Final Minutes - Item 9: Plant-based drinks Working Group- first draft report (Reserved) TOX/2023/64 

The item was previously being treated as reserved. 

Item 9: Plant-based drinks Working Group- first draft report (Reserved). TOX/2023/64 

1.               No interests were declared. 

2.               The UK Government currently advises that first infant formula (which is usually based on cows’ milk) is the only suitable alternative to breast milk in the first 12 months of a baby’s life. Whole cows’ milk can be given as a main drink from the age of 1 year. From this age, unsweetened calcium-fortified plant-based drinks, such as soya, almond and oat drinks can also be given to children, as part of a healthy, balanced diet. 

3.               The COT were asked to consider the potential risks posed by soya, almond and oat drinks consumed in the diets of infants and young children. The Committee concluded that neither the safety of these drinks, nor the suitability of the current guidance, could be confirmed from a toxicological perspective. A statement setting out the views of the Committee was published in 2021. 

4.               The Scientific Advisory Committee on Nutrition (SACN) subgroup on Maternal and Child Nutrition (SMCN) also reviewed the suitability of these drinks from a nutritional perspective due to concerns that consumption of these drinks could lead to an increased risk of insufficient nutrient intakes. 

5.               Following these reviews, it was agreed by both SACN and COT that a joint SACN/COT working group to be established to conduct a benefit: risk analysis considering both nutritional and toxicological aspects associated with the consumption of plant-based drinks by the UK population. 

6.               The draft SACN/COT WG report was presented to the Committee, this was a working document but included comments received from SACN from their November 2023 meeting. This draft report was attached as Annex A to Paper TOX/2023/64.   Members were invited to comment on the report with a focus on the overall structure and the toxicological aspects.  

7.               Although cows’ milk was the main comparator for plant-based drinks, water was also used, as in some circumstances water, rather than a plant-based drink, could be provided as the alternative to cows’ milk.  In addition, if a new plant drink came to market, there would be a baseline for the effect of removing the nutrients supplied by cows’ milk from the diet; by doing the comparison with water, then adding the nutrients that the new drinks provide allowing for easier calculation of nutrients levels and aiding future proofing.  

8.               It was suggested that in addition to the background information for each plant-based drink including the nutrients they were fortified with, a caveat should be added stating that the organic versions were not fortified; although this was already in the report, it should also appear in the summaries.  

9.               The Committee discussed whether allergenic potential should be added to the scope of the report. This concern had been raised in the context of soya, and Members considered how, and to what extent, this should be addressed. It was noted there were allergic concerns for all of the drinks, for example, nut allergy with respect to almonds and also oats as these could contain gluten due to contamination with other flours. However, it was also pointed out that cows’ milk was one of the most common allergens in children.  It was agreed that allergenic potential should not be added to the scope, but that some text explaining this should be included.

10.           Members stated that there needed to be quantification when talking about the free sugars in milk, whether it was low sugar or less that 5% of the energy intake. It was also suggested that these terms should be explained and clarified.  

11.           It was noted that at the end of each section there was a paragraph on fortification and bioavailability, however it was suggested that this be reworded to improve clarity. It was noted that clarification of ‘bioavailability’ was important as this could be interpreted differently by different specialties.  It was noted that SACN had been impressed with the report but had commented on the lack of information on the bioavailability.   

12.           The Committee were asked to comment on the usefulness of the information on contaminant levels that had been supplied by industry, Members agreed that it was useful but there were limitations and it had to be considered in context.

13.           Members suggested that the recommendations could consider the frequency of use of the drinks, if these milks were used exclusively then the risk profile would be different than if mixed with other drinks. For example, soya drinks were of more concern in combination with other dietary sources of soya. 

14.           The COT agreed that the evidence identified through the rapid scoping literature search and how this evidence was presented and used throughout the report was acceptable, but clarification was needed in several sections.