Milk is a strangely polarizing topic. The OG version from a cow and the plant-derived varieties have been the topic of starry magazine advertising campaigns (who could forget “Got milk?”) and takedown investigations. I experienced it firsthand a few years ago after posting on social media about my return to whole cow’s milk after a Goldilocks journey through the alternatives. The number of responses—and the uproar I faced for confessing that I favored whole milk—was beyond anything I had experienced. And with the recent rise of “raw” milk (aka untreated milk that is lauded by some as a health cure-all and others as a bacteria-spiked death wish), left us wondering—which type of milk is actually healthiest?
The experts warn: The answer isn’t quite so one-size-fits-all.
“In the past, places had ranked different types of milks based on calorie content or saturated fat, but today’s literature and research stress the importance of insulin and blood-sugar management over calories and fat,” says Taz Bhatia, an integrative-wellness physician and author of The Hormone Shift. “When it comes to rating different kinds of milks on their nutritional quality, it is actually tough because each has unique and distinctive properties.”
When your blood sugar is out of whack (also called hypoglycemia), you may experience cravings, lack of energy and fatigue, acne, poor sleep, and brain fog.
The Food and Drug Administration urges label literacy when it comes to choosing the best milk for you, whether you’re drinking it straight, adding it to your morning coffee, or mixing it into your breakfast. At the end of the day, though, one thing is certain: There’s a clear worst milk out there. Read on for some advice.
Cow’s Milk
Even within the world of traditional milk, there are a variety of options. First up, pasteurized milk, which is most likely the one you’re seeing at your local grocery store.
In 1924, the FDA passed the Standard Milk Ordinance (now known as the Pasteurized Milk Ordinance), which was intended to standardize and enhance safety measures for dairy products across the United States. The process of pasteurization can be distilled down to this: Once the milk is procured, it’s flash-heated for around 15 seconds to kill harmful microbes that could be deadly.
When it comes to milk, there are so—so—many different options, from whole and 2% to non-fat and lactose-free. Across the varieties, the nutritional profile is comprehensive: calcium, potassium, magnesium, zinc, iodine, and vitamins A, B, and D. The FDA adds that cow’s milk contains three nutrients (calcium, potassium, and vitamin D) that many Americans are lacking, which makes it a great choice…for those who can stomach it. Around 36% of Americans have some sort of issue digesting lactose, the natural sugar found in milk. “When we strip milk of its fat, we reduce the calories, but we also worsen its impact on our glucose levels,” says French biochemist Jessie Inchauspé, who is known online as the Glucose Goddess.
If you don’t fall into the lactose-intolerant camp, Dr. Bhatia urges you to go for cow’s milk in your diet. “If I had to pick one, this is it because of its protein content—but make sure you always choose organic,” she says. It’s a favorite of Inchauspé’s, too.
Raw milk, also referred to as unpasteurized milk, has not been treated for bacteria or pathogens. With the launch of “Make America Healthy Again,” it’s been a major topic of conversation. There is a single, small study that found that consuming raw milk may help with asthma and allergies, though it should be noted that other rural exposures (dirt, hay, ect) in general have been studied more broadly to help as well.
Raw milk and pasturized milk have essentially the exact same nutritional profiles when it comes to things like protein, sugar. There are slightly lower levels of vitamins, which are lost during the heating process.
Most medical professionals and public health experts agree that raw milk isn’t worth the potential illness (Salmonella and E. coli are two of the most prevalent pathogens found inside). Recently, MAHA-adjacent Ballerina Farms had to halt their raw milk production because harmful bateria was found in their product. Whether or not it’s legal to sell the stuff varies from state-to-state.
Alternative Milks
Regardless of why somebody might prefer alternative dairy options, there are a few rules to follow. “When choosing a nut milk, select an unsweetened variety to lower the overall sugar load that many of these nut milks already naturally have,” Dr. Bhatia says. “Remember, nut milks don’t have a lot of protein to begin with, so when sugar is added to it, we are impacting the glycemic index—or rise in blood sugar—in response to what we’re eating.”
Made from the same legume soy (aka edamame and tofu), soy milk is typically fortified or has additional nutrients added during the production process. You can expect calcium and vitamins A and D. While it’s a great option for those with a dairy intolerance, Dr. Bhatia warns, “soy milks are typically more processed than other alternative milks, which means they have more sugar. I like to limit overall soy consumption, especially processed soy, to under about three servings per week.”
Recently demonized because of the toll it has on the environment (this study found it’s second in water use after cow’s milk), almond milk is made from waterlogged almonds—and leaves behind the by-product of almond meal. This is one of the alternative milks that Inchauspé suggests because it has a “normal glucose response” after consumption. Dr. Bhatia says it’s “lower on my list” of choices she suggests.
This darling of indie coffee shops may not actually be as good for you as you hoped. “My least healthy pick is oat milk,” Dr. Bhatia says. Inchauspé agrees and has spoken to Vogue in the past about the perils of the choice. “While it does have fiber, it also has a lot of sugar and very little protein, so it will spike your blood sugar. Honestly, there are many better sources of fiber.”
Different from the liquid found inside a coconut (that’s electrolyte-rich coconut water), coconut milk comes from pressing the meat. And while it does have a distinctly sweet taste, Dr. Bhatia says that’s okay: “Coconut milk may be [the] second-best alternative-milk choice because it simply has saturated fat, which does not allow blood sugar to rise dramatically, and has medium-chain triglycerides to support the gut microbiome.”
Dr. Bhatia hit us with a surprise suggestion at the end of our interview: “The best milk for someone who is vegan is hemp milk,” she advises. Made from the seeds of the Cannabis sativa plant, it is more earthy than other varieties. “It actually has a decent amount of protein, has some dietary fiber, and is very gentle on the gut.”
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