Michael Castleman: Prevention of Osteoporosis November 4, 2009

Health journalist Castleman explains why bone health has less to do with calcium than we might've thought.

For 30 years, health authorities have insisted that calcium is the key to bone health, but during that period, fracture rates have increased. In addition, the countries that consume the most calcium have the highest rates of osteoporotic fractures. What does this mean? Noted San Francisco health journalist Castleman and nutritionist Amy Lanou, Ph.D., analyzed 1,200 studies of diet and osteoporosis risk and concluded that calcium is not the answer.

Everyone agrees that weight-bearing exercise-walking, running, dancing, gardening, etc.-is absolutely essential for bone health. The controversy concerns diet. If calcium (milk, cheese, calcium pills) prevents osetoporotic fractures, we would expect that the countries that consume the most calcium should have the lowest fracture risk. But they don't. In fact, the countries that consume the most calcium (the U.S., Western Europe, Australia, New Zealand) have the world's highest fracture rates. Many countries in Asia and Africa have fracture rates 50 to 75 percent below ours.

Adding vitamin D to a typical American diet reduces fracture risk about 20 percent. That's a step in the right direction, but it still leaves us with a fracture rate much higher than many Asian and African countries.

Our review of 1,200 studies shows that the diet most beneficial for bone health and fracture prevention is one that's rich in fruits and vegetables (6 to 9 servings a day), and with a minimum of high-protein meats, fish, poultry, and cheese. You don't have to become a vegetarian to enjoy good bone health and low fracture risk, but for most Americans, a bone-healthy diet involves eating more fruits and vegetables and less meat. The bone-healthy diet we recommend is the same diet the American Heart Association and the National Cancer Institute recommend for prevention of heart disease, cancer, and stroke.

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