Perspective: Identifying Ultra-Processed Plant-Based Milk Alternatives in the USDA Branded Food Products Database

This study explored the characteristics of plant-based beverages (PBBs) that are marketed as "milks" in the United States. First, machine searches of product names and ingredients in the USDA Branded Food Products Database (BFPDB) yielded 641 nondairy PBBs that included almond, soy, coconut, cashew, other tree nut, flax/hemp, pea, and quinoa and rice "milks." The products varied in energy density and the majority of PBBs contained added salt (69%) and added sugar (53%). Scores on nutrient density metrics [Nutri-Score, Choices, and the Nutrient Rich Food index 7.3 (NRF7.3)] were higher for almond and pea products and lower for coconut PBBs, which contained saturated fat. Ingredient lists were searched further for added flavors, stabilizers, or preservatives said to be characteristic of the NOVA food classification system's ultra-processed group. Most PBBs (90.1%) and 95% of almond milks met the NOVA criteria for ultra-processed foods, because they were created from food components and contained multiple substances not used in normal cooking. Replacing milk and dairy products with plant-based alternatives will necessarily involve the use of ultra-processed foods.