I recently got a new personal training client in my door who has osteopenia. After going through my normal schpeal about food and not wanting to overwhelm my 64 year old client on eliminating too many things too soon, we came upon the subject of dairy. After I laid out to her the basis for eating only meat, vegetables, fruits, nuts and seeds she said to me " but how will I get my calcium? you are going against everything all my doctors told me about my osteopenia."
This brings up a really relevant question for people, especially ones with osteopenia or osteoporosis. I told her what I always tell people which is that before we were dairy eaters we got our calcium from plants and green leafy vegetables. She relpiled by saying that her doctor told her she wouldn't be able to eat enough of these sorts of vegetables to get enough calcium and that she needed a calcium supplement and 1500mg a day. Obviously... this answer frustrated and frightened me.
Here are the issues with this.
1) We consume the highest amount of dairy products in the world
2) We have the highest rates of osteoporosis in the world.
Why do we seem to keep medicating this problem with calcium supplements that we don't absorb and drugs like fossamax that only increases bone density not bone strength, which beleive it or not are two separate things! Bone density refers to the amount of minerals that are in the bone matrix and bone strength measures how strong the bone is as a function of it's density and quality. For years MD's have been using bone density tests as way to say that the denser the bone is the stronger it is. For a great study and article on bone density vs bone quality click the link from the Cleavland Clinic Journal of Medicine.
Bone structure, breakdown, formation, and retention is not all about just calcium. There are internal factors going on with absorption in the gut as well as external factors going on with the pasteurization of dairy products.
When we look at bone structure, breakdown, formation, and retention from an evolutionary perspecticve, we get a clearer picture. As I always like to say, if it doesn't get inside your cells, it doenst count!
1) If your gut is irritated by neolithic foods like grains and gluten, dairy, sugar, or legumes then you are not fully able to absorb nutrients coming from foods you eat or supplements you take which means all that calcium you are taking in isn't getting made into bone! Here is a great article from Robb Wolf about why going gluten free increased a patients bone strength.
2) Mineral retention is an acid-base balance problem that is discussed very well by Dr. Cordain in the Paleo Diet book. When our bodies are at a net acid load, it wants to balance back out to neutral by finding an alkaline source. Calcium in our bones is one of the largest sources of alkalinity we have and is depleted and excreted when we need to balance our acidity.
1) Dairy sold in stores is pasteurized. This process destroys much of the enzymes in the milk that help us absorb and transform all the good stuff that's in it like calcium. Not to mention all the chemicals and hormones that are in dairy products. So all that dairy is not only irritating your gut, it's also a terrible source of bio available calcium.
So how can you get your calcium?
- Heal your gut: Eat foods that support a healthy intestinal lining like fruits, veggies, lean meats, nuts and seeds and limit your intake of gut irritating foods like dairy, sugar, grains, and legumes
- Eat lots of fresh and minimally cooked/steamed dark green, leafy veggies
- Exercise! It increases bone density and strength
- Get sun exposure, it's the best way to increase your vitamin D production
- Get the right amount of Omega-3 Fats
- Improve your hormonal functioning: Eating a high protein diet actually improves our hormonal state which helps us retain more minerals