“Milk. It does a body good.”

I’m not the big 4-0 yet. So I’m not quite old enough to remember when America’s Dairy Farmers National Dairy Board launched that campaign in 1984. But four decades later, consumers seem to still be under the hypnotic influence of the NDB. We’ve been led to believe that loading up on calcium-rich foods, particularly dairy products, is essential for maintaining strong bones. 

But is dairy really the key to building strong bones? If so, why is it that countries with very high calcium consumption such as the USA, Canada, Scandinavian countries and other higher-income countries in the West have the highest rates of osteoporosis—a condition marked by low bone density that affects 10 million Americans and puts another 44 million at risk.

Osteoporosis occurs when new bone formation can’t keep up with old bone removal, leading to potential fractures. 

If most Americans are consuming enough dairy products until the cows come home, what explains this calcium paradox? As leading consumers of calcium-rich dairy, shouldn’t Americans have the strongest bones on the planet? Adding to the paradox is that countries with the lowest dairy consumption, which tend to be poorer nations in Africa and Asia, have the lowest rates of osteoporosis, says research in the Annals of the New York Academy of Sciences.

I’ll explain this paradox shortly. But first, let’s go over some basics because there’s far more to calcium than just bone health.

Calcium: Does it Do a Body Good? 

Having enough calcium is essential not only for bone development but also for: 

  • Fat metabolism
  • Satiety (staying full for longer; preventing hunger) 
  • Blood clotting
  • Muscle contraction
  • Heart rhythm
  • Hormone release
  • Nerve function and more

Most of your calcium is indeed in your bones. In fact, 99% of your calcium is stored in your bones, according to Harvard’s T.H. Chan School of Public Health

But the 1% of calcium that’s found in blood and tissues? It’s pretty darn important, too. (see the list of functions above)

Your body works really hard to regulate your calcium levels. For instance, there’s a hormone in your body called parathyroid hormone (PTH). PTH controls calcium blood levels. When your calcium levels are too low in the blood, PTH will signal the bones to release calcium into the bloodstream. PTH can also activate vitamin D to improve the absorption of calcium. Your small intestine is where calcium is absorbed in the body. On the flip side, if you have too much calcium in the blood, your kidneys get the signal from PTH to excrete less calcium in the urine. 

So how good is dairy for keeping your calcium levels high enough but not too high? Well, on the one hand, dairy foods are definitely very rich in calcium. But that doesn’t mean your body does a good job absorbing it. In fact, Harvard Health says you only absorb about 30% of the calcium in dairy. 

So that means if your milk nutrition facts label lists 300 mg of calcium per 8 ounces, you’re only absorbing about 100 mg. 

In comparison, green leafy veggies contain less calcium but your body does a better job absorbing the mineral than dairy foods. (With the exception of spinach; but don’t cut out spinach from your diet because it contains many beneficial plant compounds.)

The Calcium Paradox & Osteoporosis 

On one hand, dairy is overrated for calcium because of the relatively low rate of absorption by the small intestine. Yes, calcium is undoubtedly crucial for bone health. But the other big problem with eating a lot of dairy is consuming too much calcium. 

When you consume lots of calcium — which is easy to do in our dairy-loving nation — it can lead to detrimental effects. When the body receives more calcium than it requires, the excess calcium deposits in soft tissues. 

This is what causes kidney stones and the calcification (hardening) of the arteries. Calcification of the arteries in the heart occurs when calcium builds up in the plaque found in the walls of the coronary arteries. 

These arteries supply blood to the heart. When the arteries of the heart harden, less blood is able to flow to the heart muscle. That’s why heart attacks and strokes can occur. When your bones leach (the “leaking out”) calcium, your bone density becomes lower. It’s no wonder there’s a higher risk of having heart disease if you have lower bone density. 

Postmenopausal women are at a higher risk for experiencing bone loss, even though they are more likely to experience vascular calcification. This means that they have high levels of calcium in the body but are more likely to have osteoporosis. This explains the calcium paradox phenomenon, says Frontiers in Cardiovascular Medicine

But calcium buildup isn’t the only problem. High calcium levels also disrupt the balance of other essential minerals like magnesium, which plays a vital role in bone health. This imbalance can hinder the body’s ability to efficiently utilize calcium for bone formation.

Rethinking Supplements Because of the Calcium Paradox

You’re probably no longer chugging 4 glasses of milk a day like you did when you were a kid. To get your daily dose of calcium, maybe you’re taking a calcium supplement or a multivitamin. Well, if you haven’t heard the news, you should probably stop taking calcium supplements because they’re more likely to do harm than good. In fact, this study and others like it show calcium supplements can increase the buildup of calcium in the heart’s arteries. 

Studies also show that calcium supplements can contribute to osteoporosis if they don’t have helper nutrients (co-factors) like vitamin D, K2 and magnesium. As we get older, our body doesn’t do as good of a job synthesizing vitamin D (the sunshine vitamin). Most people are vitamin D deficient. And when you’re low in vitamin D, you absorb less calcium from food.  

As for vitamin K2, it acts like an Uber driver for calcium, steering it into the bones instead of places like the heart. A research paper from Italy says that Vitamin K2 deficiency could be responsible of the so-called “calcium paradox”, that is the lack of calcium in the bone and its storage in the vessel wall. 

Algae For Calcium And Higher Bone Density

One supplement that you may want to take if you have osteoporosis or its precursor—osteopenia—is algal calcium (calcium from seaweed), which successfully counteracts calcium deficiency with outstanding absorbability, says this Japanese researcher

There’s also other nutrients that should get shout-outs for bone density health: 

  • Boron
  • Zinc
  • Phosphorus
  • Silica (silicon dioxide)

So how do you get enough of these minerals in your diet? For starters, you gotta eat real food. That means food that you can pronounce that comes from the ground, a tree or flies, swims and runs. Like salad, steak, eggs, apples, bananas, chicken, etc. Try to cut down on the amount of packaged foods you buy. (There’s no potato chip tree). All these foods are high in sodium and low in minerals. 

Other Lifestyle Factors

The calcium paradox as it relates to osteoporosis paradox isn’t solely related to how much calcium you consume. Lifestyle factors such as physical activity, hormonal balance, and yes, I said it above, but I’ll say it again, dietary choices all affect bone health. 

And you also have to get your stress levels under control. That’s because chronic stress can release hormones like cortisol. Too much cortisol can degrade your bone-building potential.  

Finally, if you’re going through menopause, keep in mind that you’ll likely have a lower level of estrogen. Estrogen helps increase calcium absorption and retain the mineral in your bones. But you also need progesterone to keep the estrogen in balance. 

How I Can Help With Your Bone Density

So the calcium paradox is that many Americans are consuming lots of dairy. But the calcium is going to the wrong places (not the bones). But there are also people who aren’t getting enough calcium in their diet because they’re eating too many processed foods and not enough bone-building real foods.

Yes, it’s all very confusing. That’s why I decided to be a functional medicine practitioner. 

As a functional medicine practitioner, I emphasize a holistic approach to bone health. That means I might recommend a DEXA bone scan and order diagnostic tests that will show me what your hormone levels look like as well as your levels of vitamin D and other bone-building nutrients. 

Let’s work together to strengthen your bone density. 

The first step is contacting me. 

Until next then, 

Jenna Witt, NP

Nurse Practitioner

Functional Medicine Practitioner
Founder, Fundamental Wellness of Nebraska