Doctor-Recommended Diet to Build Strong Bones Increase Your Calcium Intake with Fruits and Veggies

Think all that milk and yogurt is keeping osteoporosis away? Not according to controversial research by health expert Amy Joy Lanou, Ph.D., which blasts the benefits of dairy for strong bones. Read on to find out why… We’re eating more dairy foods than ever before. But osteoporosis rates in the U.S. are still reaching epidemic proportions. In fact, half of U.S. women will break bones in their spine, hip, wrist or back because of osteoporosis at some point after their 50th birthday, according to the Office of the Surgeon General. And these numbers could double or triple by 2020. The problem: “Our diet is destroying bone,” says Amy Joy Lanou, Ph.D., an assistant professor of health and wellness at the University of North Carolina-Asheville, where she teaches nutrition and women’s health. Lanou explains her dramatic discoveries in a book she co-authored (with health writer Michael Castleman), Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis (McGraw-Hill). Despite what we’ve been led to believe, milk and other dairy foods don’t reduce fracture risk, according to data they analyzed from 1,200 studies on calcium and bone health. In fact, they even increased the risk. According to Lanou, animal proteins like dairy increase acidity in the blood. Our blood then drains calcium from our bones to remove the acidity. For our bodies to reap the calcium benefits of these foods, we need to balance them out by eating more alkaline foods, like fruits and vegetables. “Diets that are richest in fruits and vegetables and most modest in animal protein” protect best against fracture risk, Lanou says. Trading some animal proteins for more efficient calcium sources, like beans and greens, and walking 30-60 minutes a day is the key to better bone health, according to Lanou. These fixes reduce your chances of osteoporotic fractures by 50%, according to Lanou, who’s also a senior nutrition scientist for the Physicians Committee for Responsible Medicine – a Washington, D.C., nonprofit that promotes better nutrition and preventive medicine. We sat down with Lanou to learn more about her findings. Can you explain why the typical American high-protein, high-calcium diet is bad for bone health? I’m not saying adding additional calcium is bad for bone. I do think the over-consumption of proteins, particularly from animal sources, is harming bones. When we digest animal protein-rich foods [including dairy], they become amino acids as they go across the small intestine [and] slightly increase blood acidity. The body doesn’t like acid in the blood, so it [leaches] calcium compounds from bone to readjust to a nearly neutral state. Then it dumps both acid and calcium out into the urine. Why is plant-based calcium better than dairy? The calcium in plant foods tends to be better absorbed [by bones]. With milk, about 32% of the calcium is absorbed. With cabbage and beans, it’s 50% percent, and in some cases a little higher. [Also], plant foods don’t increase calcium loss from the body the way some dairy foods, like cheese, do. What are our best, most absorbable calcium sources? Greens and beans. Cabbage-family vegetables [kale, broccoli, cauliflower, Brussels sprouts] are always on the top of my list. Meat eaters should have three servings a day of some type of [plant-based,] calcium-rich food [to balance out the acid from meat and other proteins]. Tofu, figs, almonds, fortified non-dairy milks and juices are also great choices. The only green exception is spinach. It has a fair amount of calcium, but it isn’t well-absorbed. Pretty much all beans are good sources. People don’t realize how mineral- and vitamin-rich beans are. So, have some hummus dip with lunch or a black bean burrito for dinner. What other nutrients do we need for bone health? There are 17 different nutrients important for bone [ranging from fluoride, which helps harden minerals in teeth and bones, to vitamin B6; bones become weak when you don’t get enough of it]. A key one is vitamin C. It’s important for collagen, and that makes up the matrix that is the structure of bone. If you choose a variety of foods, you should get all nutrients you need. Why do we think dairy is so good for fighting osteoporosis? There’s [logic] to the assumption that if osteoporosis is low-bone calcium, and dairy foods have calcium, then [taking calcium] would take care of the problem. There’s also pressure from the dairy industry to keep looking for the positive benefit of dairy foods on the body. But getting calcium into the bone and keeping it there [is a different story]. Adding more calcium to the body doesn’t mean more calcium is getting in, and staying in, bones. How effective are calcium supplements? If you sit on your couch and take a calcium pill, there’s no reason for that calcium to move into bone. Whatever source it’s coming from, if you don’t have a way to move the calcium from supplement to bone – such as if vitamin D isn’t present [in your diet] – [your bones aren’t getting the benefits of it]. How much calcium do women need a day for strong bones? At least 500 milligrams. It depends on your overall dietary pattern. If you’re using a lot of the calcium you’re eating to neutralize the acidity of your food [from animal proteins], then it’s not going to go into bone. So you might need 700-800 milligrams a day. There’s some evidence that calcium intake below 500 milligrams a day is harmful. Can you tell us more about new research on how calcium affects bone health? There’s strong epidemiological evidence showing that as calcium intake goes up, fracture rates go up. So the solution we’ve proposed to take better care of bones isn’t working. If you look at the Nurses’ Health Study [a long-running investigation into women’s health], you see there isn’t a strong [positive] association between calcium intake and fracture rates. In fact, two thirds of studies show no relationship between high calcium intake and fracture rates. So how should we alter our eating habits overall? A modest-size turkey and provolone sandwich on wheat bread requires 5-7 cups of raw vegetables, or fruits, to neutralize the acid [from the meat and cheese]. You can eat some highly acidic foods, but if you consume large quantities, you’re going to be working hard to balance out the acidity. I generally recommend [leaning] toward a vegetarian diet. People ask me, “If I want to keep meat in my diet, how would you recommend doing it?” I tell them to think of it as a condiment – like a vegetable stir-fry with chicken strips, or some salmon on a large green salad. Or they can think about it in terms of volume. The amount of meat on your food should be relatively small [compared with] the amount of plant matter. It’s difficult for people to make that shift, [especially] with fruit. But there are so many fruits that come ready to eat. Think bananas, berries, apples. There’s no cooking involved. The hard part is getting into the habit of buying them. When you open the refrigerator, grab berries instead of cheese. Do you recommend becoming a vegan to get the most bone benefits? No. You just have to shift your diet to at least 6-9 servings of fruits and vegetables a day – two at every meal, plus two snacks of fruits or vegetables and a moderate intake of [animal-based] foods. I try to help people see the places where they’re already eating things that could easily be converted. If you’re having spaghetti with meatballs once a week, why not change it to pasta marinara or primavera. You can eat the same foods and shift an ingredient or two in those foods. But is a vegan diet a better option than eating meat? I think so... only because it’s easier. If you just don't eat many acid-forming foods – including meats of all kinds, eggs, cheeses, ice cream, fast food and other foods processed beyond a shadow of recognition – then you don't have to think about balancing your acid-forming servings of food with alkaline-forming ones. You can get nearly the same benefit, though, by eating very little meat and cheese and balancing that with adequate servings of fruits and vegetables. In your book, you say building bone also requires 30-60 minutes of walking a day. If you’re too busy for one long daily walk, can you break it up? Yes, 10,000 steps a day is fine. It doesn’t matter if it’s all at once or not. The book also claims, “The osteoporosis cure stands on two legs: low-acid eating and regular, moderate exercise.” Do you think these steps can really cure osteoporosis? This is one place where my co-author [Michael Castleman] and I nearly went to blows. He’s more comfortable with the “cure” language than I am. What we don’t have is a 20- or 30-year clinical trial of trying only these approaches – the exercise approach and the dietary approach. If we had that study and it showed everyone’s bones got better over a period of 20-30 years, then we could say we have a cure. I think the evidence we have suggests it’s our best option for finding a cure. Any final advice for helping us alter our meat-focused eating habits? Change is almost always born out of a belief that there’s a reason to do so. What I try to do is work with people to find the reason why it’s worth [making] change. These foods are just as yummy. I often do cooking demonstrations to show [people] that it’s not hard to eat a diet rich in plant foods. Not sure how to get more plant-based foods into your meals? Try some of Lanou’s recipes at NutritionMD , a website operated by the Physicians Committee for Responsible Medicine. And for more information, visit our Osteoporosis Health Center. How Much Do You Know About Osteoporosis? In the U.S. alone, about 8 million women have osteoporosis, and more than 30 million more women may be at risk of developing it because of low bone mass. Postmenopausal women are at greatest risk and their likelihood of fracture doubles every 7-8 years after age 50.