Cow’s milk compared to oat drink and its implications for lipid profile– a pilot randomized controlled trial

Abstract A recent dietary trend involves replacing cow’s milk with plant-based drink alternatives. This shift is motivated by the perception that plant-based options are healthier and more environmentally sustainable. One of the most popular options is oat drink; however, the health effects of consuming oat drink as a replacement for cow’ s milk are not well studied. The EFSA health claims state that beta-glucans in oat drink have beneficial effects on cholesterol; however, consumption of oat drink at doses aligned with food-based guidelines for milk and dairy products has not been examined in real-world scenarios. Thus, the primary goal of this pilot randomized controlled trial was to assess the effectiveness of consuming 600 mL of oat drink daily versus 600 mL of cow’s milk daily over four weeks on blood lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides) in healthy young women in a real-world setting. A four-week, open-label, parallel-arm randomized controlled trial was conducted on women aged 18–40 years who habitually drink cow’s milk. Participants were randomized 1:1 to consume either 600 mL/day of oat drink or 600 mL/day of semi-skimmed cow’s milk. Two baseline visits were conducted before the intervention, during which informed consent, anthropometric measurements, 24-hour recalls, and blood samples were collected. During the intervention, participants recorded their milk intake in compliance diaries. Two final visits were held at the end of the study, where dietary recalls, anthropometry, and blood samples were repeated. Of the 33 women enrolled, 32 completed the trial. Baseline characteristics were similar across groups, including age (median 23 years), BMI (median 22. 9 kg/m ²), and dietary intake. Over the four weeks, the oat drink group experienced a significant reduction in mean total cholesterol (-0.3 mmol/L (95% CI 0.6 to 0.0; p = 0.026) and LDL-cholesterol (–0.4 mmol/L (95% CI − 0.6 to − 0. 2; p = 0.002), compared to the cow’ s milk control group. No differences were observed between the groups in HDL- cholesterol, or triglycerides. In conclusion, these results indicate that replacing cow’s milk with oat drink may lead to modest reductions in total and LDL‑cholesterol over four weeks in healthy young women under real-world conditions. The compliance and feasibility of this effectiveness study were good, with high compliance rates. ClinicalTrials.gov NCT06764173.