The Shift to Less Frequent Milk Consumption and the Rise of Alternative Milk: United States, Aged 2+ Years, 2009–March 2020

Objectives: Fortified dairy and soy products are important dietary sources of potassium, calcium, and vitamin D. Non-soy, plant-based, "alternative milks" have become more available to consumers. The objective of this study was to describe trends over the prior decade in the frequency of milk consumption and the type of milk consumed by daily milk consumers in the U.S. population. Methods: Responses to a limited 30-day food frequency questionnaire within the National Health and Nutrition Examination Survey were analyzed for five cycles from 2009–2010 through 2017–March 2020 (n=52,190). For the U.S. population aged 2+ years, the percentages that never or often (at least once daily) consumed milk in the last 30 days were calculated. Daily milk consumers (n=24,373) were categorized into two mutually exclusive groups by type of milk consumed: 1) any dairy or soy milk and 2) only alternative milk. For all percentages, time trends during 2009–March 2020 were analyzed using logistic regression (unadjusted and adjusted for age, sex, race/ethnicity, and income), accounting for the complex survey design and for unequal survey cycle length. Results: In 2009–March 2020, the percentage of the U.S. population that did not consume milk in the past 30 days increased (12.8% to 19.5%) and the percentage that consumed milk at least once daily decreased (49.6% to 34.1%). Among daily milk consumers, the proportion that consumed any dairy or soy milk decreased (98.2% to 92.7%), while the proportion that consumed only alternative milk increased (1.8% to 7.3%). All time trends were statistically significant (P < .001). Adjusting for age, sex, race/ethnicity, and income did not alter the direction or significance of the trends. Conclusions: Over the prior decade, the U.S. population has shifted to less frequent milk consumption. Among daily milk consumers, the proportion that consumed only alternative milk quadrupled. Funding Sources: None.