Plant-Based Drinks – Analysis of the SACN and COT report

With more people choosing plant-based drinks than ever before, questions are being raised about whether they are truly a healthy alternative to cow’s milk, especially for children. This blog takes a closer look at the latest SACN and COT report, breaking down the findings, highlighting the benefits, and exploring where the guidance could go further.

By Rosemary Martin RD 

Introduction

In the United Kingdom, the plant-based milk alternative market has become a well-established product category. Data indicates that one in three people are now choosing to drink plant-based milk alternatives as part of their diet, rising from 25% to 32% between 2020 and 20211. With more people choosing plant-based alternatives to cow’s milk, the question for nutritional professionals is: is the nutritional impact on the UK population of concern?

In light of this question, we welcome a new, independent assessment of the health benefits and risks of consuming plant-based drinks from the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and Environment (COT), published in July 20252. In this article, we will explore and evaluate the reports’ findings and discuss how we can use it to guide our nutrition advice.

Defining ‘Plant-Based Drinks’

In this report, the term ‘plant-based drinks’ is used to represent a wide range of dairy-free beverages made from beans, peas, cereals, nuts, and seeds that are regularly used as direct alternatives to cow’s milk, for example in cereals, hot drinks and cooking. The report does not however specify whether this term includes all plant-based drinks, which could include smoothies, fruit juices or fizzy drinks. This terminology could be misleading among consumers and health professionals alike.

Plant-based milk alternatives not only vary based on their foundational ingredient (e.g., soya, almond or oat), but also based on whether they are manufactured with or without sweeteners and other additives including vitamin and mineral fortification. Common additives include calcium and vitamin B12, as well as those used to improve product texture and consistency, for example gellan gum and lecithins. The SACN and COT report acknowledges the broad variety of products and categorises them into three key profiles based on their nutrient composition:

‘Typical’ drinks; commonly available, often fortified with nutrients like calcium, riboflavin, and vitamin B12, and typically containing added sugars.

‘Enhanced’ drinks; unsweetened and fortified with a broader array of nutrients, including vitamin A, riboflavin, vitamin B12, calcium, and iodine, at levels comparable to those in semi-skimmed cow’s milk.

‘Unfortified and/or sweetened’ drinks; containing little to no fortification or are sweetened.

It’s important to be aware that the report’s key focus is on comparing plant-based drinks to cow’s milk, inferring cow’s milk as the ‘gold standard’. While cow’s milk is a common dietary staple and referred to as an ‘important contributor to calcium and other minerals and vitamins’ based on data from the National Diet and Nutrition Survey (NDNS) 2019-20233, it’s essential to acknowledge that consuming dairy is not necessary for human health and that a well-planned vegan diet is approved as suitable for all ages and life stages by the British Dietetic Association (BDA)4. Notably, the report acknowledges that cow’s milk is not an essential component of the diet at any age and appropriately highlights the need for other foods and drinks to replace the nutrients dairy provides in the UK diet.

Nutritional benefits

The SACN and COT report identifies several nutritional benefits of plant-based drinks. Firstly, plant-based drinks tend to have a lower energy and saturated fat content compared to cow’s milk, which is beneficial for individuals who are looking to manage their weight and improve cardiovascular health; an important factor given that, in the UK, 1 in 4 deaths are related to cardiovascular disease but it is considered largely preventable6. For children aged 1 to 5 years, the report notes that the lower energy content of plant-based drinks may be of concern, particularly for those who are underweight or at risk of inadequate energy intake, highlighting the importance of individualised nutrition advice when selecting an appropriate milk alternative.

A second benefit is the higher dietary fibre and vitamin D content in many plant-based drinks, which is particularly advantageous for those whose diets lack these nutrients. In fact, recent NDNS data states that, of children aged 11 to 18 and adults, 96% do not meet UK fibre recommendations, with only marginally better statistics for children 18 months to 3 years at 78% and 4 to 10 years at 86%3. Vitamin D is vital for bone health and immune function, and its inclusion in plant-based drinks can bridge a gap, especially in at-risk populations7.

The report highlights soya drinks to be the most preferable alternative to cow’s milk for vegan children aged 1-5 years due to its comparable protein quantity and quality. Soya milk contains 3.3g of protein per 100ml, compared to approximately 1g in oat milk and 0.5g in almond milk, and is therefore a preferential choice for those who may lack total protein. The outdated focus on ‘quality’ based on amino acid profile and digestibility however overlooks the updated evidence on protein sufficiency with a basic variety of plant-based foods8 and therefore parental guidance on balanced and well-planned plant-based diets is likely to be a valuable adjunct here. When it comes to older children and adults, cow’s milk or plant-based alternatives are not required as a protein source in the context of a varied plant-based or non-plant-based diet.

Nutritional concerns

The report raises concerns around the higher free sugar levels in sweetened plant-based drinks. Excess sugar intake is a well-known contributor to obesity, type 2 diabetes, and dental caries, which is especially concerning in children9. While these concerns are valid, it is important that the focus is also broadened to consider the overall dietary patterns of individuals. Recent NDNS data3 notes that only 10% of respondents consumed plant-based drinks during the study period and with 95% of children 11-18 and 83% of adults consuming more free sugars than recommended, these drinks are unlikely to be a significant contributor to high added sugar intake in the wider population. In addition, plant-based diets based on whole plant foods, such as vegetables, legumes, and whole grains, are generally lower in added sugars, especially when minimally processed. It is therefore important that, although unsweetened versions are generally preferential, these drinks should be looked at within the larger context of diet quality for individuals choosing them.

A further concern highlighted in the report is the potential for micronutrient deficiency in children aged 1-5 years who are particularly vulnerable to lower intakes of calcium, vitamin B12, iodine, vitamin A, and riboflavin if consuming unfortified or minimally fortified drinks. Despite a central message that dairy is not necessary, the report states that plant-based drinks are not nutritionally equivalent to cow’s milk and that whole or semi-skimmed cow’s milk are preferable to plant-based drinks for children aged 1-5 years.

One relevant concern highlighted here is the level of uncertainty around the bioavailability of micronutrients added to plant-based drinks compared to cow’s milk. Although this is a fair reflection of the currently limited evidence base, it is worth noting that several commonly used fortificants, such as cyanocobalamin and calcium carbonate, are generally considered to have good bioavailability in appropriate forms and dosages in human studies10,11. Rather than diminishing the value of fortification, this points to the need for consistent formulation, transparent labelling, and ongoing research to ensure nutritional adequacy across a range of milk alternatives.

For ‘vegan children’, which we could assume includes any children who are dairy-free (although this isn’t specifically stated), the report recommends that fortified and unsweetened versions of almond, oat and soya drinks are preferable to water in meals and snacks where other children would usually consume cow’s milk, and that soya versions are preferable as their main alternative because they contain higher levels of protein.

Isoflavones

Despite the encouragement of soya over other plant-based milks, the report recommends that children should not rely on soya products as their main protein source due to concerns about isoflavone exposure. It is of course essential to consider all potential health risks and ensure diversity in the diet, however the report’s warnings around isoflavones in children may be overly cautious and would benefit from more context. Soya is a rich protein source with numerous health benefits. Several studies, particularly in Asia where soya consumption is higher than Western populations, have highlighted that an early soya-based diet had no impact on the onset of puberty12. Others have found a potential beneficial impact on reducing premenopausal breast cancer risk13, and others state the beneficial effect of soya for cancers, cardiovascular disease, gynaecological, metabolic, musculoskeletal, endocrine, neurological and renal outcomes, indicating that the benefits outweigh any risk14.

The report also examined a range of chemical contaminants, including mycotoxins and heavy metals and states that while the risk is minimal in the UK due to strict food safety regulations, it is still necessary to monitor these risks, especially with plant-based drinks made from nuts and seeds.

Additional points to reflect on

It is worth challenging the common assumption that cow’s milk is a ‘natural’ source of micronutrients such as iodine and vitamin B12. The presence of these nutrients in milk is largely due to fortification at the farming level, through iodine added to cattle feed and teat-cleaning solutions, and B12 present as a result of animal supplementation5. As such, cow’s milk can more accurately be described as an indirectly fortified product and should not be held to a different standard than fortified plant-based drinks.

Unfortunately, the report dismisses data relating to other important aspects of cow’s milk consumption, including allergies, sustainability and the environment, declaring them as ‘outside the scope of this assessment’. Another topic that was not addressed in the report is antibiotic residues, despite the World Health Organisation (WHO) highlight antimicrobial resistance (AMR) as a major public health concern15.   the context of our modern world, such significant health and ethical concerns are increasingly important for dietitians and registered nutritionists to incorporate within individual and population dietary advice and including these topics would have likely resulted in more favourable conclusions for plant-based milk alternatives.

One notable gap in the report is the lack of a clear call for minimum fortification standards for plant-based drinks. Although SACN and COT recommend that products be fortified with key nutrients, they also acknowledge that these products are currently not required to meet any minimum nutritional composition. Given the increasing use of plant-based drinks across the UK population, including among young children, this could have been an opportunity to strengthen public health protections and ensure consistency across the category.

While the SACN and COT report states its findings are based on an impartial review of the evidence, it is important to note that several members of the committee have declared links with the dairy and infant formula industries, which may have influenced the narrative and inflated concerns on plant-based drinks. This highlights the importance of transparency in nutrition policymaking and the need to consider a wide range of perspectives and evidence when forming public health guidance. As the population diversifies in dietary patterns, public health recommendations must reflect a wide range of evidence, free from disproportionate influence by any one sector.

Do plant-based drinks need to mimic dairy?

When dairy industry perspectives dominate, there is a greater risk that plant-based drinks are judged solely by how closely they match cow’s milk. A central question we can raise is whether plant-based drinks truly need to mimic the nutritional profile of cow’s milk. While comparisons can be useful for identifying potential nutrient gaps, this framing risks overlooking the broader dietary context in which these drinks are consumed. Rather than evaluating plant-based options solely against cow’s milk, it may be more meaningful to assess how they contribute to overall nutrient intake across varied dietary patterns, particularly as more people move towards plant-forward or dairy-free diets for ethical, cultural, or health reasons.

As dietitians, we should be cautious not to enforce a narrative that plant-based drinks need to be “just as good as” cow’s milk. Instead, we should celebrate the unique benefits they offer and encourage a holistic approach to nutrition.

Conclusion

Plant-based drinks are now a regular part of the UK diet, and this report offers valuable insight into their risks and benefits, particularly for young children. While there are some concerns raised in the report, particularly regarding free sugars and protein content in some plant-based drinks, it’s important to approach these findings with nuance as well as highlight the benefits such as increased fibre and vitamin D. We welcome the recommendations for the public on choosing fortified and unsweetened options, as well as the recommendations to the government and industry on developing research and more consistent fortification.

As nutrition professionals, we must go beyond product comparisons and consider how these drinks fit into diverse dietary patterns. Our role is to support informed choices, advocate for consistent fortification, and ensure public health guidance reflects the needs of all populations and their ranging health needs, cultural values and ethical beliefs.

References

  1. The cream of the vegan milk crop: Sales of oat milk overtake almond in the UK. Mintel. Published March 23, 2021. Accessed August 5, 2024. https://www.mintel.com/press-centre/the-cream-of-the-vegan-milk-crop-sales-of-oat-milk-overtake-almond-in-the-uk/
  2. Scientific Advisory Committee on Nutrition (SACN) & Committee on Toxicity (COT). Assessment of the Nutritional and Toxicological Aspects of Plant-Based Drinks. UK Government; 2025. Accessed August 5, 2025. https://www.gov.uk/government/publications/sacn-and-cot-assessment-of-plant-based-drinks
  3. Department of Health and Social Care. National Diet and Nutrition Survey: 2019 to 2023. UK Government. Published June 11, 2025. Accessed August 5, 2025. https://www.gov.uk/government/statistics/national-diet-and-nutrition-survey-2019-to-2023
  4. British Dietetic Association. BDA confirms vegan diets support healthy living. The Vegan Society. Published July 1, 2017. Accessed August 5, 2024. https://www.vegansociety.com/whats-new/news/british-dietetic-association-confirms-vegan-diets-support-healthy-living
  5. Feed Strategy. Cobalt or vitamin B12 for ruminant feeds? Feed Strategy. Published March 5, 2021. Accessed August 5, 2025. https://www.feedstrategy.com/blogs/feed-ingredient-insights/blog/15445375/cobalt-or-vitamin-b12-for-ruminant-feeds/
  6. The King’s Fund. Cardiovascular disease in England. The King’s Fund. Published July 2023. Accessed August 5, 2024. https://www.kingsfund.org.uk/insight-and-analysis/reports/cardiovascular-disease-england
  7. National Institute for Health and Care Excellence (NICE). Vitamin D: supplement use in specific population groups. NICE guideline PH56. London: NICE; 2014. Accessed August 5, 2025. Available from: https://www.nice.org.uk/guidance/ph56. Accessed August 5, 2025.
  8. Gardner CD, Hartle JC, Garrett RD, Offringa LC, Wasserman AS. Maximizing the intersection of human health and the health of the environment with regard to the amount and type of protein produced and consumed in the United States. Nutr Rev. 2019;77(4):197-215. doi:10.1093/nutrit/nuy073
  9. Scientific Advisory Committee on Nutrition (SACN). Carbohydrates and Health. London: The Stationery Office; 2015. Accessed August 5, 2025. https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report
  10. Shipton MJ, Thachil J. Vitamin B12 deficiency – A 21st century perspective . Clin Med (Lond). 2015;15(2):145-150. doi:10.7861/clinmedicine.15-2-145
  11. Fritz K, Taylor K, Parmar M. Calcium Carbonate. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 5, 2023.
  12. Oliveira FRK, Gustavo AFS, Gonçalves RB, et al. Association between a soy-based infant diet and the onset of puberty: A systematic review and meta-analysis. PLoS One. 2021;16(5):e0251241. doi:10.1371/journal.pone.0251241
  13. Lee SA, Shu XO, Li H, et al. Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women’s Health Study. Am J Clin Nutr. 2009;89(6):1920-1926. doi:10.3945/ajcn.2008.27361
  14. Li N, Wu X, Zhuang W, et al. Soy and Isoflavone Consumption and Multiple Health Outcomes: Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies and Randomized Trials in Humans. Mol Nutr Food Res. 2020;64(4):e1900751. doi:10.1002/mnfr.201900751
  15. Pires AJ, Pereira G, Fangueiro D, Bexiga R, Oliveira M. When the solution becomes the problem: a review on antimicrobial resistance in dairy cattle. Future Microbiol. 2024;19(10):903-929. doi:10.2217/fmb-2023-0232

 

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