"Clean Eating" and Osteoporosis

You may have noticed the mainstream media blowing up with variations of the headline, "Clean eating is a ticking timebomb that puts young at risk for fractures".  This is being widely reported by The Telegraph, BBC News, and The Times, among other news sources.  There are many definitions of "clean eating", and it wasn't until I read the introduction of The Telegraph article by Laura Donnelly that I realized that it is real food nutrition that is under attack.  Ms. Donnelly writes, "A cult of clean eating is a “ticking timebomb” that could leave young people with weak bones, the National Osteoporosis Society has warned.  

Research by the charity shows that four in ten of those aged between 18 and 24 have tried such regimes, which are now coming under attack for cutting out major food groups, such as dairy.

The diets have become increasingly fashionable, and are associated with a number of celebrities, who have boasted how they have cut out gluten, dairy, grains and refined sugars."

The National Osteoporosis Society (NOS) is a UK-based charity organization dedicated to "ending the pain and suffering caused by osteoporosis".  At first glance at the headlines, I expected to see some type of long-term population study conducted by the organization that demonstrated a link between real food nutrition and osteoporosis.  However, the research being reported is in fact a survey that found 20% of adults aged 18 - 35 were currently, or had been in the past, "dieting" by cutting out or reducing dairy in their diet.  From there, NOS jumped to the conclusion that this must be dangerous as "dairy is an important source of calcium, vital in building bone strength when you are young".

When you see research reported in the headlines, it is key to find the original source to see what it really says.  Media outlets often inflate and draw conclusions that just aren't present in the original research.  For that matter, the researchers themselves often do as well.    

Surveys are an important part of health care research that help to collect information and describe characteristics of groups of people.  However, there are limitations to survey research and it's a stretch that the NOS was able to conclude that their findings were alarming based on this survey alone.  No health indicators or outcomes were tracked as a part of the survey.  So, how does the NOS reach the conclusion that eliminating dairy from your diet is harmful?  

Another factor to consider when evaluating research is who provided the funding.  Almost all non-profit disease-specific organizations receive funding for research from pharmaceutical and food manufacturing companies.  The NOS does not advertise who their funding partners are on their website, but some of their partners do.  A bit of digging revealed that Yoplait, the world's largest franchise brand of yogurt, is a proud partner of the NOS.  As you might imagine, Yoplait is probably concerned about the dairy-free diet trend.

But is there any truth that eliminating dairy is problematic for bone health?  It is true that dairy is rich in calcium, a mineral important in building healthy bones.  However, calcium is also present (gasp!) in rich quantities in many other real food sources, such as sardines, dark, leafy greens, fish, nuts, and bone broth.  These real food sources contain easily absorbable forms of calcium that allow you to meet your body's requirements.  Additionally, if you are eating a real food diet that eliminates processed foods, grains, and legumes, you will increase the amount of calcium that is able to be absorbed since it is not binding to the phytic acid and other anti-nutrients present in grains and legumes.   

There are also several other nutrients that are just as important as calcium in building healthy bones and preventing osteoporosis.  These nutrients include vitamin K2, magnesium, and vitamin D.  Of these, vitamin K2 is the most important cofactor for calcium absorption.  Rich sources of vitamin K2 include natto, egg yolk, butter, chicken liver, chicken breast, and ground beef.  Beyond nutrition, strength training and weight-bearing movement is absolutely critical for good bone health.

Eliminating dairy in the context of a real food, nutrient-dense diet is not problematic for bone health.  In fact, I think that it is likely much more beneficial to bone health when compared to the typical Western diet.  Dairy is one of the top food sensitivities and it is  an underlying trigger of inflammation in the body for many people struggling with autoimmune and other chronic conditions.  It is not necessary to include dairy in your diet for optimal health.  That being said, properly sourced, high quality grass-fed dairy can be a beneficial source of nutrients for those who are able to tolerate it.  But regardless, don't expect dairy alone to prevent osteoporosis.