When I was a child, I despised milk. I grew up drinking water and juice, primarily, while eating my Cheerios and Raisin Bran dry. In contrast, my family loved milk. Both my mother and cousin drank it with nearly everything, including dinner. I, on the other hand, was often having a glass of wine with mine. I have never had a traditional glass of milk, though I can tolerate variations such as almond, macadamia, and coconut.
Recently, I have come to understand why I was diagnosed with osteopenia in my late 20s, and why since I have had multiple broken bones. From a clinical standpoint, the reasoning is simple, and relates to my lack of drinking milk, and a deficiency of proper calcium-enriched nutrients during my growth and developmental years.
Dr. Jeffrey O’Brien, a central Florida-based orthopedic surgeon – and the doctor who treated my many injuries, including a fractured tibia and broken kneecap – explained why the lack of calcium in young girls can wreak havoc on their skeletal structures later in life.
“In the early phases of development, from birth to early adulthood, young girls’ bodies are in an anabolic state (building and maintaining bone mass), with the hormonal function designed for growth and preparation for the future. During this time, girls need to maximize their calcium input to better prepare for the strength of their skeletal structure,” he said.
“Later in adulthood, and especially during menopause, women have hormonal changes, and the skeletal system functions as a reservoir for calcium with the catabolic function (breaking down or losing bone mass) ensuing. Normal circulating levels of calcium will be maintained, but at the expense of the strength, mass, and density of the bones.”
In other words, if as we age the calcium reservoir is of a lower level in our bone structure (like mine), the bones can become exponentially weaker, subjecting them to clinical complications of postmenopausal injury – specifically fractures. Additionally, estrogen is required for the absorption of calcium into our bones. When estrogen levels drop during menopause, the bones become even more fragile.
Accordingly, the National Institutes of Health (NIH) companions O’Brien’s comments; “a low dietary intake of calcium during childhood and adolescence may jeopardize the achievement of genetically determined peak bone mass.” The NIH further states children and adolescents, especially girls, generally are not consuming the recommended two to three servings of milk and/or milk products each day. As a result, 70 percent of girls in the United States age 6 to 11 do not meet the current recommended calcium intake.
That lack of calcium consumption during those developmental years is presumably the reason for our national osteoporosis statistics. The NIH declares osteoporosis is a public health threat for an estimated 44 million women, causing an annual healthcare cost of more than $17 billion.
O’Brien said he normally begins seeing women with skeletal injuries in their early 50s.
“Most of the earlier injuries cause fractures in the wrists. While troublesome, they are not generally disabling. In the 60s and 70s, we see compression fractures in the thoracic and lumbar spine regions, which are painful and can easily result in disability. Later, in the 70s, 80s and even 90s, we see an increase in hip fractures, which can be devastating, and life-changing to the patient,” he said.
Of course, there are medications available to minimize bone loss and protect the calcium within the musculoskeletal system. However, these drugs are not without side effects, both systemic and musculoskeletal, and their prescription usage has decreased in recent years.
It is important to recognize dairy foods are the most important source of dietary calcium for both healthy bones and teeth. Additional attributes of dairy include protein, fat, and carbohydrates, along with nutrients such as riboflavin, phosphorus, vitamins A and B12, potassium, magnesium, zinc, and iodine.
Favorable dairy sources can include goat, sheep and fortified plant-based milks (almond, soy, rice), cheese, yogurt, calcium-fortified orange juice, winter squash, edamame, tofu (made with calcium sulfate), canned sardines and almonds.
According to Healthline, a person needs vitamin D to absorb calcium. Tuna, salmon, catfish, and eggs are vitamin D-centric foods, while dark leafy greens, including broccoli, are great sources of vitamins C and K, which are also known to support bone density.
Calcium is essential to overall health, and can be obtained from many different food options – and, if necessary, through vitamin supplementation.
Studies have shown that strength training can also play a role in slowing bone loss, and in some cases help build bone mass. According to Harvard Health, weight training “is tremendously useful to help offset age-related declines in bone mass. Activities which place stress on bones can nudge bone-forming cells into action.”
While drafting this article, I began thinking about the parallels between bone health and skin health. Over-exposing unprotected skin to the sun in younger years results in unhealthy, damaged skin for life. The evolution of our skeletal state is not much different. If we do not attain the recommended calcium, we pay for that deficit with premature injuries and broken bones for life.
Personally, I am consistently trying to compensate for the lack of adequate dietary calcium consumption from years ago, while also managing skin damage due to the overabundance of sunny days without sunscreen. As the idiom clearly states, “We live, we learn, and then we grow.” So, I have learned to consistently eat calcium-enriched foods while using sunscreen daily, though I still cannot fathom drinking a glass of milk, especially with dinner. I believe I will stick with my wine.