Mainstream medicine and nutrition guidelines deliver these messages: Meet calcium intake recommendations when you’re young or your bones won’t develop well, and they’ll fracture when you’re old. To get enough calcium you’ll need dairy products or supplements. If you’re a postmenopausal woman, a bone scan will tell if you need medication, possibly for the rest of your life, to strengthen bones. But holistic health professionals question these dictums. Some of their concerns and recommendations are discussed here.
How Much Calcium?
Calcium’s level in the bloodstream is regulated by a complex interplay of organ systems and hormones. Parathyroid hormone (PTH) elevates calcium if it gets too low by enhancing absorption from food, minimizing loss in urine, and orchestrating release from bones. The hormone calcitonin opposes those same actions, working to lower blood calcium if it gets too high. Vitamin D, which is actually a hormone, works in concert with PTH. Maintenance levels of calcium in healthy people varies, as does urinary loss, suggesting that each person’s internal environment functions at a somewhat different set point—a concept called bioindividuality, as described in books such as Biochemical Individuality by Roger Williams and Nutrition Solution by Harold Kristal and James Haig.
The daily intake of calcium recommended by the Department of Agriculture and Department of Health and Human Services ranges from 500 to 1,500 milligrams, depending on age. Many people in other parts of the world with healthy bones and bodies have intakes below this, but in the western world we’ve grown up with the notion that we need calcium supplementation—whether in pill form, vitamin-enriched foods, or milk products. And while it may seem harmless to assert that everyone needs a lot of calcium, in excess it can accumulate in atherosclerotic plaques and kidney stones, and cause irregular heartbeat, confusion, and even death. Calcium supplements interfere with certain medications for heart disease, diabetes, and epilepsy, and hinder absorption of certain other essential minerals while causing bloating, gas, and constipation. Perhaps most importantly, the focus on calcium intake overshadows other essential bone-sustaining components and the importance of natural methods of bone health.
Dairy at Your Service
The dairy industry continues to have a powerful influence on national dietary guidelines. The National Dairy Council’s 3-a-Day Dairy program encourages consumers to have “a total of three servings of calcium-rich milk, cheese, or yogurt every day.” The program was developed in conjunction with the American Academy of Family Physicians, American Academy of Pediatrics, American Dietetic Association, and National Medical Association (the National Dairy Council gives presentations at the national meetings of these organizations). The program recommends flavored milk products to get children to meet the goal, and though a cup of chocolate milk has about 24 grams of sugar compared to 13 in unflavored milk, the council says its studies find that “kids who drink flavored milk, overall consume more milk and calcium without increasing sugars or total fat in their overall diet.” The council’s website advises people who are lactose intolerant (unable to digest milk’s predominant sugar, lactose) to choose hard cheeses or yogurt, whose natural lactose content is lower, or to eat specially created lactose-free products.
However, dairy products, especially pasteurized cow’s milk, evoke health problems in their own right. Dr. Frank Oski, pediatrician and author of Don’t Drink Your Milk, makes the case that cows’ milk is a poor food for humans, especially children, because of allergies, changes in intestinal bacteria, links with iron deficiency, and lactose intolerance. He reminds readers that about 70 to 90 percent of people of Asian, Arabian, or African descent are genetically lactose intolerant and so cannot digest milk well, while only 8 percent of American whites are intolerant. Other nutritionists concur: Milk isn’t for everybody.
Dylana Accolla is a practitioner of Chinese herbal medicine and a licensed acupuncturist in the Hudson Valley who counsels clients in nutrition. “For people who have dairy sensitivity or allergy, the milk they are consuming to help their bones is a problem,” she says. “I see it all the time. The Price-Pottenger Nutrition Foundation [a nonprofit that researches the scientific basis of ancestral wisdom on nutrition, agriculture, and health] recommends whole milk that is not pasteurized because that process denatures proteins and makes it somewhat indigestible, even for people who are okay with digesting the lactose.”
Accolla has a different suggestion altogether: “I recommend making a nutritious broth by picking up five pounds of bone from free-range, organically raised animals—never from industry-produced meat—and simmering it in water for four to six hours with a tablespoon of vinegar. The vinegar pulls calcium out of the bone, giving it more nutrition. It’s a good source of phosphorous and vitamin B12, which are also important to bone health. Then freeze it and have a little each day or use it to cook with.”
Too Much Acidity
Many of today’s popular foods are acidic, overly taxing the body’s natural acid-buffering ability. As a result, calcium is dissolved from bone as an alkaline material that helps neutralize acid. “Often the problem is not a lack of calcium in the diet,” says Dr. Tammi Price, a naturopathic physician and acupuncturist based in Kerhonkson and Hudson, “but that it is being leached from the bones. In osteoporosis we live in too acidic a terrain.” This can be aggravated at menopause, with additional acid accumulation. “Women are accustomed to acidic loss through the menses,” Price explains. “At menopause you stop loosing blood, and you stop loosing acidity. Women become osteopenic, then get night sweats and hot flashes. Often, if I just give tissue salts and change of diets [to reduce acids], that gets rid of hot flashes. It’s so simple to change.” A number of books and websites explain acid/alkaline balance and how to achieve it through food choices.
Diets that are especially high in protein also draw calcium out of the bones as the protein is digested into amino acids and then absorbed into the bloodstream. This has led to the warning that proteins—especially animal sources—are harmful to bone health. But protein in moderation is essential for healthy bone, because about half of bone is protein and is responsible for its ability to absorb shock and bend to some degree. People with osteoporosis have been shown to recover better after hip fracture and improve bone density when their diets include more protein.
The Mineral Mix
A lot of calcium conversation is about building strong bones and teeth. But calcium is only one player. While some clinical trials have reported reduced bone loss and fracture with calcium supplementation alone, most studies that follow people in the real world do not support this. “The medical profession has been throwing 1,500 milligrams of calcium at women for a long time,” says Susan Willson, a certified nurse-midwife in Stone Ridge who works with women to achieve healthy bones. “But the types of calcium they are taking are not absorbed well, or are not the right kind. There are a lot of other minerals to take into account—phosphorus, magnesium, zinc, copper, boron—everything is trying to balance itself. So when you take a huge dose of calcium, it disrupts the mineral balance.” If a supplement seems warranted, she says, “I like to use a microcrystalline hydroxyapatite supplement that has all the minerals in the right ratio. Several companies put out a formula (like Now brand’s Bone Strength).”
Price concurs. “The problem when we come to bone health is whether there are enough of the cofactors to build that tissue appropriately. I love to give tissue salts, like Dr. Schuessler’s Biochemic Cell Salts, which are supplements containing mixtures of minerals appropriate for different tissues. They are a very benign supplement—they don’t hurt you but have lots of good things for the body. There are also herbs for helping build bone. I use a lot of homeopathics in my practice. Birch, sequoia, and silver fir are wonderful for generating bone and for healing fractures.”
“To make healthy bones we have to have a healthy adrenal system and functional thyroid, which needs iodine,” Accolla says. “Seaweeds have iodine and so does salt—but use sea salt, not commercially iodized salt. Apples, nuts, and whole grains are good sources of boron. Magnesium in trace amounts is in many of the yellow-colored foods. And fluoride—of course we know that in the water it’s not good for us, but drinking hard water from your well probably has enough to build your bones. Organic green tea has trace amounts of fluoride. And even if you have a great diet with whole grains and legumes, you want to soak them first, which neutralizes acid in them that blocks calcium absorption. Our ancestors did this to their food, so we can utilize the foods we eat better.”
Dr. Carol Robin, a chiropractor and certified clinical nutritionist in West Shokan, says it’s much harder to get magnesium than calcium. “There is a widespread deficiency in foods because the way we do [industrialized] agriculture in this country depletes crops of magnesium.” Organically grown whole grains, nuts, and seeds are the best sources. “You can get trace amounts of boron from fruits and nuts,” she adds. “If you’re on a good natural diet, you’re getting other necessary minerals.”
Vitamin D isn’t a mineral, but it’s essential for calcium balance as well. “But we’re becoming rampantly deficient in that, too,” says Robin. “It’s a pretty serious problem, and it’s important for so many things besides bone health. The use of sunscreen has caused a good deal of the deficiency. We evolved to make vitamin D in our skin with exposure to the sun, but we’ve become afraid of it. And people living in the northern areas of the world can’t get enough sun in the winter. Where we are, you can lie naked in the sun in December and not make enough vitamin D. You can get your blood level tested easily, and if you’re deficient, you really need to take the supplement separately to get enough.”
The Osteoporosis Scare
Bone is a living organ. Its cells are constantly at work making an organic matrix of proteins onto which minerals crystallize in a specific proportion. Together, the proteins, minerals, and other molecules make bone strong and resilient. Throughout life, bones are remodeled on a microscopic scale. Older or worn parts are digested away by cells called osteoclasts, and rebuilt by cells called osteoblasts. This continual remodeling allows for the renewal of the organic matrix as well as deposited minerals, and allows bone to strengthen or slim down in response to pull from muscles.
Perhaps one of the strongest polarizations in calcium-related health is over the need for pharmaceutical intervention to maintain skeletal strength after menopause. Bisphosphonate drugs like Fosamax (alendronate) and Aredia (pamidronate) have been prescribed for millions of women to enhance bone density. They are toxic to osteoclasts, so they shift the bone remodeling cycle to more deposition. The drugs actually become incorporated into bone as well. Clinical trials have shown increases in bone mineral density and reduced fracture incidence in women taking the drugs for five years, but the changes are small, and concerns have been raised about the safety of the drugs and durability of bones subjected longterm to this imbalance.
“When we’re young and growing, we’re building bone faster than we’re breaking it down,” Willson explains, “and women naturally have increased bone density during childbearing years, which stores excess minerals for the fetus to use. At around age 35, the ratio shifts from building extra to breaking down a little more. The body wants you to be as light and efficient as you can be. For the first four or five years after menopause you have an accelerated loss. It’s a natural process. If you are exercising and eating a good diet, it will stabilize, and you can start building again. Where you get osteoporosis is people who don’t exercise or have a poor diet that’s really acidic, or you have many cups of coffee, lots of processed foods, or sodas all day.” Willson points out that in Europe, bone density tests aren’t considered that significant or reliable. “The test compares your bone to that of a healthy 25-year-old woman. It just doesn’t mean anything. And then we’re given drugs as though only bone density matters. But in fact, it makes bone with distorted architecture.”
Many of Accolla’s clients are health-conscious women who have just gotten a diagnosis of osteoporosis or osteopenia after a bone-density scan. “They’ve been given a prescription for one of these drugs but are hesitant to take it,” Accolla says. “Doctors often don’t explain how these drugs work. They just say your bone density is low, and you need to increase it. But if you disable osteoclasts, you keep bone from doing the constant readjusting it needs to do. What are the long-term effects? Women don’t know that this drug is linked to ulcers and liver damage. We’re still guinea pigs.”
Accolla instead uses Chinese herbal formulas that have been treating osteoporosis for 1,500 years. “The beauty of them is that, depending on the other symptoms along with osteoporosis, I can use herbs that are tailored for a client’s individual picture. There’s a supplement, too—Perque’s Bone Guard Forte—that’s one of the few products on the market shown to build matrix.”
Best Advice: Exercise!
All health experts recommend exercise, for diverse reasons: For bone health, it is considered more important than supplementation. It stimulates osteoblasts to fortify areas where contracting muscles pull, building density naturally. “You can build bone at any age,” says Willson. “Miriam Nelson from Tufts University did studies with women in their eighties, doing strength training at home and building bone mass, and there are several books about this, such as Nelson’s Strong Women, Strong Bones. So we really know that strength training is important.”
Exercise also improves balance and agility overall. “Women can be at risk of fractures because of poor muscle strength and flexibility and balance. Strength training makes a huge difference, so women are less likely to fall in the first place.” A little trampoline—the kind you can step onto and bounce—is a good tool for improving all of those.
With that inspiration, don’t despair that your skeleton will dissolve just because of age or because you don’t eat dairy. But do put these recommendations into practice and continue to bone up on good calcium maintenance.
This article appears in June 2009.
