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Frequently Asked Questions - Health without milk

Summary

  • Children and young adults do not need dairy foods for good bone health; they do need exercise and a healthy plant-based diet to ensure strong bones.
  • Diets loaded with dairy products are associated with an increased risk of many diseases including osteoporosis, cancer, heart disease, obesity and diabetes.
  • From a health perspective, dairy foods should be avoided in the diet.
  • Cow’s milk is not a natural food for humans to consume.
  • Most people in the world are lactose intolerant.
  • Many children are affected by cow’s milk allergies.
  • Looking solely at calcium intake and not at calcium losses tells only half the story, while a vegan’s intake might be less than a meat eater’s, their losses are likely to be much lower. A plant-based diet free of animal products - a vegan diet – does not produce these losses.
  • There are no scientific reports of calcium deficiency in adult vegans.
  • Vitamin D, magnesium, potassium, vitamin C and vitamin K are all required for good bone health.
  • Plant-based sources of calcium are many and varied and offer many other health benefits as well as providing a natural and safe source of calcium.

Your skeleton is the scaffolding that houses and protects your organs, gives your muscles something to cling to and stores minerals such as calcium and phosphorus. In the centre of some of your bones is red bone marrow, responsible for producing blood cells. So, far from being just a collection of bones, your skeleton is a living network of cells, fibres, minerals and blood vessels.


As bones grow, become worn or suffer minor damage from physical activity, they are constantly repaired. Damaged and worn bits are cleared away and new bone is built in the gaps.


Some 99 per cent of your body’s calcium is in your skeleton and so anything that affects calcium levels in the body – food, lifestyle, medication – has an impact on your bones. If the effect is negative it can result in bone loss leading to osteopenia (the forerunner to osteoporosis) and it can happen at any age. Women have a higher risk because of the dramatic drop in oestrogen at menopause – much greater than the corresponding decline of testosterone in men – and hormone levels are an important player when it comes to bone health.


Your bones, just like the rest of your body, need a wide range of nutrients to be healthy. If you have a bad diet and top it up with an extra dose of calcium, you won’t get the benefits you might think you’re getting and it can actually be harmful for your bones.


More calcium = better bones?


In the UK, a half of all women and one in five men over the age of 50 will suffer a fracture and this level of risk is fairly common in many Western countries. This simple fact destroys the old myth that osteoporosis is caused by calcium deficiency because those nations that consume the most cow’s milk and other dairy products have the highest rates of osteoporosis and hip fracture.


Getting the balance right


To keep your bones strong and healthy, it’s as important to know what weakens them as well as what strengthens them. The myth about people needing calcium from cows’ milk is so pervasive that you’d think vegans were boneless blobs, wobbling around the floor!


This is the crème de la crème (excuse the pun) of myths from the dairy industry: we, but especially our children, must have cows’ milk for strong bones and teeth.


Western nations have been duped into believing that we need to suckle from cows to obtain calcium! When you think about it, the notion is preposterous. After all, how did we develop a healthy skeleton for most of our evolution when we did not drink dairy? And how, today, do the majority of the world’s people have strong bones when they don’t consume dairy?


The latest figures from 63 countries show the truth of this, with a huge variation in fracture rates – some countries having 10 times as many fractures as others (Kanis et al, 2012).



Hip fractures of women according to countries

Nations such as the UK, where dairy consumption is high (av. 270 grams dairy products a day), has one of the highest osteoporosis rates in the world. Nigeria, on the other hand, which eats a diet high in plantains,  tubers, wholegrains, vegetables and pulses and where only one per cent of the diet is dairy and less than three per cent is meat – has almost no cases of osteoporosis. (National Bureau of Statistics, Nigeria, 2010.)


You may be wondering how Inuit (used to be referred to as Eskimos) people survive? When scientists studied them, one outstanding discovery was that after the age of 40, Inuits had high bone loss and fast progression of osteoporosis. This was attributed to a diet very high in animal protein and phosphorus and low in fresh fruit and vegetables (Mazess et al, 1974).


There are copious scientific studies showing that people eating a diet high in dairy products and animal protein have high bone loss. And conversely, that fresh fruit and vegetables protect and strengthen our bones. A huge analysis of 34 surveys from 16 countries found that 70 per cent of all fractures resulted from eating animal protein (Abelow et al, 1992). Not satisfied with that, another scientific team tested the same theory in a seven-year study of 1,035 women. They found that those with diets high in animal protein had almost four times more bone loss – and a 3.7 times higher risk of hip fracture – than women who ate the least amount of animal protein (Sellmeyer et al, 2001).


A highly-regarded study of more than 120,000 women lasting 12 years showed that eating more than 95g of protein a day significantly increased the risk of forearm fracture (Feskanich et al, 1996).


And there’s more! A gargantuan study of almost 80,000 women in the USA led by scientists at the Department of Nutrition, Harvard School of Public Health, examined whether by increasing your milk intake you can reduce the risk of fractures. It found that not only does milk not protect bones from fractures but that women drinking two or more glasses of milk a day increased their risk of hip fracture (Feskanich et al, 1997). A recent study looked at children and the growth of their bones and it concluded that animal foods, particularly meat, had a significant negative effect on bone mass increase (Zhang et al, 2010).


And an important review of 58 different scientific papers examining whether high calcium or high dairy intake improves bone health in children was published in the highly esteemed Pediatrics journal. It concluded neither option gives even a modest benefit (Lanou et al, 2005). One of the authors of this review, Professor Amy Lanou, PhD, holds a doctorate in human nutrition from Cornell University and her book, Building Bone Vitality, makes clear that for healthy bones we must:


  • Increase fruit and vegetable servings to six to 10 per day
  • Avoid or limit protein from animal sources (no meat, dairy and so on)
  • Exercise regularly (at least 30 minutes every day)
  • Get adequate vitamin D through sunshine or a supplement
  • Obtain calcium and other bone–healthy nutrients from plant sources

When we consume dairy, calcium floods our body and much of it is quickly lost in our urine because so much of it can’t be immediately used or stored. Animal protein increases our absorption of calcium but this is not necessarily a good thing. The ongoing European Prospective Investigation into Cancer and Nutrition (EPIC) studied almost 9,000, 35 to 67 year old women. It was carried out by the Department of Epidemiology at the German Institute of Human Nutrition and it showed that as animal protein intake increases, bone health deteriorates. Conversely, as vegetable protein increases, bones are found increasingly to be protected. This study accounted for age, weight, hormone replacement therapy, smoking, exercise, alcohol intake, menopausal status, education and occupation… in other words the scientists narrowed down the impact to the effects of protein alone (Weikert et al, 2005).


When we eat healthy plant foods, we are not overwhelmed with excessive calcium but instead we get a steady supply throughout the day. Our body then uses what it needs without depositing excess calcium in the wrong places, risking kidney stones and hardening of tissues – including blood vessels which can increase the risk of heart attack.


Also, when small amounts of calcium are absorbed into our blood, hormone regulation is more precise so that bone breakdown and build up is not overstimulated. However, osteoporosis is generally not a disease of low calcium. It is caused by many factors including bad diet (often with excess calcium and animal protein and low fruit and veg), smoking, alcohol consumption, low oestrogen or testosterone, lack of exercise and being underweight.


Despite relentless claims by the dairy industry, milk is neither the only nor the best source of calcium. It takes strength to stand up against a lifetime of propaganda – but that is what we have to do in order to sweep aside the myth that dairy is the holy grail for strong bones and teeth. In fact, the opposite is true. In terms of diet, the biggest favour you can do for  your bones is avoid dairy and all animal products and enjoy a wholefood vegan diet packed with fruit and vegetables, mushrooms, pulses, nuts and seeds and small amounts of vegetable oils.


How much calcium do we need?


How well you absorb calcium depends on your age. It’s highest in infancy (50– 60 per cent), especially from breast milk, but by adulthood it drops to about 30 per cent.


This is how much calcium (mg/day) you need at different ages:


Children


  • 0-12 months: 525 mg
  • 1-3 years: 350 mg
  • 4-6 years: 450 mg
  • 7-10 years: 550 mg

Males


  • 11-18 years 1,000 mg
  • Over 19 years 700 mg

Females


  • 11-18 years: 800 mg
  • Over 19 years: 700 mg
  • During lactation: +550 mg

Latest studies show that calcium intake above the recommended dose offers no additional protection from fractures and can actually increase the risk.


 


How to eat right?


The high alkaline content of many fruits and vegetables can counteract the effects of some acid-generating foods (see the chart in our guide pages 19-22) and generally promotes good health. The science is now absolutely clear - fruits and vegetables improve bone health in both children and adults. Aim for eight portions of fruit and vegetables a day – build it up gradually and you’ll be eating better in no time! Here's is how to get children to eat more bone-friendly foods and here are some tricks for grown-ups.


Calcium from plant foods doesn’t flood the body with excessive amounts but provides a steady supply throughout the day, which is used for your body’s immediate needs and keeps blood levels steady. If you fill your diet with plenty of vegetables, fruit, nuts and seeds and pulses, you’ll get all the calcium you need. Good sources are sesame and other seeds, tofu (calcium-set), pulses, almonds and Brazil nuts, green leafy vegetables (including broccoli), figs, cinnamon, oregano and parsley.


For calcium content of foods and to find out what other nutrients are important for healthy bones, please see our guide, pages 12-15.


Move it!

Exercise is important for healthy bones throughout your entire life. It’s the old adage of use it or lose it as bone adapts to the loads put on it and therefore weight-bearing exercise such as walking, running, dancing, yoga, ball games and so on, leads to an increase in bone density.


 


How to build bone-healthy habits into your daily life:


  • Use stairs rather than lift.
  • Carry your shopping bags (weight permitting).
  • Walk to the shops, café, restaurant, pub etc. or park further away so you simply have to walk a little bit more.
  • If you use public transport, get off a stop before your usual stop and walk the rest.
  • Even if it’s just for a couple of minutes, dance to your favourite song at home.
  • Try to incorporate 30 minutes of walking, running or other exercising (any activity using your own body-weight is good for your bones) into your daily routine.
  • When watching TV, get up during ad breaks and walk around or do a few squats.
  • Try yoga – everyone can do it, there are styles and classes to suit everyone’s abilities.

 


How about weekends?


  • Go for long walks, hike and jog.
  • Ball games, tennis, etc. are great for your bones but also a good family activity
  • Volunteer in a local shelter – walking dogs helps them as much as it helps you!
  • Gardening helps your bones too!

 


 

For example, calcium is much more easily absorbed from kale than cow’s milk. However, while spinach contains a lot of calcium, it is bound to a substance called oxalate which inhibits calcium absorption, so it is important to obtain calcium from low-oxalate green vegetables (eg broccoli, cabbage, bok choy, watercress). Grains, nuts and seeds contain a substance called phytic acid which until recently was also considered to hinder calcium absorption; however phytic acid is now believed to have only a minor influence. Caffeine and smoking has been shown to reduce calcium absorption.

What is calcium?


Calcium is a soft grey metallic element. It is the fifth most abundant element on the earth’s crust and occurs in compounds such as limestone, chalk and marble.


Why do we need calcium?


This important mineral plays a central role in maintaining bone health and strength; around 99 per cent of our calcium is deposited in the bones and teeth, the other one per cent is involved in the regulation of muscle contraction, heart beat, blood clotting and functioning of the nervous system.


How much do we need?


The UK government currently suggest that the reference nutrient intake (RNI) value for calcium in adults aged between 19 and 50 years of age is 700 milligrams per day.


What foods contain calcium?


While milk and dairy products do contain calcium, plant-based sources provide a much healthier source. Good plant-based sources include green leafy vegetables such as broccoli, kale, spring greens, cabbage, parsley and watercress. Also rich in calcium are dried fruits such as figs and apricots, nuts, particularly almonds and brazil nuts and seeds including sesame seeds and tahini (sesame seed paste). Pulses including peas, beans, lentils and calcium-set tofu (soya bean curd) provide a good source of calcium as does molasses.


How much calcium is in these foods?


The following table shows how much calcium is present in a range of calcium-rich foods.














Food (and serving size)

Calcium (milligrams)

Cauldron Foods Organic Plain Tofu (one pack - 250g)

500

Sesame seeds (25g - a small handful)

168

Sunflower seeds (25g - a small handful)

28

Broccoli (80g portion boiled in unsalted water)

32

Curly kale (80g portion boiled in unsalted water)

120

Watercress (80g portion raw)

136

Almonds (30g - a small handful)

72

Brazil nuts (30g - a small handful)

87

Alpro Soya Milk (200ml glass)

240

Dried Figs (100g - four to six pieces of fruit)

250

Tahini (10g - two teaspoonfuls generously spread on one piece of toast or stirred into a bowl of soup)

68

 



 


 


For more information, see our calcium fact sheet.


 


 


 



 


 


See our new poster illustrating good plant sources of calcium.

Milk is a natural food... isn't it?


All mammals drink the milk of their mothers until they are weaned. Unlike all other mammals though, humans continue to drink milk after weaning and into adulthood, and not just that, we drink the milk of another species! To state the obvious (but often overlooked fact) cow’s milk has evolved to help turn a small calf into a cow in less than a year. That’s why cow’s milk contains around four times as much calcium as human milk. Calves need a huge amount of calcium to promote the massive level of skeletal growth required over the first year of life. A human infant does not require such high levels of calcium; indeed the high mineral content of cow’s milk puts a strain on the human infant kidney which is why most governments strongly recommend that children do not drink normal ‘off the shelf’ milk in the first year.


The proteins in cow's milk (especially casein) are the most common food allergen and most people in the world are unable to digest milk sugar, lactose, after weaning (they are lactose intolerant). The explanation to this is simple - cow's milk is not natural food for people.



Read more in our new guide Why You Don't Need Dairy.

Don’t children need milk for calcium?


No, what they do need is exercise and a healthy plant-based diet. A recent review on dairy products and bone health (Lanou et al., Pediatrics 2005) shows that there is very little evidence to support increasing the consumption of dairy products in children and young adults in order to promote bone health. This review examined the effects of dairy products and calcium on bone strength in children and young adults and found that physical exercise is the most critical factor for maintaining healthy bones, followed by improving the diet and lifestyle; this means eating plenty of fresh fruit and vegetables, and - for young adults - cutting down on caffeine and avoiding alcohol and smoking.


Find out more:



 


 


  See our calcium fact sheet.


 


 



 


 


See our new poster illustrating good plant sources of calcium.


 


 


 



  Building Bones for Life - This guide will provide you with all the theoretical and practical information on healthy bones you need. Written in a very easy to read way it explains what the key players in bone health are and how you can achieve healthy bones at any age, even if your bone health is already compromised. 


 


 

 


 

Doesn’t most of our calcium come from milk?


No, only 35-45 per cent of the calcium in the average UK diet comes from milk and milk products. This was reported in the latest Food Standards Agency’s National Diet and Nutrition Survey Results from Years 2008-2012 (published in 2014). So despite the misconceived notion that milk is the best (or only) source of calcium the facts show that a large share of the calcium in our diets is derived from sources other than dairy foods. This is not surprising as most people in the world (around 70 per cent) obtain their calcium from plant-based sources rather than dairy products.


How much calcium do we need?


The UK government currently suggest that the reference nutrient intake (RNI) value for calcium in adults aged between 19 and 50 years of age is 700 milligrams per day.


What foods contain calcium?


While milk and dairy products do contain calcium, plant-based sources provide a much healthier source. Good plant-based sources include green leafy vegetables such as broccoli, kale, spring greens, cabbage, parsley and watercress. Also rich in calcium are dried fruits such as figs and apricots, nuts, particularly almonds and brazil nuts and seeds including sesame seeds and tahini (sesame seed paste). Pulses including peas, beans, lentils and calcium-set tofu (soya bean curd) provide a good source of calcium as does molasses.


How much calcium is in these foods?


The following table shows how much calcium is present in a range of calcium-rich foods.














Food (and serving size)

Calcium (milligrams)

Cauldron Foods Organic Plain Tofu (one pack - 250g)

500

Sesame seeds (25g - a small handful)

168

Sunflower seeds (25g - a small handful)

28

Broccoli (80g portion boiled in unsalted water)

32

Curly kale (80g portion boiled in unsalted water)

120

Watercress (80g portion raw)

136

Almonds (30g - a small handful)

72

Brazil nuts (30g - a small handful)

87

Alpro Soya Milk (200ml glass)

240

Dried Figs (100g - four to six pieces of fruit)

250

Tahini (10g - two teaspoonfuls generously spread on one piece of toast or stirred into a bowl of soup)

68


 

 


Find out more:



 


 


  See our calcium fact sheet.


 


 



 


 


See our new poster illustrating good plant sources of calcium.


 


 


 



  Building Bones for Life - This guide will provide you with all the theoretical and practical information on healthy bones you need. Written in a very easy to read way it explains what the key players in bone health are and how you can achieve healthy bones at any age, even if your bone health is already compromised. 


 


 


 


 

What is lactose intolerance?


Lactose intolerance is the inability to digest lactose, the sugar in milk. In order for the sugar in lactose to be digested it must be broken down in the gut by the enzyme lactase into its two component sugars (glucose and galactose). Most infants produce lactase for a while but lose the ability to digest lactose after weaning (commonly after the age of two). Losing this ability is a clear indication that after weaning, milk is not a natural food for us. Lactose intolerance occurs in around 90-100 per cent of Asians, 65-70 per cent of Africans, and 10 per cent of Caucasians. Symptoms include nausea, cramps, bloating, wind, and diarrhoea. If you suffer from lactose intolerance you should avoid all dairy products.


 


See our infographic about milk and health.

What causes milk allergies?


Milk allergies occur when the body’s immune system perceives one of the proteins (casein or whey) in milk as a foreign invader and launches an attack. Symptoms are usually more extreme than in lactose intolerance and include excessive mucus production resulting in a runny nose and blocked ears. More serious symptoms include eczema, colic, diarrhoea, asthma and vomiting. The milk protein casein is difficult to avoid as it is commonly used in the production of bread, processed cereals, instant soups, margarine, salad dressings, sweets and cake mix.


For more information, see our website section on Allergies.

What is the link between cow’s milk and diabetes?


Early exposure to cow’s milk formula has been linked to an immune response that can lead to type 1 diabetes in some children. The immune response involves the body’s immune system reacting to a trigger (which may be cow insulin or a protein called casein from cow’s milk). Structural similarities between the triggering molecule and the insulin-producing pancreatic beta cells confuse the human immune system and it attacks the cells in the pancreas. This limits the ability to produce insulin and may lead to diabetes. The avoidance of cow’s milk during the first few months of life may reduce the risk of type I diabetes in some children.


See our special section on diabetes for more information or see Viva!Health’s fully-referenced scientific report The Big-D: Defeating Diabetes through Diet and a practical guide The Big-D: defeating diabetes with the D-Diet, both can be downloaded here.

Which other nutrients help calcium absorption?


Several other nutrients help calcium absorption. Vitamin D is very important for calcium absorption, it is either obtained from the diet or it is made in the skin following exposure to sunlight. Vitamin D deficiency may occur if exposure to the sun is limited and without sufficient vitamin D, calcium deficiency is likely to occur even if the diet provides enough calcium. The consequences may be serious, resulting in rickets or osteomalacia (softening of the bones). Over the last few years there have been cases of vitamin D deficiency in some large UK cities. Vegans obtain vitamin D from sunlight and fortified foods such as soya milks, cereals and margarines. It is important to get the balance right between being cautious about exposure to the sun and aware of the need for some exposure. It is now advised by the UK government that we apply sun block after 10 to 15 minutes exposure to the sun, this is so that we can synthesis vitamin D in the skin. Furthermore, magnesium, potassium, vitamin C, and vitamin K, are all required for good bone health. A healthy diet that includes at least five servings a day of fruit and vegetables should optimise the intake of these and other micronutrients required.


What if we don’t eat enough calcium?


When the diet does not provide enough, calcium is reabsorbed from the bones to restore blood levels and maintain calcium-dependent functions. If enough calcium is then supplied in the diet, bone levels are restored, but if the diet fails to supply sufficient calcium, bone loss persists.


 


Find out more:



 


 


  See our calcium fact sheet.


 


 



 


 


See our new poster illustrating good plant sources of calcium.


 


 


 



  Building Bones for Life - This guide will provide you with all the theoretical and practical information on healthy bones you need. Written in a very easy to read way it explains what the key players in bone health are and how you can achieve healthy bones at any age, even if your bone health is already compromised. 


 


 


 


 

Doesn’t cow’s milk protect against osteoporosis?


No, osteoporosis occurs most commonly in countries where they drink the most milk! American women are among the biggest consumers of calcium in the world yet they suffer one of the highest levels of osteoporosis, while African Bantu women eat almost no dairy products at all and have a relatively low calcium intake from vegetable sources yet osteoporosis is virtually unknown among Bantu women. Increasing milk consumption does not protect against bone fracture, in it may be that an increased calcium intake from dairy foods increases the risk of fracture. 


What increases our risk of osteoporosis?


Calcium loss from the bones has been linked to high intakes of animal protein. By the age of 80, vegetarians tend to have lost less bone mineral compared to omnivores. Research suggests that the more animal protein you eat, the higher your risk of hip fracture becomes. Cross-cultural studies show strong links between a high animal protein diet, bone degeneration and the occurrence of hip fractures. In a rural community in China where most of the protein in the diet came from plant foods rather than animal foods, the fracture rate was one-fifth of that in the US.  


For more information on the topic see our Healthy bones section.


Find out more:



 


 


  See our calcium fact sheet.


 


 



 


 


See our new poster illustrating good plant sources of calcium.


 


 


 



  Building Bones for Life - This guide will provide you with all the theoretical and practical information on healthy bones you need. Written in a very easy to read way it explains what the key players in bone health are and how you can achieve healthy bones at any age, even if your bone health is already compromised. 


 


 


 


 

Can a vegan diet supply sufficient calcium?


Yes it certainly can. There are no scientific reports of calcium deficiency in adult vegans. Looking solely at calcium intake and not at calcium losses tells only half the story - while a vegan’s intake might be less than a meat eater’s, their losses are likely to be much lower. The evidence is that a plant-based diet free of animal products - a vegan diet - doesn’t produce these losses. A vegan diet rich in vegetables, fruits and whole grains can provide the basis for a long and healthy life, reducing the risk of osteoporosis and many other diseases. In contrast, diets loaded with dairy products are associated with increased risk of osteoporosis, certain cancers, heart disease, obesity and diabetes.


 


Find out more:



 


 


  See our calcium fact sheet.


 


 



 


 


See our new poster illustrating good plant sources of calcium.


 


 


 



  Building Bones for Life - This guide will provide you with all the theoretical and practical information on healthy bones you need. Written in a very easy to read way it explains what the key players in bone health are and how you can achieve healthy bones at any age, even if your bone health is already compromised. 


 


 


 


 

With scientific research challenging the widespread misconception that a healthy diet needs to contain milk, it's time to take a closer look at what we are putting into our bodies and how it affects our health. Of particular concern is the outdated concept that cow's milk is the best source of calcium. This is true for calves but human children (after weaning) and adults are better able to digest calcium from other sources such as broccoli and kale as well as other green leafy vegetables, nuts and some dried fruits. An increasing amount of research shows that consumption of dairy products is doing us much more harm than good. With dairy being linked to cancers, heart disease, diabetes and obesity, it's no wonder many people are turning to a dairy-free diet to improve their health.


If you want all the basic facts on health without milk and where to get your calcium from, see our handy fact sheet here.


 

Find out more

If you'd like a paper copy, please order it here.

wl

This report combines the findings of over 400 scientific papers from reputable peer-reviewed journals such as the British Medical Journal and the Lancet.

How to build healthy bones and what really matters in the prevention of osteoporosis.

This guide will provide you with all the theoretical and practical information on healthy bones you need.

calcium

A handy fact sheet summarising everything you need to know about calcium and your diet.

If you'd like a paper copy, please order it here.