Calcium and Osteoporosis

The low down on calcium, dairy and osteoporosis

Naturopath Brisbane Southside - The low down on Calcium, Dairy and Osteoporosis.

Michelle Blum who practices Acupuncture and Naturopathy in Moorooka, a suburb in Brisbane's south, discusses all things Calcium, Dairy and Osteoporosis in this latest blog.

Calcium is synonymous with three things; strong bones, strong teeth and dairy. They fit nicely together when it comes to selling milk and dairy products, but is it all really that simple? With the rates of osteoporosis on the rise in the western world, despite regular consumption of calcium-rich dairy, it’s time to review the role of calcium. 

Calcium and bone health

Yes, calcium is vital for strong bones and teeth, with 99% of the body’s calcium stored in these connective tissues. The intake and absorption of dietary calcium are critical for the mineral deposition in the bone as well as bone growth and repair [1]. Outside of bone tissue, calcium also helps to regulate muscle contractions and movement1. To read this study, click here.

Does calcium actually lower the risk of Osteoporosis?

If you are a woman in your post-menopausal years, chances are that you have a little bottle of calcium in your medicine cabinet. If you don’t, your elderly parents probably do. Maintaining bone mineral density (BMD) is a key measure in preventing osteoporosis, and calcium supplementation aim to support this.

The evidence between average calcium intake from milk consumption and the prevention of osteoporosis and fractures is limited. A Harvard-led study found that men and women who drank one glass of milk or less per week were at no more risk of fracture than those who drank two or more glasses of milk each week [2, 3]

A large analysis of the available evidence concluded that there is no significant association between calcium intake or supplementation and the risk of fracture in men and women [4]. However, the study acknowledges that the form and effects of supplemental calcium in some of the trials were not assessed [4], 

Not all calcium supplements are created equal

Over the counter calcium supplements often contain calcium in the form of calcium carbonate. Which actually has the same chemical structure as chalk!

A recent trial administered 60 post-menopausal women either calcium carbonate, calcium hydroxyapatite or control for two years, to determine the effects of calcium supplementation on BMD [5]. The hydroxyapatite form resulted in less than 1% loss in BMD at the two-year mark, compared to almost 4% BMD in the calcium carbonate group (Figure 1) [5]. This confirms that for the purpose of maintaining BMD, calcium hydroxyapatite is likely to be superior to supplementation with calcium carbonate [5]. These findings supported those of an earlier trial in Figure 2 [6].

Figure One: Calcium Hydroxyapatite Reduces Bone Loss [5]

Figure Two: Calcium Hydroxapatite Reduces Trabecular Bone Loss [6]

Is dairy the best dietary source of calcium?

Calcium has been dairy’s selling point for, well, ever. While dairy does contain calcium and is a convenient source for many people, the correlation between dairy consumption and disease prevention is not strong. At present, the recommended dietary calcium intake for adults is upward of 1000mg per day. To meet this target through dairy alone would require drinking 2-3 glasses of milk daily. This can present other health challenges in terms of:

• Bloating, gas, pain and diarrhoea from excess lactose consumption

• The effects of lactose and casein as proteins that can trigger the immune system

• Saturated fat intake particularly in populations already consuming animal products

• Possible increased risk of ovarian [7, 8] and prostate cancer [9, 10]

The best non-dairy calcium sources11:

• Firm Tofu - 1 cup delivers 832mg

• Sardines - a 90g can deliver between 330-486mg

• Pink salmon - a 90g can deliver between 183-279mg

• Red salmon - a 90g can deliver between 175-203mg

• Mussels - 100g delivers 173mg

• Snapper - 1 fillet delivers 163mg

• Silverbeet, boiled – 1 cup delivers 174mg

• Figs, dried – 6 figs deliver 160mg

• Soybeans – 1 cup delivers 106mg

• Tahini - 1 tablespoon delivers 66mg

A word on the environmental impacts of milk…

There is an emerging concern that the recent demand for plant-based milk substitutes is contributing to greenhouse gas emissions and the destruction of the land. Currently, it is still more environmentally friendly in terms of greenhouse gas emissions and land use, to grow almonds than it is to produce dairy milk [12].

Unfortunately, the current agricultural paradigm means that the farming of most crops is having detrimental effects on the climate and environment. When choosing your milk, whether it is dairy or plant-based, consider purchasing an organic brand or do some research and find a source that has been biodynamically farmed. 

Ways to maintain healthy bones and prevent osteoporosis:

• Keep active – using your muscles also strengthens bone tissue [13]

• Get plenty of sunlight – vitamin D helps to regulate calcium in the body to prevent fractures [14]

• Avoid Cola – cola soft drinks contain a lot of phosphorous, which has been associated with loss of bone mineral density and weaker bones [15]

For Acupuncture and/or Naturopathy bookings or enquiries please visit Michelle Blum Natural Health here, located on Brisbane's south side.

Reference List:

1. Harvey NC, Biver E, Kaufman JM, et al. The role of calcium supplementation in healthy musculoskeletal ageing: An expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF). Osteoporos Int. 2017. doi:10.1007/s00198-016-3773-6

2. Owusu W, Willett WC, Feskanich D, Ascherio A, Spiegelman D, Colditz GA. Calcium Intake and the Incidence of Forearm and Hip Fractures among Men. J Nutr. 1997. doi:10.1093/jn/127.9.1782

3. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: A 12-year prospective study. Am J Public Health. 1997. doi:10.2105/AJPH.87.6.992

4. Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, et al. Calcium intake and hip fracture risk in men and women: A meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007. doi:10.1093/ajcn/86.6.1780

5. Castelo-Branco C, Pons F, Vicente JJ, Sanjuán A, Vanrell JA. Preventing postmenopausal bone loss with ossein-hydroxyapatite compounds: Results of a two-year, prospective trial. J Reprod Med Obstet Gynecol. 1999.

6. Rüegsegger P, Keller A, Dambacher MA. Comparison of the treatment effects of the ossein-hydroxyapatite compound and calcium carbonate in osteoporotic females. Osteoporos Int. 1995. doi:10.1007/BF01623655

7. Genkinger JM, Hunter DJ, Spiegelman D, et al. Dairy products and ovarian cancer: A pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev. 2006. doi:10.1158/1055-9965.EPI-05-0484

8. Ganmaa D, Sato A. The possible role of female sex hormones in milk from pregnant cows in the development of breast, ovarian and corpus uteri cancers. Med Hypotheses. 2005. doi:10.1016/j.mehy.2005.06.026

9. Giovannucci E, Liu Y, Platz EA, Stampfer MJ, Willett WC. Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. Int J Cancer. 2007. doi:10.1002/ijc.22788

10. Giovannucci E, Rimm EB, Wolk A, et al. Calcium and fructose intake in relation to risk of prostate cancer. Cancer Res. 1998.

11. Committee OAM& SA. Calcium Consumer Guide 4th Edition.; 2006. https://www.osteoporosis.org.au/sites/default/files/files/OA Calcium Ed4(1).pdf.

12. Poore J, Nemecek T. Reducing food’s environmental impacts through producers and consumers. Science (80- ). 2018. doi:10.1126/science.aaq0216

13. Borer KT. Physical activity in the prevention and amelioration of osteoporosis in women: Interaction of mechanical, hormonal and dietary factors. Sport Med. 2005. doi:10.2165/00007256-200535090-00004

14. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: A meta-analysis of randomized controlled trials. J Am Med Assoc. 2005. doi:10.1001/jama.293.18.2257

15. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham osteoporosis study. Am J Clin Nutr. 2006. doi:10.1093/ajcn/84.4.936