Milk, Does It Do A Body Good? Part 1: Calcium and Osteoporosis
We’ve all seen the advertisements, from the It Does A Body Good commercials to the Got Milk? campaign. It’s been drilled into our heads, over and over again, that milk is absolutely essential to the body. If you’re young, you need the protein, vitamins, and minerals for growth. If you’re not young, you need the calcium to protect your bones against osteoporosis. In this series, I want to examine the good and the bad of dairy consumption. I’m going to break the dairy debate down into five posts:
- Calcium, Bone Health, and Osteoporosis
- Allergenic Components
- Other Possibly Detrimental Components
- Raw vs. Pasteurized/Homogenized
- My Take On The Whole Ordeal
Calcium, Bone Health, and Osteoporosis
Tell someone that you don’t consume dairy products and the immediate question is “Where do you get your calcium,” the implication being that your bones are going to crumble under their own weight without the calcium that the dairy industry tells you is so important. So what’s the big deal about this “calcium” anyway?
What Is Calcium?
Calcium (chemical symbol CA) is the fifth most abundant element by mass in the crust of the Earth. It’s also the most abundant metal by mass in animal bodies, accounting for 1-2% of body weight, most of this in the teeth and bones.(1) Along with potassium, calcium plays a role in proper metabolic function, cellular permeability, and electrical conductance in your nerves. Muscle contractions, nerve impulses, and properly functioning glands and blood vessels, along with blood clotting, are all functions of calcium-potassium channels. Needless to say, calcium is an important element in the body.
Calcium is also one of the three main building blocks of your bones, a point that the marketing firms behind the dairy campaigns are sure to drive home. The other two dietary building blocks are vitamin D and magnesium. And of course, given the “Use It or Lose It” attitude your body brings to the party, weight-bearing activity is necessary to maintaining bone strength. Your bones aren’t just sticks on which to hang skin and hair. They are living pieces of the body, constantly being torn down and rebuilt, luckily in very small sections rather than wholesale.
So there’s no question that calcium is essential to the body. But how much calcium do we need? World’s Healthiest Foods suggests:(3)
Most men should aim for 1000-1200 mg daily, young women for 1000-1300 mg daily, and postmenopausal women for 1200-1500 mg of calcium daily.
Another answer to that question, and one I am more inclined to believe, comes from the work of Dr. Loren Cordain. While I can’t find an exact range, I recall that daily intake for hunter-gatherer tribes was in the 300-600mg/day range. Perhaps someone with The Paleo Diet book can give me an answer from the book. Obviously, our ancestors must have had weak bones since they had such a low calcium intake.
So It Prevents Osteoporosis, Right?
But wait…something doesn’t add up. The United States has a very high consumption of dairy products and calcium, yet it also has one of the highest rates of osteoporosis, while hunter-gatherers were known to have quite robust bones. What gives? The problem is that, contrary to what the dairy industry tells us, there is far more to the equation of bone health than just calcium. Those other pieces of the equation, vitamin D and magnesium, are as important, if not more important to bone health. For instance, hunter-gatherers typically had a 1:1 ratio of calcium to magnesium. Today, it’s more like 4-to-1.(5)
Could too high an intake of calcium actually exacerbate the issue? Would I have asked the question if the answer wasn’t “Yes”? Calcium and magnesium compete for the same absorption channels, so too much of one will preclude the other from being properly absorbed.(5)
High dietary calcium can cause magnesium deficiencies, even when normal levels of magnesium are ingested
And of course, most people are also not eating enough of the right foods for sufficient magnesium intake: nuts, seeds, green leaves, certain fishes. So we take in too much calcium and not enough magnesium.
Vitamin D Works Its Magic
Now we know that too much calcium is a problem. What about the vitamin D variable in this equation? Well, when it comes down to it, vitamin D is necessary for proper absorption and retention of calcium. And where do we get vitamin D? The most prevalent source is our skin, but that requires UVB rays to help the body synthesize the vitamin from cholesterol. We all know that we shouldn’t get any sun though because that’ll cause skin cancer (please note the biting sarcasm here). Other sources of vitamin D are foods that few people eat enough of: eggs, liver, fish, oysters. Eggs are too high in cholesterol, liver is scary, fish tastes “too fishy,” and oysters are like snot. Of course, I only agree with the last one there, but that seems to be the general consensus. Dairy products are fortified with synthetic vitamin D, but you all know how I feel about foods that have to be fortified to have enough of something. If it requires fortification, it’s not a good source for that vitamin.
Vitamin D may actually be more important than calcium. Studies have shown that vitamin D protected women against hip fractures even when milk and high intakes of calcium didn’t.(6) Vitamin K also plays a role in bone health, helping to produce bone-building proteins and inhibiting production of substances that break down bone. But both vitamin D and vitamin K are fat-soluble vitamins and we know that fat should be avoided. Of course, this is a cursory overview of the vitamins and minerals involved in bone health, but it’s illustrative. Others such as potassium also play a role, but are unimportant to our discussion of dairy. Contrary to popular opinion, higher protein intake also appears to be beneficial to saving your bones.
So when you couple too much calcium and not enough magnesium with deficient levels of vitamins D and K and a mostly sedentary lifestyle, what do you get? “Weak bones” is the proper reply. But for some reason the dairy industry isn’t telling us that part. There are two other interrelated components to this debate as well: acid-base balance and calcium balance. Acid-base balance is a measure of the net renal load of the foods you eat.(8) Some foods break down as acid-forming compounds, namely animal products and grains. Other foods break down as base-forming compounds, such as fruits and vegetables. Fats are mostly neutral. Since few of us question the benefits of meat, fruits, or vegetables, that leaves grains and dairy as the dietary components in question.
Understanding Acid/Base Balance
Moving along, the body works to maintain a very tight balance on the pH of the body. If there are too many acid-forming foods in the diet, the body must use a base to neutralize the acid. Your bones are the largest deposits of alkaline material in the body. I’m talking specifically about the calcium in your bones. So if you eat a diet high in meat, grains, and dairy and low in fruit and vegetables (anyone seeing a Western dietary pattern here?), you have a net acid-forming diet, which will cause the body to scavenge calcium from the bones. This leads directly into the discussion of the calcium balance.
Which is better, a calcium intake of 300mg/day or 1500mg/day? The correct answer is “C) There is not enough information to answer this question.” To answer the question, we need to know what the calcium outflow is. If the body in question for the first choice only has a daily requirement of 250mg of calcium while the second body is in need of 1700mg due to the dietary factors we’ve discussed, who is better off? It’s all about balancing the see-saw, not just getting as much calcium as possible. Other factors increasing the need for calcium are smoking, too much alcohol, and too much salt.
It Takes More Than Just Calcium
Looking at the big picture, it appears that a moderate calcium intake is a necessary, but not sufficient, condition in building strong bones. However, dairy is not a necessary component in the equation because calcium is available from so many other sources: kale, almonds, sardines and canned salmon with bones, oranges, broccoli, sweet potatoes. In fact, one study showed that the calcium in kale is better absorbed than that in milk.(9) Note that the mean absorption for dairy was only 32% (that for kale was 40%). Of course, the total calcium content of the milk is far higher, but the point is that the acidic nature of milk may not lend itself to proper calcium assimilation.
When all of this is put together, does anyone think that more milk is the answer to keeping your bones strong? It sounds to me like the proper answer is to eat a more alkalizing diet, meaning that at the very least grains have to go, in favor of fruits and vegetables, along with getting plenty of vitamins D and K and magnesium. Moving about here and there wouldn’t hurt anything either.
Next time we’ll discuss milk allergies.
Sources:
(1) Calcium
(2) Calcium – Deficiency and Toxicity
(3) How Much Calcium Do I Need?
(4) Calcium
(5) Imbalance in the calcium/magnesium ratio
(6) Preventing Osteoporosis
(7) Nutrition Fact Sheet: Vitamin D
(8) The Importance of Acid-Base Balance
(9) Calcium absorption from kale
About Scott
Scott Kustes loves to cook and loves to eat. He started Real Food University to help you get maximum enjoyment out of the meals that you eat. To find out more about how he has rebelled against the fast food culture and counting calories or carbs, join the Real Food Revolution.
22 Reader Comments
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This is a great article and remarkably timed. I look forward to reading the whole series.
My milk consumption dropped immensely when I stopped eating cereal for breakfast. One of my nicknames growing up was Jethro because I ate cereal from a salad bowl like the illustrious Beverly Hillbilly. Fortunately, I’m eating most of what you listed above, and do plenty of weight bearing exercise. I should be ok.
One thing I do love is oysters but they have to be fried–not the healthiest of options. Now if you want real “snot” food–how about the okra they used to feed us in school, complete with what I called “essence of mucous!”
Scott,
Great points about calcium choices and movement. I’m curious if part 2 might make a play on the “every good study is paid for by the dairy lobby” argument?
As for me, I’ve always been great with milk as far as digestion, with nary a GI issue in sight during my “skinny guy bulking” phase. It’s not a part of my diet now and I haven’t noticed a difference in any sort of allergy aspect. N=1, but that’s sometimes how it goes.
Best,
Skyler
I remember reading somewhere about calcium absorption rates being even lower in skim and low fat milk because of the fat to lactose ratio being way off. I though that insulin blocked calcium absorption? Is that coming up in a later post? If not would you mind commenting if this sounds legit?
Thanks and keep up the good work!
Dave
But what about the “calcium emergency”? Haha, I think the real emergency is that the dairy industry’s coffers aren’t full enough. The simple fact that the Japanese eat far less calcium than Americans but have fewer fractures pretty much deep-sixes the Ca hypothesis.
I’m with you about vitamin D, if I had to guess I’d say it’s the biggest player. By hunter-gatherer standards, 99% of americans are deficient (<50 ng/mL).
Nevertheless, good quality milk itself isn’t sufficient to harm the skeleton, even in large quantities. Weston Price documented that in Swiss villagers and the Masai.
Scott,
I am sure you have heard of the supplement ZMA. I have read that it should not be taken with calcium because the calcium blocks the absorbtion of the magnesium which you mention in the article. I don’t think the purpose of ZMA is bone health. If you were interested in bone health then would it be better to get calcium and magnesium in the same meal? Or does the timing not really matter as long as you get enough of each mineral every day?
bpeck
Dave, yes, okra is rather snottish too. One guy told me he made the mistake of adding it to vegetable soup…he ended up with soup with snot.
Skyler, I wasn’t going to go into the dairy funding of the studies as I think there’s enough other evidence against its consumption that I don’t need to go there.
Dave, good thought on the insulin/calcium mechanism. I did some brief research and found that insulin does in fact seem to affect calcium absorption. Here is one link that I found: The Confusion About Calcium
Sasquatch, right-o! I agree with you on the good quality milk, i.e., raw. Though I think I’m giving away the premise to the last post when I say that I think the best milk for humans (other than human breast milk) is none, with raw milk being a tolerable second place.
bpeck, zinc blocks the absorption of calcium, as does iron. Oxalates, such as those in tea, block calcium absorption, which is why putting milk in tea isn’t beneficial (and also ruins the tea…sorry to all the Brits in the audience). From what I’ve found, it appears that for the body to adequately absorb calcium, it actually needs about a 2:1 ratio of calcium to magnesium, along with 1.5g of phosphorus (a 3:2 phosphorus:calcium ratio).
Cheers all…good discussion
Scott
Interesting post. I’ve been drinking a lot of raw milk lately, and tend to see it as a good source of nutrients, protein and fat, rather than something I have to drink because the dairy industry threatens that my bones will turn to dust if I don’t. Your points about Vitamin D and magnesium are interesting.
I admit, I’m a little skeptical about the idea of acid-forming foods and leaching calcium out of the bones. I’m checking out the source you list for that, and would be interested to see other data. One reason I’m skeptical is that so many hunter-gather populations and traditional societies have subsisted on meat-based diets, some almost exclusively on animal products including dairy. It doesn’t seem logical from an evolutionary standpoint that our bodies would have to leach from bones to balance the pH of what we eat.
Food Is Love
Debs -
“One reason I’m skeptical is that so many hunter-gather populations and traditional societies have subsisted on meat-based diets, some almost exclusively on animal products including dairy.”
I share your skepticism. It only takes one exception to disprove a theory. If milk is so bad for us, why are/were the Masaii so healthy? There’s the exception that should be disproving the theory. If one has an axe to grind about milk one presumably either ignores the issue or one searches for evidence of some “factor X” that somehow mitigates for these people the presumed damaging effects of milk. To my mind that’s quite a stretch and it’s a lot more straightforward (Occam’s razor and all that) just to assume that raw unadulterated milk is NOT inherently bad for humans. Of course, what the US milk producers are pushing with their Got Milk? campaign is very far from unadulterated.
Dan
Well, here’s an idea: calcium’s a buffer, right? And you’re intaking calcium in milk, right? So, looking at the Maasai for instance–if they don’t eat a lot of vegetables, and if meat is acid-forming, wouldn’t they be counterbalancing that by drinking milk? And it’s raw milk, too, not the adulterated stuff we have to drink here if we want any. (Don’t even get me started about the stupid laws we have to follow in Ohio if we want to so much as *try* raw milk…) So it seems to me that drinking the milk in their case offsets the lack of vegetable matter in their diet.
I’ve had raw-foodists get on my case about eating meat because of the body pH thing. I just remind them that grains have the same effect and that if I eat enough vegetables it all balances out. I’m not sure why that doesn’t convince them.
Dan and Dana,
Studies have shown that high-protein intakes increase calcium absorption when calcium intake is high, but not when it is low. We also have to consider the higher intakes of vitamins A, D, and K and magnesium amongst these groups eating the entire animal. The Inuit eat lots and lots of whole fish, eyes and all and their diet is actually largely fat, not protein. The Masai drank a good bit of milk as I recall, which is a great source of vitamin K. It could be that the theory isn’t bunk, but that it requires lots of whole foods and other factors to offset. For instance, meat also contains phosphorus, which helps to offset the acidity. Then there’s the iodine in the sea salt and there was likely plant matter consumed while eating the stomach and intestines of animals.
It’s also worth noting that the effects of osteoporosis are gradual and some studies have shown the Inuit to have higher levels of osteoporosis, though those are disputable. Here’s some further reading.
Cheers
Scott
Just as a side note which I didn’t see you mention in your analysis of the calcium/magnesium ratio: An unbalanced ratio of cal/mag in favor of calcium is also one of the most common (and most unmentioned by the medical community) causes of migraines. One of the simplest ways of ending migraines is to put this ratio back in balance. However, with the general population eating a lot of dairy, not eating enough foods with magnesium and then taking a multivitamin that has double (or more) the amount of calcium as magnesium, is it any wonder there are so many commercials on tv for Imitrex, Topamax, etc?
I’ve found the only way to tackle this problem is one of the following:
1. Eliminate (or at the very least, severely limit) dairy and eat more foods containing magnesium. If eating a nutrient dense diet, you’ll still get enough calcium from veggies and other sources. – My preferred method.
2. Supplement with chelated magnesium. Not magnesium oxide, when can cause stomach problems and for the love of your head, not a cal/mag combo which will just start the whole cycle over again. – Not my preferred method, but I used to supplement before I gave up dairy. It worked well, but now opt for the food route and my success continues.
Sure you could just increase your mag intake with food and not limit dairy, but for the amount of dairy we eat, it would take a pretty crazy amount of almonds to keep up! (Or, at least that’s the way it appears to work in practice as those who have tried this couldn’t eat enough mag to compete with their dairy intake.)
My whole family does this along with a few people I’ve mentioned it to. All have had great success and many (including myself) were able to discontinue migraine medication.
So much for milk.
Good stuff Anyway. I didn’t know about the migraine issue. Very interesting and makes sense that an imbalance could cause such issues. It also makes sense when considering that so many people live with migraines.
Cheers
Scott
Very interesting points. I have never had a problem with dairy and always loved it, but my husband and his father both dislike milk, and also suffer joint pain and other physical symptoms when they consume it. Both our children are allergic to dairy protein. I would like to see some investigation into whether all humans are the same when it comes to consuming the milk of another species, or whether, as with Native Americans who are healthy on their traditional diet yet become obese and diabetic on the Western diet forced on them by reservations and the US government, different ethnicities might reflect different adaptive radiations to diverse niches. The Masai, the Swiss, and the Mongolians tribespeople all depend on dairy consumption and are quite healthy on it, but other gene pools seem to do quite poorly with it.
I think it’s time we debunked the idea that all humans are interchangeable with respect to evolutionary adaptation. Some humans thrive on dairy (or meat, or a vegetarian diet, or whatever the eating preference we focus on) and some humans get sick on it. We may be the same species, but dogs are all the same species too, yet display an amazing variety of different needs and abilities which are genetically embedded, and that was done by selective breeding by humans fairly recently. It’s not such a stretch to think that humans also may bear the differences of their ancestors’ ways of life in their genetic makeup.
Meg, there’s obviously some genetic variation amongst people with different ancestral lines. For instance, those of us of European descent tend to handle dairy much better than African or Asian descendants. I think the raw vs. pasteurized issue is a much bigger one than the milk/no milk one, which is why I’m rather lenient in my dietary philosophy in regards to raw milk. For the most part, we’re pretty interchangable, but there are minor differences, such as our ability to process milk. I think wheat is one that few are adapted to consume without some level of detrimental effects. You can find some good posts on that over at Whole Health Source…great blog.
Cheers
Scott
In regards to calcium consumption.
A few factors to consider that affect the strength of your bones that you didn’t mention!
If you only Live to the age of 40 you are unlikely to see osteoporosis. Hunters and gathers did not have a long life span.
Hunters and gathers actually had a lower protein intake the north americans today.
Societies today that have a lower protein intake also need less calcium (in the 300 to 600mg range) and have lower incidences of osteoporosis.
High intakes of phosphorus; Soft drinks and alcohol; as well as smoking also increases bone loss
And Please Don’t Forget that the meat companies have a huge influence as well as the Dairy on our dietary recommendations.
Note: I do not eat dairy products and have not for 14 years, but I do take a calcium supplement twice daily
What I would like to see; is the relation to dairy consumption before bed time and how that affects children with a bed wetting problem? I have seen this tried with only one child but cutting dairy out after lunch, stopped the bed wetting in this child. Anyone else ever tried this, or heard about it?
Thanks so much for this article! I’m trying to heal a fractured collarbone and was distressed at how little it had healed by the 3 week post injury xray. The doctor told me the sliver healed in 3 weeks is normal. I’ve been eating primarily total cereal (grain) and Raisin Bran (mostly grain)… With dairy milk and sometimes soy.
So I guess the milk and the cereal have been turning acid and breaking my bones down at the very time I’m trying to heal a fracture. It’s totally CRAZY that ortho doctors don’t even ask their patients about their diet!
Thanks again!
Dan
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I just have one question. Why do doctors (who should know these things) shove calcium supplements down the throats of the elderly women in order to prevent osteoporosis? Is it because they (1) don’t know this or (2) are just lazy?
Calcium from milk or butter milk ,which is readily absorbed by the body ?
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