‘Bone’ appetite

by Royce Bailey M.D., M.P.H., F.A.A.C.

-Your bones are what you eat
-Controversies in calcium
-What makes strong bones for life?

Requirements For Calcium Absorption

Calcium is the most abundant mineral in the body. Every cell requires calcium. Most chemical reactions in your body require calcium. 99% of your body’s calcium stores are in your bones and teeth. Calcium is essential for proper blood clotting, nerve impulse function, muscle operation and proper bone, teeth and cartilage formation. Proper calcium absorption requires vitamins A, D, C, phosphorus, boron and magnesium. Note, fluoride is not needed for absorption.

Bone Loss

Bone loss is not just a old age problem. You start to lose calcium bone mass at around age 35. Most women have 22 pounds of calcium in their body, but by age 45 they have lost 2 pounds of bone. By age 55, they have lost another four pounds. At age 60 the average American female has lost another three pounds of bone. That’s almost 40% of your bone mass lost before you even reach retirement age!

What Causes Calcium Loss?

We all should be protecting our calcium stores. Once calcium is lost it is very hard to restore it to near-normal. If there is not enough calcium in your diet where does your body get extra calcium? If there is not enough calcium in your blood stream where does your body get extra calcium? What causes calcium loss? Your diet!!! Lifestyle causes osteoporosis (thin bones):

1. Lack of weight bearing exercises. Astronauts lose 200mg/d of calcium in space.
2. Excess protein intake. (> 65 grams/day, recommended .8 gm/kg)
3. Caffeine intake.
4. Nicotine.
5. Carbonated beverages.
6. Lack of sun exposure.
7. Excess salt

But I Want My Soda

Calcium (Ca) binds with phosphorus roughly one to one. In a simplified explanation of the chemistry, high phosphorus (high salt/protein) diets (soft drinks are high in phosphoric acid) are usually two phosphorus molecules to one calcium molecule. Again, where does the body get the extra calcium to bind the outstanding phosphorus? From the blood stream. What if it is not available in the blood stream? It steals the extra calcium from your bones. What happens when your bones are finally depleted?

Deficiencies Are Not Seen In Third World Countries

It was found that African women over 60 years old who rarely, if ever, ate dairy products, consumed only 250-400 mg of calcium a day from vegetables and had an average of ten children in their life, had healthy bones and no calcium deficiency. But young women eating the Great American Diet (McDonald’s type) who had no children, were eating heavily of dairy products and consuming over 500 mg of calcium/day, suffered significant loses of calcium from their bones. Native women who moved to the city and began eating the Great American Diet, suffered significant loses of calcium from both their bones and teeth. Research shows that the National Institutes of Health Recommended Daily Allowance (RDA) of 1500 mg of calcium a day isn’t even enough for those who eat the Great American Diet! Why?

Brain-Washed By The Milk Board

But milk is good for your bones-RIGHT? The Milk Board (The United States Lobby For Milk Use) would have you think so. Milk is touted as preventing osteoporosis, yet clinical research shows otherwise. The Harvard Nurses Health Study, followed 75,000 women for 12 years, showed that a increased intake of calcium from dairy products was associated with a higher fracture risk. Do you remember the Ad, “Everybody Needs Milk?” In 1974, the Federal Trade Commission found the Milk Ad Campaign deceptive. Several very large studies showed excellent absorption of calcium from milk into the blood stream, but did not demonstrate increased bone calcium mass. Later smaller studies showed that the higher the protein content in the diet, the more calcium was lost through the kidneys, with a net total loss of body calcium when milk was consumed.

Eat Your Protein, Lose Your Bones

The higher the protein in the diet the better-RIGHT? Unprocessed plant-based foods easily meet the protein needs for both adults and children. But no study exists proving that high blood level of calcium from milk and meat ended up in your bones. In fact, the higher the daily protein intake, (and milk is a protein and acts like a solid in your stomach), the less calcium was found in the bones. Why? Milk is made up of two parts 1. Casein (Curds) 2. Whey Remember “Little Miss Muffit sat on a tuffit eating her curds and whey.” Casein acts like a diuretic of calcium. The more casein eaten the more wasting of calcium in your urine. Also, the more protein eaten, the more wasting of calcium in your urine. So, milk can cause a double calcium loss; ultimately thinning your bones.

The Long Term Problem With High Protein

Quick weight loss programs emphasizing high protein diets include: Atkins, Zone, Protein Power, Sugar Busters and the Stillman Diet. These diets are rich in protein and animal/saturated fat, such as meat, meat substitutes, cheese, milk and eggs. Long-term diets high in fatty animal foods increase your risk for: coronary artery disease, diabetes, stroke, cancer, compromised vitamin and mineral intake, worsened liver and kidney disease. Here are some reasons for high protein diets: They may provide a quick drop in weight; this is through the loss of fluid, by the diuretic effect of eliminating too many carbohydrates; Complex carbohydrates reduce blood pressure and cholesterol, but replacing them, however, raises bad oxidized Cholesterol (LDL). My patients say this is the only way they have been able to lower their blood sugar and lose weight. But it doesn’t last for long. No one can live on eight eggs a day for long. There is a healthier way.

Magnesium (Mg) Deficiency

We’ve tilled our soil for 200 years. Most of our fresh fruits/veggies in the winter come from outside the United States, and they have tilled their soil for over 2000 years. Our calcium ratio should be two calcium molecules to every one magnesium molecule (2:1). The usual American diet with calcium supplements of 1500mg/day is a five calcium to one magnesium ratio (5:1). Intakes and nutrients that increase magnesium need in the body include: fats, calcium, phosphate, Vitamin D, sugar, alcohol, high fiber (interferes with mineral absorption) and Cortisone (Prednisone) Calcium/Magnesium Deficiency and Stroke.

Finland has the highest stroke and ischemic heart disease rate in the world for young and middle aged men. Finland follows the Great American Diet: low fiber, high sugar, high salt, high protein, 50% empty calorie diet (Junk Food). Finland has a life long Ca/Mg ratio of 4:1. Osteoporosis is prevalent. Japan has the best Ca/Mg ratio of all industrialized countries. Japan has the lowest heart disease when not adopting a Western Diet. Magnesium is an essential part of the organic bone matrix. Calcium supplements intensify the negative Mg balances in your body.

Long-term Magnesium Deficiency Cause:

1. Arrhythmias (High Mg < Adrenaline release)
2. Sudden Death
3. Vascular damage, ie. Arteriosclerosis
4. Hypertension (Free intracellular Mg is depressed)
5. Kidney stones
6. Brittle bones
7. Hypercoagulability
8. Eclampsia
9. Calcinosis (Calcium in soft-tissue other than bone)

Magnesium Deficiency May Lead To:

1. Irritability
2. Mental fog
3. Muscle weakness
4. Cramping
5. Palpitations
6. Low potassium levels

Which Kind Of Calcium?

Calcium is an unstable mineral. In nature it is almost always found as a calcium salt. Like calcium plus carbon (carbonate), calcium plus citric acid (citrate), calcium plus lactate (found in milk) and calcium plus animal bone (hydroxyapatite).

The vast majority of calcium sold in the stores is calcium carbonate (including coral calcium and antacids like Tums). It’s cheap and plentiful, but absorption into our bones is only about 20%, so you have to take a lot. The fracture rate for those taking calcium carbonate is still 357 fractures/one thousand patient years in one study. Calcium citrate is easily absorbed but contains only 10% elemental calcium. That’s why calcium citrate pills are so large.

The best source of calcium is from vegan sources. There may not be very much calcium in these sources but all of this calcium goes to your bones: Tofu, Rhubarb, Collard greens, Spinach, Turnip greens, Okra, White beans, Baked beans, Broccoli, Peas, Brussel sprouts, Sesame seeds, Bok choy, Dried fruit, Brazil nuts and Almonds (six almonds/day gives 84mg magnesium and 75mg of calcium).

Boron

Boron is the forgotten trace mineral. Boron influences Ca and Mg metabolism to prevent bone demineralization. Boron helps cell membrane function. It increases concentrations of plasma estrogen and decreases cardiovascular disease incidence. Boron assists in the development of new bone.

What do you know about Vitamin D?

A recent study found that 57% of the people admitted to a Boston Hospital had a Vitamin D deficiency. Sunlight on unprotected skin causes the body to produce vitamin D. Get 15 minutes of sunshine a day on your hands, feet, back of your legs and arms. If your bones are thin consider taking 1000-5000 International Units of Vitamin D a day to make up for lack of sun exposure.

Vitamin D deficiency:

1. Decreases bone mass.
2. Increases risk of fractures.
3. Increases risk of kidney stones.
4. Causes muscle weakness.
5. Worsens generalized fibromyalgia-type pain and peripheral neuropathy.
6. Worsens Multiple Sclerosis (MS).
7. May contribute to autism.
8. Increases risk of many cancers.
9. May induce diabetes.
10. Increases risk of vascular disease and hypertension.
11. Worsens Polycytic Ovarian Syndrome (PCOS).
12. Worsens depression.
13. Worsens balance problems and causes more falls.

Vitamin K

Vitamin K helps prevent arterial calcifications (hardening of the arteries) by keeping the calcium in your bones, not in your tissues. Calcium supplements alone can be detrimental and then can seep into your arteries. Imagine a vitamin that could keep calcium in bones and out of your arteries. Vitamin K is found in abundance in green veggies. Avoid Vitamin K if you are taking Coumadin/Warfarin, for it attaches to the same clotting receptor as coumadin, thus making your blood too thick.

Calcium Study

If you have had a bone density study and have found your bone too thin, here are my recommendations for stronger bones:

1. Calcium/Magnesium supplement with a ratio of 2:1 (like 1500mg Ca/750mg Mg)
2. Vitamin D (sun and pill 5000IU)
3. Boron 3 mg/day
4. Avoid high protein and salt diets
5. Vitamin K 5-10mg/day
6. One ounce of water for every kilogram of your body weight every day
7. Daily exercise
8. An alkaline diet (fruits, nuts, grains, veggies) vs. the Great “Acidic” American Diet
9. “A merry heart doeth good like a medicine, but a broken spirit drieth the bones ” Proverbs17:22

References:

Lovendale,M., “Are Cows Hurting Children?” Quality Longevity.

Walker, “Calcium Study,” Clinical Science, 1972.

Anad, C., “Effects of Protein Intake on Calcium Balance of Young Men Given 500mg Calcium Daily,” Journal of Nutrition, 1974;104:695.

Feshanich,D., “Milk, Dietary Calcium, And Bone Fractures In Women: A 12-year Prospective Study,”Am J Public Health, 1997;87:992-7.

Oski,F., “Don’t Drink Your Milk,” Mollica Press, LTD, Syracuse, NY; 1983.

Nomilk.com and Notmilk.com are good resources.

Hegstead, M. “Urinary Calcium and Calcium Balance in Young Men as Affected by Level of Protein and Phosphorous Intake.” Journal of Nutrition, 1981;111:53.

Finn,S.C., “The Skeleton Crew: Is Calcium Enough?” J Women Health, 1998;7(1):31-6.

USDA, “Bone Loss, Phosphorous And Soft Drinks,” Nutrition Week, September 18, 1998;28(36):7

Walker, R., “Calcium Retention In The Adult Human Male As Affected By Protein Intake,” Journal of Nutrition, 1972;102:1297.

Johnson, N., “Effect of Level of Protein Intake on Urinary and Fecal Calcium and Calcium Retention of Young Adult Males,” Journal of Nutrition, 1970;100:1425.

Linkswiler, H., “Calcium Retention of Young Adults Males As Affected by Level of Protein and Calcium Intake,” Trans New York Academy of Science, 1974;38:333.

McDougal, J., “McDougal’s Medicine,” New Publishers, NY, 1985.

Karppanen, H., “Magnesium Bulletin,”1990;12:80-86.

Seelig,M.S., “Magnesium Deficiency In The Pathogenesis Of Disease. Early Roots of Cardiovascular, Skeletal, and Renal Abnormalities.” Publ Plenum Press, NY, 1980.

Thomas M., “Vitamin D Deficiency Is Very Common,” Harvard Medical School News Letter, 5/1/02.

Hunt,C.D., “Metabolic Responses Of Postmenopausal Women To Supplemental Dietary Boron and Aluminum, During Usual And Low Magnesium Intake: Boron, Calcium, And Magnesium Absorption And Retention And Blood Mineral Concentration,” Am J Clin Nutr, 1997;65:803-813.

Samman,S., “Minor Dietary Factors In Relation To Coronary Heart Disease-Flavonoids, Isoflavones And Boron,” J Clin Biochem Nutr, 1996;20:173-180.

Vitamin K Articles:

Circulation 2000,102:380-385

J Am Col Card 2000;36(1):326-340

Hematol Oncol Clin North Am 2000 Apr;14(2):339-353

Int J Exp Pathol 2000 Feb;81(1):51-56

Tucker,K.L., “Potassium, Magnesium, And Fruit And Vegetable Intakes Are Associated With Greater Bone Mineral Density In Elderly Men And Women,” Am J Clin Nutr, 1999;69:727-36.