
What is Buttermilk? Nutritional Benefits, Health Risks & Substitutes
- Nutrition
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- 20 minutes read
Buttermilk is a fermented dairy product.
The modern version of buttermilk is cultured, which means that good bacteria have been added to it. Of course, it differs greatly from traditional buttermilk, which is not readily available in most Western countries today.
This article will discuss the cultured version.
Cultured buttermilk is mostly used in baking. For instance, it is an essential ingredient in muffins, biscuits, pancakes, and quick bread. It also serves as a creamy base in potato salad, soups, and salad dressings.
This article discusses buttermilk nutritional benefits, how to make it, the downsides, and healthy substitutes.
Photo Credit: Alexa Fotos
What is buttermilk?
Let’s start by saying that the name buttermilk may be a bit misleading – why? Because there’s no butter in the milk.
The traditional version is the liquid that remains after you’ve churned whole milk into butter. Of course, you can’t readily find traditional buttermilk in Western nations, but it is still common in some parts of India, Pakistan, and Nepal.
Constituents of modern buttermilk include casein (milk protein), lactose (milk sugar), and water.
Buttermilk has been pasteurized and homogenized. It also contains lactic-acid-producing bacteria like Lactococcus bulgaricus or Lactococcus lactis.
Lactic acid makes the product more acidic and prevents the growth of unwanted bacteria, thus prolonging its shelf life. It is also responsible for the slightly sour taste of the milk, which is caused by the bacteria fermenting the lactose (1).
Buttermilk has more thickness than milk. Production of lactic acid by the bacteria causes the pH level to reduce, and casein, the main protein in the milk, turns solid.
Reduction of the milk’s pH results in curdling and thickening of the product. Why does this happen? Well, when the pH reduces, the milk becomes more acidic. The pH has a scale ranging from 0 to 14. 0 is the most acidic. The pH of cow’s milk ranges from 6.7 to 6.9. conversely, buttermilk has a pH ranging from 4.4 – 4.8.
The nutritional profile of buttermilk
A whole lot of nutrition is packed into a small serving of buttermilk.
You can get the following nutrients from a cup (2):
- Protein: 8g
- Calories: 98
- Carbs: 12g
- Sodium: 16 percent of the daily value
- Calcium: 22% of the daily value
- Riboflavin: 29% of the DV
- Vitamin B12: 22% of the DV
- Fiber: 0g
- Pantothenic acid: 13 percent of the DV
Health benefits
Buttermilk benefits your health in many ways, such as improved bone health, oral health, and blood pressure.
Buttermilk is easier to digest compared to other dairy products
The lactic acid makes it easier to digest its lactose content. Lactose is the sugar that occurs naturally in dairy products.
Many people are intolerant to lactose. This means that they lack the enzyme required to digest this sugar. Studies have shown that over 65% of humans worldwide have some degree of intolerance to lactose (3).
Some lactose-intolerant people can drink cultured dairy products without experiencing any side effects, as the lactose will be broken down by the bacteria (4).
Buttermilk benefits for bone health
Buttermilk is rich in phosphorus and calcium, and vitamin D as well if it has been fortified. Full-fat versions of fat milk also contain a lot of vitamin K2 (5, 6).
These nutrients help your bone to grow stronger and prevent degenerative ailments like osteoporosis. The sad news, however, is that many people are deficient in these nutrients (7, 8, 9, 10).
A 5-year study involving people between the ages of found that higher intake of phosphorus caused a 2.1% increase in their mineral bone density as well as a 4.2% increase in their bone mineral content (8).
An increase in phosphorus intake was associated with an increased calcium intake as well. Eating more phosphorus and calcium caused a 45% reduction in the overall risk of osteoporosis among adults who had normal levels of these minerals in their blood (8).
Also, there is evidence that vitamin K2 improves bone health and treats osteoporosis, especially when combined with vitamin D. Vitamin K2 enhances the formation of bones and prevents its breakdown (11, 12).
A boost in oral health
Inflammation of your gums is known as periodontitis. It is a common condition and usually caused by periodontal bacteria.
Studies have shown that buttermilk and other fermented dairies have anti-inflammatory properties that affect the skin cells lining your mouth (13).
Consumption of fermented dairies is associated with a reduced risk of periodontitis. These effects may not present in non-dairy foods (14, 15, 16).
This may be of immense benefit to people suffering from oral inflammation due to chemotherapy, radiation therapy, or Crohn’s disease (13, 17).
Buttermilk cholesterol-lowering effects
In an 8-week study involving 34 adults, consumption of 45g of reconstituted buttermilk (buttermilk powder and water) daily caused a 3% reduction in total cholesterol level and a 10% reduction in triglycerides, compared with placebo (18).
Also, participants who had elevated LDL cholesterol at the start of the study had their cholesterol level reduced by 3% (18).
This effect may be due to the presence of sphingolipid compounds present in the buttermilk. Sphingolipids inhibit cholesterol absorption in your gut. Sphingolipids are a component of the milk fat globule membrane in buttermilk (18).
Buttermilk is associated with reduced blood pressure levels
There is evidence that buttermilk may facilitate blood pressure reduction.
In a study involving 34 people with normal blood pressure, daily consumption of buttermilk reduced systolic blood pressure by 2.6 mmHg, plasma angiotensin-1 converting enzyme by 10.9%, and mean arterial blood pressure by 1.7 mmHg, compared with placebo (19).
Mean arterial blood pressure refers to the average pressure in your arteries during a single heartbeat. On the other hand, plasma angiotensin-1 converting enzyme assists in blood pressure control by regulating the volume of fluid in your body (19).
These are encouraging results no doubt, but there is a need for further research.
Downsides
The downsides of buttermilk are related to its salt content as well as its allergic potentials.
The sodium content of buttermilk may be high
Milk products are usually rich in sodium. So, you must check the nutrition label if you need to regulate your sodium intake.
Taking sodium in excess is associated with high blood pressure, especially among people who have a high salt sensitivity. It is important to note that high blood pressure contributes greatly to heart disease (20).
If you are sensitive to dietary salt, then high sodium diets may put your blood vessels, brain, kidneys, and heart at risk of damage (21).
Foods that qualify as “low-sodium” have a sodium content no more than 140mg per serving. On the other hand, a cup of buttermilk (equivalent to 240ml) contains between 300-500mg of sodium.
It is worthy of note that there’s more sodium in lower-fat versions compared to the high-fat versions (2, 22).
Some people are allergic to buttermilk
It is a fact that buttermilk contains lactose. Lactose is a natural sugar and many people are intolerant to it.
Some lactose-intolerant people can digest it with ease but still, many are sensitive to its lactose content.
Common symptoms of lactose intolerance include diarrhea, gas, and upset stomach.
If you are allergic to milk, don’t eat buttermilk. Milk allergy causes hives, wheezing, vomiting, upset stomach, and anaphylaxis in serious cases (23).
How to make healthy substitutes for buttermilk
There are several substitutes (if you don’t like it, or if it isn’t readily available).
Plain yogurt
Plain yogurt, just like buttermilk, is a fermented dairy. You can substitute it for buttermilk in baking at a ratio of 1:1.
If your recipe requires a cup of the product (240ml), then you can substitute a cup of yogurt.
Learn more: The Instant Pot Yogurt Recipes: Delicious, Easy-to-Recall & Quick-Cooking Instant Pot Yogurt Recipes
Acidified buttermilk
What you need is milk and an acid. After mixing both, the milk will curdle.
Acidified buttermilk can be made with dairy milk of varying fat content. It can also be made with almond, soy, cashew milk, or other non-dairy alternatives. You can also make it with apple cider vinegar, white vinegar, or lemon juice. The ratio is an easy one. Just one cup of milk to one tablespoon of acid. Mix both ingredients gently and allow it to sit for 5-10 minutes until it starts curdling.

Tonika Bruce, also known as The Network Nurse, is a multi-talented individual with a career spanning over 20 years. She’s a Registered Nurse, speaker, author, and advocate for change, excelling in business building and team development. Tonika holds two Master’s degrees in Nursing and Business Administration, (MSN & MBA) and is currently pursuing her Doctorate of Nursing Practice in Executive Leadership.
Her expertise extends to various fields such as nursing, entrepreneurship, business, basketball coaching, and executive leadership. She is a published author of “Relentless Pursuit: Proven Tips for Unlocking Your Potentials, Limitless Success and Post COVID Syndrome: A Guide to Repositioning the Nursing Profession for A Post COVID Era”. Currently, Tonika is working on Thrudemic, an anthology examining the impact of the coronavirus pandemic on medical professionals and patients.