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This post was originally published in 2012. It has been revised, updated and republished!
It's inevitable. Those who choose to limit or eliminate dairy products, whether because they're “Paleo,” allergic, or simply don't like the stuff, get the concerned question from family and friends:
“You don't eat dairy?! But how do you get CALCIUM?”
They’re convinced – probably because many generations before us grew up on dairy, and more likely because of the massively successful “Got Milk” campaign that I discuss in my book, that calcium is the only real way to get adequate dairy in the modern diet.
The truth is that healthy foods like leafy greens, sardines and homemade bone broth – one of my absolute favorite superfoods – are sources of highly bio-available calcium (this means it's easily absorbed and utilized by the body). Often, they're higher in calcium per serving than dairy (another topic I discuss in my book).
I wouldn’t worry about somebody’s calcium status if they were eating lots of real food – because eating real food is a healthy habit above and beyond guzzling ultra-pasteurized skim milk between bites of Fiber One.
That said, the dairy question is interesting and I'm not totally against the white stuff. Read this. While I have no hard-and-fast dairy “Manifesto,” I do think a responsible consumer of dairy products who includes dairy for so-called health reasons does need to be well-informed.
Back to the calcium question. If you simply must engage in this conversation, there are a few fun (and legitimate) ways to address the inquiry. I begin by putting on my Nutritional Therapist hat.
Okay. Ready, aim, moo.
The Calcium Answer, Method One: The Awesome Answer.
My preferred answer to the question “But how will you get your CALCIUM?” is to simply say, “from your MOM!”
Unfortunately, that’s not always constructive.
The Calcium Answer, Method Two: The short, yet open-ended answer.
I like to address the calcium question with yet another question, such as: “Who told you that DAIRY is the only way to get CALCIUM?”
Often the answer is a bumbling “…uh, well, the food pyramid – er, plate? The government? Dr. Oz…Osteoporosis?” which opens the door to the following response:
I eat natural, unprocessed foods – not pasteurized, homogenized, de-fatted industrial products. Broth, sardines, greens and even raw dairy, if you know what you're doing, is perfectly nutritious and far less processed. If you knew what happened to conventional dairy from udder to cup, you'd avoid it too.
Here's the really important thing, and depending on the attention span of your inquisitor, you might want to add this:
Whether you’re concerned only about calcium intake or you're extrapolating to calcium's relationship with bone degeneration or disease, realize that it’s not about quantity anyway. It’s about giving your body the tools to use calcium efficiently and properly.
As in, it doesn't matter how much calcium you drink OR eat if your body can't use it.
I take care of this by getting the co-factors that MAINTAIN quality bone. Co-factors are everything from balanced blood sugar to other vitamins and minerals, fatty acids, and even exercise.
You could get REALLY didactic by adding:
It’s ignorance of this fact that’s caused doctors and Big Pharma to have dairy-calcium tunnel vision. Incidentally, leafy greens are higher in calcium, calorie-for-calorie, than milk, and have none of the allergenic properties of standard, grocery store, corn-fed, factory-farmed, pasteurized, homogenized dairy. Bone broth is rich in other minerals, like magnesium, as well.
Okay, so altogether that’s a bit of a mouthful. But our modern obsession with conventional dairy products hasn't really improved peoples' overall bone health – judging by the ever-present advertisements for drugs that “fight osteoporosis.” Something’s not right.
(And the “Got Milk” campaign marches on…)
We're incredibly bone-centric when it comes to the issue of calcium, dairy and health – understandably so, since 99% of our calcium is stored in our skeletal system. Your entire body uses calcium, however, not just your bones, and that storage system is important – it allows the body to recruit the calcium it needs, when it needs it.
Yep, we've got a built-in system of bone remodeling that keeps our bones strong as they give-and-take calcium over time. No, you don't want to simply pack the calcium in and never let it go. Bone remodeling – the giving and taking of calcium in concert with the needs of the body and the help of other nutrients that help the body do just that – is what keeps bones healthy. Otherwise, they'd get brittle and – you guessed it – osteoporotic. (Which is, apparently, a word.)
The truth is, it’s not about how much calcium we take in. It’s about balancing bodily systems with Real Food so that the body can maintain homeostasis, optimize nutrient absorption and utilization, and – of course – maintain excellent bone health.
The Calcium Answer, Method Three: The awesomely intricate, FULL STORY about Calcium…
…and specifically, why someone on a dairy-free plan – including an optimized “Paleo plan” rich in healthy, calcium and calcium-cofactor-containing foods – simply doesn’t need to worry about their calcium status!
The most important thing to understand is this: the way your body uses calcium – including how your bones maintain density and quality – is entirely dependent on co-factors.
Here’s a rundown:
Co-Factor 1: Hormonal & Blood Sugar Balance.
The body obsessively regulates both blood pH and blood sugar balance. And this process is modulated by hormones.
“Buffering” blood pH involves the alkalinizing properties of calcium. The parathyroid gland releases parathyroid hormone, which initiates osteoclastic activity – releasing calcium from the bones – which buffers blood pH.
Calcitonin (released from the thyroid) counter-balances this process by inhibiting osteoclastic activity. Estrogen and progesterone “check-and-balance” one another in calcium utilization as well.
(Another problem in modern life? Xenoestrogens. Estrogen-mimicking substances like over-reliance on soy and over-use of plastics can skew this balance.)
The body prioritizes blood sugar balance so highly because it profoundly affects your hormonal balance and signaling. If your blood sugar is out of control, nothing else will fall into place – including calcium balance. Elevated blood sugar, stress, and resulting cortisol dysregulation and adrenal stress (also hormonal) increases calcium mobilization from the bones – as in, they reduce bone density.
The hormone-deploying parathyroid gland also signals the body to produce specific binding proteins for the minerals it needs – for example, calcium. (Yet another signaling loop that’s inhibited by a bad diet.)
Co-factor 2: Hydration (Water & Electrolytes)
Water, broth, and water-dense foods like whole proteins and vegetables are extremely hydrating, especially when they come with a pinch of sea salt (which helps the body maintain cellular fluid balance).
Soda, however, is not hydrating – it’s important to note that the orthophosphoric acid in soft drinks may cause bone breakdown, especially with high, chronic consumption over time. Think that Diet Coke is a healthier habit than regular ol' sugary soda? Not even close.
A balance of electrolytes is in the body is important to hydration as well, as electrolytes regulate body fluid balance and the transmission of electrical impulses across cell membranes (these impulses enable us to move, so they're pret-ty darn important). Himalayan or Celtic sea salt is a great addition to the diet, although adding excess refined salt to a Standard American Diet filled with packaged and processed foods is obviously not recommended.
Also – kick the Cola.
Co-factor 3: Don't Take Counterproductive Drugs.
I’m not talking about the fun kind of drugs (although you should probably toss those as well). Big Pharma has created some truly gnarly “solutions” to osteoporosis (like Boniva). These drugs literally inhibit osteoclastic activity.
This means they keep bones from breaking down – and stop the natural, necessary and constant process of bone remodeling. Think about it as packing clay on to a crumbling sculpture. OsteoBLASTIC activity without osteoCLASTIC activity means bones become more dense, but NOT stronger. Sorry Sally.
Co-Factor 4: Digestion.
The body must have adequate HCL (stomach acid) to absorb calcium. Modern acid blockers like Nexium and Prilosec literally stop the production of stomach acid, and because of this, nutrients can’t be absorbed properly. This wreaks havoc across all bodily systems, because they all require adequate nutrients to function properly.
(In fact, you want MORE stomach acid, not less!)
Additionally, dietary factors – like the consumption of gluten and grains – can interfere with nutrient absorption in the gut. Specifically, the phytic acid in grains and beans can bind to minerals like calcium, magnesium and zinc, rendering them indigestible. This becomes a marked problem in a Standard American Diet, which is dangerously rich in these “mineral binders.”
Co-factor 5: Other minerals & vitamins…and more hormones
Your ability to absorb and utilize minerals is absolutely mediated by the components – the vitamins, minerals, and hormonal effects – of the foods you eat.
Adequate intake of magnesium and vitamin D (which is technically a hormone, generated by sunlight's action on the skin; and also found in some seafood, cod liver oil, and raw milk) are the co-factors you’ll hear about most often. But it’s not about hammering your body with one at the exclusion of another.
Calcium, Magnesium and Vitamin D are not the Three Musketeers. They’re more like the Executive, the Legislative, and the Judiciary: they’re not always friends, but they keep one another in check. They even inhibit one another – but only when necessary.
Vitamin D works with parathyroid hormone to increase blood calcium when necessary. It also works with vitamin K2 to regulate the depositing of calcium in the proper areas to protect the body from improper calcium deposition (like arterial calcification – also known as clogged arteries).
Magnesium is involved in calcium transport, but it will also block calcium pathways as needed – acting as a counter (a “relaxer”) to calcium’s properties of contraction (remember, minerals are electrolytes, and electrolytes are needed to enable us to move by contracting and relaxing our muscles). Magnesium also helps convert vitamin D to its active form, which allows for calcium absorption.
But wait…there's more!
Vitamin K2 is active in everything from bone synthesis and formation to fertility and skin health. You can supplement with it, you can choose grass-fed, full-fat dairy products like butter and ghee (a rare argument FOR dairy, with important quality standards), or you can try Walkabout Emu Oil, which claims to be high in vitamin K2 (and which I've enjoyed taking).
While most “Paleo” folk don't generally do dairy, this post may shed some light on why certain types of dairy may be good to go, and why eating OR NOT EATING something just because it is/isn't Paleo is – well – kinda silly.
Other minerals are critical to calcium use as well. Calcium must also be in-balance with potassium and trace elements like boron, copper and zinc. I gotta say, though, I'm not writing a textbook here, so I'm gonna keep things moving.
The point is: balance is critical, and nearly impossible to achieve definitively if all you're freakin' thinking about is calcium. Step back, eat real food, and let your body fall into balance based on its innate ability to prioritize and utilize the nutrients from Real Food (and sunlight).
Co-Factor 6: Fatty Acids
Fatty Acids are responsible for the transport of calcium across cell membranes, which also has an effect on electrolyte balance. Too many polyunsaturates (predominantly from vegetable oils) decreases the stability of the cell membrane, and saturated fats strengthen it, according to the late Mary Enig, who wrote the definitive book on the topic of fatty acids.
That’s why both unsaturated and saturated fats are important in proper proportion with one another. To keep 'em in proper proportion, simply consuming them in their natural form is the way to go: natural polyunsaturates are found in abundance in oily fish, and saturated fats are found in coconut oil, animal fat, butter and ghee.
Vegetable oils, by contrast, are highly processed and not appropriate sources of nutrition of any kind.
Additionally, fats and cholesterol are critical to the creation and synthesis of hormones, although not all Fatty Acids are created equal. A study from Purdue University indicated that high levels of free radicals from linoleic acid (an Omega-6 fatty acid found in excess in the Standard American Diet because it’s found principally in unhealthy, highly processed fats like “vegetable,” corn and soy oils), interfered with bone-building.
Co-Factor 7: Exercise.
Exercise builds bone strength. (I think the audience understands this one.)
So there you have it: The Calcium Rundown. Memorize it. Carry a copy with you at all times. The most important factors to calcium status are real food and the 7 Calcium Co-Factors. Processed foods and the Standard American Diet are NOT high in these co-factors.
End of (long, delightfully complex) story.
Thanks to the Nutritional Therapy Association for providing the education that inspired this post!
And thanks for reading!
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