Lifelong high milk consumption is recommended to meet the calcium requirements for bone health. But Hegsted DM in an article titled ‘Fractures, calcium, and modern diet, published in Am J Clin Nutr 2001;74:571-573 reported countries where peoples have the highest milk and calcium intake tend to have the highest rate of hip fractures. What could be the reasons behind this paradox?
Rather interesting finding there. The body does not absorb all the calcium in meals, in fact I would say too much calcium in a single meal is self limiting when it comes to absorption due to over saturation at the receptor sites. Another cause would be the combination of other foods which may form complexes with calcium thus limiting absorption.
Highest milk consumption is probably in northern part of Europe and its decents (northern half of USA and Canada). That are also countries with rather low sun exposition (lower vitamin D) and long living (more chance of breaking your hip when you are over 70 years).
A more recent community based cohort study with large numbers also came to the same conclusion that higher milk intake did not protect against hip fractures (as attached). On the other hand, in countries where there is a low intake of milk and calcium e.g. Asia, hip fracture rates are generally lower. The increase in hip fracture rates expected in Asia in the future are linked to the increasing ageing of the population, rather than milk or calcium intake. So, the reasons for hip fracture occurence is definitely more complex than just due to milk/calcium intake.
Just came accross this newly published NEJM review paper on milk and health in general, which includes a section on bone health, discussing the paradox of milk intake and fractures.
Milk and Health.
Willett WC, Ludwig DS.
N Engl J Med. 2020 Feb 13;382(7):644-654. doi: 10.1056/NEJMra1903547.
Thanks to Jos Weilders and Swan Sim Yeap for your worthwhile comments. Many many thanks to Swan Sim Yeap for sharing very informative links.
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