Could Plant-Based Milk Be the Future of America’s Diet: An Interview with Tiffany Bruno, MS, RDN

When it comes to eating plant-based, excluding dairy has often been seen as a separate battle from excluding meat. Many can support the idea of reducing their meat consumption; the same can’t always be said for their milk or cheese. Vegetarians draw the line at giving up dairy. Milk and other dairy products are also found in a wide variety of foods you wouldn’t think of (breads, candies, etc.) that not consuming it at all feels herculean, and perhaps even a bit silly. 

Vegans of course think differently, but it’s not at all easy to convince others that a dairy-free diet is actually well worth adopting. Dairy-free cheeses are still ‘fake cheeses’. Alternative milks are still ‘alternative’, not the norm. 

All of which begs the question: what does a dairy-free life actually look like? 

Tiffany Bruno, MS, RDN . Image provided by Tiffany Bruno .

Tiffany Bruno, MS, RDN is the Director of Education at Switch4Good, a non-profit organization that advocates for a dairy-free lifestyle. Her work involves heavily advocating for better access to plant-based milk, while also educating the public on what plant-based milks have to offer. I had the rare treat of speaking with her about her work, the struggle to make plant-based milk more prominent in American Dietary Guidelines, and the current barriers to adopting a dairy-free lifestyle. 

The Tenacity of Dairy-Forward Thinking

Image from Georgia Grown

It’s undeniable that Americans are stubbornly in love with all things dairy: cheese, milk products, yogurts. Despite the heavy influx of alternative milks now available in almost every supermarket, dairy milk is here to stay, where it’s been a fixture in healthy American diets for four centuries and counting. Many of our most beloved meals (macaroni and cheese, cheeseburgers, lasagne, etc.) involve heaping amounts of dairy. 

And yet, dairy is not a healthy product for a wide variety of Americans. According to a 2017 study by Storhaug, Fosse, and Fadnes, an estimated 68% of the world’s population suffers from lactose malabsorption (affecting approximately 36% of the American population). 

Instead of shifting instead to dairy-free products however, many lactose sensitive or intolerant Americans will either ‘suffer the consequences’ or use Lactaid. This latter product has been marketed to me on several occasions. Though well-meaning, the people who do so often don’t understand that excluding dairy is sometimes a purposeful choice, one that’s grounded not only in sensitivity to the environment and animal cruelty, but also for health reasons. 

‘Lactaid is the enzyme lactase,’ Tiffany says when I asked her why Lactaid isn’t the miracle cure that many people believe it is. ‘All mammals produce lactase at birth, but it starts to decrease as we age as we no longer need to consume and digest breast milk anymore. Some people have a genetic mutation where their body continues producing lactase into adulthood, and are the people who don’t suffer from consequences after consuming dairy.’  

More to the point though, ‘your body is trying to tell you something’ if it’s sensitive to dairy. To use Tiffany’s analogy, ‘If you’re constantly hitting your head on a doorway, you need a different doorway.’ 

That’s where plant-based dairy comes in. It’s the perfect solution. In using a plant-based cheese or milk, not only will people hardly notice the difference, everyone is able to enjoy it without falling prey to illness. Isn’t this much easier in the long run? 

The Benefits of Dairy-Free Products

But what are the specific benefits of consuming plant-based milks and other dairy-free products? Many discuss the benefits of shifting to dairy-free milks for sustainability reasons, or to lessen animal cruelty. Tiffany explained to me just how beneficial plant-based milks are, just by themselves. 

Soy milk, for instance, is especially wonderful. It’s full of phytoestrogens, which help in protecting against certain illnesses. The consumption of it lowers your chance of developing prostate cancer. Populations that consume more soy milk have lower instances of breast cancer (a far cry from the disclaimed theory that soy milk actually causes it). A 2024 study also found that consuming soy milk, compared with dairy milk, leads to better cardiometabolic health. 

What’s more, plant-based milks, like all plant-based foods, are high in antioxidants. While a carton of oat milk might not have as much as say blueberries or kale, it’s better than not having any (dairy milk is void of antioxidants). And just like dairy milk, they can be pumped with calcium, vitamin B12, and vitamin D, all the necessary vitamins that we all need to live healthy lives. 

But despite these things, many cling to the fact that dairy milk is still healthy, even imperative, for us to drink. Doctors promote its consumption, schools, nursing homes, and hospitals still make it the default milk in all their food. Why is this? 

Dietary Guidelines

To answer this, you have to know about Dietary Guidelines. Like most people, I’d only heard of them by name, but knew little about how they’re developed or how they affect the average American consumer. Tiffany on the other hand, is an expert in what they are and how they’re created.

The ‘Basic 7’ (USDA 1943). Image from Research Gate

The History of Food Guidelines in America

Before 1943, the federal government had never interfered in suggesting what Americans should and should not eat. In the midst of WWII however, food shortages made it difficult for Americans to get the proper nutrition. The American government released a basic food guide to help determine what foods were the most nutritious and valuable to consume. This was meant more as a survival guide to assure Americans obtained the necessary vitamins (particularly if they were lacking certain foods).  

Thirty-seven years would pass by until the next guide was published, in 1980. By then, food science had developed considerably. In 1977, the U.S. Senate created a Select Committee on Nutrition and Human Needs, its purpose being to help Americans eat nutrient-rich meals and achieve better health. Back then, their goals included reducing sugar and sodium, making fat consumption 30% of energy consumption, and reducing cholesterol consumption. The 1980 guidelines proposed these exact points.  

While not all institutions in America have to follow these guidelines, those that were formed from federal nutrition programs are bound to follow them. These include the National School Lunch Program (NSLP), the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and nutrition programs that affect institutions for the elderly. Other institutions not bound by the DGA often still follow the guidelines as those they were. Medical institutions and private universities often cite the Guidelines in their decisions to offer and advocate for certain foods. State and local governments will often turn to the DGA for their own food initiatives. Even non-profits will use the Guidelines as their guiding star in their health and wellness programs. 

The Process

Since 1980, new Dietary Guidelines have been published every five years. Nowadays, the process has become firmly established to include outside expert guidance. ‘What happens first is the USDA and Health and Human Services departments come together to create a Scientific Advisory Committee, Tiffany begins. This board is composed of twenty experts in the field working outside the federal government: nutritional experts, doctors, and researchers.  These experts don’t generally have ties to the food industry, but if they do, they’re meant to disclose this. Once formed, the board reviews all the recent analyses of food. It’s a herculean task, and one that involves thousands of hours deciphering the latest evidence of what food does for our health. 

The result of this is a 421 page document that’s sent back to the USDA and HHS. This document makes recommendations based on the research they collectively reviewed. From there, a second (completely anonymous) committee is formed that creates the actual Dietary Guidelines that are published and later dispersed to the public. The results aren’t always consistent. While the 1980 Guidelines promoted reducing several foods, later versions opted to focus more on moderation. Nor are the guidelines always as novel as we might like. The Dietary Guidelines published in 2015 for instance, despite heavy research regarding the health concerns from consuming red meat, said nothing about this.

The 2020 published Dietary Guidelines, including soy milk as an alternative to dairy milk. Image from dietaryguidelines.gov

The Guidelines and the Plant-Based Movement

In terms of the dairy-free movement, it wasn’t until 2020 that soy milk became a ‘dietary equivalent’ to dairy milk on My Plate (formerly the Food Pyramid), and this after extensive advocation for the benefits of soy milk and hundreds of studies proving that dairy milk consumption can lead to health issues for several patients. 

Obviously, this raises significant concerns. ‘Can we even trust these guidelines, then?’ I ask Tiffany. For despite the intensive process that goes into their creation, it seemed to me that very little has changed with regard to dairy-free options. Tiffany says the answer is yes and no. ‘If you have a medical condition, or dietary preference, they might not apply. But there’s also a lot of work that goes into making them adaptable for different needs.’ Tiffany also provided the example of traditional Asian eating patterns, which hardly include any dairy. Their populations are some of the healthiest. ‘It’s simply not equitable to say to someone that their diet isn’t healthy because it doesn’t fit this mold,’ she states, the mold being of course the guidelines. 

Nutritional Studies

This had me thinking about nutritional studies. Why is it so hard to collect solid data from a study done on food? If these are the key to making important changes to our Dietary Guidelines, guidelines that affect more of us than I’d realized, why aren’t the results making a difference?

For starters, research in food is incredibly difficult, just by the mere fact that food is a complicated thing to begin with. And with food, results can often be interpreted the way people want them to be. When doing a study on how dairy consumption affects blood pressure for instance (which seems like an easy question on the surface), the results can mean many things. ‘Say a patient stops drinking dairy and goes to a plant-based alternative. They drop some weight in the process, and their blood pressure is lower. The next question to ask is why exactly is their blood pressure lower: their weight loss? Their reduced dairy consumption? The specific properties of the plant-based alternative?’ 

Another problem is the (oftentimes accidental) misinterpretation of studies. This is something many influencers, and even some dietitians, are guilty of. Most of the general public sadly doesn’t have access to the full study (most journals are paywalled or require the reader to belong to an institution for access). The parts that are available (the abstract, a catchy title, etc.) can sometimes be misleading. 

A great example of this was a study that stated chocolate milk was the best post-workout drink. Though it sounds great on the surface (who doesn’t like a sweet chocolate treat after shedding calories?), the study compared chocolate milk with water, hardly a fair match. And yet, according to the study abstract: “Consuming chocolate milk (1.0-1.5•g•kg(-1) h(-1)) immediately after exercise and again at 2 h post-exercise appears to be optimal for exercise recovery and may attenuate indices of muscle damage”. 

Image from Crystal Creamery.

The implications of this are profound, and explain why a good portion of Americans (not to mention some experts) aren’t receiving correct information when it comes to food. ‘You have to go back and look at what the research question was,’ Tiffany says. ‘They may be answering the question, but it probably wasn’t the best question to be asking in the first place.’ 

So how does one assure they’re reading a food study correctly, I ask. One great method to counteract the disbursement of false information is to ask the author themselves for the full study. ‘The fact that their study is paywalled has no effect on them, and many are happy to share what they’ve discovered.’ Great advice for us all, and one that seemingly all of us should take full advantage of, particularly as the fight for plant-based options continues.

Switch4Good, and the good it’s doing in the American Foodscape

Finally, I asked about Tiffany’s work at Switch 4 Good. This past spring they worked with college students on a program called Campus Action Now, which helped educate them on ways to create sustainable recipes in their dorm rooms, with oftentimes limited access to groceries. The program also works with business school students in helping to advocate for removal of the upcharge for plant-based milks in cafés. There are several other projects that allow Switch4Good to reach students from many academic disciplines. 

Tiffany is especially excited about something called the FISCAL act (Freedom in School Cafeteria and Lunches). It will make plant-based milk available for all students in the National School Lunch Program. Currently, students require a note from a physician for anything other than cow's milk, a barrier that almost certainly prevents them from receiving the proper nutrition. Since its inception in 1946, an alternative to cow's milk has not been readily available. She hopes this will be passed in the fall when congress reconvenes.

Image of Tiffany with a few of her colleagues at Switch4Good. Image provided by Tiffany Bruno.

Another project is geared towards healthcare providers. The Kids + Dairy Symptoms (KiDS) program is designed to assure healthcare providers are aware of just how many health issues stem from dairy consumption. The other side to the program helps to assure that parents know what dairy alternative is best for their child. The program guides them through all the steps, from finding the basics at the grocery store to providing gourmet recipes they can create with non-dairy foods. 

Finally, as if this wasn’t enough, Tiffany and her non-profit organization are working hard to make sure the 2028 Olympics offer more plant-based options, something that could have a tremendous impact on the public’s perception of vegan eating. 

These projects are just the tip of the iceberg of Tiffany’s extraordinary work. Throughout our conversation, I was struck both by her passion for her work, as well as her thinking on how dairy-free living can impact the richness of our lives. Something she said about using plant-based dairy in cooking really struck a cord: ‘There are so many more culinary applications to using plant-based dairy. Dairy milk is all the same.’ It’s something I’ve thought about and simply didn’t have the words to say. And yet, it’s one of the defining reasons for why I find plant-based eating so fascinating: far from being the restrictive diet it appears to be on the outside, there’s so much you can do with plant-based cooking that hasn’t yet been explored. 

What’s more, there are so many health benefits to consuming plant-based dairy, more than our Dietary Guidelines would have us believe. While there’s much work left to do to convince others of this, Tiffany’s successes are proof that it’s working. It’s thanks to organizations like Switch 4 Good, advocates like Tiffany Bruno, that more of us are aware and have access to plant-based milks. And who knows? Maybe one day, they’ll end up becoming our default milks.