The United States is second in dairy consumption and protein intake (1), 5th in calcium intake (2), and #1 in hip fractures (3).
From a tender age, we are told that to build strong bones we need calcium; that calcium is present in dairy products; therefore, dairy products help build strong bones. “Milk. It does a body good,” right? Wrong. If this were true, then it would also be true that the countries with highest dairy consumption would have the lowest incidence of osteoporosis-related hip fractures. Wrong again.
The most common first question I get from menopausal women, parents of young kids and every patient in between in response to a ZERO dairy policy is “But where am I going to get my calcium to build strong bones?” My answer is always the same, “The best thing you can do for your/your kid’s bones is to stop consuming dairy products.”
So, if none of what we have heard is true about dairy and building strong bones, what is true?
Diet and the Incidence of Osteoporosis
According to the National Osteoporosis Foundation, “In the U.S. today, 10 million individuals are estimated to already have the disease [osteoporosis] and almost 34 million more are estimated to have low bone density [osteopenia], placing them at increased risk for osteoporosis and broken bones.”(4)
The higher our ratio of animal protein to vegetable protein is, the greater the incidence of osteoporosis and osteopenia (5). While vegetable protein, including soy protein, has protective benefits for bone health (6), it is animal protein in particular that is linked to bone mineral density loss. Studies show that the more animal protein we consume, the more calcium comes out of our bones and is lost through urination (7). There are different possible reasons for this. T. Colin Campbell, one of the foremost epidemiologists in the US, in his seminal work, The China Study, posits that excessive animal protein intake creates a highly acidic internal environment that our bodies deal with by leaching calcium out of our bones to act as a buffer (8). Our bodies are finely tuned to keep our pH within a narrow range to survive, so I question this explanation.
Another possible reason is that, as is true for so many western diseases of excess, inflammation is the key—the natural response from the body toward a foreign pathogen. It is well-understood that the Standard American Diet (S.A.D.) is pro-inflammatory. Animal protein in particular raises certain inflammatory markers in the blood which are linked to bone loss (9). What is it in the animal protein that triggers such an inflammatory response? Could it be the hormone residues, the bacteria residues, the retro-viruses, or the pesticide residues? And those are just a few of the likely ingredients in your burger for lunch today. So take your pick. Choosing organic sources is certainly a step in the right direction, but does not protect against an e.coli bacteria presence in beef or even the potentially harmful effects of the animal’s own hormones on our system.
Then, there is dairy. In 100grams of cow’s milk there are 122mg of calcium and 3,000mg of protein (10). In dairy, you are ingesting far more protein than you are calcium, with a net effect of calcium loss. And when you consider that you may have already had animal protein at each of your meals that day, in addition to your milk, you are looking at an even greater likelihood of calcium loss. Now, take a look at the Twenty Reasons for Zero Dairy and the extensive list of scientifically-documented diseases and conditions linked to dairy consumption. With all this in mind, it makes me question the benefits of dairy as a healthy source of calcium given all the possible inflammatory triggers present in dairy.
Should osteoporosis be your biggest concern?
While osteoporosis is in fact a concern for menopausal women and older men and it is a good thing to build strong bones in your children, the sheer reality is that day to day, the conditions we should be most concerned about are the top 10 leading causes of death in the US: heart disease, cancer, chronic lower respiratory diseases, stroke (cerebrovascular diseases), accidents (unintentional injuries), Alzheimer’s disease, diabetes, influenza and pneumonia, nephritis, nephrotic syndrome, and nephrosis, and intentional self-harm (suicide) (11). Six out of these 10 conditions are linked to dairy use. And if we are talking about kids, you might add the common concerns of allergies, asthma, eczema, inflammatory bowel diseases like Crohn’s and Irritable Bowel Syndrome, cancer, autism and hormone disturbances like acne and dysmenorrhea. All of which are linked to dairy use.
Healthy Sources of Calcium
With all that said, calcium is still a vital nutrient that is essential for strong bones and other body functions and should be present in the foods you choose to eat. The top 10 sources of calcium: almonds, figs, dandelion greens, collard greens, spinach, fortified soy milk, hazelnuts, cow’s milk, beet greens and mustard greens (12). Yes, cow’s milk is indeed on this list, but it comes in 8th place! There are 7 other choices that have higher calcium content than cow’s milk and without the huge downside. So the next time you are feeling the need to strengthen your bones, have a handful of almonds and hazelnuts as a snack and make a side dish at dinner of some sautéed greens!
The Optimal Diet for Strong Bones
The US recommended daily allowance (RDA) for protein is 10-11% of total calorie intake and is calculated as .8g/kg of body weight per day (1kg = 2.2lbs) (13). The actual amount needed to replace protein loss regularly excreted by the body is 5-6%, but the RDA has been increased to make sure we are covered each day. Yet, Americans consume on average 15-16% of daily calories in protein (14). In other words, we consume far more animal protein than we need.
In the immediate moment and over the long-term, I find in patients an increasing amount of bacterial and viral load, cardiovascular disease risk, diabetes risk, digestiv problems and pain coming from their animal protein intake, and as such recommend scaling back that consumption and introducing more veggie sources. To support that evolution, I encourage them to throw out their calculators and learn through Food-Mood Journaling to cultivate their own awareness around their food choices and how those choices relate to their health symptoms. You may find, as I did, that my prior “need” for animal protein frequently and often, was more that my blood sugar kept dropping as a result of my prior meal. Once I addressed that, my body was not crying out for as much protein as before. In fact, the main nutrient that most Americans are deficient in is not protein, it is fiber. Plant protein has both, animal does not.
If bone density loss is an issue for you, please take a look at my list of Calcium Content in Foods for sources other than dairy to get your daily calcium requirements.
One service I offer, not just my acupuncture and herb patients, but also those people who simply want to focus on their relationship with food is to do a series of appointments of Food-Mood Counseling. We would work together slowly and gently, keeping your health issues in mind, helping you to better understand not just What you eat, but How, When and Why you eat what you eat. It is a powerful first step on the road to optimal health. And as you learn to take better charge of your food, you will come to your own understanding of how best to nourish yourself each and every day. It’s a lot easier than you think!
• ChartsBin.com available at: http://chartsbin.com/view/1155
• Hegsted, DM. Calcium and Osteoporosis. Journal of Nutrition. 116 (1986): 2316-2319. Available at: http://jn.nutrition.org/content/116/11/2316.long
• National Osteoporosis Foundation, Fast Facts. Available at: http://www.nof.org/node/40
• Sellmeyer, Deborah, et.al. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. [Abstract] American Journal of Clinical Nutrition. January 2001 vol. 73 no. 1 118-122. Available at: http://ajcn.nutrition.org/content/73/1/118.long
• Fernandes G, Lawrence R, Sun D. Protective role of n-3 lipids and soy protein in osteoporosis. [Abstract]. Prostaglandins Leukot Essential Fatty Acids. 2003 Jun;68(6):361-72. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12798656
• Hegsted M, Schuette SA, Zemel MB, et al. Urinary calcium and calcium balance in young men as affected by level of protein and phosphorus intake. Journal of Nutrition. 111 (1981): 553–562. Available at: http://jn.nutrition.org/content/111/3/553.full.pdf
• Campbell, T. Colin PhD, Campbell, Thomas II. Wide-Ranging Effects: Bone, Kidney, Eye, Brain Diseases. The China Study. Benbella Books. Dallas, TX. 2006: 205.
• Braun T, Schett G. Pathways for bone loss in inflammatory disease. [Abstract] Current Osteoporosis Reports. 2012 Jun;10(2):101-8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22527726
• USDA National Nutrient Database for Standard Reference: http://ndb.nal.usda.gov/ndb/foods/list
• Centers for Disease Control and Prevention: http://cdc.gov/nchs/fastats/lcod.htm
• Ibid., USDA National Nutrient Database for Standard Reference.
• Dietary Reference Intake Research Synthesis Workshop. Institute of Medicine Food and Nutrition Board. Available at:CLICK HERE
• Wright JD, Kennedy-Stephenson J, Wang CY, et al. "Trends in Intake of Energy and Macronutrients - United States, 1971–2000." Morbidity and mortality weekly report 53 (February 6, 2004): 80–82. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5304a3.htm