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Dear Dr. Roach: I’m vegan, primarily for ethical reasons, but I also enjoy the health benefits. There are so many more nondairy milks on the market now than when I went vegan, 23 years ago. I especially enjoy the taste of soy, coconut and almond milks, but from a health perspective, which is best?

I.M.

Dear I.M.: From a health perspective, there are pros and cons to all. These recommendations are for adults: Infants and young children need the many nutrients that are ideally in human milk.

Soy milk has lots of protein, and diets with high amounts of soy protein may cut heart disease risk. The isoflavones in soy act as weak estrogens, and women with a history of estrogen-receptor-positive breast cancer should be cautious. Soy milk has little calcium unless it’s fortified.

Almond milk (like cashew, hazelnut and walnut milks) has a lot less protein than soy, but the unsweetened version has no sugar. It does have calcium and vitamin D. Coconut milk has a lot of saturated fat; however, early data show the saturated fat in coconut is not as likely to cause damage to arteries as saturated fat from cow’s milk.

None of these milks is a complete source of nutrition, so I would say any of the unsweetened versions of the milk alternatives you mention are reasonable for cooking, for eating with cereal or for drinking, but not as a major calorie source. Sweetened versions of any of these add 8-20 grams of sugar per 1-cup serving, which is a substantial proportion of your recommended intake for the day.

Dear Dr. Roach: I have a 12-hour flight. When sitting for a long time, my legs feel like hot needles are pricking them. What can I do for my legs during or before this flight? I have varicose veins on my right leg.

E.M.

Dear E.M.: During the flight, get up and walk up and down the aisle as often as possible. If the attendant takes a dim view of this, explain why you’re doing it. If you must remain seated, contract your thigh and lower leg muscles many times every 15 minutes.

Email questions to ToYourGoodHealth@med.cornell.edu.

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