There is no need for calcium supplements on the Wheat Belly lifestyle. They can even be dangerous. Let me explain.
Calcium is a mineral that the body needs to conduct hundreds of physiologic processes, as well as serve as the structural material for bones and teeth. Without calcium, you’d be sunk.
But taking calcium as a nutritional supplement is like tossing a bunch of bricks into the backyard hoping that they form a nice, neat patio—the world doesn’t work that way. Just because bones contain calcium does not mean that taking calcium orally will cause it to be directed to the bones. In fact, calcium taken as a supplement can contribute to calcification of arteries (part of atherosclerosis and heart attacks) and probably to making heart valves stiff (e.g., aortic valve stenosis treated by surgically replacing the valve). Several recent studies suggest that calcium supplements raise risk for heart attack by 30% and stroke by around 20%, as well as worsening of cholesterol values. Ironically, the data are also quite clear: calcium supplementation has little to no effect on osteopenia/osteoporosis (bone thinning) and little to no effect on reducing risk for osteoporotic fractures. Likewise, drinking more milk or consuming more dairy products does not protect from osteoporosis but has been associated with a modest increase in osteoporotic hip fracture and total mortality.
Yet doctors continue to urge female patients to supplement calcium, often at high doses, and to consume more milk and dairy products for bone health—outdated, even dangerous, advice. (Remember: healthcare has little to do with health, but plenty to do with dispensing revenue-generating products and procedures for the benefit of healthcare insiders.)
Well, there are additional reasons to not take any calcium supplements while living the Wheat Belly lifestyle. Among them:
- Gluten (actually gliadin) from wheat and grains increases calcium loss in the urine, calciuria, by 63%, reversed with wheat/grain elimination. (By this means, grains also increase risk for calcium oxalate kidney stones, by the way.) In other words, you retain more calcium when wheat- and grain-free.
- Intestinal calcium absorption increases dramatically with removal of wheat/grain phytates that bind calcium in the intestinal tract, making it unavailable for absorption. Removal of grain phytates also allows better absorption of magnesium that contributes to bone health.
- Intestinal calcium absorption increases with restoration of vitamin D, one of the cornerstones of the Wheat Belly lifestyle.
- Although only a modest effect, wheat/grains tip the body’s pH towards acidic, a situation that encourages calcium removal from bones; removing wheat and grains allows a net shift towards alkaline.
Combine the above—wheat/grain elimination, vitamin D restoration—with a handful of additional strategies, such as exercise involving axial impact (e.g., jumping), vitamin K2 restoration (via bowel flora cultivation and K2-rich foods and perhaps supplements), and magnesium supplementation, and you can appreciate that the idea that calcium must be supplemented for bone health holds as much water as the “eat more whole grains for health” argument.
Hi Bob,
There were no more “reply” boxes available on the strontium discussion, so I’m replying here. Thanks so much for digging up the Jarrow article. As you say, “sobering.” This has given me a lot to think about. What a crap-shoot this all is, eh?
Osteoporosis runs in my family. So far I’m well ahead of where my mom and grandmother were at my age (68.) I’m inclined to give up my Sr supplement and go back to Square One. Keeping in mind that you can’t necessarily trust Amazon reviews either way, I read some of the negative ones for Jarrow’s “Bone-Up” and was turned off by that product, too (and besides, it contains Ca.)
I’d love to do weight training, but had 13 lymph nodes removed a few years ago with mastectomy (all nodes were “clean,” thank goodness.) I’ve been cautioned that weight lifting and even vigorous aerobic exercise could trigger lymphedema even many years post-op. I’ll research this site and WBTH ….. if I ever get it back, that is (it’s been about a month since I loaned it out) and go from there. Back to the drawing board! Thanks again for all your help! :-)
Kate wrote: «There were no more “reply” boxes available on the strontium discussion, so I’m replying here.»
Yep. Nesting depth limit. For more on how to use the WB Blog, see:
http://wheatfreeforum.com/index.php/topic,126.0.html
«Thanks so much for digging up the Jarrow article.»
Actually, it was found by a user on the Cureality forum. We just happen to be having a similar discussion there at the moment.
«What a crap-shoot this all is, eh?»
That, alas, describes too much of consensus medicine.
«Osteoporosis runs in my family. So far I’m well ahead of where my mom and grandmother were at my age (68.) I’m inclined to give up my Sr supplement and go back to Square One.»
Sr is worth considering when nothing else works. Wheat Belly has a multi-faceted strategy that is easily worth implementing first, covered in Wheat Belly Total Health (p231…) and in the Cureality program. Highlights are (and most of this is standard WB fare):
☤ Grain elimination
☤ Consume ample leafy vegetables with Ca and K1 content
(natural sources of calcium hydroxyappatite won’t hurt either)
☤ Avoid carbonated beverages
☤ Optimize Vitamin D titer
☤ Obtain suggested Vitamin K2 (MK-4 & MK-7) intake
☤ Obtain suggested magnesium and potassium intake
☤ Correct hormonal status as needed
☤ Exercise providing axial bone loads, although…
«I’ve been cautioned that weight lifting and even vigorous aerobic exercise could trigger lymphedema even many years post-op.»
That I can’t provide any insight on without some further research, except to say that I consider the Wheat Belly dietary recommendations to be cancer-protective.
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Hi again, Bob,
Wow, thanks for the great suggestions. (One area of needed improvement that immediately jumped out at me was Vit K.) And yes, I agree that the WB dietary recommendations are cancer-protective.
Don’t know if this would interest your Cureality group, but to muddy the strontium waters further, this evening I spent some time on the the AlgaeCal web site, which presents a qualified “pro” position. https://www.algaecal.com/expert-insights/the-truth-about-strontium-supplements-side-effects-dexa-results-efficacy-and-more/
Also took a look at another site with the “con” position. http://saveourbones.com/strontium-demistyfied/
The argument at AlgaeCal is that it’s only the ranelate form that causes the adverse effects, due to ranelate being a synthetic substance. The contention is that the “natural” forms (citrate, et al) are completely safe, as demonstrated in some published studies summarized elsewhere on the site. (It’s too late to follow the links tonight!)
Hmm …. conflicting stories. What a surprise!
BTW, both sites make the case for plant-based (rather than rock-based) calcium supplementation, which is kind of an intriguing idea at the moment.
Thanks for the link with tips on using the blog. I’ll be sure to look at it tomorrow when I’m not so sleepy. :-)
Kate wrote: «Hmm …. conflicting stories. What a surprise!»
Well, that seems to be what the internet is for. And I’m not sure they disagree all that much.
The “pro” site, by the way, doesn’t address a key consideration with the citrate form, which is a lack of data on how well it is incorporated into bone. Only the ranelate form has been seriously studied.
«…both sites make the case for plant-based (rather than rock-based) calcium supplementation,…»
That overlooks actual bone as a source. Our ancestors may have gotten a lot of Ca that way, from consuming small critters whole, as well as gnawing on bones. Three cans of sardines a day, for example, would provide your entire DV of Ca (and DV or more of Vitamin D, B12, phosphorous & selenium), plus the full WB target of Omega 3 DHA & EPA.
«Thanks for the link with tips on using the blog. I’ll be sure to look at it tomorrow when I’m not so sleepy. :-)»
It may put you back to sleep. ☺
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Hi Bob,
I was just beginning to think that sardines might become my new best friends ….. but that’s a lotta little fish! Thanks for the reply and for all of your insights. Much appreciated! :-)
Kate wrote: «I was just beginning to think that sardines might become my new best friends…»
I would look for sardines packed in water, and a claim of Bpa- and Bps-free packaging.
If they are packed in oil, that can leach out a lot of the fats you came for, so it would need to be a safe oil that you could consume entirely. I have low confidence that the olive oil used for sardine packing low in Omega 6 linoleic acid, or even really what it claims to be, much less being EVOO.
«…but that’s a lotta little fish!»
If you think about a tribe of ancestral sea-side humans eating mostly seafood, it’s actually not a lot, and may shed some light on why we seem to need so much DHA & EPA, among other micronutrients.
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Hi Bob,
Thanks for posting the Koncentrated K link earlier. Very impressive info there, and lots of it. I’ve got a mind to replace the strontium citrate with this product. In the meantime, I’ll check out the little fishies, but probably won’t be doing 3 cans per day. Although ….. how does a nice refreshing Sardine Smoothie sound? (Rhetorical question.)
Your techie article about using the WB blog didn’t put me to sleep. In fact, I printed it out for future reference and even used it tonight to get around the “nesting depth limit.” Cool! :-)
Kate wrote: «and even used it tonight to get around the “nesting depth limit.” Cool! :-) »
You are now a blog ninja of the white sash rank, and probably are thus aware that this thread is likely to close for comments in the next 24 hours.
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Thanks a million for such excellent information. Just wondering if K-2 is required on a grain free diet?
Thanks!
JV wrote: «Just wondering if K-2 is required on a grain free diet?»
Adequate vitamins K (K1, and K2 as MK-4 and MK7) are required on any diet, but only as supplements where not being obtained in sufficient amounts from food.
K1 is pretty easy to get from food, and if you’re not eating grains, you get to keep it. Excellent sources include kale, spinach, mustard greens, collard greens, beet greens, swiss chard, turnip greens, parsley, broccoli and brussel sprouts. 5 mg (5000 mcg) per day might be a reasonable target (there’s apparently no additional benefit above that).
K2 is more challenging, particularly for anyone avoiding animal meat, eggs and fermented dairy. Some is also produced by gut bacteria, and we expect to learn more about optimizing this source over time. You can get a blood test for K titer, but that’s uncommon, so many of us just choose to take a supplement. The product I use provides 25 mg of MK-4 and 500 mcg of MK-7.
Anyone on a blood thinner or anticoagulant needs to check with their doctor before deliberately increasing Vitamin K intake.
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Thanks for your help Bob. Cheers
Does the article on calcium supplements apply to people who have osteoporosis ?
Joan Mercantini wrote: «Does the article on calcium supplements apply to people who have osteoporosis?»
Yes. Just adding calcium to the diet is no assurance that it will end up in bones (or even primarily in bones, compared to places where it needs to not be).
This is why Wheat Belly Total Health has an extended discussion of bone health, summarized briefly in the response above: https://drdavisinfinitehealth.com/2016/04/why-calcium-supplements-are-unnecessary-on-the-wheat-belly-lifestyle/comment-page-1/#comment-64628
In the future, I suspect that the practice of throwing calcium carbonate at osteoporosis is going to be viewed much as we now see one primitive diabetes therapy, which correctly observed that diabetics were spilling sugar in their urine, and then incorrectly concluded that the solution was to have the diabetics eat more sugar.
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Shared this with my boss who lives on supplements and he said he was aware of this and is taking Bone-UP by Jarrow. He said it’s absorbed right to the bones but it appears to be just another calcium supplement with a long pedigree.
LA Berry wrote: «Shared this with my boss who lives on supplements and he said he was aware of this and is taking Bone-UP by Jarrow. »
From the Supplement Facts…
Item : amount / DV
Vitamin C (as calcium ascorbate) : 200mg / 333%
Vitamin D3 (cholecalciferol) : 1000 IU / 250%
MK-7 (vitamin K2 as menaquinone-7) : 45mcg / 56%
Calcium (elemental) (from microcrystalline hydroxyapatite) : 1000mg / 100%
Magnesium (as magnesium oxide) : 500mg / 125%
Zinc (L-OptiZinc) (as zinc monomethionate) : 10mg / 67%
Copper (as copper gluconate) : 1mg / 50%
Manganese (as manganese citrate) : 1mg / 50%
Potassium (as potassium citrate) : 99mg / 3%
Boron (as boron citrate) : 3mg / *
My personal opinion on that is:
Vitamin C: modest amount (optimal may be somewhere between 500 and 2000 daily).
Vitamin D3: modest amount (unless getting ample sun, and verifying titer, many people following WB are taking much higher amounts)
MK-4: (not included, and I would seek it in a bone health formulation)
MK-7: modest amount (benefits in studies are seen at levels above 100 – I take 500)
Ca: no opinion on the dose (hydroxyapatite might be the ideal form if one insists on a non-food Ca supplement)
Mg: dose is fine for daily (note that the serving size is 6 capsules – and the directions instruct taking 3, twice a day)
Zn: dose looks fine
Cu: dose might be fine (Zn & Cu need to be in an optimal ratio, but that’s a matter of blood titer, and not dose)
Mn: dose looks safe
K: seems low
B: no opinion
That’s an interesting product, with some science to support it. As with all combination supplement products, anyone who has done their supplement homework is probably going decide that they’d prefer different amounts of this and that, and will have to adjust everything else they take in order to use it.
«He said it’s absorbed right to the bones but it appears to be just another calcium supplement with a long pedigree.»
I don’t know that I can endorse it, but it’s not just another calcium supplement.
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Hi Bob,
On multiple occasions, I have seen supplements criticized for *low* (or no) K. I wonder if it has to do with the widespread use of Coumadin and the associated interaction. For example, the default multivitamin formula by Pure Encapsulations contains no K. The have a special formulation containing K: http://www.pureencapsulations.com/nutrient-950-with-vitamin-k.html
Thanks for your work.
John Es wrote: «…I have seen supplements criticized for *low* (or no) K. I wonder if it has to do with the widespread use of Coumadin and the associated interaction.»
That’s probably no coincidence. People on blood thinners like warfarin are often counseled to minimize vitamin K for that reason. Deficient vitamin K comes with some risks, which may outweigh the expected benefits of the anticoagulant.
If I were on such an anticoagulant, or one was proposed, I think I’d focus on resolving the underlying problem, and wind down or avoid that med. But anyone already on a thinner, and wanting to increase K, may be facing a tricky transition process that I’ve not looked into at all.
«…the default multivitamin formula by Pure Encapsulations contains no K. They have a special formulation containing K…»
And calcium citrate, sigh, but they are at least trying.
I might add that I’ve lately switched brands of K supplement, to a product called “Koncentrated K” (available on Amazon). It contains K2 (MK-4), K1, K2(MK-7) and Astaxanthin, but no Ca.
They have a huge number of cites in support of why it’s formulated the way it is, including an interesting page specifically on bone health: http://www.k-vitamins.com/index.php?page=Bone
I haven’t used it long enough to have any further insight.
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Thanks everyone. I am now motivated to make my own almond milk, which will be far superior to the commercial version we’ve been using. The calcium carbonate component, among other things, turned me off.
The brand of almond milk we buy is “Silk,” Unsweetened Original.
Bob makes a good point. The first ingredient is “Almond Base (Filtered Water, Almonds)” which means you have no idea about how many almonds are used to make the beverage. Probably not very many. The nutrition facts label doesn’t even mention vitamin E, which almonds are known for.
The next ingredient is sea salt.
Then comes locust bean gum, sunflower lecithin, and gellan gum. These are the emulsifiers that Bob mentions, which presumably are used to give the milk a nice creamy texture.
The Silk product also lists “natural flavor.”
Under Vitamins and Minerals comes Calcium Carbonate, Zinc Gluconate, Vitamin A Palmitate, Riboflavin (B2), Vitamin D2, Vitamin B12. Basically very similar to what Bob found.
My wife once made real almond milk from scratch. She used lots of almonds (which we had soaked previously), ground up in our trusty Vitamix. It turned out quite well but for now we can’t imagine going through the laborious process (which includes squeezing the milk through a cheesecloth) every time we want some almond milk.
Malcolm Achtman wrote: «The brand of almond milk we buy is “Silk,” Unsweetened Original.»
Silk’s product page for that says:
“INGREDIENTS: Almondmilk (Filtered Water, Almonds), Sea Salt, Locust Bean Gum, Sunflower Lecithin, Gellan Gum, Natural Flavor.
VITAMINS & MINERALS: Calcium Carbonate, Vitamin E Acetate, Vitamin A Palmitate, Vitamin D2.”
«The first ingredient is “Almond Base (Filtered Water, Almonds)” which means you have no idea about how many almonds are used to make the beverage.»
Actually, it’s not too hard to make a pretty fair guess. This product has 1 gram of protein per cup. If all of that came from almonds, it would be only ½ tablespoon of them per cup.
«The nutrition facts label doesn’t even mention vitamin E, which almonds are known for.»
The product page does, but it’s shown in such a way as to be ambiguous about whether those vitamins and minerals are native, or added. Why would they need to add E to a nut that is rich in it, unless they are sourcing impaired nuts which are not rich in it, and covering it up with added E and “natural flavors”.
«Then comes locust bean gum, sunflower lecithin, and gellan gum. These are the emulsifiers that Bob mentions, which presumably are used to give the milk a nice creamy texture.»
They may “cream” your microbiome too.
2.5g fat, 1g protein and essentially no carbs is not much nutrition. Let’s face it, the industry is going to great effort to disguise the fact that many of these beverages are basically flavored water with a bunch of iffy additives. This may change, by the way. I see that Pacific Naturals calls their product “Almond Beverage” instead of almond milk.
Then there’s the further question of what water. Filtered municipal water can still contain a lot of non-native halogens (fluorides and chlorides), perhaps putting your thyroid at risk as well as your gut flora. Making it at home puts you in full control of these issues.
«It turned out quite well but for now we can’t imagine going through the laborious process (which includes squeezing the milk through a cheesecloth) every time we want some almond milk.»
Large batches. Freeze it.
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It really gives a bit of work to do at home almond milk or other nuts, but worth it for those who want to replace the traditional industrialized milks. Usually I talk a quantity for three days, because it spoils quickly, as well as other liquid milks. As the freezing I have never experienced but I intend to do it. I indicate a portion freeze as soon as it is ready.
What about when you have a fractured bone? Would supplementing vitamins D and K alongside calcium and magnesium?
Ana wrote: «What about when you have a fractured bone?»
Bone health is a major topic of Chapter 10 in Wheat Belly Total Health.
«Would supplementing vitamins D and K alongside calcium and magnesium?»
Sounds like you’ve been reading ahead in class. ☺
Vitamins D, K1 (from food), MK-4 and MK-7 (from food, supplementing as needed), Mg supplements, potassium from food or supplements and strength training are suggested, with bio-identical hormone as something to consider.
If more actual calcium is needed in the diet, get it from food. Sardines, for example, are a great source of both calcium and the key Omega 3s. Get them packed in water.
Outside the US, strontium supplements might be worth a look.
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Strontium is available in the U.S. as Ultimate Bone Support from Advanced Bionutritionals. Two tablets per day supplies 500 mg strontium, 40 mcg K2, plus a number of other “bone supporting nutrients.” Looking at the web site just now I noticed that they’ve recently changed up the fairly short list of “Other Ingredients” by substituting calcium stearate for magnesium stearate and adding rice extract.
http://www.advancedbionutritionals.com/Products/Ultimate-Bone-Support.htm
Kate wrote: «Strontium is available in the U.S. as…»
…strontium citrate, it appears.
Dr. Davis’ Cureality program suggests strontium ranelate as a back-up strategy for bone health restoration. It’s available, even prescribed, in Europe, but not in the US, due to FDA policy that probably goes back to the days of above-ground nuclear testing, and the solemn hazards of Sr90 at the time.
Just looking on Amazon, you can get a lot of hits searching for “strontium ranelate”, but every one I looked at turned out to be:
• strontium citrate,
• had no strontium at all, or
• clearly had strontium ranelate, but was “currently unavailable”
«Looking at the web site just now I noticed that they’ve recently changed up the fairly short list of “Other Ingredients” by substituting calcium stearate for magnesium stearate and adding rice extract.»
You’re becoming a Nutrition Ninja.
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Thanks for the info, Bob ….. and the enlightenment. Do you suppose there’s any benefit at all from taking the citrate form, or am I merely converting my $$$ into a more “flushable” form?
Kate wrote: «Do you suppose there’s any benefit at all from taking the citrate form…»
I don’t know, and it may not be known. Apparently strontium citrate and chloride have not been adequately studied in controlled trials.
Also be aware that because Sr is a heavier element than Ca, successful use of it in a bone therapy program causes conventional bone density testing to report misleading high readings.
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On strontium (any form), here’s a sobering overview by Jarrow, who make the Bone-Up supplements (some with Sr):
http://www.jarrow.com/eMarketing/StrontiumFAQ_Dec9.pdf
In addition to the dramatic and persistent distortion of bone density scans, there are potential neurological and cardiovascular adverse effects to factor in.
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I drink unsweetened almond milk. According to the label on the carton, 1 cup contains 30% of your recommended daily value of calcium. Since real almonds don’t contain a lot of calcium, I presume this product has been “fortified” with added calcium. Is that the same as taking a calcium supplement? I imagine it is.
I only drink about a cup a day of this almond milk, but if someone drank a quart of it I imagine they would be getting quite a large calcium hit.
Malcolm Achtman wrote: «Since real almonds don’t contain a lot of calcium, I presume this product has been “fortified” with added calcium.»
The Ingredients list tells most of that tale – it’s not an analysis like the NF panel; it’s more of a recipe. One I just looked at lists “calcium carbonate”. Yup, it’s added, and yup, it’s a form of Ca fortification to avoid. Why do they add it? I’m guessing in large part to make what would otherwise be beige water look like mammal milk, and also due to popular misunderstanding about dietary calcium.
Had it been calcium hydroxyappatite (bone calcium), we might have something to mull over, but you are exceedingly unlikely to encounter that Ca compound in products to date.
The rest of that list, for the product I looked at, is also instructive: “almond milk (filtered water, almonds), calcium carbonate, tapioca starch, natural flavors, sea salt, potassium citrate, carrageenan, sunflower lecithin, vitamin a palmitate, vitamin D2 and D-alpha-tocopherol (natural vitamin E)”
It leads off with “almond milk (filtered water, almonds)”. Notice that they don’t list water and almonds separately. Had they done so, almonds would be WAY down on the list of ingredients. Deceptive ingredient bundling sort of makes it look like almonds are #1. You can run the numbers to try to reverse engineer the actual almond content here, but it looks to me like a cup of this milk contains less than a tablespoon of actual almond.
” tapioca starch” means that the “unsweetened” claim needs to be called into question. This is a high-gly carb, although there’s apparently little of it, given the 1 gram net carb in a cup (this implies that the product is largely water). In any case, this is more “tapioca milk” than “almond milk”.
“natural flavors” can mean darn near anything, and if were beneficial, they wouldn’t bury it under this euphemism.
“sea salt” mostly likely means “we’re pandering to buzzword blinded buyers”. All salt is sea salt (it’s just a matter of when it was last in liquid form). At this point in history, mined ancient unrefined salt, coarse, is your best bet. Minimally refined salt from modern sea water has serious issues, and refined salt from anywhere does as well.
“carrageenan, sunflower lecithin” – emulsifiers. These are suspect as gut biome antagonists and need to be avoided to the extent practical.
“vitamin D2” – why?
The ingredients I didn’t discuss are harmless, if needless.
«…if someone drank a quart of it I imagine they would be getting quite a large calcium hit.»
Yup. I suspect organic bovine cow’s milk (ideally A2) is a safer bet than any nut milks like this.
But don’t take this as a blanket condemnation of nut milks. Formulations vary considerably. However, if most of the “almond milk” products were being honest about ingredient #2 (after water), they’d have to be called “calcium milk”, “pea milk”, “rice milk” or “locust bean milk”.
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Sounds like it would be better to make your own almond milk from almonds and water. Forget the store bought almond milk.
Beverly wrote: «Sounds like it would be better to make your own almond milk from almonds and water.»
There’s a lot to be said for that, and there are any number of what appear to be suitable low carb recipes out there, such as:
http://nomnompaleo.com/post/84257950678/vanilla-almond-milk
These recipes usually start with whole almonds (which surprised me), soaked overnight before processing, and you’ll need a strainer bag. Watch out for recipes with added sugars (what’s in any added vanilla extract isn’t going to amount to much per final portion).
Commercial nut milks have some challenges that homemade doesn’t have, such as room temperature shelf life, total avoidance of separation, being a high fidelity bovine milk mimic, not to mention gratifying random focus groups hauled in off the street to test formulations on matters of visual presentation, consistency, aroma and taste.
«Forget the store bought almond milk.»
Anything with a Nutrition Facts panel and/or Ingredients list needs full due diligence, even if it’s a product targeting (too often pandering to) health seeker market segments like grain-free, low-carb, organic, pastured, gluten-free, etc.
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I make my own almond milk with almonds and water. Being addicted to cow’s milk, it was the only way I can avoid. But I do not take a large amount on average 250 ml per day.