is not alone in the milk beverage market. Milk substitutes are also available and aim to be nutritionally similar.Comparing the labels is the most effective way to stay informed about what your milk provides. Here are the facts on a few of the most common types of milk or milk substitutes on the market today.Lactose-free Milk This milk lies within the dairy milk family and is produced for individuals with an intolerance to the sugar found in milk, also known as lactose. When the body cannot fully break down lactose, symptoms such as bloating, gas or stomach cramps may occur. Nutritionally, lactose-free milk is essentially cow's milk with the lactose removed. It has 90 calories per serving, 0 grams of fat, 13 grams of carbohydrates, 8 grams of protein, and 30 percent of the daily value of natural calcium.Many who follow a lactose-free diet are able to tolerate small amounts of dairy. Try products such as lactose-free milk, yogurt or ice cream or even top your favorite sandwich with a slice of cheddar, Colby, Monterrey Jack or Swiss cheese. These are low in lactose.Soy Milk This plant-based substitute provides adequate protein when compared to dairy milk and is enriched with plenty of calcium. Soy milk is the liquid obtained after crushing cooked soybeans and soaking them in water.The resulting fluid is usually enriched with nutrients such as calcium, vitamin A, vitamin D, riboflavin (B2) and vitamin B12. Nutritionally, unsweetened soy milk contains 80 calories per 8 ounce cup, 3-4 grams of fat, 4-5 grams of carbohydrates, 7 grams of protein and 45 percent of the daily value of added calcium. Sweetened varieties have added calories and carbohydrates for flavor. Because soy milk is plant based, it is often a favorable substitute for individuals following a vegetarian diet.Almond Milk Almond milk is also plant derived and is defined as a mixture of sugar, water and the liquid obtained from ground, blanched almonds. Almond milk is a lower calorie alternative to most milk beverages and, like soy milk, it contains plenty of added calcium. On the other hand, it contains far less protein than its competitors and should not be considered an adequate source of protein per serving.Unsweetened almond milk contains 50 calories per cup, 3.5 grams of fat, 3 grams of carbohydrates, 1-2 grams of protein and 45 percent of the daily value of added calcium. Potassium, vitamin A, vitamin D, and D-alpha-tocopherol (vitamin E) are also commonly added to almond milk for additional nutrition. Almond milk is another substitute popular with vegetarian diets and can be a lower calorie addition to smoothies, cereals, oatmeal, etc.Coconut Milk The coconut craze is a topic popular to recent media, but what exactly is coconut milk? Coconut milk is the liquid extracted from the "meat" of a mature coconut, the white flaky product often used in baking once it has been processed. Nutritionally it contains 70 calories per 8 ounce cup, 4.5 grams of total fat, 8 grams of carbohydrates, 0 grams of protein, and 10 percent of the daily value of added calcium. When compared to fat-free milk, coconut milk has no protein and has a higher saturated fat content. It is also enriched with vitamin A, vitamin D, calcium and vitamin B12, and additionally contains zinc and folic acid. Change up your daily coffee routine and swap dairy cream with coconut milk for a lower fat option.Rice Milk Rice milk is made from extracting the liquid, usually from brown rice, and adding sugar and water. Rice milk is the least allergenic when compared to other milks making it a friendly choice for individuals with milk, nut or soy allergies. It contains almost double the carbohydrates of dairy milk and very little protein per serving. Rice milk provides 113 calories, 2.5 grams of fat, 22 grams of carbohydrates, 1 gram of protein, and 30 percent of the daily value of added calcium. Like other milk substitutes, vitamin A, vitamin D, and vitamin B12 are also added for enrichment. Not all milks are created equal. Aim for three servings of dairy each day by switching up your routine. Add soy milk to your morning cereal or trying lactose-free yogurt with lunch. It's up to you to compare the facts and decide which milk or milk substitute is best for you.-- Sources: "NDL/FNIC Food Composition Database Home Page." USDA Food Composition Database. United States Department of Agriculture, 17 May 2016. Web. 27 July 2016. "Milk vs. Milk Substitutes." EatSmart. Washington State Dairy Council, n.d. Web. 27 July 2016.--- 30 ---