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From: Bryanna (
Subject:         Re: PreMenopause/Full Menopause
Date: March 31, 2009 at 2:29 pm PST

In Reply to: PreMenopause/Full Menopause posted by Dot on March 31, 2009 at 1:04 pm:

Your doctor is misinformed about dairy being the
only source of these nutrients, which is not
You can easily take supplements for both, but here
is some information about obtaining enough of both:

Vit D does not occur naturally in milk. It is
added. Here is some information about Vit.D for

Here is my list of good (low-fat) non-dairy sources
of calcium:

here is an article on osteoporosis and menopause
from vegan Rd, Virginia Messina:

Here is a good article by another registered

Here is another by a registered dietitian that
addresses bone density:

And one more:
Hip Fracture Rates and Vegan Calcium Needs

The following information is from "Nutrition
Answers from Virginia Messina, MPH RD"

Q) Youíve written about calcium, protein, and bone
health a number of times and you always seem to
stress that itís important for vegans to get the
RDA for calcium. Most of what Iíve read about vegan
diets shows that we donít need to worry about
calcium. You ignore the fact that, in cultures
where people eat very low protein diets, they donít
have osteoporosis even though they have very low
calcium intakes. Since protein causes osteoporosis,
and vegans eat a low protein diet, vegans have low
calcium needs.

A) Well, first of all, it is not actually a fact
that people donít have osteoporosis in those
cultures. What is a fact is that we see a smaller
incidence of hip fractures in those cultures. And
you are right, I do ignore this, because it turns
out that it is not especially useful information
for western vegans.

The idea that vegans do not need to worry about
calcium is based on the fact that, world wide,
there is no relationship between the incidence of
hip fractures and intake of calcium. There does
seem to be a relationship between hip fractures and
protein intake, however, with hip fracture rates
rising in countries where protein intake is high
(like the United States). There are also laboratory
studies showing that high protein intake negatively
impacts bones. As a result, many vegans believe
that they have low calcium needs because they have
low protein intakes. But this is actually a very
simplistic interpretation of an extremely complex
health issue. Although Iíve written about the
relationship between protein and calcium before, I
havenít written much about the hip fracture data,
so let me try to pull all of this information
together here.

First, when we try to make comparisons of bone
health in different countries based strictly on
rates of hip fractures, we are on rather shaky
ground. This is because, among different cultures,
hip fracture rates are affected by much more than
diet. Here are some of the factors that affect hip

1. Culture: The leading cause of a hip fracture
is falling. That is, if you have two people who
both have osteoporosis, the one who falls is the
one who is going to break a hip. It is possible
that people fall more in some cultures than in
others. For example, in some Asian cultures, older
people do not often go out by themselves. They are
part of an extended family and are often with an
adult child when they are away from home. This kind
of support would greatly reduce the risk of
falling. People in these cultures may also eat a
lower protein diet. But if they simply fall less,
how can we say that their reduced hip fracture rate
is related to their diet rather than their
2. Geography: Again, this is related to falling.
People who live in warmer climatesĖwhere there is
less snow and ice on the groundĖare less likely to
slip and break a hip.
3. Genetics: This is especially important
because it is less speculative than the two factors
I noted above. The hip bone in Asians is shorter
than in other groups and is more resistant to
breakage. This has nothing to do with diet and
lifestyle; it is purely a genetic factor. Also,
some people, particularly those of African
background, metabolize calcium differently and have
a genetic predisposition to denser bones.

Itís easy to see that you canít look at hip
fracture rates in different cultures and make a
conclusion about diet. There are too many other
factors at work here. So it shouldnít be too much
of a surprise to learn that, in some countries
where hip fracture rates are low, people still have
considerable osteoporosis, in their spine for

Therefore, it just is not possible to draw any
conclusions about bone health based on comparisons
of hip fracture rates. It is also impossible to
determine vegan calcium needs based on these hip
fracture observations.

Certainly, the relationship of protein to calcium
is important. Diets high in protein, particularly
high in meat protein, can cause excessive calcium
losses. Protein increases the acidic condition of
the body, and the reaction in the body that
neutralizes that acid results in loss of calcium
from bones. Itís normal to lose some calcium since
bones are dynamic and are always turning over. But
anything that raises the rate of calcium loss will
also raise calcium needs. But this is probably much
less important when calcium intake is high. Itís
only when calcium intake is low that protein
appears to have an important effect on bone health.
And it may also be that it isnít so much the total
amount of protein in your diet that matters, but
the ratio of protein to calcium. Vegans actually
have a ratio that is too high since, although their
diets are lower in protein, they are also often
lower in calcium. (With the growing number of
calcium enriched foods for vegans on the market,
however, this may change).

Also, while too much protein may be harmful to
bones, so is too little protein. Studies show that
among western women, protein is linked to better
bone health. And protein supplements have been
shown to speed healing of fractures. Although it
isnít very difficult to get adequate protein on a
vegan diet, some vegan womenĖespecially those who
eat low calorie dietsĖmay have protein intakes that
are marginal.

In addition, there is some evidence that vegan
women have lower blood levels of estrogen. Since
estrogen strengthens bones, these lower levels may
actually counter any positive effects of a more
moderate protein intake. Some vegans also have low
levels of vitamin D in their blood, which would
increase risk for osteoporosis.

None of this is to say that vegans are actually at
higher risk for osteoporosis. The point is that we
have no good evidence that they are at lower risk.
Itís possible that eating a vegan diet does lower
calcium needsĖbut we donít know that yet. So until
then, itís important for vegans to meet the RDA for
calcium, which is 1,000 mg for adults. For
information on how to get enough calcium on a vegan
diet see my article from November 20, 2000.

Of course, it still makes sense to eat a vegan
diet. The foods that provide calcium to vegans are
far more healthful than dairy products. In
addition, plant foods provide other compounds that
may enhance bone health. For example, leafy green
vegetables provide calcium and they also provide
vitamin K, which may be important for bone health.
Many soyfoods provide both calcium and isoflavones,
compounds that may help maintain the health of
bones. Calcium-fortified orange juice contains
vitamin C which is needed for healthy bones. And of
course, plant foods are rich in all types of
compounds that protect against other diseases.

More arfticles from Virginia Messina on calcium,
bone density, vit. D, etc:

You might like to read my book, "Soyfoods Cooking
for a Positive Menopause."

It has information on menopause, of course, and the
two nutrients you mention, plus bone density and
heart disease and women.

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