Got Calcium? Milk’s Not The Only
Nor Necessarily The Best Source

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

“Drink your milk.”

Who hasn’t been told to drink milk? My mother insisted I drink milk to grow up healthy and strong, even though it caused me to suffer nausea, cramps and vomiting. Lactose intolerance wasn’t well known then. Now I have choices about how to obtain the dietary calcium I need. I am able to eat some ice creams and cheeses, but still can’t drink cow’s milk without intestinal pains.

My daughter drinks soymilk. She’s been lactose intolerant since infancy and was switched to soymilk when she finished nursing. When she was a tiny baby, I ate some ice cream. The next morning, she awoke screaming with a hard tummy and diarrhea. I was frantic, but my mom reassured me that it was most likely due to something I had eaten that had entered the breast milk. After reviewing everything I had eaten the day before, I realized the ice cream was the thing she had never had. I avoided dairy products for the rest of the time I nursed her and she’s had no further problems. She eats a dairy free diet, lots of vegetables and soy and takes a multivitamin supplement containing calcium. I also make sure that she plays vigorously for at least thirty to sixty minutes each day.

There is an ongoing debate about whether milk is the “nearly perfect food” it’s claimed to be. The debate has received renewed fervor following a published report in the March 2005 Pediatrics, the journal of the American Academy of Pediatrics. Researchers with the Physicians Committee for Responsible Medicine (PCRM) reviewed fifty-eight studies that named milk as the best source of calcium. They agreed with findings that calcium is needed for strong teeth and bones, but disagreed that milk is the best source of calcium. They note specifically that the Harvard Nurses Study showed nurses who drank or ate three or more servings of dairy products daily had no fewer wrist or hip fractures over the twelve years of the study than nurses who consumed no dairy. The researchers also believe the recommended daily intake suggested by the US Department of Agriculture and the American Dairy Council, eight hundred to thirteen hundred milligrams daily, is inflated and believe five hundred milligrams daily is enough. The group is receiving backlash from pro milk supporters because the PCRM group is best known for opposing animal research, is strongly pro-vegetarian, and advocates elimination of all animal products, including milk, from the diet.

Proponents of milk argue, “Milk is rich in calcium and protein. All children should drink three to four glasses of milk daily to build strong bones and healthy teeth.” But what about children and adults who are lactose intolerant and lack the enzyme lactase, which breaks down the milk sugar lactose?

Research published in the May 2002 American Family Physician, the journal of the American Academy of Family Physicians, stated lactose intolerance is experienced by fifteen percent of Caucasians, up to eighty percent of Latinos and African Americans, and between eighty percent and one hundred percent of Asians and American Indians. Yet, African Americans and Latinos have the lowest rates of osteoporosis, while Caucasians and Asians have the highest rates. (There is insufficient data on rates of osteoporosis in Native Americans.) Of note, with the exception of the Asian population, those ethnicities with the highest rates of lactose intolerance have the lower rates of osteoporosis. Do we need milk?

Proponents of dairy say those of us with lactose intolerance can drink milk—if we drink it with meals and space out servings. No pain no gain? I’ll pass (on the gas) thank you.

Dairy proponents say most people can’t (or won’t) eat enough calcium rich foods (such as dark, green leafy vegetables, beans, salmon, nuts, and soy products) daily to meet their calcium requirements. While four eight ounce glasses of milk will meet the recommended daily calcium requirements, two and a quarter cups of cooked broccoli and eight cups of cooked spinach are needed to meet the recommended daily requirements.

It’s true that Americans don’t eat the recommended daily servings of fruits and vegetables, so relying on these sources alone for calcium could leave a lot of people at risk for calcium deficiency and osteoporosis. Perhaps if we had commercials and billboards of celebrities with broccoli or apricots hanging out of their mouths saying, “Got veggies?” or “Fruit it does a body good” then produce consumption would skyrocket. But until someone steps up and funds such an initiative, our eating habits are unlikely to change.

Another concern is that milk proponents don’t mention anything about weight bearing exercise which is critical to maintaining bone mass and strength. Opponents say cow’s milk is rich in fat and proteins that are neither necessary nor healthy for humans. With the growing obesity epidemic in America, they recommend eating a wide variety of plant based calcium rich foods and incorporating daily weight bearing exercise into a person’s regimen to help support bone health and to maintain healthy weight.

Why not get calcium from as many sources as possible? We’re fortunate in this country to have such sources as calcium fortified cereals and juices. Those of us unable to digest milk can choose alternatives. For those who can digest milk, have a glass or two of milk daily, but also eat some vegetables and nuts and throw in a brisk walk for good measure.