The Calcium-Protein Battle: Osteoporosis Risks and Nutrition

The Battle Between Calcium and Protein - Osteoporosis

I apologize for the intrusion.
(I am currently serving at National Chiao Tung University) I have a question to ask.
A colleague sent me an email, and I am unsure of its authenticity.
Could Director Tang please respond? Thank you! The content is as follows: ----- Original Message ----- Sent: Thursday, January 16, 2003 4:55 PM Subject: The Battle Between Calcium and Protein - Osteoporosis My mother-in-law is over seventy years old and is very attentive to her health.
Every morning, in addition to exercising for two hours, she strives for a balanced diet, especially ensuring she consumes "no less than three large cups" of milk daily to intake sufficient calcium.
She believes that with such meticulous dietary habits, osteoporosis would be out of the question for her.
However, while traveling in Malaysia, she accidentally stepped into a hole and fractured her left calf severely.
After returning home, she spent two months in the hospital, where the doctor confirmed that her bones were extremely fragile and she had "severe" osteoporosis.
Such examples are common in society.
Many people believe that as long as they drink plenty of milk, eat small dried fish, and consume bone broth rich in calcium daily, they will not develop osteoporosis.
However, this understanding is superficial.
The Dairy Council recommends a daily calcium intake of 1,000 milligrams as optimal.
Strangely, Bantu women living in near-primitive conditions in Africa consume only 350 milligrams of calcium daily and have never experienced osteoporosis.
In contrast, the Inuit, who consume the highest daily calcium intake of about 2,000 milligrams—twice the normal value—due to their fish diet, have the most severe osteoporosis in the world.
Moreover, the countries with the highest dairy consumption, such as the United States and the United Kingdom, also have the highest prevalence of osteoporosis.
What is the reason behind this? It turns out that the occurrence of osteoporosis is not dependent on whether you consume enough calcium; the quantity of calcium does not affect your risk of developing osteoporosis.
The key is whether you can "retain" calcium without losing it.
So, why does calcium get lost? Because people in our country tend to consume protein-rich foods such as "meat, milk, and eggs," an excess of protein in the body creates an "acidic" environment.
Once the body becomes acidic, it will naturally extract calcium from the "bones" to neutralize the acidity, achieving a slightly alkaline state.
Imagine a person who has calcium extracted year after year to maintain balance; how can they not develop osteoporosis with daily calcium loss from their bones? Therefore, the culprit is "excessive protein," which leads to calcium loss, not insufficient calcium intake.
Now, let’s examine whether our daily protein intake is indeed excessive.
According to the National Science Council's recommendations, the normal protein requirement for a woman weighing 60 kilograms is only 45 grams per day (about 50 grams for men).
For a pure vegetarian, it is easy to obtain 57 grams, not to mention for meat-eaters, where just a piece of meat or an egg would exceed the requirement.
While milk is indeed high in calcium, it is even higher in protein, so those who drink more milk lose more calcium.
Additionally, "meat and eggs" are high-protein foods, making it unusual for osteoporosis not to occur.
Therefore, do not blame insufficient calcium intake; a normal diet provides adequate calcium.
The amount of calcium does not cause osteoporosis; excessive protein is the real culprit.
I hope everyone gains a correct understanding so that osteoporosis will never affect you!

Jim, 40~49 year old female. Ask Date: 2003/02/17

Dr. Tang Weili reply Nutrition

The causes of osteoporosis are complex.
Approximately 1 in 3 women and 1 in 6 men will experience a hip fracture as they age.
Women's bones are generally smaller and less dense than men's, and the decline in female hormones after menopause exacerbates bone loss.
Consequently, 80% of individuals with osteoporosis are women.
Insufficient calcium intake is a significant contributor to osteoporosis.

Regarding calcium absorption, older adults may have impaired kidney function affecting the activation of vitamin D, which in turn stimulates calcium absorption.
Additionally, excessive meat consumption and high intake of carbonated beverages can lead to increased phosphorus intake, further reducing calcium absorption.
The issue of "calcium versus protein" and the associated problem of body acidity remains controversial.
According to nutritional surveys in Taiwan, older adults typically consume about 5-6 servings of meat (including meat, fish, beans, and eggs) per day, which is not considered excessive.
Serving sizes are approximately 1 ounce for meat and beans, 1 egg per serving, and 240 c.c.
(one cup) of milk per serving, which is a good source of calcium due to its higher calcium content compared to other foods.

Reply Date: 2003/02/17

More Info

The discussion surrounding osteoporosis, calcium, and protein intake is complex and multifaceted. The email you received raises several important points about the relationship between dietary habits and bone health, particularly the balance between calcium and protein consumption.
Firstly, it is crucial to understand that osteoporosis is a condition characterized by weakened bones, which increases the risk of fractures. While calcium is often highlighted as a key nutrient for bone health, the relationship between calcium intake and osteoporosis is not as straightforward as many believe. The email suggests that excessive protein intake may lead to calcium loss from bones, which is a topic of ongoing debate in the medical community.

Research indicates that protein is essential for bone health, as it contributes to bone density and strength. However, the concern arises when protein intake is excessively high, particularly from animal sources. High protein diets can lead to increased acid production in the body. To neutralize this acidity, the body may draw calcium from the bones, potentially leading to a decrease in bone density over time. This phenomenon is sometimes referred to as the "calcium-protein battle."
However, it is essential to note that moderate protein intake is beneficial for calcium absorption. Studies have shown that adequate protein can enhance calcium absorption in the intestines, which is vital for maintaining bone health. The key is to strike a balance; both calcium and protein are necessary for optimal bone health, but excessive amounts of either can lead to complications.

The email also references the dietary habits of different populations, such as the Bantu women in Africa and the Inuit populations, to illustrate that high calcium intake does not always correlate with lower rates of osteoporosis. This observation highlights the importance of considering other dietary and lifestyle factors, such as physical activity, vitamin D levels, and overall dietary patterns, which can significantly influence bone health.

In terms of dietary recommendations, the general guideline for calcium intake is about 1,000 mg per day for most adults, increasing to 1,200 mg for women over 50 and men over 70. However, this intake should be balanced with adequate protein consumption. The recommended dietary allowance (RDA) for protein is approximately 46 grams per day for women and 56 grams for men, but individual needs may vary based on age, activity level, and health status.

For individuals concerned about osteoporosis, it is advisable to focus on a well-rounded diet that includes a variety of nutrients. Foods rich in calcium include dairy products, leafy greens, and fortified foods. Protein sources should include both animal and plant-based options, such as lean meats, fish, legumes, and nuts. Additionally, engaging in weight-bearing exercises can help strengthen bones and reduce the risk of osteoporosis.

In conclusion, while the email raises valid points about the potential risks of excessive protein intake and its impact on calcium retention, it is essential to approach the topic with a balanced perspective. Both calcium and protein play critical roles in bone health, and maintaining a well-rounded diet, along with regular physical activity, is key to preventing osteoporosis. If there are specific concerns regarding dietary habits or osteoporosis risk, consulting with a healthcare professional or a registered dietitian can provide personalized guidance.

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