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Milk "Best Calcium Source" for Girls?
By Dr. Stephen Walsh

12/16/01 -- Letter to the Editor

Dear BBC News:

Your article Milk 'Best Calcium Source' for Girls contains two serious factual errors, the first being its title. The overall claim is based on observations by Eastell and others that many forms of short term calcium supplementation do not result in sustained gain in bone mineral content or density in children. This is used as the basis of a claim that milk is the best source of calcium.

However, the main evidence for a sustained effect of short-term calcium supplementation on bone mass comes not from a study on milk supplementation but from the work of Bonjour et al (Calcium enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind placebo-controlled trial, Journal of Clinical Investigation, 1997,  99:1287 -1294 and A significant effect of calcium enriched foods on bone mineral mass gain is maintained more than 3 years after discontinuation of intervention, Journal of Bone Mineral Research, 14, S185). This study used a calcium phosphate salt derived from milk, and not milk itself, as the supplement. It therefore indicates that phosphate is important for bone growth as well as calcium. This is not controversial or novel. Indeed, calcium phosphate has been used in calcium-fortified soy milks for many years.


The claim that cow's milk is specially advantageous for bone growth is therefore a supposition rather than a deduction from evidence. Bone health is influenced by many factors, including calcium, protein, potassium, phosphate, vitamin-D, vitamin-K and magnesium. Up to 10,000 years ago no humans consumed cow's milk yet the archaeological record shows that our ancestors, in common with our ape relatives, maintained excellent bone health without having to steal milk from the children of other mammals to do so. Our ancestral diet, and that of other apes, includes abundant levels of all the nutrients required for bone health, drawn overwhelmingly from plant sources. This included about 1500mg a day of calcium from plant sources such as leaves, shoots, flowers, nuts and seeds.

The second serious error in your article is to suggest spinach is a good plant source  of calcium. This is unfortunate as although spinach, like most dark green leafy vegetables, contains abundant calcium it also contains exceptional levels of oxalate. The high levels of oxalate block the absorption of calcium so that only 5% of the calcium is absorbed, compared to about 30% from cow's milk or fortified soya milk. In contrast, absorption of calcium from low-oxalate vegetables such as kale exceeds 50%. A vegan diet including plentiful green leafy vegetables, such as kale and collards, meets calcium requirements in a manner consistent with our evolutionary heritage. In addition such vegetables provide potassium and vitamin-K abundantly and provide alkali salts that prevent acid from protein causing increased calcium loss from the body via urine. They also provide abundant folate. Inadequate folate increases risk of birth defects and cancer.

For those who are unenthusiastic about the green stuff (beats the white stuff any day of the week) calcium-fortified soya or pea milks provide a suitable source of calcium that can be expected to be fully effective in promoting bone growth. Tofu set with calcium salts also provides a useful source of calcium, though other forms of tofu do not.

Cow's milk belongs to calves. We have no need to steal it.

Stephen Walsh
Vice-chair UK Vegan Society


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