Sodium also increases calcium excretion through the kidneys. Studies show that when sodium is reduced from the high levels common in some diets, the effect on bone density is similar to consuming approximately 890 mg. of calcium. A plant-based diet focusing on whole grains and unrefined foods has a significantly lower amount of sodium, since it is estimated that approximately 75 percent of the average salt intake is due to what was added during processing and manufacturing. Many dairy products and most processed meats are very high in sodium.(7)
Because of the reduced calcium excretion rates accompanying a diet low in animal protein and sodium, it is easy to understand why the World Health Organization recommends only 400–600 mg. of calcium per day. Most of the rest of the world does not eat the large quantities of animal protein and salt that people eat in Westernized countries.
Also important for bone formation is vitamin D. Vitamin D stimulates calcium absorption and bone formation, and decreases calcium excretion. Vitamin D is formed in our skin upon exposure to sunlight. Sufficient sunlight can satisfy our vitamin D requirements, and this is the best way to get vitamin D in the body. While vitamin D may be found in some fish and eggs or is added to milk, animal protein inhibits the body from being able to use it, due to the acid-forming nature of these foods. Studies show that season and latitude (how far north or south a person lives) affect vitamin D levels in the body. Levels were higher in the summer and higher the farther south a person lived. It is estimated that 10 to 15 minutes of sun exposure on the face and hands three times per week provide enough vitamin D for an adult, with the elderly requiring longer exposure and dark-skinned people needing as much as six times the exposure. It is important that a person takes advantage of the sun in the summer, as studies show that vitamin D levels during the following winter are determined by the previous summer’s sun exposure.(8)
Vitamin K, which is found in large quantities in green leafy vegetables, has been shown to significantly reduce calcium excretion in postmenopausal women, especially those not on hormone replacement therapy. This vitamin apparently works synergistically with calcium and vitamin D in their beneficial effects on bone health. Vitamin C, which is found in abundance in fruits and vegetables, especially peppers, broccoli, tomatoes, and oranges, is important for the formation of the collagen framework in the bones. Other important minerals are potassium and magnesium, which are found in good quantities in plant foods. Phosphorus is also needed for bone formation, but not too much of it; otherwise it will have a negative effect. Plant foods, especially fruits and vegetables, contain appropriate levels of phosphorus for good calcium absorption, while liver, chicken, beef, pork, and fish contain levels of phosphorus that hinder calcium absorption. Thus we continue to see that eating our fresh fruits and vegetables is very important for healthy bones.(4, 9, 10) Milk is not able to supply all of these important nutrients for bones at optimal levels.
Other Considerations for Building Strong Bones
Exercise is very important for strong bones. It is the concept of “If you don’t use it, you lose it.” If you do not give your bones a workout through physical exercise, they are not stimulated to build up bone density. In fact, the level of physical activity engaged in while a teenager can have significant beneficial effects on bone density later in life. In one study of women 45 years and older, those who exercised four or more times per week as teenagers were only a quarter as likely to have a hip fracture compared to those who exercised once a week or not at all.(11)
Some studies have suggested that estrogen helps maintain a positive calcium balance. However, in his clinical work, the late Dr. John Lee discovered that it is the addition of natural progesterone, along with a good diet and exercise, which actually increases BMD. His tests showed that women with the lowest bone densities experienced the greatest increase of bone densities when they used his program of natural progesterone, good diet, and exercise, even though some had already lost as much as five inches in height due to osteoporosis. Thus, it appears that estrogen only temporarily retards bone loss, but natural progesterone administered transdermally actually reverses bone loss.(12)
Most people do not see water as an essential nutrient; however, Dr. F. Batmanghelidj sees it as a preventative for many chronic problems, including osteoporosis. He believes that chronic dehydration, brought about by simply not drinking enough water and by the use of diuretics, such as coffee and other caffeine containing foods and beverages, is a major cause of this disease. The solution is to daily drink one-half ounce of water for every pound of body weight.(13) Considering the large quantities of caffeine that are consumed in the United States (which should be eliminated for a bone healthy lifestyle anyway) and insufficient water intake by most people, he may really be on to something very important.
Other important considerations for building strong bones include Omega-3 fatty acids (1–2 teaspoons of flaxseed oil daily) in the diet, as well as good sources of beta-carotene, which include carrots, pumpkin, sweet potatoes, dark green leafy vegetables, and red peppers. Proanthocyanidins and anthocyanidins, found in deep red-blue berries such as blackberries, blueberries, cherries, and raspberries, have the ability to stabilize the collagen matrix.(14) Inclusion of these items in the diet or supplementing with grapeseed extract may be an important aspect of an osteoporosis prevention program. MSM supplementation may also hold promise for supporting the connective tissue matrix of bones. While animal protein has a negative effect on calcium balance, particularly due to the increased acid load, studies do show that a sufficient (but not excessive) intake of protein is necessary for bone health. Again, plant sources of protein best suit this need.(4) Of course, smoking and alcohol should be eliminated, as these items also induce a negative calcium balance.
The issue of healthy bones is a complex one that includes a variety of diet and lifestyle factors. The assertion that milk is the solution to the osteoporosis and bone health problem ignores all the other important aspects of bone health except calcium. It is important to realize that milk is not the only food containing calcium, and instead there are other dietary sources from which the calcium is better utilized by the body. These sources are plant based, with fruits and vegetables needing to be emphasized. Legumes are also important, as they provide both calcium and protein. Animal foods need to be eliminated because of the acid load they bring to the body, along with the problems of saturated fats, cholesterol, and lack of fiber.
A review of studies dealing with bone health shows that vegetarians have a normal bone mass. Researchers would like to determine which aspects of a vegetarian diet contribute to bone health.(15) However, it may be concluded in the end that it is the synergistic effects of a good plant based diet along with healthy lifestyle factors. Certainly, a bone healthy program should include many, if not all, of the factors discussed above.
- Stephen Walsh. “Diet and bone health.” A Vegan Society briefing paper. January 2002. Internet: http://www.vegsource.com/articles/walsh_diet_bone.htm (accessed February 20, 2005).
- V. Messina, R. Mangels, M. Messina. The Dietitian’s Guide to Vegetarian Diets. Sudbury, Massachusetts: Jones and Bartlett. 2004:108, 109
- Ibid.: 106, 107, 183–186.
- S. A. New. “Intake of fruit and vegetables: implications for bone health.” Proceedings of the Nutrition Society. 2003 November; 62(4):889–899.
- John Robbins. Diet For a New America. Walpole, New Hampshire: Stillpoint. 1987:196–198.
- J. W. Nieves, J. A. Grisso, J. L. Kelsey. “A case-control study of hip fracture: evaluation of selected dietary variables and teenage physical activity.” Osteoporosis Institute. 1992: 2:122–127.
- John R. Lee. What Your Doctor May Not Tell You About Menopause. New York: Warner Books. 1996: 164–168.
- F. Batmanghelidj. Water for Health, for Healing, for Life. New York: Warner Books. 2003: 213–218
- M. Murry and J. Pizzorno. Encyclopedia of Natural Medicine. Rocklin, California: Prima Publishing. 1991:461.
- S. A. New. “Do vegetarians have a normal bone mass?” Osteoporosis Intstitute. 2004 September; 15(9):679–688. E-publication, 2004 July 16.
Diane Herbert is a naturopath and lifestyle consultant. She received training from the NAD Lifestyle Consultant program, Thomas Edison State College, Clayton College of Natural Healing, and Bastyr University. Diane teaches health classes at the Gilead Institute located in Norcross, Georgia, gives health presentations, and contributes to the Institute’s literature and health flyer series. She may be contacted by e-mail at: firstname.lastname@example.org.