I’ve been working with the U.S. dairy industry for nearly 25 years, and pride myself on regularly consuming three servings of dairy per day. So, I was surprised when my bone density score revealed that I was sliding into osteopenia, but fortunately not osteoporosis. I’m not alone. An estimated 44 million Americans have low bone mass.
Low dairy consumption can impact bone health and nutrient adequacy. It is globally estimated that hip fractures currently affect around 18% of women and 6% of men. As populations age, the worldwide incidence of hip fracture is projected to grow by 310% in men and 240% in women by 2050, compared to rates in 1990. The combination of osteoporosis and sarcopenia is known as osteosarcopenia, which contributes to frailty, poor balance, falls, and fragility fractures.
A 2019 paper titled “Lactose Intolerance and Bone Health: The Challenge of Ensuring Adequate Calcium Intake” notes that “Osteoporosis constitutes a major health burden, with an average of 2 million osteoporotic fractures annually. These fractures are especially common in females over age 55, accounting for 40% of all hospitalizations and related costs, which is nearly as much as myocardial infarction, stroke, and breast cancer combined.”
The good news is that there are lots of lower lactose or lactose-free dairy options for older adults.
Recipe for strong bones
Approximately 95% of adult peak bone mass is acquired by 16 years of age. Like many teens, I was not an avid consumer of dairy in my youth. After my bone density test, my doctor recommended a calcium supplement, but I prefer to get my calcium from food sources. Dairy foods are the most concentrated source of calcium in the diet.
The recommended daily intake of calcium for post-menopausal women is 1,200 mg per day, and the upper limit (UL) is 2,000 mg per day. Calcium intake in excess of the UL increases the risk of various adverse events, including hypercalcemia, hypercalciuria, vascular and soft tissue calcification, kidney stones, and constipation.
“Having been long associated with bone health, milk sets the gold standard when it comes to bone density due to its calcium, vitamin D, and protein content. This means that other products that are derived from milk with calcium and vitamin D are good options for maintaining bone health as we age,” says Jacqueline Van Schaik, global lead nutritionist, Fonterra Medical Innovation.
Certain risk factors for osteoporosis, such as age, sex, and ethnic background, are beyond our control. Risk for osteoporosis is increased with tobacco and alcohol use, an unhealthy diet, and physical inactivity. Older adults should include regular resistance and cardio exercise. Yoga or similar exercises that promote balance and reduce the risk of falls are also helpful.
It takes more than calcium for strong bones. Other important nutrients for bone health include: vitamin D, protein, phosphorus, magnesium, potassium, zinc, and copper. The main biological function of vitamin D is regulating calcium absorption and also maintaining bone health. Not all dairy foods are fortified with vitamin D, so a D supplement may be helpful.
Adequate dietary protein improves bone health and reduces the incidence of falls. “A 2019 review, “High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis,” showed that high protein intake trends to a positive association with bone mineral density (trend) and significantly decreases the risk of hip fractures.
Dairy proteins such as MPC (milk protein concentrate) or calcium caseinate can be ideal ingredients because they are a source of both protein and mineral (calcium & phosphorus) components required to build and maintain bone,” Van Schaik adds.
Many dairy foods are excellent sources of calcium, with the exception of cream, sour cream, and cream cheese, which have low calcium content. Some plant-based dairy alternatives are fortified with calcium, but the calcium may not be as bioavailable as dairy calcium. Dairy alternatives typically don’t contain the same package of bone-supporting nutrients as dairy. Milk is a good source of phosphorus and potassium, and also contributes magnesium and zinc to the diet.
I consume a wide variety of dairy foods and recently have added an early afternoon latte to my daily routine. A cup of fairlife milk (or similar ultrafiltered milk) contains 30% of the daily value (DV) of calcium, 25% of the DV for vitamin D, and 13 grams of protein. The caffeine keeps my energy up through the evening hours. Decaf coffees or chai milk teas are alternatives for those who prefer to limit caffeine.
My new motto is, “A latte a day helps keep the bone doctor away.”
Sharon Gerdes is a Certified Food Scientist and author who writes extensively about dairy’s role in Health and Wellness. Learn more at http://sharongerdes.com.