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Difference between revisions of "Draft:Calcium"

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see [[Help:Writing Fact Sheets]]  and  the articles in [[Fact Sheets Listing]]
 
see [[Help:Writing Fact Sheets]]  and  the articles in [[Fact Sheets Listing]]
  
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== Fact Sheet ==
 
== Fact Sheet ==
  
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=== Assertion ===
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=== Summary ===
  
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* This fact sheet supports the assertion that calcium from animal sources is not necessary and may be harmful to health.
+
* Heavy advertising and public relation campaigns by the dairy industry have perpetuated the myth that cow's milk is essential for bone health and is a superior source of calcium.<ref>“Calcium in the Vegan Diet -- The Vegetarian Resource Group.” Accessed February 27, 2020. https://www.vrg.org/nutrition/calcium.php.</ref>  <-- rewritten, old: Because milk and other dairy products contain calcium, Americans have been encouraged for decades to consume dairy as a way to strengthen their bones and fight against ???issues??? like osteoporosis. -->
 +
* While it is true that calcium is essential for bone health and other physiological functions.<ref>National Osteoporosis Foundation. “Calcium/Vitamin D Requirements, Recommended Foods & Supplements.” Accessed January 28, 2020. https://www.nof.org/patients/treatment/calciumvitamin-d/.</ref>, it does not follow that dairy is the healthiest source for calcium. Instead, getting calcium from dairy comes with risks not associated with plant sources (shown below
  
−
=== Context ===
+
=== Evidence ===
  
−
* Because milk and other dairy products contain calcium, Americans have been encouraged for decades to consume dairy as a way to strengthen their bones and fight against issues like osteoporosis.
+
* <-- rewritten. now this is a strong statement -->Harvard’s School of Public Health, the number one medical research school in the United States<ref>“Best Medical Schools (Research) Ranked in 2017 | US News Rankings.” US News Education. Accessed August 1, 2017. <nowiki>https://www.usnews.com/best-graduate-schools/top-medical-schools/research-rankings</nowiki></ref> says that milk is not the best source of calcium, and encourages people to look beyond the dairy aisle.<ref name="harvard">Boston, 677 Huntington Avenue, and Ma 02115 +1495‑1000. “Calcium and Milk.” The Nutrition Source. Accessed 28 January 2020. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-and-milk/</ref>
−
* To reach the daily recommended amount of calcium, a person would have to consume large amounts of dairy, calcium-fortified foods, or supplements. However, due to dairy’s links to heart disease, type 2 diabetes, and other conditions, animal-derived calcium sources like dairy can cause plenty of health problems that non-animal sources do not.
+
* According to a study from the China Health and Nutrition Survey, a plant-based diet may actually be associated with a lower calcium requirement for bone health.<ref>Fang, Aiping, Keji Li, Meihan Guo, Jingjing He, He Li, Xin Shen, and Jie Song. “Long-Term Low Intake of Dietary Calcium and Fracture Risk in Older Adults With Plant-Based Diet: A Longitudinal Study From the China Health and Nutrition Survey.” Journal of Bone and Mineral Research 31, no. 11 (2016): 2016–23. https://doi.org/10.1002/jbmr.2874.</ref>To reach the daily recommended amount of calcium, which ranges between 1,000 milligrams to 1,200 milligrams per day depending on one's age and gender<ref>National Osteoporosis Foundation. “Calcium/Vitamin D Requirements, Recommended Foods & Supplements.” Accessed January 28, 2020. https://www.nof.org/patients/treatment/calciumvitamin-d/.</ref>, a person would have to consume large amounts of dairy, calcium-fortified foods, or supplements. However, due to dairy’s links to heart disease, type 2 diabetes, and other conditions, animal-derived calcium sources like dairy can cause plenty of health problems that non-animal sources do not.
−
* According to a study from the China Health and Nutrition Survey, a plant-based diet may be associated with a lower calcium requirement for bone health.
+
* Despite often being touted as being healthy due to its calcium content, there are plenty of health concerns that outweigh the calcium benefits. The Physicians Committee for Responsible Medicine has noted that dairy can be the cause of some serious health issues, including heart disease, type 2 diabetes, and even Alzheimer's diseases.<ref>Physicians Committee for Responsible Medicine. “Health Concerns About Dairy.” Accessed January 28, 2020. https://www.pcrm.org/good-nutrition/nutrition-information/health-concerns-about-dairy.</ref>
 +
* While dairy is one of the most discussed sources of calcium, it doesn't necessarily lead to healthier bones. According to the ''British Medicine Journal'', an analysis showed that most studies cannot link the consumption of dairy to broken bones or fractures. The study concluded that there is no clinical trial evidence to show that increasing calcium from dietary sources prevents fractures and that any evidence supporting calcium supplements helping to prevent fractures is generally weak and inconsistent.<ref>Bolland, Mark J, William Leung, Vicky Tai, Sonja Bastin, Greg D Gamble, Andrew Grey, and Ian R Reid. “Calcium Intake and Risk of Fracture: Systematic Review.” The BMJ 351 (September 29, 2015). https://doi.org/10.1136/bmj.h4580.</ref>
 +
* Consuming dairy doesn’t lead to the strong bones most people have been led to believe. In fact, studies have shown that drinking milk was not associated with healthy bones: instead, it was linked to not only an increased mortality but a higher chance of fractures and hip fractures.
 +
* In a 2003 study, researchers found that calcium balance is not affected significantly when calcium is provided by plant foods compared a diet that includes dairy products, concluding that a vegan diet is sufficient in calcium. <ref>Kohlenberg-Mueller, Kathrin, and Ladislav Raschka. “Calcium Balance in Young Adults on a Vegan and Lactovegetarian Diet.” Journal of Bone and Mineral Metabolism 21, no. 1 (2003): 28–33. https://doi.org/10.1007/s007740300005.</ref>
  
−
=== Research ===
+
=== Conflicting Claims ===
  
−
* According to the NHS, there are many good sources of calcium that are not animal derived. Instead, vegan calcium sources largely come from plants, such as green, leafy vegetables and dried fruits, in addition to fortified non-dairy milks.<ref>https://www.nhs.uk/live-well/eat-well/the-vegan-diet/</ref>
+
* In a 2009 study by Robert P. Heaney, known for his work with the Institute of Medicine to determine a recommended daily dose of calcium<ref>“Dr. Robert P. Heaney | Creighton University.” Accessed February 24, 2020. http://www.creighton.edu/heaney/.</ref>, the researcher concluded that without three servings of dairy per day, it would be difficult to be bone healthy.<ref>https://www.tandfonline.com/doi/full/10.1080/07315724.2009.10719808?needAccess=true</ref> Not only was Heaney a member of the National Fluid Milk Processor Promotion board<ref>Jack Rosemberger. “Ad Campaign Causes Controversy.” Vegetarian Times, May 1995.</ref>, which was responsible for milk advertisements, but his research has been proven wrong: there are plenty of non-dairy sources of calcium, protein, and potassium making the consumption of dairy unnecessary.<ref>https://www.vrg.org/nutrition/calcium.php</ref>
−
* Harvard’s School of Public Health has guidelines for choosing the best sources of calcium and encourages people to look beyond the dairy aisle. Though Harvard recommends one to two servings of dairy-derived calcium per day, the school acknowledges that more servings will not improve your bone health, nor will less harm you, providing you find calcium from other sources, such as leafy greens, broccoli, and tofu. Other tips for healthy bones do not include dairy, instead focusing on getting enough Vitamin D and getting active on a regular basis.<ref>https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-and-milk/</ref>
+
* In 2018, the Public Library of Science published a study on dietary calcium intake and food sources among Chinese adults. Focusing on 18-64 year-olds in 15 different provinces, the researchers found that vegetables, legumes, and cereals were the main sources of dietary calcium in its participants, and they concluded that Chinese adults are "severely insufficient in calcium and urging China to increase its milk and dairy consumption.<ref>Huang, Feifei, Zhihong Wang, Jiguo Zhang, Wenwen Du, Chang Su, Hongru Jiang, Xiaofang Jia, et al. “Dietary Calcium Intake and Food Sources among Chinese Adults in CNTCS.” PLoS ONE 13, no. 10 (October 1, 2018). https://doi.org/10.1371/journal.pone.0205045.</ref>. This study is problematic, as it was funded by China's Ministry of Finance<ref>Huang, Feifei, Zhihong Wang, Jiguo Zhang, Wenwen Du, Chang Su, Hongru Jiang, Xiaofang Jia, et al. “Dietary Calcium Intake and Food Sources among Chinese Adults in CNTCS.” PLoS ONE 13, no. 10 (October 1, 2018). https://doi.org/10.1371/journal.pone.0205045.</ref>, and Chinese leaders have frequently championed the consumption of milk<ref>Lawrence, Felicity. “Can the World Quench China’s Bottomless Thirst for Milk?” The Guardian, March 29, 2019, sec. Environment. https://www.theguardian.com/environment/2019/mar/29/can-the-world-quench-chinas-bottomless-thirst-for-milk.</ref>. These findings have also been contradicted by other Chinese studies that show that a plant-based diet with its calcium sources did not show an increased rate of bone fractures.<ref>Fang, Aiping, Keji Li, Meihan Guo, Jingjing He, He Li, Xin Shen, and Jie Song. “Long-Term Low Intake of Dietary Calcium and Fracture Risk in Older Adults With Plant-Based Diet: A Longitudinal Study From the China Health and Nutrition Survey.” Journal of Bone and Mineral Research 31, no. 11 (2016): 2016–23. https://doi.org/10.1002/jbmr.2874.</ref> In fact, vegan sources of calcium have other health benefits<ref>Healthline. “Top 10 Vegan Sources of Calcium.” Accessed January 28, 2020. https://www.healthline.com/nutrition/vegan-calcium-sources.</ref> that dairy sources don't.
−
* Though it is not common, it is possible to consume too much calcium. Naim Maalouf, MD, an endocrinologist specializing in mineral metabolism, claims that, while 50% of his female patients don’t get enough calcium, about 5% consume too much. These women generally take calcium supplements on top of getting the amount of calcium they need just from food. This can possibly result in the calcium making its into fatty plaques in the arteries, which can then reduce blood supply to the heart.<ref>https://utswmed.org/medblog/calcium/</ref>
 
−
* Consuming too much calcium can also lead to Milk-Alkali Syndrome. In the beginning of the 20th century, people began treating peptic ulcer disease with a combination of milk and alkali. While issues of MAS initially decreased, there was a resurgence due to an increased use of calcium carbonate, which was used to fight off osteoporosis. Milk-Alkali Syndrome can cause hypercalcemia, renal failure, and metabolic alkalosis and is the third most common cause of hypercalcemia, which is the result of too much calcium in a person’s system.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664604/</ref>
 
−
* Consuming too much dairy doesn’t lead to the strong bones most people have been led to believe. In fact, studies have shown that too much milk (more than three glasses a day) was not associated with healthy bones: instead, it was linked to not only an increased mortality but a higher chance of fractures and hip fractures.
 
−
* In a 2003 study, researchers sought “to determine the calcium balance of individuals on a vegan diet in comparison with a lactovegetarian diet in a short-term investigation.” The results showed “that calcium balance and a marker of bone turnover are not affected significantly when calcium is provided either solely by plant foods or by a diet including dairy products, despite the significantly different calcium intake levels in the diets.” That same study concluded “that a well-selected vegan diet maintains calcium status, at least for a short-term period.”<ref>https://www.ncbi.nlm.nih.gov/pubmed/12491091</ref>
 
  
−
=== Conflicting Information ===
+
=== Sources of Calcium ===
 +
* The National Health Service (NHS) of the United Kingdom asserts that you can easily get enough calcium from just plant-based sources, such as green, leafy vegetables and dried fruits, in addition to fortified non-dairy milks.<ref>“The Vegan Diet.” Nhs.Uk, 3 Sept. 2018, https://www.nhs.uk/live-well/eat-well/the-vegan-diet/.</ref>
 +
* Soy milk, such as Silk's brand, contains 50% more calcium than the average dairy milk, and Califa Farms' almond milk has 120 grams of calcium more.<ref>PETA. “Vegan Sources of Calcium | Living | PETA.Org,” May 13, 2015. https://www.peta.org/living/food/vegan-sources-of-calcium-better-than-cows-milk/.</ref>
 +
* One serving of fortified orange juice contains 500 mg of calcium, which is 50% of the Recommended Daily Allowance of calcium, and half a cup of tofu can have up to 860 mg, or 86% of the RDA.<ref>PETA. “Vegan Sources of Calcium | Living | PETA.Org,” May 13, 2015. https://www.peta.org/living/food/vegan-sources-of-calcium-better-than-cows-milk/.</ref> One cup of cow's milk accounts for only 276-352 mg of calcium, thus requiring more servings than plant-based sources.<ref>Healthline. “Top 15 Calcium-Rich Foods (Many Are Non-Dairy).” Accessed February 20, 2020. https://www.healthline.com/nutrition/15-calcium-rich-foods.</ref>
  
−
* In a 2009 study by Robert P. Heaney, MD, Heaney concluded that “it is difficult to devise a diet that is ‘bone healthy’ without including three servings of dairy per day, not just because of dairy calcium, but dairy protein and potassium as well.” However, there are plenty of non-dairy sources of calcium, protein, and potassium making the consumption of dairy unnecessary.<ref>https://www.tandfonline.com/doi/full/10.1080/07315724.2009.10719808?needAccess=true</ref>
+
=== Dietary Guidelines ===
 +
* The amount of calcium necessary differs depending on one's age and gender.
 +
* For women between the ages 18 and 50 and men between the ages of 18 and 70, the Recommended Daily Allowance is 1,000 mg of calcium.<ref>American Bone Health. “Guidelines on Calcium and Vitamin D Supplements,” May 22, 2018. https://americanbonehealth.org/nutrition/guidelines-calcium-vitamin-d-supplementation/.</ref>
 +
* Women who are over the age of 50 and men over the age of 70 require more calcium to maintain bone health. The RDA for this demographic is 1,200 mg of calcium.<ref>American Bone Health. “Guidelines on Calcium and Vitamin D Supplements,” May 22, 2018. https://americanbonehealth.org/nutrition/guidelines-calcium-vitamin-d-supplementation/.</ref>
 +
* Generally, the United States Preventives Services Task Force does not recommend taking a calcium supplement, but there are instances where a supplement could be necessary, including adults with intestinal problems, women with premature menopause, adults with osteoporosis, and vegans.<ref>American Bone Health. “Guidelines on Calcium and Vitamin D Supplements,” May 22, 2018. https://americanbonehealth.org/nutrition/guidelines-calcium-vitamin-d-supplementation/.</ref>
  
−
=== Other Sources ===
+
=== Temp: To Be Deleted ===
 +
<nowiki>These items will be deleted. I will explain why in a zoom session. ~~~~</nowiki>
 +
* <-- not a strong point, also wordy, rambling, not concise,  -->Consuming too much calcium can also lead to Milk-Alkali Syndrome. In the beginning of the 20th century, people began treating peptic ulcer disease with a combination of milk and alkali. While issues of MAS initially decreased, there was a resurgence due to an increased use of calcium carbonate, which was used to fight off osteoporosis. Milk-Alkali Syndrome can cause hypercalcemia, renal failure, and metabolic alkalosis and is the third most common cause of hypercalcemia, which is the result of too much calcium in a person’s system.<ref>Medarov, Boris I. “Milk-Alkali Syndrome.” Mayo Clinic Proceedings 84, no. 3 (March 2009): 261–67.</ref>
  
−
* <-- expert testimony from prestigious or credentialed people or organizations -->
+
* <-- relevance? succinct warning on supplements is could be put in "sources," but not needed--> Though it is not common, it is possible to consume too much calcium. Naim Maalouf, MD, an endocrinologist specializing in mineral metabolism, claims that, while 50% of his female patients don’t get enough calcium, about 5% consume too much. These women generally take calcium supplements on top of getting the amount of calcium they need just from food. This can possibly result in the calcium making its into fatty plaques in the arteries, which can then reduce blood supply to the heart.<ref>“How Much Calcium Is Too Much? | Nutrition | UT Southwestern Medical Center.” Accessed January 28, 2020. http://utswmed.org/medblog/calcium/.</ref>
 +
* (the first sentence edited was kept under Sources of Calcium)Harvard’s School of Public Health has guidelines for choosing the best sources of calcium and encourages people to look beyond the dairy aisle. Though Harvard recommends one to two servings of dairy-derived calcium per day, the school acknowledges that more servings will not improve your bone health, nor will less harm you, providing you find calcium from other sources, such as leafy greens, broccoli, and tofu. Other tips for healthy bones do not include dairy, instead focusing on getting enough Vitamin D and getting active on a regular basis.<ref name="harvard" />
  
 
== See Also ==
 
== See Also ==
 +
* https://veganhealth.org/calcium/
 +
* https://www.pcrm.org/good-nutrition/nutrition-information/health-concerns-about-dairy/calcium-and-strong-bones
 +
* https://www.theveganrd.com/vegan-nutrition-101/vegan-nutrition-primers/calcium-a-vegan-nutrition-primer/
 +
* https://www.ouh.nhs.uk/osteoporosis/documents/calcium-for-vegans.pdf
 +
* https://www.tandfonline.com/doi/abs/10.1080/07315724.1998.10718789
 +
* https://www.nature.com/articles/6604331
 +
* https://academic.oup.com/ajcn/article/74/4/549/4737495
  
 
== Plain Text ==
 
== Plain Text ==

Latest revision as of 08:09, 3 March 2020

This draft article has been assigned to User:Tessa.Altman, and will be moved to the main namespace when completed.

<-- see Help:Writing Fact Sheets and the articles in Fact Sheets Listing

Note that we want only enough information to convincingly support the assertion and counter inaccurate information. When making a point, it is important to find those sources that will result in the most convincing arguments, and to summarize findings in the most convincing manner, all without misrepresenting or exaggerating those sources.

Places to start for research:

Is there research showing that vegans are generally not deficient in calcium, or that non-vegans are?

-->

Fact Sheet

Summary

  • Heavy advertising and public relation campaigns by the dairy industry have perpetuated the myth that cow's milk is essential for bone health and is a superior source of calcium.[1] <-- rewritten, old: Because milk and other dairy products contain calcium, Americans have been encouraged for decades to consume dairy as a way to strengthen their bones and fight against ???issues??? like osteoporosis. -->
  • While it is true that calcium is essential for bone health and other physiological functions.[2], it does not follow that dairy is the healthiest source for calcium. Instead, getting calcium from dairy comes with risks not associated with plant sources (shown below

Evidence

  • <-- rewritten. now this is a strong statement -->Harvard’s School of Public Health, the number one medical research school in the United States[3] says that milk is not the best source of calcium, and encourages people to look beyond the dairy aisle.[4]
  • According to a study from the China Health and Nutrition Survey, a plant-based diet may actually be associated with a lower calcium requirement for bone health.[5]To reach the daily recommended amount of calcium, which ranges between 1,000 milligrams to 1,200 milligrams per day depending on one's age and gender[6], a person would have to consume large amounts of dairy, calcium-fortified foods, or supplements. However, due to dairy’s links to heart disease, type 2 diabetes, and other conditions, animal-derived calcium sources like dairy can cause plenty of health problems that non-animal sources do not.
  • Despite often being touted as being healthy due to its calcium content, there are plenty of health concerns that outweigh the calcium benefits. The Physicians Committee for Responsible Medicine has noted that dairy can be the cause of some serious health issues, including heart disease, type 2 diabetes, and even Alzheimer's diseases.[7]
  • While dairy is one of the most discussed sources of calcium, it doesn't necessarily lead to healthier bones. According to the British Medicine Journal, an analysis showed that most studies cannot link the consumption of dairy to broken bones or fractures. The study concluded that there is no clinical trial evidence to show that increasing calcium from dietary sources prevents fractures and that any evidence supporting calcium supplements helping to prevent fractures is generally weak and inconsistent.[8]
  • Consuming dairy doesn’t lead to the strong bones most people have been led to believe. In fact, studies have shown that drinking milk was not associated with healthy bones: instead, it was linked to not only an increased mortality but a higher chance of fractures and hip fractures.
  • In a 2003 study, researchers found that calcium balance is not affected significantly when calcium is provided by plant foods compared a diet that includes dairy products, concluding that a vegan diet is sufficient in calcium. [9]

Conflicting Claims

  • In a 2009 study by Robert P. Heaney, known for his work with the Institute of Medicine to determine a recommended daily dose of calcium[10], the researcher concluded that without three servings of dairy per day, it would be difficult to be bone healthy.[11] Not only was Heaney a member of the National Fluid Milk Processor Promotion board[12], which was responsible for milk advertisements, but his research has been proven wrong: there are plenty of non-dairy sources of calcium, protein, and potassium making the consumption of dairy unnecessary.[13]
  • In 2018, the Public Library of Science published a study on dietary calcium intake and food sources among Chinese adults. Focusing on 18-64 year-olds in 15 different provinces, the researchers found that vegetables, legumes, and cereals were the main sources of dietary calcium in its participants, and they concluded that Chinese adults are "severely insufficient in calcium and urging China to increase its milk and dairy consumption.[14]. This study is problematic, as it was funded by China's Ministry of Finance[15], and Chinese leaders have frequently championed the consumption of milk[16]. These findings have also been contradicted by other Chinese studies that show that a plant-based diet with its calcium sources did not show an increased rate of bone fractures.[17] In fact, vegan sources of calcium have other health benefits[18] that dairy sources don't.

Sources of Calcium

  • The National Health Service (NHS) of the United Kingdom asserts that you can easily get enough calcium from just plant-based sources, such as green, leafy vegetables and dried fruits, in addition to fortified non-dairy milks.[19]
  • Soy milk, such as Silk's brand, contains 50% more calcium than the average dairy milk, and Califa Farms' almond milk has 120 grams of calcium more.[20]
  • One serving of fortified orange juice contains 500 mg of calcium, which is 50% of the Recommended Daily Allowance of calcium, and half a cup of tofu can have up to 860 mg, or 86% of the RDA.[21] One cup of cow's milk accounts for only 276-352 mg of calcium, thus requiring more servings than plant-based sources.[22]

Dietary Guidelines

  • The amount of calcium necessary differs depending on one's age and gender.
  • For women between the ages 18 and 50 and men between the ages of 18 and 70, the Recommended Daily Allowance is 1,000 mg of calcium.[23]
  • Women who are over the age of 50 and men over the age of 70 require more calcium to maintain bone health. The RDA for this demographic is 1,200 mg of calcium.[24]
  • Generally, the United States Preventives Services Task Force does not recommend taking a calcium supplement, but there are instances where a supplement could be necessary, including adults with intestinal problems, women with premature menopause, adults with osteoporosis, and vegans.[25]

Temp: To Be Deleted

These items will be deleted. I will explain why in a zoom session. ~~~~

  • <-- not a strong point, also wordy, rambling, not concise, -->Consuming too much calcium can also lead to Milk-Alkali Syndrome. In the beginning of the 20th century, people began treating peptic ulcer disease with a combination of milk and alkali. While issues of MAS initially decreased, there was a resurgence due to an increased use of calcium carbonate, which was used to fight off osteoporosis. Milk-Alkali Syndrome can cause hypercalcemia, renal failure, and metabolic alkalosis and is the third most common cause of hypercalcemia, which is the result of too much calcium in a person’s system.[26]
  • <-- relevance? succinct warning on supplements is could be put in "sources," but not needed--> Though it is not common, it is possible to consume too much calcium. Naim Maalouf, MD, an endocrinologist specializing in mineral metabolism, claims that, while 50% of his female patients don’t get enough calcium, about 5% consume too much. These women generally take calcium supplements on top of getting the amount of calcium they need just from food. This can possibly result in the calcium making its into fatty plaques in the arteries, which can then reduce blood supply to the heart.[27]
  • (the first sentence edited was kept under Sources of Calcium)Harvard’s School of Public Health has guidelines for choosing the best sources of calcium and encourages people to look beyond the dairy aisle. Though Harvard recommends one to two servings of dairy-derived calcium per day, the school acknowledges that more servings will not improve your bone health, nor will less harm you, providing you find calcium from other sources, such as leafy greens, broccoli, and tofu. Other tips for healthy bones do not include dairy, instead focusing on getting enough Vitamin D and getting active on a regular basis.[4]

See Also

Plain Text

Footnotes

  1. ↑ “Calcium in the Vegan Diet -- The Vegetarian Resource Group.” Accessed February 27, 2020. https://www.vrg.org/nutrition/calcium.php.
  2. ↑ National Osteoporosis Foundation. “Calcium/Vitamin D Requirements, Recommended Foods & Supplements.” Accessed January 28, 2020. https://www.nof.org/patients/treatment/calciumvitamin-d/.
  3. ↑ “Best Medical Schools (Research) Ranked in 2017 | US News Rankings.” US News Education. Accessed August 1, 2017. https://www.usnews.com/best-graduate-schools/top-medical-schools/research-rankings
  4. ↑ 4.0 4.1 Boston, 677 Huntington Avenue, and Ma 02115 +1495‑1000. “Calcium and Milk.” The Nutrition Source. Accessed 28 January 2020. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-and-milk/
  5. ↑ Fang, Aiping, Keji Li, Meihan Guo, Jingjing He, He Li, Xin Shen, and Jie Song. “Long-Term Low Intake of Dietary Calcium and Fracture Risk in Older Adults With Plant-Based Diet: A Longitudinal Study From the China Health and Nutrition Survey.” Journal of Bone and Mineral Research 31, no. 11 (2016): 2016–23. https://doi.org/10.1002/jbmr.2874.
  6. ↑ National Osteoporosis Foundation. “Calcium/Vitamin D Requirements, Recommended Foods & Supplements.” Accessed January 28, 2020. https://www.nof.org/patients/treatment/calciumvitamin-d/.
  7. ↑ Physicians Committee for Responsible Medicine. “Health Concerns About Dairy.” Accessed January 28, 2020. https://www.pcrm.org/good-nutrition/nutrition-information/health-concerns-about-dairy.
  8. ↑ Bolland, Mark J, William Leung, Vicky Tai, Sonja Bastin, Greg D Gamble, Andrew Grey, and Ian R Reid. “Calcium Intake and Risk of Fracture: Systematic Review.” The BMJ 351 (September 29, 2015). https://doi.org/10.1136/bmj.h4580.
  9. ↑ Kohlenberg-Mueller, Kathrin, and Ladislav Raschka. “Calcium Balance in Young Adults on a Vegan and Lactovegetarian Diet.” Journal of Bone and Mineral Metabolism 21, no. 1 (2003): 28–33. https://doi.org/10.1007/s007740300005.
  10. ↑ “Dr. Robert P. Heaney | Creighton University.” Accessed February 24, 2020. http://www.creighton.edu/heaney/.
  11. ↑ https://www.tandfonline.com/doi/full/10.1080/07315724.2009.10719808?needAccess=true
  12. ↑ Jack Rosemberger. “Ad Campaign Causes Controversy.” Vegetarian Times, May 1995.
  13. ↑ https://www.vrg.org/nutrition/calcium.php
  14. ↑ Huang, Feifei, Zhihong Wang, Jiguo Zhang, Wenwen Du, Chang Su, Hongru Jiang, Xiaofang Jia, et al. “Dietary Calcium Intake and Food Sources among Chinese Adults in CNTCS.” PLoS ONE 13, no. 10 (October 1, 2018). https://doi.org/10.1371/journal.pone.0205045.
  15. ↑ Huang, Feifei, Zhihong Wang, Jiguo Zhang, Wenwen Du, Chang Su, Hongru Jiang, Xiaofang Jia, et al. “Dietary Calcium Intake and Food Sources among Chinese Adults in CNTCS.” PLoS ONE 13, no. 10 (October 1, 2018). https://doi.org/10.1371/journal.pone.0205045.
  16. ↑ Lawrence, Felicity. “Can the World Quench China’s Bottomless Thirst for Milk?” The Guardian, March 29, 2019, sec. Environment. https://www.theguardian.com/environment/2019/mar/29/can-the-world-quench-chinas-bottomless-thirst-for-milk.
  17. ↑ Fang, Aiping, Keji Li, Meihan Guo, Jingjing He, He Li, Xin Shen, and Jie Song. “Long-Term Low Intake of Dietary Calcium and Fracture Risk in Older Adults With Plant-Based Diet: A Longitudinal Study From the China Health and Nutrition Survey.” Journal of Bone and Mineral Research 31, no. 11 (2016): 2016–23. https://doi.org/10.1002/jbmr.2874.
  18. ↑ Healthline. “Top 10 Vegan Sources of Calcium.” Accessed January 28, 2020. https://www.healthline.com/nutrition/vegan-calcium-sources.
  19. ↑ “The Vegan Diet.” Nhs.Uk, 3 Sept. 2018, https://www.nhs.uk/live-well/eat-well/the-vegan-diet/.
  20. ↑ PETA. “Vegan Sources of Calcium | Living | PETA.Org,” May 13, 2015. https://www.peta.org/living/food/vegan-sources-of-calcium-better-than-cows-milk/.
  21. ↑ PETA. “Vegan Sources of Calcium | Living | PETA.Org,” May 13, 2015. https://www.peta.org/living/food/vegan-sources-of-calcium-better-than-cows-milk/.
  22. ↑ Healthline. “Top 15 Calcium-Rich Foods (Many Are Non-Dairy).” Accessed February 20, 2020. https://www.healthline.com/nutrition/15-calcium-rich-foods.
  23. ↑ American Bone Health. “Guidelines on Calcium and Vitamin D Supplements,” May 22, 2018. https://americanbonehealth.org/nutrition/guidelines-calcium-vitamin-d-supplementation/.
  24. ↑ American Bone Health. “Guidelines on Calcium and Vitamin D Supplements,” May 22, 2018. https://americanbonehealth.org/nutrition/guidelines-calcium-vitamin-d-supplementation/.
  25. ↑ American Bone Health. “Guidelines on Calcium and Vitamin D Supplements,” May 22, 2018. https://americanbonehealth.org/nutrition/guidelines-calcium-vitamin-d-supplementation/.
  26. ↑ Medarov, Boris I. “Milk-Alkali Syndrome.” Mayo Clinic Proceedings 84, no. 3 (March 2009): 261–67.
  27. ↑ “How Much Calcium Is Too Much? | Nutrition | UT Southwestern Medical Center.” Accessed January 28, 2020. http://utswmed.org/medblog/calcium/.

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This article was originally authored by Tessa Altman with contributions by Greg Fuller. The contents may have been edited since that time by others.

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