Guest guest Posted August 4, 1999 Report Share Posted August 4, 1999 >>---------------------------------------------------------------- >You can find this article online at >http://www.slate.com/Features/osteo/osteo.asp, >or check out our full contents at http://www.slate.com. > >Visit MSN Greetings at >http://www.slate.com/redirect/slatecard.asp and send a >SLATE-O-GRAM to a friend or colleague today! Choose from >electronic greeting cards for a variety of occasions, created >by illustrators and editors of Slate. > >---------------------------------------------------------------- >ARTICLES >Got Osteoporosis? >Maybe all that milk you've been drinking is to blame. >By Yoffe >Posted Monday, August 2, 1999, at 4:30 p.m. PT > >It will be hard to frolic through the next millennium with >bones that have turned to sawdust. That is the fate that >awaits those of us, we are told, who don't consume the >escalating amount of calcium--now at a quart of milk a day or >the equivalent--endorsed by public health officials. Just two >years ago the National Academy of Sciences increased its >daily recommendation for calcium by 50 percent for older >Americans. Another upward revision and we will all have to be >attached to udders with an IV. Strange, then, that most of >the world's people, who rarely if ever drink milk and who get >just a small percentage of the calcium we are told is vital, >have not devolved into boneless heaps of protoplasm. Even >stranger, in many of these dairy-avoiding countries, people >get through life with far fewer of the age-related hip >fractures that plague Americans. > >This paradox has led a small number of researchers to become >dairy doubters, questioning the wisdom of the calcium >recommendations of the public health establishment. For one >thing, the doubters say, our diet is so fundamentally flawed >that trying to protect our bones by taking in loads of >calcium is like trying to fill a tub with no stopper by >turning up the faucets. The problem is this: In general, >world dietary patterns show that countries where people >consume large amounts of calcium are also countries where >people eat extravagant amounts of animal protein, places such >as the United States and northern Europe. These countries >also suffer among the world's highest rate of fractures due >to osteoporosis, the disease characterized by weak, porous >bones. " The correlation between animal protein [intake] and >fracture rates in different societies is as strong as that >between lung cancer and smoking, " says T. Colin , >professor of nutritional biochemistry at Cornell University. > >Our bodies contain 2 pounds to 4 pounds of calcium, 99 percent >of which is in our bones and teeth, the rest circulates in >the blood where it is necessary for nervous-system function. >Eating animal protein, which is high in sulfur-containing >amino acids, requires the body to buffer the effects of those >amino acids. It does so by releasing calcium from the bones, >literally peeing them away. But this leeching of calcium >should be offset if the balance of calcium to protein in the >diet is within a reasonable range. Heaney, professor >of medicine at the Creighton University School of Medicine >and a proponent of high dairy consumption, found in a study >he co-authored that the " single most important determinate of >the rate of bone gain " in young women was not the amount of >calcium consumed but the ratio of calcium to protein. But >it's a difficult balance to strike when it's common for >Americans to eat double the protein we need, with 70 percent >of it coming from animal sources. > > >Could there be some other dietary factor at work as well? >Retired Harvard professor of nutrition Mark Hegsted thinks >there may be. He believes calcium consumption may be at the >root of our bone problems, but his heretical hypothesis is >not that we don't get enough calcium but rather that we get >too much. In an article in the Journal of Nutrition he >writes, " [H]ip fractures are more frequent in populations >where dairy products are commonly consumed and calcium >intakes are relatively high. Is there any possibility that >this is a causal relationship? " > >Hegsted explains the way such a mechanism would work. The body >adapts to low calcium intake by efficiently using what is >available. Conversely, high calcium consumption causes the >body to decrease the amount of the mineral that is absorbed, >excreting the excess. That's why populations with low calcium >consumption manage to form healthy skeletons, and high >calcium consumers don't develop bones like mastodons. But >what happens over time, Hegsted suggests, is that the >inefficient consumers may permanently damage their abilities >to effectively use dietary calcium and to conserve calcium in >the bones later in life. As we age, the body naturally goes >from building bone to losing it. Hegsted's hypothesis >explains why high dairy consumers so often end up with >rampant bone loss. He cites studies of rural Gambian women >who don't drink milk, get about one-quarter of the calcium >we're told to consume, yet rarely have osteoporotic >fractures. " It will be embarrassing enough if the current >calcium hype is simply useless; it will be immeasurably worse >if the recommendations are actually detrimental to health, " >he writes. > > >Cornell's says our fate could be different if we >would take a lesson from the Chinese (fortunately he's a >nutritionist, not a political scientist). He has spent the >last 20 years studying the health and dietary habits of rural >Chinese and comparing them to those in the West. These >Chinese consume less than half the calcium we're told is >necessary, virtually all of it from plant sources, in >particular leafy green vegetables. They have one-fifth the >incidence of hip fracture of Americans. Although they consume >more calories per day than we do, only about 10 percent of >their diet is from animal sources. On average, American diets >are 70 percent animal-based. > > has what could be called the unified field theory of >bones and breasts. He explains the mortal consequences of >diets high in dairy, protein, and fat. Early in life, >American girls consume lots of these, which leads to >relatively dense bones, high levels of estrogen, and early >sexual maturation. The age of menarche has been dropping for >decades in this country and now often occurs as early as age >10. In rural China, girls don't usually begin menstruation >until age 15. Chinese women have only about two-thirds of the >amount of circulating estrogen that American women do, which >helps account for their far lower rate of breast cancer, says >. > > >Estrogen helps maintain bone, so most women's skeletons are >fine until menopause. Then estrogen levels drop, in the case >of American women faster and lower than their Chinese >counterparts. " Now they're vulnerable, " says . " That >all suggests that the factors that cause osteoporosis are >rather similar to the ones that cause breast cancer. " > >Two very different sets of studies support his theory. One >compares bone density of Japanese and British women. The >Japanese get almost all their calcium from soy, the bones of >small cooked fish, and vegetables. They also have about 40 >percent the rate of hip fracture of the West. The British >diet is similar to ours and so is their hip fracture rate. >Before menopause, the British women do indeed have denser >bones than the Japanese. But following menopause, the British >women end up losing more bone than the Japanese. And a spate >of recent studies in this country has found that women with >the highest measured bone density, a much-desired goal >according to the literature on osteoporosis, have a >significantly increased incidence of breast cancer. > > says views such as his are not more widely known >because, " Unfortunately, we are absolutely drowned in >information coming out of the dairy industry. ... Our >national nutrition policies are corrupted by the influence of >the dairy industry. " > > >The milk proponents offer a variety of responses as to why >osteoporosis is far less common in the nonmilk-drinking >world. One is that the theories of the doubters could be >characterized as demented ravings, probably induced by dairy >deficiency. Another boils down to: " We're Americans. If we >were rural Chinese or Gambians, sure we'd be eating primarily >beans and vegetables, so thank goodness we aren't. " The >public health official's version of the line, " Take my wife, >please, " is " Tell Americans to eat kale five times a week. " > >The milk advocates rightly point out that physical activity, >particularly the kind that requires weight-bearing, is >crucial to bone growth and maintenance. For example, while we >have turned our bathrooms into palaces of comfort, lots of >the world's people still squat over holes, which makes it >difficult to finish reading the business section, but is a >real bone builder. Another theory holds that Asian women in >particular have better designed hips than Caucasians, making >them like inflatable punching toys that can't be knocked >down, thus less likely to suffer hip fractures. The problem >with this theory is that recent studies show that the Chinese >diet is rapidly becoming more Westernized. Guess what, so is >the Chinese rate of osteoporosis. > > >But most of all, they say, forget population statistics and >instead look at the laboratory. Indeed, there are dozens of >clinical experiments showing that high doses of calcium >either arrest bone loss or even build bone in older women. >Fine, say the dairy doubters, if calcium is the answer, then >it should both prevent and cure osteoporosis, but it doesn't. >The doubters also argue that these laboratory studies, which >usually run from two to four years, may just be seeing a >short-term effect. That is, there is some initial >bone-building response by the body to large calcium doses, >but it may be a temporary and unsustainable change. > >Which camp is right has enormous public health consequences. >Eight million American women and 2 million men have >osteoporosis. The disease is responsible for more than 1.5 >million fractures annually, with a direct cost of $14 >billion. Of those, 300,000 are hip fractures; one-third of >the people over age 50 who break their hips never walk >independently again, and 20 percent die within a year from >related complications. With an aging population, and in the >absence of some plumbing apocalypse that will cause Americans >to adopt a squatting posture to relieve themselves, the >incidence and cost of osteoporosis can only rise. > > >In a way, Americans are voting with their stomachs on the milk >issue and unintentionally siding with the dairy opponents. >Milk consumption has been falling for decades. It is now >about half what it was in 1945. Other beverages have >displaced it--in the case of young people especially, soft >drinks. Soft drinks are loaded with phosphorus, which is an >essential and widely available nutrient. The problem is that >too much phosphorus itself causes calcium to be lost from the >bones. Then there's excess salt, another component of the >average diet and a bone-killer as well. > >The battle between the vegetable advocates and dairy advocates >over the nutritional choices of Americans is like symphony >orchestras dueling with opera companies over the >entertainment dollars of teen-agers. While they're fighting, >they forgot to notice the audience is at American Pie. So it >turns out that no matter who is right, the calcium doubters >or the calcium advocates, that shattering sound you will hear >as the 21st century progresses will be America's bones. > >RELATED ON THE WEB > >A militant anti-milk site [http://www.notmilk.com/] could >scare you off calcium. If you're still pro-milk, download >celebrity screensavers of the white mustache ads here >[http://www.whymilk.com/]. Testifying to the commercial >exploitation of the big calcium scare, a Kline Beecham >site [http://www.calciuminfo.com/] peddles its supplements >and provides a calculator to estimate your current daily >calcium intake. Colorado Health Net >[http://www.coloradohealthnet.org/site/idx_osteo.html] provides >facts on osteoporosis and links to the latest research >developments. The International Osteoporosis Foundation >[http://www.effo.org/] offers lots of information about the >disease, brought to you by an impressive array of >international pharmaceutical companies. > >---------------------------------------------------------------- > >TODAY IN SLATE > >Got Milk? Don't Drink It >[http://www.slate.com/Features/osteo/osteo.asp] > >What Does W. Really Believe? >[http://www.slate.com/code/BallotBox/BallotBox.asp?Show=7/30/99 & idMessage=3 304] > >Chatterbox: Hot Enough for Ya? >[http://www.slate.com/Code/chatterbox/chatterbox.asp?Show=7/28/99 & idMessage =3295] > >July Ends Hot, Dry, Engaged to Ron Perelman >[http://www.slate.com/newsquiz/entries/99-08-02_32708.asp] > > > >Brought to you by the Internet's informed look at politics and >culture. Read Slate at http://www.slate.com. > >Slate. What Matters. > Quote Link to comment Share on other sites More sharing options...
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