Do You Need Milk For Strong Bones? Marketing Says Yes But Science Says No.
“Milk helps build strong bones and teeth!”
Like many, I first heard this mantra when I was a child in elementary school and it is a message that is firmly ingrained in the minds of most as one of the few universal truths in nutrition. The need for dairy products as an irreplaceable part of the human diet for building and maintaining strong bones and warding off the ravages of osteoporosis is considered common knowledge, an unshakable truth, and a message repeated ad nauseum in the media. A message that few would find reason to question. It’s no secret that milk contains calcium- a key mineral for maintaining bone health. Thus, there would appear to be little reason to question its importance as a protective shield against bone loss. As popular and seemingly rational an idea as it may be, the scientific evidence doesn’t support it. Very early in my career I myself was quite surprised to learn that my early indoctrination to the health benefits of dairy consumption didn’t come from credible peer reviewed scientific research, but from a rather successful marketing campaign on the part of the dairy industry. A campaign influential enough to have the US government (and many others around the world) classify milk as a food group- a decision made based on profit and not sound nutritional science. Contrary to popular belief billions of people on the planet do just fine without having milk as a part of their diet. Not hundreds of thousands or millions, but billions. Surprisingly enough, people in countries where milk consumption is minimal have some of the lowest incidences of osteoporosis and hip fractures on earth. A revealing statistic that somehow never seems to find its way to American audiences, nor does the fact that for hundreds of thousands of years, most humans on the planet didn’t drink milk and that many enjoy rather robust health without it. There is a reason for our rather myopic understanding of milk and what it can and cannot do for us and it’s the dairy industry. The reach of the dairy industry’s influence is impressive to say the least, spreading information designed to help them sell more milk not just nationally but globally.
Using a consumer creating model sanctioned by government entities, teaching material for young children in schools about the role of milk in building strong bones and teeth is graciously supplied by the American Dairy Council. Presented as educational material at an early age, such influence affects our perception of milk as a required part of our diets and it is hard, if not impossible for a child to question such authoritative information. An effective model that ensures that as adults the party line that milk is a requirement for optimal health is firmly rooted in our core set of beliefs. It’s a similar methodology used by fast food chains like McDonald’s to market to children, knowing fully well that it will guarantee another generation of customers.
Not only is milk taught at an early age to be an essential part of our diet, it is provided to us as well. As a food product produced far in excess of what we as a nation can consume thanks to heavy government subsidies secured by the dairy lobbies, it can be literally given away and dairy producers still make profits. With the early consumer marketing model in mind it thus makes sense that milk is distributed to young children in schools through government food programs. Good business as it helps to cement the thought process of milk being a necessity as an unquestioned view.
Milk & Calcium- Understanding The Science
As adults we are bombarded by messages and dairy lobby funded ‘studies’ reminding us about the calcium content of milk and dairy products. Most notably for women and the steadily aging American population, milk’s supposed prophylactic effects against bone loss are emphasized. But can the calcium in milk really make a difference in bone density? Looking internationally at the dairy-equals-calcium-which-equals-strong-bones idea, we see clearly that the countries with the highest rates of osteoporosis are the largest consumers of dairy products. The dairy consumption of countries like the United States, Australia, New Zealand, Switzerland, the UK and Northern Europe is enormous when compared to Asian countries such as China where dairy consumption is rare, yet those very countries where less dairy is consumed have they have the lowest rates of hip fracture and osteoporosis in the world.[1,2,3,4]
Rates Of Osteoporosis Are Lower In Populations Who Do Not Consume Milk & Dairy Products
To give an idea of the prevalence of osteoporosis, estimates are that 40% of American Caucasian women and 13% of Caucasian men aged 50 years will experience at least one bone loss related fracture in their lifetime. At age 50, a Caucasian woman has a 17% chance of sustaining a hip fracture, 15% chance of vertebral fracture and 16% chance for forearm fracture, with comparable figures of 6%, 5% and 2.5%, respectively, for fractures in white males. Interestingly enough among the female African American population the age-adjusted prevalence of hip related osteoporosis is only 6%, compared to 17 % for postmenopausal White women- difference consistent with the much lower fracture rates observed in African Americans. African Americans, by the way consume almost 40% less milk and dairy products as their Caucasian counterparts which if by itself renders the milk/dairy-equals-strong-bones theory to be questionable. Statistics from the observation of low dairy intake in Asian population contradict the milk/dairy-equals-strong-bones theory completely. Using China as an example, where cheese and other popular dairy products are not a part of their regular diet and where milk consumption is 10% of the American per capita consumption rate  age standardized incidence of hip fractures is far lower than their milk drinking American and European counterparts. Based on the 1990 China census figures hip fracture rates were only 87 per 100,000 for women and 97 per 100,000 for men. Contrast these numbers with 510-559 per 100,000 for white American women and 174-207 per 100,000 for American Caucasian men. In fact, hip fractures in Beijing are reportedly among the lowest rates of occurrence in the world- and with a population where milk is by no means a staple.
Debunking The Need for Milk- It’s The Calcium Lost Not Calcium Consumed That Causes Osteoporosis
As much as the good (and well paid) folks at the American Dairy Association would like you to think that increasing your calcium intake by drinking milk would decrease your risk of osteoporosis, the science behind this premise simply doesn’t support it. From what we do know about bone loss, it happens not so much from not having a high enough calcium intake, but rather from having a high level of calcium loss due to dietary and lifestyle choices.  According to the findings of the 1994 National Institutes of Health Consensus Conference, at least one third of calcium balance and bone density is dependent on the ratio of intake to loss and not solely on calcium intake alone as the marketing campaigns would have you believe. To be frank, meta-analysis of literature meeting the provisions for unbiased scientific research found there were no significant relationships proved between milk consumption or any other dairy product to measures of bone health nor were there no correlations between calcium intake and bone loss.[9,10,11,12] Similarly, an 18 year analysis of 72 337 postmenopausal women published in the February 2003 American Journal of Clinical Nutrition, found that an adequate vitamin D intake was associated with a lower risk of osteoporotic hip fractures in postmenopausal women. Neither milk nor a high-calcium diet in the study had any correlation with a reduction in risk of osteoporosis.
Milk Isn’t The Best Or Only Source Of Calcium
So we have established that bone loss has little to do with intake, but for those concerned nevertheless about their calcium intake, it should be noted that a 1990 report in the American Journal of Clinical Nutrition found that green leafy vegetables such as broccoli and kale have high levels of calcium and is absorbed at least as well as the calcium in milk. [12,13,14] Proper calcium balance on a non-dairy diet is easily attained because ALL vegetables and legumes contain calcium.  Thus within the context of a balanced diet it is more than adequate to prevent frank deficiencies which are rare to nonexistent in developed countries such as the United States. In terms of the ultimate source of calcium, however no other food source can compete with the bioavailability of calcium from bones. That’s right, bones. You don’t hear much about it since eating bones isn’t that popular here in the United States and given that both dairy producers and supplement manufacturers would be hard pressed to sell their wares if the general population was aware that eating small amounts of bone is how humans got most of their calcium for several hundred thousand years. The small and soft bones of fishes like sardines are a perfect source of calcium in a form our bodies can easily absorb, as is the use of bone meal that can be added to soups and broths. Since these sources are better absorbed (and it makes sense that bones would be the best source of building material for bones) our body retains more of it as opposed to being mostly excreted in urine as is often the case with dairy products and artificial supplements.
Osteoporosis is a very real concern for many women, as they make up 80% of those affected by this condition. Osteoporosis is a major public health threat for an estimated 44 million people here in the United States with almost 10 million individuals estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. It is time we paid more attention to what has been proven to be real risk factors, such as soda consumption, high sodium diets, smoking, excessive caffeine consumption, alcohol and an inactive lifestyle, than simply falling for the marketing hype that somehow drinking milk or eating yogurt and cheese will magically protect you from low bone density.
Getting the recommended daily allowance of calcium at all ages is important, preferably from dietary sources. But bone nutrient requirements are wide and far more complex than simply drinking milk or taking a calcium supplement. A diverse diet of natural foods that includes meat, fish, fresh vegetables, fruits and nuts will always cover the diverse nutritional needs of our bones as long as we stay away from high fat, high sugar and high sodium processed foods. Limit high fat protein sources, keep your salt intake low, reduce your alcohol consumption and don’t smoke and you’ll be fine. Also important is the amount of time spent outdoors. Get sunlight on your skin at safe times of the day for vitamin D as it plays an integral role in helping our body use calcium efficiently. As much as commercials warn us of the dangers of sunlight, recent studies have suggested that avoidance of sunlight is associated with higher risks of certain cancers- which should not be surprising as we did in fact evolve outdoors and not in the confines of fluorescent lit cubicles.
Dairy Products and Weight Gain
One of the most puzzling aspects of the practice of drinking milk and dairy products is that in a society where obesity is rampant, few are willing to give up what is essentially nature’s weight gain formula for young mammals. What puts that plump layer of fat on nursing babies and makes them expand almost as the days go by, is milk. From baby elephants to baby gorillas, milk is the primary food source when they are in early infancy and is responsible for a significant growth spike helping them to pack on. A mixture of water, sugars, fats and salt, milk is nature’s ultimate weight gain formula, helping infant mammals increase their body mass significantly in relatively short periods of time. Milk helps calves pack on hundreds of pounds to become cows, and interestingly enough, no adult mammal living in their environment consumes milk past infancy. Only humans and the animals we domesticate will drink milk as adults and it bears mentioning that the very countries with the highest dairy consumption are also the ones with the highest rates of obesity and metabolic disease. From a weight gain standpoint, as early as the 1950’s when bodybuilders wanted to decrease body fat and increase their muscular definition the first thing they would cut out of their diet was milk and dairy products as those were only consumed in the offseason when trying to get as big as possible. In the natural bodybuilding world today as well, dairy is almost universally restricted by those trying to reduce their body fat as it has been long observed that additions of seemingly benign products such as low fat yogurt make it more difficult to attain the higher degrees of muscle definition and lowered body fat needed for competitions. Whey protein shakes are also chucked aside during periods of contest dieting as they are in essence glorified milk shakes to say the least. (See my article on protein shakes and why you don’t need them here). Some studies, heavily popularized by the media found an association between dairy consumption and fat loss as the theory was that because dairy products contain calcium, protein and other bioactive compounds, that it might somehow favorably affect energy balance. In randomized controlled trials, however these findings were inconsistent at best and a meta analysis of all the trials did not support the beneficial effect of increasing dairy consumption on body weight and fat loss in long-term studies or studies without energy restriction. Finally, it is important to stress the role of exercise and not dairy intake as a way of increasing bone density. Weight training in particular plays a poignant role in maintaining and building healthy bone mass levels (Read my article here on weight training and osteoporosis). It’s a simple and scientifically proven way for prevention of low bone mass and in helping those with low bone mass levels build up their bones. So put down that glass of milk and start pumping some iron!
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References for Do You Need Milk For Strong Bones:
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