Managing your IBS (Irritable Bowel Syndrome) can feel like a constant balancing act. You have to deal with a range of often unexpected symptoms, like bloating, abdominal pain, diarrhoea and constipation. It can be really confusing when you’re trying to decide which products to choose that will be best for your health without upsetting your tummy.
Have you ever stood in the supermarket aisle in front of a wall of cartons wondering where to start? When it comes to lactose-free milks and plant-based alternatives, it’s a minefield due to the huge range of options available. There’s a lot to consider before settling on the best one (or ones) for you. What are the low FODMAP options? What is a low FODMAP portion size? Does it provide useful nutrition? That’s all before even thinking about whether or not you like the taste!
This blog is a guide to help you to make an informed decision about which low FODMAP milk alternatives to go for if you’re struggling with IBS symptoms. Whether you’re a seasoned vegan, plant curious, or somewhere in between, I’m here to help you choose the right milk for you, without compromising your gut health or principles.
If you want to learn more about following the low FODMAP diet as a vegetarian or vegan, have a read of this blog I’ve written just for you.
I’ve tried to give you an overview of the nutritional profile and the FODMAP content of milk and milk alternatives. As well as a balanced view of the pros and cons of each plant-based milk alternative to help you make an informed decision about which milk alternative is best for you.
Low FODMAP milk alternatives: an overview
Here’s a useful at-a-glance summary of the selection of plant-based and low FODMAP milks available on the market that have been tested by Monash University. This Australian university is where the low FODMAP diet was developed. They regularly tests and retest foods for FODMAP content. The following tested milks and milk alternatives are in order of lowest to highest FODMAP content.
| Milk / milk alternative | Safe low FODMAP serving size | FODMAPs contained in higher serving sizes |
|---|---|---|
| Soy (made with soy protein) | 257 ml | None |
| Lactose free dairy milk | 250 ml | None |
| Almond | 240 ml | None |
| Rice | 200 ml | None |
| Macadamia | 240 ml | None |
| Quinoa | 240 ml | None |
| Coconut (unsweetened) | 180 ml | Sorbitol |
| Oat | 140 ml | Galacto-oligosaccharides, fructans |
| Hemp | 120 ml | Fructans |
| Soy, unsweetened (from soy beans) | 30 ml | Galacto-oligosaccharides, fructans |
| Cow’s milk, regular fat (for reference) | 20 ml | Lactose |
A note on sweetening; sweetened varieties contain more fructans and fructose from the sweetener used, which is typically apple extract. Therefore, the FODMAP limit will go down to a lower allowed serving size. Try to choose unsweetened varieties if you can.
Nutritional content of low FODMAP milk alternatives
The nutritional content of plant-based milks is variable, partly due to their diverse sources and processing methods. For instance, different almond drink varieties have a wide range of calories and fat depending on the brand.
Due to the generally poorer nutritional content of plant-based milk alternatives, complete replacement of milk with a plant-based drinks without adjusting your overall diet can lead to deficiencies of certain important nutrients in the long term. Generally, it is a good idea not to rely on one alternative to optimise your nutritional intake. Instead, opt for a combination of plant-based alternatives as part of a balanced diet to ensure you meet macro- and micro-nutrient needs.
Here’s an overview of the nutritional content of plant-based alternatives and how they compare to cow’s milk.
Energy
Almond drink, hemp drink, pea drink, flax drink, macadamia drink, and quinoa milk alternatives all are lower calorie options, compared to semi-skimmed cow’s milk, which has about 50 kcal per 100 ml.
Oat drink, rice drink, and certain types of coconut drink and hazelnut drink are similar to or higher calorie compared to semi-skimmed cow’s milk. The highest energy milk alternatives I found were hazelnut and tiger nut drinks at 70 and 74 kcal per 100 ml respectively. This is only slightly higher than whole milk at 65 kcal per 100 ml, so would not be considered a high calorie product.
Fat
Many milk alternatives like almond, soy, rice, hemp, flax and pea milk alternatives tend to have fat contents similar to or less than that of semi-skimmed cow’s milk, which contains 1.8 g of fat per 100 ml.
Some varieties of coconut, macadamia and cashew milk alternatives provide more fat per 100 ml than semi-skimmed cow’s milk, especially macadamia with 2.9 g of fat per 100 ml. This is still lower than the fat content of whole cow’s milk, which is 3.7 g per 100 ml.
The fatty acid profile of plant-based milk alternatives are healthier with higher levels of the mono- and poly-unsaturated fatty acids compared to cow’s milk, which contains more saturated fatty acids. The exception is coconut-based drinks which contains medium chain triglycerides, a shorter and healthier type of saturated fatty acid.
Protein
Soya milk often contains a protein content close to that of cow’s milk, making it a good alternative for those looking to maintain protein intake, as long as you can tolerate it in larger amounts.
Otherwise, plant-based drinks are very low in protein compared to cow’s milk and can’t be relied upon as a significant source of protein.
Vitamins and Minerals
While plant-based milks offer the nutritional benefits already discussed, it’s important to choose versions that are fortified with nutrients and that are low in added sugars if possible to maximise health benefits. Added vitamins and minerals tend to include calcium, vitamin D, B vitamins and iodine.
As organic varieties will not be fortified with vitamins and minerals, I recommend choosing non-organic varieties if that option is available. But generally, you should pick the plant-based milk that’s best for you, taking into account the FODMAP content first, if that’s relevant to you, followed by both the nutritional content and your preference for taste.
Which milk alternatives are low FODMAP?
Low FODMAP milk alternatives are those that can be drunk in larger amounts, over around 200 ml, which is a small cup. They are soy milk made with soy protein, lactose free dairy milk, almond milk, macadamia milk, quinoa milk and rice milk. These don’t contain any FODMAPs in a normal portion size and can be used in smoothies, on cereal, in cooking and baking and any way you like! They do have different nutritional profiles and tastes and some work better for certain uses than others.
Not all plant-based milk alternatives have been tested by Monash University. They include cashew, pea, flax, hazelnut and tiger nut milk.
However, we can make an educated guess about their suitability on the low FODMAP diet if we compare them to other plant-based milk alternatives that have been tested. For example, almonds, which are low FODMAP up to 12 g, produce a milk that is suitable up to 240 ml. This indicates that any other nuts with a similar FODMAP profile would also be suitable in the same amount.
Lactose free milk
Lactose free milk is made from cow’s milk by adding the lactase enzyme directly to the milk to break down the lactose into simpler sugars which are easier to digest. Other than being almost lactose free, the benefit of lactose free milk is that is contains all the nutritional benefits of dairy milk. These include being high in protein, vitamins C, A, K2, B2, biotin, pantothenic acid (B5) and vitamin B12 and minerals phosphorus, potassium, calcium, zinc, sulfur, iodine and chloride.
Is lactose free milk low FODMAP?
Yes, lactose-free milk is low FODMAP as almost all the lactose has been removed. Monash give lactose-free milk a low FODMAP serving size of 250 ml.
If you do struggle with dairy intolerance, you are still likely to tolerate some lactose. So it’s worth testing how much you can have before your IBS symptoms start to appear. You may not need to buy all your dairy products without lactose and hard cheese and butter is naturally low in lactose.
Lactose-free products have the benefit of all the nutrients in dairy but without the lactose so it’s a great choice if you’re someone who struggles with dairy intolerance, but it is obviously unsuitable on a vegan diet.
Almond milk
Almond milk is light and has a slightly sweet, nutty flavour. It is one of the plant-based milk alternatives, with soya milk, that is naturally high in the antioxidant vitamin E and also the mineral phosphorus.
Is almond milk low FODMAP?
Almonds are a low FODMAP nut in amounts up to 12 g (10 nuts). Larger portions become high in galacto-olicosaccharides (GOS, the ‘O’ in FODMAP for oligosaccharides) and therefore have to be limited.
So, yes, almond milk is suitable on the low FODMAP diet in any amount, having been tested up to 240 g. This means you can use it in any way you like, including drinking a full glass or using it for your lattes and smoothies and on cereal.
Does almond milk constipate you?
Have you ever wondered, ‘does almond milk cause constipation’? It has been speculated that almond milk can constipate some, however this happily doesn’t seem to be the case. There is no evidence to indicate a problem with almond milk itself causing constipation. Of course, drinking more of any fluid can help to relieve constipation, including almond milk.
Confusion may be related to some containing calcium carbonate, a common additive to plant-based milks to provide the essential mineral calcium. Calcium carbonate has been linked to constipation, flatulence and bloating at doses of 1200 mg/day and above. This is a very large amount of calcium and you would need to drink at least 1 L per day of fortified plant milk to achieve this level of calcium carbonate.
Calcium supplementation is a good idea for supporting those who don’t eat and drink dairy to meet their daily requirements for maintaining bone health (700 mg per day for most adults in the UK). You wouldn’t need to worry about the calcium carbonate content even if you were getting all your calcium from 3-4 portions of fortified dairy alternatives.
There is also the possibility that some sweeteners in plant-based milks could cause IBS symptoms. High FODMAP additives include apple extract and polyols (such as mannitol and isomalt), which could contribute to IBS issues if you are sensitive to these.
Rice milk
Rice milk drink is the most hypoallergenic of all the plant milks. Commercial rice milk drink is made from milled rather than cooked rice. It has a naturally sweet taste and a higher carbohydrate content than other plant-based milks. It is low in protein and other nutrients but is a useful alternative for those with a nut or soy allergy.
However, rice milk has been found to contain the highly toxic element arsenic, therefore regular consumption of rice drinks could significantly contribute to arsenic exposure. If you are using rice milk, it is a good idea to avoid having it as your main milk alternative and not to rely on it as a sole milk replacement. This is especially true for infants, children and pregnant women.
Rice milk is low FODMAP in larger amounts and has been tested up to 200 ml, so you could use this in smoothies, on cereal and in baking.
Macadamia nut milk
Macadamia nut milk alternative offers a rich, creamy texture with a subtle, buttery flavour, which is great for coffee and smoothies. It has a healthy fat profile, mainly from monounsaturated fatty acids and provides a small amount of protein, however more than many alternative milks.
Unfortunately it is not readily available to buy in the UK, but it could easily be made at home and lasts for a few days in the fridge – see the end of the blog on how to make nut drinks at home.
Macadamia milk is low FODMAP up to 240 ml so it could well be worth making yourself if you can’t get it in the shops or online.
Quinoa milk
This is another milk alternative that is suitable on the low FODMAP diet and for those with nut allergies. It has a unique, mild nutty flavour, making it a good choice for breakfast cereals and in smoothies. It is a little higher in protein than the nut milks due to quinoa’s high protein content and is a good source of antioxidants and minerals, including magnesium and iron.
When I was researching the plant-based milk alternatives, I found that quinoa milk was usually combined with rice milk. Even then, it is very difficult to find to buy and you may want to try making it yourself if you’re not keen on the available milk alternatives.
Pea milk
Pea milk is made from yellow split peas. It is one of few plant-based milks that are high in protein, including all 9 essential amino acids, with similar levels to cow’s milk. It has a creamy texture and a flavour not dissimilar to soy milk, if a bit pea-like.
Although pea milk hasn’t been tested by Monash, pea milk made from pea protein only is likely to be low FODMAP. It is available in the UK made from pea protein isolate from Mighty and Sproud brands. It would be a great all-rounder, being suitable for a wide range of uses.
Hazelnut milk
Made from blended hazelnuts, it has a rich, nutty flavour and is great with chocolate as we all know. This makes it perfect for coffee, desserts and drinking on its own.
Hazelnut milk is rich in healthy monounsaturated fatty acids and contain B vitamins, vitamin E and the minerals calcium, magnesium and potassium.
Hazel nut milk has not been tested by Monash, however since hazelnuts are a low FODMAP nut, when eaten in moderate amounts of 15 g, it is likely that the milk is low FODMAP. We can compare it to almonds, which are low FODMAP up to 12 g, where the milk is suitable up to 240 ml.
This could be a brilliant choice for those looking for an indulgent and low FODMAP option. In the UK, hazelnut milk is available from Alpro, Rude Health and Plenish.
Flax milk
Produced from flax seeds, it’s light and has a mild flavour. Rich in omega-3 fatty acids, it’s good for drinking straight, in cereals, or in smoothies.
Flax seeds are suitable on the low FODMAP diet up to 15 g (1 tbsp), therefore it is likely that flax seed milk is suitable in moderate amounts, up to a small cup.
Unfortunately, I have not been able to find this anywhere in UK shops or online so it’s one you’d need to make at home.
Tiger nut milk
Also known as horchata de chufa, tiger nut drink is made from tiger nuts. They are not actually nuts but a small tuber. They are native to Southern Europe and North Africa and have a sweet, nutty and slightly earthy flavour and a creamy texture. It is popular in Valencia in Spain where is traditionally served sweetened and cold.
Nutritionally, tiger nut milk is rich in healthy monounsaturated fats and rich in vitamins E and C and minerals potassium and phosphorus.
Tiger nuts have been tested by Monash and are low FODMAP at 20 g. This means they are very likely to produce a low FODMAP milk drink. This one is yet to make it to our stores, but a trip to Spain would be a good opportunity to stock up. Just be careful to buy an unsweetened variety.
If you’re interested in learning more about managing IBS on a plant-based diet, download my my free guide on diet and lifestyle changes to improve bloating and gut pain:
Which milk alternatives are high FODMAP?
These milks are to be avoided or included in smaller amounts when you’re following a low FODMAP diet. Normally, after following a strict low FODMAP diet for 4-6 weeks, you would test each FODMAP group separately to identify your tolerance levels. So it may not be necessary to avoid them in the long-term.
Coconut milk
Coconut milk for drinking is made from the white flesh of mature coconuts, boiled and mixed with water, then strained. It is lower in fat than coconut milk in cans used for cooking. Nevertheless, it has a creamy texture and a tropical flavour and can be used to add a creaminess to desserts and tropical smoothies.
UHT coconut milk used as a drink is low in protein but high in vitamin C, iron, magnesium, potassium and other minerals. It is naturally high in medium chain triglycerides, which are thought to have numerous health benefits including weight management and improved psychological health.
Coconut milk contains the FODMAP sorbitol (a polyol). The low FODMAP limits are 180 g for the unsweetened variety and 120 g for the sweetened variety, as it contains fructans in larger amounts. Therefore, it could be a good option for those who are sensitive to FODMAPs as long as you stick to the limits. At 120 g, you could still just about use this on your cereal but could definitely use it safely in baking and with hot drinks.
Oat milk
Oats themselves are low FODMAP and can be used for baking and as a low FODMAP breakfast, for example porridge or overnight oats. Oat milk is gaining popularity as an alternative to dairy in lattes as it froths up well and has a sweet and creamy flavour. It is also useful in baking and in cereal due its sweet and creamy flavour.
Oat milk is generally low in micronutrients, but it is unique in that it contains some beta-glucans. This is a type of soluble fibre, which is a prebiotic and therefore good for your gut bacteria, but may cause IBS symptoms in some.
Is oat milk low FODMAP?
In amounts over 140 g (just over half a cup), oat milk contains moderate to high levels of GOS and fructans. This means you wouldn’t even get a small latte out of it, although it would be suitable to use in baking and on cereal, as long as you stick to the low FODMAP portion.
Hemp milk
Made from hemp seeds, it offers a slightly nutty, earthy flavour. It is low in protein but can provide essential omega-3 fatty acids and is high in vitamins E and K and the mineral copper.
Hemp milk is low FODMAP at servings of 120 ml (half a cup), above which it contains fructans. It could be a good option for adding a source of omega-3 fatty acids in smoothies in small amounts, on cereal, in cooking and in your tea and coffee.
Soy milk
Soy or soya milk drink has the nutritional profile closest to dairy milk of all the plant-based alternatives. It naturally provides a significant amount of vitamin E and the minerals phosphorus, manganese, zinc, iron, magnesium and copper. It contains a similar amount of protein to milk and contains all 9 essential amino acids.
Is soy milk low FODMAP?
Soybeans themselves are not low FODMAP as they contain large amounts of GOS (galacto-oligosaccharides). Soy milk is such a popular alternative to diary, there are now many different forms available. The FODMAP content of the milk depends on how it was processed.
Low FODMAP limits of different soy milks:
- Soy milk made from soybeans: 30 ml
Milk produced using the soybean is high in FODMAPs due to the GOS and fructans leaked into the milk during production. This amount makes this version suitable for a cup of tea or coffee but you wouldn’t be able to have a soy latte unfortunately.
- Soy milk made from hulled soybeans: 60 ml
Soy milk made with hulled soy beans is lower in GOS because some has been removed in processing. This gives you a slightly more generous portion to have in your hot drinks and could be used in baking, but we’re not up to latte or cereal level.
- Soy milk made from soy protein: 257 ml
If you can find soy milk made from soy protein, you can have it in pretty much unlimited amounts on a low FODMAP diet as the GOS is removed entirely during processing. However, this doesn’t seem to be available in the UK unfortunately. Hopefully it’s only a matter of time!
- Sweetened soy milk: 60 ml (moderate serving)
Sweetened varieties contain more fructans and fructose from the sweetener used, which is typically apple extract. A moderate FODMAP serving is 60 g, there is no low FODMAP serving, so you would have to be very careful about avoiding any other FODMAPs within about 3 hours either side if using it.
Cashew milk
Cashew milk is rich and creamy with a subtle sweetness, making anything you add it to taste more indulgent. Like most other plant-based milks it is low in protein and fibre but is a good source of vitamin E and the minerals magnesium, selenium and copper.
Monash haven’t tested cashew milk yet, however raw cashews are high FODMAP at all serving sizes, containing both GOS and fructans. Therefore, it is unlikely that any amount would be suitable on a low FODMAP diet.
You can buy it from shops in the UK from the Plenish and Rude Health brands. Unfortunately, they are not fortified with vitamins and minerals as they are both organic varieties, therefore you would need to be careful you were consuming a varied diet if you were to choose this as your main milk.
How to make milk from nuts and grains
Unfortunately, some milk alternatives aren’t easy to find in the shops or even online, in the UK. These include macadamia, quinoa, hemp and flax milk. So, here’s a quick guide to making your own at home. It is quite simple and it will save you a lot of money. All you need is a fine mesh (you can also use a clean tea towel) and basic kitchen equipment. Your ‘milk’ should be kept in the fridge and will stay fresh for 3 days.
How to make nut and oat milk
If you want to make a nut or oat milk, you would take the raw nut or oats, soak them in water overnight. Once soaked, blend the nuts or oats with fresh water, using a ratio of 1 cup of soaked nuts or oats to 3 cups water, and then strain out the solids through a fine mesh to produce the nut drink.
How to make milk from grains
To make quinoa and rice drinks, first rinse well then cook grain to soften it. Next, blend this with water (ratio 1 cup cooked grain to 3-4 cups water) and strain the mixture through a fine mesh to produce a smooth drink.
Tips for Bringing Low FODMAP Milk Alternatives into Your Diet
If you’re managing IBS and looking to include low FODMAP milk alternatives in your diet, start by exploring options like almond milk, lactose-free cow’s milk or rice milk. These can be great substitutes in your daily meals, whether you’re pouring them into your morning cereal, blending them into smoothies, or using them in cooking recipes.
It’s crucial to read the labels on these products carefully. Watch out for additives like inulin, oligofructose, prebiotics and sweeteners, including apple extract, which are high in FODMAPs and can trigger symptoms.
Finding the right milk substitute can be a personal journey, so experimenting and tracking how you feel can help you effectively manage your IBS symptoms.
Conclusion
The world of lactose free and plant based milks can be challenging, even before having to think about which are suitable for IBS.
In this guide I have taken you through the various options available, from soy and almond to less common alternatives like tiger nut and quinoa milks. Each type offers distinct nutritional benefits and vary in their FODMAP content, making them suitable for different dietary needs and preferences.
I hope you feel better equipped to stand confidently in that supermarket aisle and select the best plant based, low FODMAP milk alternatives that will not only please your palate but also soothe your gut.
Remember, plant based milks vary greatly in terms of nutritional content. Therefore, it’s wise not to rely solely on one type but rather to incorporate a small range of these milks into your diet to ensure a balanced intake of nutrients. Always opt for unsweetened varieties to avoid high FODMAP sweeteners and consider fortification to support your overall nutrient requirements.
Thank you so much for reading. Please comment below to tell me what the most useful thing you learnt from this blog or to ask any questions. Sign up to my newsletter to get handy tips and weekly updates to help you manage your IBS on a vegetarian or vegan diet:
