Why Is Milk Consumption Associated with More Bone Fractures?

Image Credit: Sally Plank

Why Is Milk Consumption Associated with More Bone Fractures?

Milk is touted to build strong bones, but a compilation of all the best studies found no association between milk consumption and hip fracture risk; so, drinking milk as an adult might not help bones, but what about in adolescence? Harvard researchers decided to put it to the test.

Studies have shown that greater milk consumption during childhood and adolescence contributes to peak bone mass, and is therefore expected to help avoid osteoporosis and bone fractures in later life. But that’s not what researchers have found (as you can see in my video Is Milk Good for Our Bones?). Milk consumption during teenage years was not associated with a lower risk of hip fracture, and if anything, milk consumption was associated with a borderline increase in fracture risk in men.

It appears that the extra boost in total body bone mineral density from getting extra calcium is lost within a few years, even if you keep the calcium supplementation up. This suggests a partial explanation for the long-standing enigma that hip fracture rates are highest in populations with the greatest milk consumption. This may be an explanation for why they’re not lower, but why would they be higher?

This enigma irked a Swedish research team, puzzled because studies again and again had shown a tendency of a higher risk of fracture with a higher intake of milk. Well, there is a rare birth defect called galactosemia, where babies are born without the enzymes needed to detoxify the galactose found in milk; so, they end up with elevated levels of galactose in their blood, which can cause bone loss even as kids. So maybe, the Swedish researchers figured, even in normal people that can detoxify the stuff, it might not be good for the bones to be drinking it every day.

And galactose doesn’t just hurt the bones. Galactose is what scientists use to cause premature aging in lab animals—it can shorten their lifespan, cause oxidative stress, inflammation, and brain degeneration—just with the equivalent of like one to two glasses of milk’s worth of galactose a day. We’re not rats, though. But given the high amount of galactose in milk, recommendations to increase milk intake for prevention of fractures could be a conceivable contradiction. So, the researchers decided to put it to the test, looking at milk intake and mortality as well as fracture risk to test their theory. 

A hundred thousand men and women were followed for up to 20 years. Researchers found that milk-drinking women had higher rates of death, more heart disease, and significantly more cancer for each glass of milk. Three glasses a day was associated with nearly twice the risk of premature death, and they had significantly more bone and hip fractures. More milk, more fractures.

Men in a separate study also had a higher rate of death with higher milk consumption, but at least they didn’t have higher fracture rates. So, the researchers found a dose dependent higher rate of both mortality and fracture in women, and a higher rate of mortality in men with milk intake, but the opposite for other dairy products like soured milk and yogurt, which would go along with the galactose theory, since bacteria can ferment away some of the lactose. To prove it though, we need a randomized controlled trial to examine the effect of milk intake on mortality and fractures. As the accompanying editorial pointed out, we better find this out soon, since milk consumption is on the rise around the world.

What can we do for our bones, then? Weight-bearing exercise such as jumping, weight-lifting, and walking with a weighted vest or backpack may help, along with getting enough calcium (Alkaline Diets, Animal Protein, & Calcium Loss) and vitamin D (Resolving the Vitamin D-Bate). Eating beans (Phytates for the Prevention of Osteoporosis) and avoiding phosphate additives (Phosphate Additives in Meat Purge and Cola) may also help.

Maybe the galactose angle can help explain the findings on prostate cancer (Prostate Cancer and Organic Milk vs. Almond Milk) and Parkinson’s disease (Preventing Parkinson’s Disease With Diet).

Galactose is a milk sugar. There’s also concern about milk proteins (see my casomorphin series) and fats (The Saturated Fat Studies: Buttering Up the Public and Trans Fat in Meat and Dairy) as well as the hormones (Dairy Estrogen and Male Fertility, Estrogen in Meat, Dairy, and Eggs and Why Do Vegan Women Have 5x Fewer Twins?).  

Milk might also play a role in diabetes (Does Casein in Milk Trigger Type 1 Diabetes, Does Bovine Insulin in Milk Trigger Type 1 Diabetes?) and breast cancer (Is Bovine Leukemia in Milk Infectious?, The Role of Bovine Leukemia Virus in Breast Cancer, and Industry Response to Bovine Leukemia Virus in Breast Cancer). 

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


39 responses to “Why Is Milk Consumption Associated with More Bone Fractures?

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  1. http://www.bodytunehealth.com/docs/Galactose-Food-Lists.pdf

    So what about the plant-based forms of galactose? Might they also be contributing to osteo for some folks
    without the proper digestive enzymes?

    I know that my skin, fingernails, and hair, and overall strength of bones seem to decrease in vitality and growth (nails, skin hair) when I eat lots of beans and broccoli. For some people it is the opposite of this, as these foods help these issues, but more important here today, since most of us on this website are vegans already, Dr. G,, what about vegan eaters not having the proper enzymes to break down or deal with plant based sources of galactose, and how this might then negatively effect their skeletal/bone integrity?




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      1. Yeah, I read this. This is actually why Dr. G. might want to address this issue for vegans, as plant-sourced forms of galactose might be causing same negative issues with bone fractures as does dairy, as far as for those with enzyme deficiency issues to digest/absorb perfectly, and well, galactose.

        Yes, there are positives to bean consumption, and other plant sources of galactose, but those positives are not what needs to be figured out here for some of us, I think. For some of us, the positives might not even come close to balancing out the negatives, in this regard.




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        1. ” As we lack a digestive enzyme with α-galactosidase activity to break
          them down for absorption, they pass on to our colonic microbiota. Much
          is then fermented to beneficial short chain fatty acids, though those
          whose microbes haven’t adjusted to regular bean consumption experience
          more gas.”

          As I understood this statement, humans don’t digest/absorb plant (alpha) galactose at all, so it isn’t an issue.




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          1. Actually, this IS the issue, that some people don’t digest absorb plant galactose at all. For the people who digest it somewhat, good for them. And while there may be good qualities and attributes to this inability to digest, the negative quality might be far outweighing the positive, for some.

            Something to consider…..humans have been eating cooked beans for how long, when takin into context of their total existence on earth? Not very long. Beans likely were not meant to be eaten, or even a necessity for humans to consume. Raw beens are mostly toxic.




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            1. “Beans are so health promoting that their consumption is now believed to be the single most important predictor of longevity among older populations around the world.” -See http://nutritionfacts.org/topics/beans/ for a list of their benefits.

              If people can eat beans then it would be in their best interest to. If the beans don’t agree with them, then maybe they can look for lie galactose beans, sprout their beans, or just plan their diets without them. Diets do have to be individualized where genetic abnormalities come into play.




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            2. Actually, and maybe ironically, they recently found DNA evidence in the dental plaque of our “paleo” ancestors of the legumes and grains that are purportedly “new” in our diets according to the paleo faddists, so far longer than anyone thought previously.




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            3. That’s funny. I have been eating both raw and cooked beans for decades now. About a year and a half ago, I started eating beans three times a day. So it seems like they can’t be all that toxic. Maybe I’m about ready to drop but I know very few people half my age that can beat my 5K times. As far as I know, humans have been cultivating and eating legumes for thousands and thousands of years (see “The Starch Solution”). In fact everybody I know that eats a WFPB diet with lots of beans is in really good health. Without exception. Am I missing something here?




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            4. Not some humans lack the enzyme, all humans lack the enzyme.

              ‘Meant to be eaten’? People need to understand that there’s no intentionality in food (and that applies to everyone on all sides of the ‘diet debates’).




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    1. I would play it safe and avoid any dairy for a whole laundry list of reasons, and make kefir with nut or plant based milks, adding dates for the sugars the microbes need to consume.




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      1. I’ve been drinking Fat-free Organic Publix my entire life and my chiropractor just now told me to quit drinking it; he said to begin drinking Vanilla Almond Milk so I’ve switched to the latter and disposed of the halaf-gallons of regular milk!




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    2. Yes the probiotics in kefir are healthy for our guts. They also break down the galactose during fermentation. “So, the researchers found a dose dependent higher rate of both mortality and fracture in women, and a higher rate of mortality in men with milk intake, but the opposite for other dairy products like soured milk and yogurt, which would go along with the galactose theory, since bacteria can ferment away some of the lactose.”

      However, kefir contain estrogens and IGF-1 (as do all dairy products) which can increase cancer risk. Dairy products also contain persistent pollutants like dioxins. And full-fat dairy contains atherogenic saturated fat.




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  2. An excellent book on the role of Galactose: ” Milk And Mortality” by David B. Gordon, PhD, ISBN 0-9671605-0-2 ” It highlights the connection between milk drinking and coronary heart disease.




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  3. I notice that the Mediterranean diets consume little to no cow’s milk. Most of the milk consummed is either from sheep or goats. Also 95% of the cheese consumed is made from the milk of these animals. Greeks consume Feta almost daily.
    Is there a difference?




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    1. Goat milk, and I assume sheep milk, is said to be easier to digest than cow milk. I don’t imagine that a lot of people will come out on this website in favor of consuming any animal food product.
      John S




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    2. Goat milk has a lower level of lactose (milk doesn’t actually contain galactose, it contains lactose which broken down into galactose by the lactase enzyme), so it has less galactose as well. I am lactose intolerant and able to eat more goat cheese than cow cheese. Also, cheese is fermented and generally has less sugar than the milk it was made from, regardless of whether it came from a cow or goat.




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  4. Hi, I know that this question is off topic but I need some clarity on the microwave controversy and am unable to participate in your Live Q & A February 2nd due to a prior obligation. I was wondering if you could shed some light on the microwave controversy. Some say it’s this horrible thing that causes cancer and zaps all the nutrients from food, whereas, some sources say that as long as the dish is covered with a little bit of water in order to cause a steaming effect that it is actually the healthiest way to reheat your food.




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    1. brittney: The overwhelming misinformation about microwaves that you find repeated again and again is a perfect example (for me anyway) on how the internet can go wrong. To me, this is what going ‘viral’ really is, because the result is so destructive. People repeat what they read somewhere else as fact even when there is no evidence to back it up or when the information is misleading.
      .
      I think the following article does a fantastic job of debunking the microwave myths, complete with references. While the following site is often full of bad information in general, no one is wrong about everything. This article is well researched and easy to read: http://www.drmyattswellnessclub.com/Microwave.htm
      .
      Dr. Greger has some videos on microwaves that back up what the above article claims:
      http://nutritionfacts.org/video/best-cooking-method/
      http://nutritionfacts.org/video/raw-vs-cooked-broccoli-2/
      .
      The cautions for microwaving are: Stay away from plastic in the microwave. Skip the butter flavored microwave popcorn (see videos on NutritionFacts for this). Beware that the microwave can make food hot (duh) and create hot spots, including super heat water without looking like it. Keep in mind that microwaving means heating/cooking food. Thus, like other heating/cooking methods (ex: the oven or stove top), some nutrients are destroyed while other nutrients are made more absorb-able by the body. Over cooking can destroy more nutrients than lightly cooking for some foods.
      .
      If you get a chance to read the article above from the first link, I would be curious to hear what you think of microwaves after reading that article and whether this response has helped you.​




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  5. Calcium may be distributed to the bones (where it belongs) or the arteries
    and organs – where it causes damage. It is all to do with the type, rate and
    respective ratio of calcium, vitamin D and vitamin K. If it is out of wack, then
    the risk of both cardiovascular disease and osteoporosis increases. Therefore,
    osteoporosis and cardiovascular disease should be bracketed whenever discussing
    these conditions. Likewise the incorrect intake of both vitamin D and vitamin K
    – which may well contribute to these diseases. The referenced study is highly
    selective, and does not include these factors.
    (http://www.bmj.com/content/349/bmj.g6015). However, they do state ‘Our present
    investigation should not be evaluated in isolation and its merits should be
    judged in light of other study findings’. Hear, hear. ‘Other studies’ would have
    to include the following more recent meta-analyses from Danish, Dutch and UK
    researchers:

    ‘Intake of milk and dairy products was associated with a reduced risk of
    childhood obesity, improved body composition and weight loss during energy
    restriction, neutral or reduced risk of type 2 diabetes, reduced risk of
    cardiovascular disease, particularly stroke, beneficial effect on bone mineral
    density, no association with risk of bone fracture, inversely associated with
    colorectal cancer, bladder cancer, gastric cancer, and breast cancer, and not
    associated with risk of pancreatic cancer, ovarian cancer, or lung cancer, while
    the evidence for prostate cancer risk was inconsistent. Not associated with
    all-cause mortality. Nutritionally, cow’s milk and plant-based drinks are
    completely different foods. They conclude: ‘The totality of available scientific
    evidence supports that intake of milk and dairy products contribute to meet
    nutrient recommendations, and may protect against the most prevalent chronic
    diseases, whereas very few adverse effects have been
    reported’.http://www.bmj.com/content/349/bmj.g6015

    Galactose is the latest buzz-word-demon, but it is all very speculative.
    The 2016 meta-analysis suggests it is more fallacy than fact.




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      1. Scott, I do not agree that consuming dairy is ‘scary’. The majority of research (including the references I provided) suggests quite the opposite. However, I am opposed to factory farms. They excessively push the genetic boundaries of cows, shortening their lifespan. The quality of milk is inferior to grass-fed cows. They require the excessive use of antibiotics, which is not a good thing. Ideally, milk production should be restricted to regions that allow cows to graze during winter. If at all possible, consumers should insist on milk from pastured cows.




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  6. Dr. Greger mentioned in his book and I believe in this article the large British study that showed that both yogurt and kefir are linked to longer lifespan, but other dairy is not.
    John S




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    1. Thanks for bringing that to my attention John- that warrants some more research on my part. Do you remember which book that was? Dr. Greger has written more than one and I’m not remembering that being in How Not To Die…




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  7. Dr. Gregor, it is not the galactose. It is that cooked milk is Acidic, along with cheese, sour cream, etc. Which causes the body to steal calcium from the bones. Norwegians have high rates of osteoporosis as others that have high acid diets.
    That is a known fact in the natural health fields but not in medicine because they don’t look at people’s diets.




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  8. Hormones, steroids, rbst and pasteurization of milk all change and destroy the quality of raw milk, and it’s highly likely that the majority of participants in above clinical studies did not drink raw milk. What would be the results if only raw milk is drunk longterm by participants?




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    1. I would like to know the answer to that, as well as dairy kefir and yogurt. From the transcript above, men did not suffer a higher mortality rate from soured milk and yogurt.




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  9. Hi Shirley,
    I’m one of the site moderators. In answer to your comment pasteurization not only kills off the bacteria and viruses that may be lurking in milk but the heat does denature the enzymes which are proteins in the milk. This is the argument used in favor of consuming raw milk although it can be a dangerous practise. Hormones – which are a type of steroid will always be in milk because the act of lactation by the cow requires a very high level of hormone production by the animal to produce milk for its young. The recombinant hormone that is similar to what the cow normally makes is injected into some cows in order to maintain their state of lactation beyond what would be normal. Many dairies no longer do this due to market pressures for a more natural product.
    The aspects of milk that correlates with osteopenia leading to fracture, namely the galactose, is a milk sugar not an enzyme so it should be in the same state as the non-pasteurized product. The enzyme that is mentioned is present in the infant’s stomach not the milk so the pasteurization would not be an issue. Since nearly every country has laws requiring pasteurization for safety purposes it would be difficult to get a study looking at the difference between the two.




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    1. hormones will only be present if the farmer abuses the animal. If you try to produce much more milk than the cow produces you end up with what you said. And about laws for pasteurisation fortunately many countries did not follow the crazy band wagon on that.




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  10. Andres,

    Interesting findings in the article. I think it’s just a reinforcement of the negative effects of dairy products, period. Your contention might be on mark but would take a lot more in depth study to confirm. In the meantime ditch the dairy….

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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