Does Milk Build Strong Bones?

Dr. Matthew NagraArticles, Dairy

Marketing has told us for decades that we need to consume dairy for our bones, but like I said, it’s marketing. As with any health claim, you can certainly find a study to support the consumption of milk; however, a 2011 meta-analysis that looks at the bulk of research showed no overall improvements in fracture risk in those who consumed more dairy products1, while a 2018 meta-analysis reported that there is no consistent evidence that milk lowers fracture risk2. Even a study on milk consumption during teenage years showed no changes in fracture risk in later life.⁣3

You may have heard that the countries that consume the most dairy actually tend to have higher fracture rates. While this doesn’t prove that dairy is a cause of those fractures, more research has come out that suggests a connection. A massive 2014 study with over 60,000 women and 45,000 men found that 3 or more glasses/day resulted in higher fracture rates in women AND higher death rates in both!4 One of the primary reasons for this is thought to be the galactose in milk, which creates oxidative stress and inflammation leading to bone loss and other health issues.4

In addition to the detriments to bone health, there are certainly more concerns with regard to dairy products. Right off the bat, I must note the fact that up to 65% of the human population has a decreased ability to digest lactose since we have no need for it beyond infancy. Surprising to some, dairy consumption has been associated with Parkinson’s disease, a serious neurodegenerative disease, likely due to the galactose within dairy and the ability of dairy products to drop uric acid levels too low.5-7

Furthermore, dairy consumption has been linked to the development of type 1 diabetes for decades, although definitive proof is still lacking.8 I should also mention that dairy is the number 1 source of saturated fat in the American diet, which contributes to heart disease. Lastly, it has been linked to prostate cancer with outlined mechanisms for how it may contribute to cancer progression.9,10 I do need to mention, on the topic of cancer, that dairy consumption has been shown to reduce colorectal cancer risk because of its high calcium content,11 but since those following plant-based diets have the lowest overall risk of cancer, it may be worth choosing high calcium plant foods instead.12

However, if you are consuming a strictly plant-based diet and are not getting adequate calcium, you can also end up with lower bone mineral density, which can lead to fractures. The best study on the topic demonstrated that vegans who consume a minimum of 525mg of calcium per day do not have higher fracture rates than their omnivorous counterparts, so it’s important to make sure you’re including good calcium sources, such as firm tofu, mustard greens, kale, and broccoli In fact, the calcium in tofu is about as absorbable as the calcium in milk and all the other listed vegetables have even higher bioavailability!13,14

Beyond calcium, there are several other nutrients that are important for bone health including vitamin D for improved calcium absorption15, vitamin K to reduce bone turnover, and magnesium, silicon, and boron for overall bone mineral density.16 Nutrition aside, the most important factor for bone health is weight bearing exercise. You can have the perfect diet, but if you aren’t stressing your bones, they won’t build. This can be done through walking, running, or weight lifting since you are actively holding up your bodyweight or an external weight. Unfortunately, swimming or cycling wouldn’t be considered weight bearing.

So to make things simple, it’s important to eat a variety of healthy plant foods and move your body regularly.

  1. Bischoff-Ferrari, HA et al. Milk Intake and Risk of Hip Fracture in Men and Women: A Meta-Analysis of Prospective Cohort Studies. J Bone Miner Res. 2011.
  2. Bian, S et al. Dairy product consumption and risk of hip fracture: a systematic review and meta-analysis. BMC Public Health. 2018.
  3. Feskanich, D et al. Milk consumption during teenage years and risk of hip fracture in older adults. JAMA Pediatr. 2014.
  4. Michaelsson, K et al. Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ. 2014.
  5. Jiang, W et al. Dairy foods intake and risk of Parkinson’s disease: a dose-response meta-analysis of prospective cohort studies. Eur J Epidemiol. 2014.
  6. Chen, H et al. Diet and Parkinson’s disease: A potential role of dairy products in men. Annals of Neurology. 2002.
  7. Ridel, KR et al. An updated review of long-term neurological effects of galactosemia. Pediatr Neurol. 2005.
  8. Chia, JSJ et al. A1 beta-casein milk protein and other environmental pre-disposing factors for type 1 diabetes. Nutr Diabetes. 2017.
  9. Aune, D et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. AJCN. 2014
  10. Park, SM et al. A milk protein, casein, as a proliferation promoting factor in prostate cancer cells. World J Mens Health. 2014.
  11. Aune, D et al. Dairy products and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. Ann Oncol. 2012.
  12. Dinu, M et al. Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition. 2017.
  13. Appleby, P et al. Comparative fracture risk in vegetarians and non-vegetarians in EPIC-Oxford. Eur J Clin Nutr. 2007.
  14. Burckhardt, P. Calcium revisited, part III: effect of dietary calcium on BMD and fracture risk.
  15. Bischoff-Ferrari, HA et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005.
  16. Price, CT. et al. Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet. Open Orthop J. 2012.