Alkaline Diets, Animal Protein, & Calcium Loss

Alkaline Diets, Animal Protein, & Calcium Loss
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The decades-old dogma that the acid-forming quality of animal protein leads to bone loss has been called into question.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

For most of the last century, a prevailing theory within the field of nutrition was that by eating acid-forming foods (such as meat), we were, in essence, at risk of peeing our bones down the toilet. And, no wonder! Experiments dating back to 1920 showed over and over that if you add meat to the diet, you get a big spike in the amount of calcium being lost in the urine. And so, this made total sense; we had known since 1912 that meat was acid-forming within the body. And, how do you buffer acid? What are in antacid pills, anti-acid pills—like Tums? Calcium.

Meat and eggs have a lot of sulphur-containing amino acids (two to five times more than grains and beans) that are metabolized into sulphuric acid, which the body buffers with calcium. That’s why the antacids, like Tums, are made out of calcium. Calcium can buffer acid. And, where is calcium stored in the body? The skeleton. So, the thinking was that every time we ate a steak, our body would pull calcium from our bones, bit by bit, and over time, this could lead to osteoporosis. Based on 26 such studies, for every 40 grams of protein we add to our daily diet, we pee out an extra 50mg of calcium. And look, we only have about two pounds of calcium in our skeleton, so the loss of 50 a day would mean losing close to 2% of our bone calcium every year. And so, by the end of the 20th century, there was little doubt that acid-forming diets would dissolve our bones away.

But, if you actually look at all the studies done on protein intake and bone health, that’s not what you find. So, where’s the flaw in our logic? Meat leads to acid, which leads to calcium loss, which leads to bone loss, right?

Well, it’s uncontroversial that protein results in greater calcium excretion, but we’ve just been assuming it’s coming from the bone. I mean, where else could the extra calcium dumped in our urine be coming from, but from our bones?

This is the study that appeared to solve the mystery. An intrepid group of researchers tried feeding a bunch of volunteers radioactive calcium, and then putting them on a high-protein diet. What happens when you put people on a high-protein diet? The amount of calcium in their urine shoots up. And indeed, that’s just what happened. But, here’s the big question: was that extra calcium in their urine radioactive, or not? And, to everyone’s surprise, it was radioactive—meaning that the excess calcium in their urine was coming from their diet. Remember, they were feeding them radioactive calcium. So, the excess calcium in their urine wasn’t coming from their bones, but from what they were eating.

What seemed to be happening is that the excess protein consumption boosted calcium absorption—from down around 19% up to 26%. So, all of a sudden, there was all this extra calcium in the blood, so presumably the kidneys are like, whoa, what are we going to do with it all? So, they dump it into the urine. 90% of the extra calcium in the urine after eating a steak doesn’t appear to be coming from our bones, but from our diet. We’re not sure why protein boosts calcium absorption. Maybe the protein increases the solubility of calcium by stimulating stomach acid production? Whatever the reason, yes; more calcium lost. But, more calcium gained, such that in the end, most of that extra calcium is accounted for. So, in effect, more calcium is lost in the urine stream, but may be compensated by less loss of calcium through the fecal stream.

This was repeated with even more extreme diets— an acid-forming five burgers a day worth of animal-protein diet that limited fruits and vegetables, versus an alkaline diet emphasizing fruits and vegetables. More calcium in the urine on burgers, but significantly greater calcium absorption, such that at the end, it was pretty much a wash.

Other studies have also since supported this interpretation. Here’s an ingenious one. Feed people a high animal-protein diet, but with “an alkali salt to neutralize the acid.” Now, the old thinking would predict that there would be no calcium loss, since there was no excess acid to buffer. But no, even though the acid load was neutralized, there was still [this] excess urinary calcium, consistent with the radioactive isotope study, “challenging the long-standing dogma that animal protein consumption results in an acidosis that promotes the [excess] excretion of calcium…”

So, if our body isn’t buffering the acid formed from our diet with our bones, how is it neutralizing the acid? Maybe with our muscles. Alkaline diets may protect our muscle mass—all covered in my next video, entitled Testing Your Diet with Pee and Purple Cabbage. Stay tuned !

Please consider volunteering to help out on the site.

Images thanks to Devlin Thompson and Robert Belknap via flickr, Petwoe and BruceBlaus via Wikimedia, and diy.org.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

For most of the last century, a prevailing theory within the field of nutrition was that by eating acid-forming foods (such as meat), we were, in essence, at risk of peeing our bones down the toilet. And, no wonder! Experiments dating back to 1920 showed over and over that if you add meat to the diet, you get a big spike in the amount of calcium being lost in the urine. And so, this made total sense; we had known since 1912 that meat was acid-forming within the body. And, how do you buffer acid? What are in antacid pills, anti-acid pills—like Tums? Calcium.

Meat and eggs have a lot of sulphur-containing amino acids (two to five times more than grains and beans) that are metabolized into sulphuric acid, which the body buffers with calcium. That’s why the antacids, like Tums, are made out of calcium. Calcium can buffer acid. And, where is calcium stored in the body? The skeleton. So, the thinking was that every time we ate a steak, our body would pull calcium from our bones, bit by bit, and over time, this could lead to osteoporosis. Based on 26 such studies, for every 40 grams of protein we add to our daily diet, we pee out an extra 50mg of calcium. And look, we only have about two pounds of calcium in our skeleton, so the loss of 50 a day would mean losing close to 2% of our bone calcium every year. And so, by the end of the 20th century, there was little doubt that acid-forming diets would dissolve our bones away.

But, if you actually look at all the studies done on protein intake and bone health, that’s not what you find. So, where’s the flaw in our logic? Meat leads to acid, which leads to calcium loss, which leads to bone loss, right?

Well, it’s uncontroversial that protein results in greater calcium excretion, but we’ve just been assuming it’s coming from the bone. I mean, where else could the extra calcium dumped in our urine be coming from, but from our bones?

This is the study that appeared to solve the mystery. An intrepid group of researchers tried feeding a bunch of volunteers radioactive calcium, and then putting them on a high-protein diet. What happens when you put people on a high-protein diet? The amount of calcium in their urine shoots up. And indeed, that’s just what happened. But, here’s the big question: was that extra calcium in their urine radioactive, or not? And, to everyone’s surprise, it was radioactive—meaning that the excess calcium in their urine was coming from their diet. Remember, they were feeding them radioactive calcium. So, the excess calcium in their urine wasn’t coming from their bones, but from what they were eating.

What seemed to be happening is that the excess protein consumption boosted calcium absorption—from down around 19% up to 26%. So, all of a sudden, there was all this extra calcium in the blood, so presumably the kidneys are like, whoa, what are we going to do with it all? So, they dump it into the urine. 90% of the extra calcium in the urine after eating a steak doesn’t appear to be coming from our bones, but from our diet. We’re not sure why protein boosts calcium absorption. Maybe the protein increases the solubility of calcium by stimulating stomach acid production? Whatever the reason, yes; more calcium lost. But, more calcium gained, such that in the end, most of that extra calcium is accounted for. So, in effect, more calcium is lost in the urine stream, but may be compensated by less loss of calcium through the fecal stream.

This was repeated with even more extreme diets— an acid-forming five burgers a day worth of animal-protein diet that limited fruits and vegetables, versus an alkaline diet emphasizing fruits and vegetables. More calcium in the urine on burgers, but significantly greater calcium absorption, such that at the end, it was pretty much a wash.

Other studies have also since supported this interpretation. Here’s an ingenious one. Feed people a high animal-protein diet, but with “an alkali salt to neutralize the acid.” Now, the old thinking would predict that there would be no calcium loss, since there was no excess acid to buffer. But no, even though the acid load was neutralized, there was still [this] excess urinary calcium, consistent with the radioactive isotope study, “challenging the long-standing dogma that animal protein consumption results in an acidosis that promotes the [excess] excretion of calcium…”

So, if our body isn’t buffering the acid formed from our diet with our bones, how is it neutralizing the acid? Maybe with our muscles. Alkaline diets may protect our muscle mass—all covered in my next video, entitled Testing Your Diet with Pee and Purple Cabbage. Stay tuned !

Please consider volunteering to help out on the site.

Images thanks to Devlin Thompson and Robert Belknap via flickr, Petwoe and BruceBlaus via Wikimedia, and diy.org.

Doctor's Note

Note that the boost in calcium absorption described in the video can compensate only if you’re taking enough in. For example, dietary acid load may be associated with lower bone mineral density in those getting under 800mg a day; see linked journal article for details.

I previously touched on this topic in Is Protein Bad to the Bone? But, I promised I’d take a deeper dive, and here it is! If there are other topics you’d like me to cover in greater depth, please note them below in the comment section.

Plant protein is preferable to animal protein for a variety of reasons; see Plant Protein Preferable.  It tends to have less methionine (see Starving Cancer with Methionine Restriction), and is also less IGF-1 promoting (see Protein Intake & IGF-1 Production). For more reasons why, see my other videos on plant protein. However, it’s not clear how much of an advantage plant protein has when it comes to bone health.

Note to chemistry geeks: of course it’s the calcium salt anions that really do the buffering (carbonate in Tums, and phosphate in bones). But, I’m trying my best to simplify for a largely lay audience! Get ready for some kitchen chemistry (actually bathroom chemistry!), coming up in Testing Your Diet with Pee & Purple Cabbage.

For more context, check out my associated blog post: Does Animal Protein Cause Osteoporosis?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

137 responses to “Alkaline Diets, Animal Protein, & Calcium Loss

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  1. So am I understanding this correctly… “excess protein consumption boosted calcium absorption, from down around 19% up to 26%.”?

    It seems to me that this lends itself to the possibility that a more acid-forming diet
    is better for calcium absorption. Is my (our) plant based diet too alkaline? Vegan bodies becoming less able to absorb the calcium than our fellow carnivores? I’m a bit thrown off by all this thinking. Anyone?

    1. Agree with you Elsie….true, this is confusing.
      That leaves me thinking, should we also infer that calcium from animal sources is not used by the body in the sense, it simply passes through the digestive tract and gets excreted! Whatever calcium we derive from the diet is ONLY from plant sources?! We need more research..
      – Vegetarian since birth

    2. I believe that’s precisely what the video is not saying. Acid/alkaline has no or little influence on the absorption of calcium in the digestive system but protein seems to increase calcium absorption.

      Why is there more calcium excreted in the urine? I didn’t quite catch that. Maybe because there tended to be more calcium to begin with from animal sources?

    3. But if you are not getting the calcium or phosphates required to supplement this absorption it takes from your bones to balance your blood acidity levels. As far as a vegan diet balancing vegetables with legumes is key to balancing the alkaline?

  2. The science is a bit confusing and these studies do challenge the scientific paradigm of acid base. As we see the science keeps coming however it is important to remember that our bodies consist of many systems working together. Bone health is about alot more then calcium… Amy Lanou’s book, Building Bone Vitality, lists 18 other substances needed for bone health. From a general health standpoint a varied non GMO whole plant based diet with adequate Vitamin B12 seems to be best supported by the science. For patients with osteoporosis the “best” diet is now being rethought. It seems that there is general agreement that weight bearing exercise is beneficial for everyone. The problems with animal protein in the diet as far as other diseases such as kidney disease and cancer are still there. These studies demonstrate the need to keep up with the science but also point to the limitations of reductionistic studies when dealing with complex systems.

    1. More confusion…. My understanding was that all the earlier studies on protein raising increased calcium excretion were all net calcium. That is, (all calcium in) minus (all calcium out). Nothing else makes sense. Since calcium is an element, it is neither created nor destroyed in the body. Thus, the net pool of calcium in the body MUST be decreasing with increased protein intake. This calcium can only come from that stored plus that circulating on the way to being stored or released. Measuring some radioactive calcium in the urine does not mean that it is all radioactive (some stored, plus some circulating being peed out). This whole mess strikes me as more confusion being promoted by the meat/dairy industry, which now wants to claim that eating meat actually increases calcium storage and the whole bone problem is one of inactivity. However, sound science has already shown that BOTH a good diet (whole foods vegan is the best) and moderate activity are needed for skeletal and overall health.

      1. @Doctor Dave—
        Thank you for that. It appears we have a real mystery on the “purpose” of increased calcium absorption after increased animal protein intake– an effect demonstrably independent of blood/tissue acidity. Even after we neutralize the meat-protein-induced decrease in Ph, calcium absorption increases.

        One thing we do know is free circulating calcium has an unfortunate tendency in poorly-regulated metabolism to end up in the soft tissues of the body, from cardiovascular to even calcification of the larynx (leading to the “tinny” voice of some elderly). Calcified plaque in the arteries is a lethal threat.

        So, while calcium intake is essential for health, proper management of that calcium is critical. As you point out, the meat and dairy industries are likely to distort the science about animal protein and calcium, just as the bad news about egg and animal tissue intake was swept under the rug for decades. To resolve the calcium issue, what we need now is more research, but would the meat and dairy industry sponsor that, on the idea they have a (vested) interest in the outcome?

        Could that research be conducted by a truly independent research institution? If industry would gamble the funding– yes, even hoping for a financially favorable outcome– that same research might spare American consumers any need to gamble their health.

    2. We’re discussing calcium and bone health here. Please don’t go off topic. And refer from spreading common myths.

      (E.g. adding the “non-GMO” part was really unnecessary given that there is a positive scientific consensus on “ts health effects already (those that are on the market) while the few studies portraying it as bad has been severely debunked and labeled as agenda-biased pseudoscience.)

      1. Even if the quality of GMO food was equal to organic food concerning human consumption it does grevious harm to the animals in the ground and the environment. Did you notice all those bees and ladybugs have gone missing? Do you notice all those pests getting stronger and stronger each year? We must not use pesticides and genetic modifications to increase yields! You can’t eat money!

        1. I never noticed I had a reply. Non-corporate sponsored? How about every major scientific society and national academy of science on the topic?
          [1] http://www.who.int/foodsafety/publications/biotech/20questions/en/
          [2] http://www.aaas.org/news/aaas-board-directors-legally-mandating-gm-food-labels-could-%E2%80%9Cmislead-and-falsely-alarm
          [3] http://ec.europa.eu/research/biosociety/pdf/a_decade_of_eu-funded_gmo_research.pdf
          [4] http://www.nap.edu/catalog.php?record_id=10977#toc
          [5 ] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408621/
          [6] http://www.genetics.org/content/188/1/11.long
          [7] http://www.geneticliteracyproject.org/2013/10/08/with-2000-global-studies-confirming-safety-gm-foods-among-most-analyzed-subject-in-science/
          [8] http://www.fao.org/docrep/006/Y5160E/y5160e10.htm#P3_1651The
          [9] http://www.akademienunion.de/pressemitteilungen/2006-06/english.html
          [10] http://www.sivb.org/publicPolicy_CropEngineering.asp
          [11] http://www.toxicology.org/ai/gm/gm_food.asp
          [12] http://academy.asm.org/images/stories/documents/100yearsofbtcolor.pdf
          [13] http://www.ncbi.nlm.nih.gov/pubmed/16442880
          [14] http://www.apsnet.org/members/outreach/ppb/positionstatements/Pages/Biotechnology.aspx
          [15] http://www.ascb.org/index.php?option=com_content&view=article&id=315&Itemid=31
          [16] http://www.siga.unina.it/circolari/Consensus_ITA.pdf
          [17] http://c.ymcdn.com/sites/my.aspb.org/resource/group/6d461cb9-5b79-4571-a164-924fa40395a5/statements/genetic_engineering.pdf
          [18] http://www.worldseed.org/isf/biotechnology.html

        2. Do you have any citations to reputable scientific papers for your claims? Thus far the consensus is clear on both health and environment. The International Council for Science summarized the statements by over 100 national academies of science and 30 scientific unions which also concluded “Currently available genetically modified foods are safe to eat” and “there is no evidence of any deleterious environmental effects having occurred from the trait/species combinations currently available.”

        3. Also there is no evidence – according to the last 50 years of research – of any health benefits of organic food over conventional food.
          http://ajcn.nutrition.org/content/early/2009/07/29/ajcn.2009.28041.abstract
          http://www.ncbi.nlm.nih.gov/pubmed/20463045
          http://annals.org/article.aspx?articleid=1355685

          It may not even be more environmentally or ethically friendly due to low yields which increases rates of deforestation and erosion while putting up higher emissions. As summarized in the last reference; “However, from the 34 reviewed LCA studies, which compared products from organic and conventional farming systems, it is not yet possible to draw a conclusive picture on the general environmental performance of the different farming systems.”

          http://www.nature.com/nature/journal/v485/n7397/full/nature11069.html
          http://www.sciencedirect.com/science/article/pii/S0048969713010255
          http://www.sciencedirect.com/science/article/pii/S0301479712004264
          http://www.sciencedirect.com/science/article/pii/S0016706114000020
          http://www.sciencedirect.com/science/article/pii/S0301479714004964

            1. Be more specific. What research is unconvincing to you? There are over 2000 studies on the topic demonstrating safety of GM crops from both an environmental and health perspective. There is no general biological mechanism that would rank a GM plant as more dangerous than a conventional or organic plant.

              If anything you should theoretically be more concerned with traditional breeding and mutation techniques that involves up to thousands of gene manipulations at once rather than just one or two as in GM crops – i.e. the much more predictable technique which is thoroughly tested for each new crop, unlike most organic and non-GM conventional crops.

              1. I remember a news story that a woman suddenly became allergic to taco bell corn shells. She only had an allergy to shellfish. It was discovered that the corn was genetically engineered using DNA from shellfish to increase the plants ability to thrive in a salty environment. This report was a while ago. I’ve been hearing several people say that they use to eat this or that but now they can’t. I think it’s GMO’s.

                1. I don’t know the details of that story but significant allergens should always be listed, irrespective of how the food is derived. According to Food Allergy Research and Education: “nearly any food is capable of causing an allergic reaction.” and 90% of those allergies are caused by primarily milk, eggs, fish/shellfish, wheat, soy, and nuts. Only soy here available as GM food. So the main issue is primarily animal products.

                  Aside from that; it’s more or less a personal anecdote and doesn’t really qualify as much evidence compared to actual studies that look for causes. And thus far there’s no conclusive evidence that GM foods contribute to allergies. And in fact; geneticists are now experimenting with highly allergic foods like peanuts to derive new varieties without the allergens which may actually help reduce risk. [1]

                  [1] http://www.wired.com/2008/11/peanuts-with-le/

        4. So funny how my arguments are completely ignored. I just got a long lamentations that are completely irrelevant to what I said.

          I said: poison is killing the environment.
          They said: poison doesn’t harm us.

          How is that even an attempt at addressing what I said?

      2. @Eskil J.–
        You began your post by admonishing others not to “go off-topic”. Then you proceeded to do exactly that– dumping at least two pages of argument about GMO-based products.

        By the end of your exposition, we never got the benefit of your ideas on the original topic– the relation of animal protein and calcium regulation.

    3. I haven’t read the book mentioned, but I would bet that it mentions magnesium and K2. I have read that D, while increasing calcium absorption, doesn’t direct where the calcium goes. Magnesium and K2 (distinct from K1) direct the calcium out of soft tissue (e.g. blood vessels!) and into the bones & teeth.

    4. Great point that bone health is about a lot more than calcium. D helps the absorption of calcium everywhere in the body (including blood vessels, muscles, corneas), but it’s magnesium and K2 that guide the calcium out of the soft tissue and into the bones and teeth. Our bodies aren’t always effective at converting K1 to K2, so eating K2-rich foods (such as natto, a fermented soy product) can be beneficial. If we have a certain strain of Bacillus subtilis in out gut, it will make K2 for us. This is the strain used to make natto.

  3. My mind leaps ahead – then why do countries whose people eat more meat and consume more dairy have proportionally higher rates of osteoporosis? One theory I have heard is that these people are more sedentary. There’s always another question!

    1. There’s also a vitamin D link with bone health, and most of the high dairy consuming countries are further north of the equator. (or perhaps the casein protein in dairy damages the bones as well??)

    2. When I ate meat and dairy I was NOT sedentary. But, for the most part, other than walking my dog 2.5 miles per day, I was not doing weight bearing exercise. Instead, I was swimming 1.5 miles per day plus walking.

      Since fracturing my spine, going vegan to reduce pain and inflammation, I’m doing Pilates, which is more weight bearing to build stronger bones, and am trying to walk, which is very painful.

  4. Wow, Exactly the kind of exciting video I was waiting for ! Since “Is Protein Bad to the Bones” we were in lack of explanation. Can’t wait for the next video !! I used to believe in this theory and I find it really sane to challenge my own dogma, that’s the only way to move forward. Congratulation Doc.

  5. I still find it more painful to consume dairy or meat including fish than eating a plant based diet and getting my calcium from collards, and to a lesser extend kale, and bok choy than yogurt, which I loved but did not help me prevent osteoporosis.

    It is actually painful for me to eat dairy or flesh of animals and it is not just in my mind. My injured (but now healing) spine and legs where I have had a total hip and knee replacement scream in pain. Perhaps, the pain is caused by all the poisons that have built up in animal protein (and fat) from excessive use of pesticides that are falling from the sky as rain, in surface and groundwaters. Livestock and wildlife do not drink carbon or RO filtered water. They drink whatever comes from the tap or the waterways. So, even if the livestock are raised by the organic method, they are still consuming pesticides and industrial poisons.

    It’s healthier to eat very slow on the food chain –plants!

  6. You mention that the calcium in and the calcium out are pretty much a wash… so in my thinking you are not getting calcium to build bone mass if you are getting rid of what you consume. Eating a plant based diet may not give you the calcium absorption but you also would not be excreting what your eating. Why do the countries that consume the highest amount of dairy have the highest amount of osteoporosis? Maybe it is because they are excreting the calcium they consume and so there is not enough for bone building?

    1. Is exercise the missing factor here? The body will only absorb what it needs and excrete the rest. If the bones is not being “built” through weight bearing exercise, it would be logical to assume that the body excretes any excess, regardless of where it comes from (plant or animal origin). I am very much in favor of a vegan diet and I do believe it is more efficient to provide calcium to the body, but if the body is not being challenged through exercise, it has no need of excess calcium.

    2. My sentiments exactly Dr. Holdeman!! If there is a wash then what is happening long term to the density of our bones? I am seeing an alarming number of patients in my office over the age of 40 with T scores at least in the osteogenic range with lower extremity stress fractures.

  7. The only interesting thing is hard end point. Calcium here and calcium there – as Dr Forrester points out, bone health is about alot more than calcium. We are too reductionistic when we think of bone health and calcium. The question is, who is getting more hipfractures, meat eaters or people on a WFPB-diet. Well off to my calcium-pill………

  8. HEY, I’m a meat eater along with good source of vegetables (cruciferous mostly) ,I have a bone density of a forty year old .I’m sixty-five. So what gives!!
    Dr .Bill Natusch

      1. DrBill is on target. The five-dollar term he might have used ,’bio-chemical individuaity’ predicts and allows for bio-chemical variants … like yourself.

    1. Bone density in and of itself is not an indication of health – obese people generally have very high bone density because of the excess weight they carry around.

      1. I thought that also. But, it is not true. Despite my initial weight gain prior to going vegan, I was carrying around a lot of weight and fractured my hip and later my spine, and was diagnosed with osteoporosis.

    2. I would assume your DNA maybe a recessive gene, or a genetic mutation giving you exceptional bone density. Just as some people put on muscle easier than others, predisposed to it. You are probably considered an exception to the norm since its apparent this country and other high dairy consuming populations are indeed experiencing an osteoporosis issue.

  9. I think one could est s pirce of meat with hot peppers. hot peppers lower stomach acid. i have them with every meal to prevent GERD which started after gall bladder surgery. gall bladder went bad (dr said) from a combo, low fat diet and long time vegetarianism. then i beceme anemic and had to eat beef liver and their were new guidelines from healthy fats……. perfect storm

    1. Your gall bladder did not go bad from a low-fat vegitarian diet, LOL! Your making this stuff up to dog on veggie diets. Oh, so eating guts and liver healed ya huh? hahahahaha.. That’s a bunch of old Weston A Price malarkey. lol! Try a WFPB vegan diet if you really want to re gain your health.

  10. According to the studies cited, the extra absorption accounted for 93%
    of the extra excretion, or “nearly” the same amount. That still leaves a
    7% loss. We wait to see where that is coming from. We also wonder
    what is the actual mechanism increasing absorption, and how we might accomplish that without meat protein.

  11. 2 questions.
    1> What if someone has very low calcium intake from his diet but still consumes lots of meat products, thus requiring buffering of the acidity in the blood. Where then, would the calcium be coming from.
    2> Since some of the “marked” calcium would be absorbed and integrated in the bones, how can we know for sure which is excreted (short half-life ?)

  12. would be nice to know about the yield of ALA transformation to EPA and DHA in our body. Wiki says that it’s virtually non existent. Is this true? If it is true why do people take flax seed oil?

    1. This study showed that the conversion rate in Vegans is 2x that of a fish-eater from ALA to DHA/EPA.

      “Comparison of the PLLC n23 PUFAs:DALA ratio between dietary-habit groups showed that it was 209% higher in vegan men and 184% higher in vegan women than in fish-eaters, was 14% higher in vegetarian men and 6% higher in vegetarian women than in fish-eaters, and was 17% and 18% higher in male and female meat-eaters, respectively, than in fish-eaters This suggests that the statistically estimated conversion may be higher in non-fish-eaters than in fish-eaters.”

      http://www.ncbi.nlm.nih.gov/pubmed/20861171

  13. another topic to cover is racemization of amino acids by microwave irradiation. Also, how method of cooking influencing isomerization of cis fats?

  14. The idea that consuming calcium will strengthen your bones is about as silly as thinking protein consumption will build muscle mass. In both cases, physical strain is needed to promote growth/strength.

    There are many articles about some studies that show vegans have lower bone density. They are all extremely misleading. If you read the studies, you will find that they do not compensate for the weight of the participants. And since vegans, on average, weigh less than non-vegans, their bone density is going to be less because they don’t have to support that extra weight. When the data is adjusted to include weight, there is no significant difference in bone density between any of the groups.

  15. This was way to confusing. The thing I understood was dietary calcium with meat was absorbed better into the body but no evidence showing it actually going to the bones. It mean it could have been laid down on the arteries for all we know. So then there is the acid problem which calcium then is leaching from the muscle to neutralize this. So two different situaitons going on. Protein helps absorption from diet but then the acidity of that protien causes mucles to leach calcium therefore weakening the muscle. http://link.springer.com/article/10.1007/s00198-012-2236-y

    So if dietary calcium is absorbed but then the excess gets filtered out do we know that any calcium is reaching those bones? A lot of unanswered questions about the whole process.

    And yes to much focus on calcium, innactivity and lack of sun are factors as well and probably thousands of other reasons we have not accounted for. Even gladiators had good bone density and markes that showed that they were vegetarian alkaline eating people. http://www.cosmosmagazine.com/features/what-gladiators-were-really/.. So the take away to me here is more greens, enough sun and physical activity keeps good bones. More junk and high acid forming foods, low D and low to no exercise is a recipe for bone fractures.

  16. If the body sees ‘radioactive’ calcium being dumped into the system wouldn’t the body dispoae of the ‘radioactive’ calcium… straight away?? I know i would!
    I have osteoarthritis in the hips… I have never been a great consumer of dairy, hated milk as a kid still do, loathe cheese, but have a fondness for new zealand butter but in no great quantities sometimes on bread or a baked potato. And i would walk everywhere.

    But my diet choice was the atkins diet! 1lb of sausage for breakfast, piece of chicken for lunch…. So i reckon i am going to stick with the calcium down the toilet theory1

    1. I would concur – calcium is extracted from the bones to neutralise acid.

      People’s lives are saved by applying the theory that acid causes calcium from the bones to be extracted to neutralise the acid.
      Explanation: Hydrofluoric Acid is lethal in the smallest of topical applications to any extremity of the body; the HF acid draws (over the period of a number of days) calcium from the bones to the extent where the body is no longer able to regulate the electrical signals to the heart (as this is mediated through the skeletal bone structure) resulting in the patient dying from multiple ever increasing heart attacks. So how do they protect against this in industry? Besides having complete PPE (covering everything including hair, etc.) there are fully funded hospital wards for the application of calcium cream should the need ever arise (much like the addition of calcium to neutralise an acidic stomach).
      The system of death resulting of exposure to HF acid is stronger proof than any radioactive studies that the body does extract calcium from the bones to neutralise acid.
      They’ve also forgotten the obvious – what happens if there is no calcium in the diet – where do the researchers imagine it would come from then?

  17. Perhaps John Bergman’s You tube video Healthy bones,Healthy Life :
    Osteoporosis Cause and Solution will help . 45 minute lecture with some great points.

  18. Very interesting video. I am all for learning, unlearning and relearning :). So eating an animal protein diet increases blood calcium levels to a point that it is excreted in the urine. Why is this calcium not getting into the bone matrix to supplement the daily calcium loss (due to natural causes of course)? Would it be beneficial for these folks to take high doses of Vit D3 to help this calcium get into the bone matrix or some other transport agent (for eg R-ELF)? Would this slow down the excretion process and actually utilize the calcium better?

    1. I am now taking 2,000 IU vitamin D3 per day, as recommended by several physicians. Before I fractured my hip in 2006, I was swimming laps outside in the sun or walking my dog, again, outside. Wouldn’t I get enough vitamin D from the sun if I was exercising outside 45 minutes to 2 hours per day year around.

      We are living in South Louisiana.

      We all need calcium for other bodily functions, not just our bones, but I was trying to minimize bone loss without taking dangerous severe symptom drugs.

      BTW, I took cal-mag and other nutrients as part of my multi-mineral supplement with vitamin D for decades. But the level of vitamin D in the supplement was low then…about 400 mg. Now, online physicians and most nutrition researchers recommend 2,000 IU. I’ve found that if I take 2,000 IU or more, I urinate constantly. But, when I took 1,000 IU of vitamin D, my bones were not repairing themselves. Now, I try to ingest all my vitamin D for the day by noon.

    2. When I consumed dairy, as well as supplements containing calcium, it did not prevent me from getting osteoporosis. I was getting enough vitamin D from the sun, as I was swimming outside mid-day.

      However, I was not getting enough weight-bearing exercise and that may have had a big impact on the weakening of my bones.

    1. What I know is that I consumed one quart of milk and 1 quart of low fat yogurt per day, which helped my bad cholesterol rise, and did nothing positive for my bones after I passed menopause. I did this for my entire life.

      I now have osteoporosis, and have had a total hip and total knee replacement and 3 spinal fractures.

      Since going healthy vegan (two years), I’m breaking less bones, doing Pilates 3x week, and walking very slow and a very short distance 3 days a week. I’m getting stronger.

      I think eating healthy vegan is better because my calcium and other nutrients are coming from dark, leafy greens and calcium rich beans instead of dairy and I no longer eat any kind of meat. I think plants are more easily absorbed by the body. But, I’m no expert.

      1. Hi Becca,

        I travel quite a bit for work, and when on the road, I will seek out more ethnic vegan cuisine than the Americana vegan junk food. Vietnamese, Korean, Thai, Chinese, Ethiopian, etc, tend to be mostly whole foods. Sometimes I just get a salad from Whole Foods salad bar, but that is usually pretty expensive. There are still some restaurants that offer salad bars. Souper!Salad! is all you can eat, and they have a pretty good selection on their salad bar.

        Your Pilates and other exercises will do more for your bones than increasing nutrient intake.

        1. Thank you for your feedback.

          My main concern was getting enough calcium, as I am getting enough magnesium, manganese and other nutrients needed for strong bones, but calcium seem to be always lacking. With significant osteoporosis in my spine, I’m trying to ingest 1000mg of calcium from food per day. This is no problem at home, but a major problem when I have no control over what I eat.

          1. Ingesting calcium is not the only factor for having strong bones.

            Calcium needs for humans are not as high as the DRI may recommend, and if we consumed a low sodium diet low in animal protein, our calcium needs can be as low as 450 mg per day as discussed more extensively in this article from the Food and Agriculture Organization of the UN. As represented in the figure below, and citing from the article “In a western-style diet, absorbed calcium matches urinary and skin calcium at an intake of 840 mg as in Figure 14. Reducing animal protein intakes by 40 g reduces the intercept [calcium balance] value and requirement to 600 mg. Reducing both sodium and protein reduces the intercept value to 450 mg.”

            http://www.fao.org/docrep/004/Y2809E/y2809e0h.htm#bm17

            “Under the extreme condition of immobilization, rapid bone loss occurs despite consumption of 1,000 mg (25 mmol)/day of calcium”
            http://www.nap.edu/openbook.php?record_id=5776&page=74

            So exercise is important. Cooked greens like collards and kale can provide a lot of well absorbed calcium.

      2. Hi Becca, great comment :) I know this probably seems obvious, but, if you can, call the restaurant you plan to visit ahead of time, and ask them about healthy plant-based options. I have been surprised several times in the last year when I was handed a “Veg Menu” at chains such as Cheesecake Factory and Roy’s. Good luck :))

      1. At least based on this video I would suggest that the theory still stands other than the calcium is used to boost alkalinity before it ever gets to the bones. Final result being the same – more animal protein equals weaker bones.

  19. Hi,
    I have been meaning to contact you about my pet peeve: Alkalarianism.
    As a Respiratory Therapist we study acid/base balance extensively. We analyze blood gasses from persons coming in for a simple PFT to the most critical of patients. The results that we see are predictable and reproducible, the hallmark of very good science.

    Dr. Greger, you and I, both know that it is VERY HARD to shift your pH out of the range of 7.35-7.45. Our respiratory system responds quickly to acidic metabolic changes, and our kidneys respond more slowly to respiratory acidosis in order to bring us as close to the normostatsis of 7.40. You and I, both, know that it is only the MOST critically ill patients who have pHs outside of that normal range.

    Furthermore, Alkalarianism condemns vinegar, ph of 2.2, as an acidic evil, yet, promotes lemon juice, pH 2.0, to alkaline, angelic-status. AHEM, Alkalarians, lemon juice is MORE acidic than vinegar.
    So, then the Alkalarian responds, “But it PROCESSES in the body as acid or alkaline.”….and I’m thinking…WHAT!??

    Blood pH is the most accurate way to measure the body’s pH. Has anyone drank a quantity, say, a third of a cup, of said “poison”,vinegar, then had a blood gas measured?…and then drank the same quantity of lemon juice with a follow-up blood gas? I bet not.

    My conclusion: Alkalarianism is bad science and quackery!

    Thanks,
    Susan Zinaich, BS, RRT
    20+ year ethical vegan.

    1. Thank you Susan, you had the courage to say what I did not. Where the heck is this coming from? What is an alkalarian?

      I’m a chemist. Calcium cannot be a not a buffer. Its a divalent ion. There are cations and anions… some, like quaternary amines and carboxylic acids or carbonate ions can accept or donate protons so they are buffers. Calcium ion does not do that.

      This is all too strange to me. but you know, its Dr G. So what gives?

      2.5 years vegan, ethics…not so much.

      1. I agree with the posts always nice to have scientists and other health care professionals joining in to the discussion. In my experience people are just trying to negotiate a complex world by developing beliefs or paradigms… term coined in The Structure of Scientific Revolution by Thomas Kuhn and more recently popularized in The Tipping Point. Remers work in 1990’s which looked at the effect of specific foods on the pH of the urine is the best one I have seen that has contributed to the alkaline/acid issue. Looking at his list of acid/alkaline foods you realize that animal products are at the acidic end and plants at the alkaline end. When you read Dr. Campbell’s new book, Whole, you get a sense of the limitations of reductionistic science when looking at complex systems. For me at this point in time and given the science as a clinician it is clear weight bearing exercise and eating less dairy and animal products makes the most sense. I don’t know if that is do to acid/base issues or vascular issues (i.e. the effect of blockage of middle lumbar arteries on low back health for instance) or the other almost 20 factors associated with bone health. Given our anatomy and physiology we are designed as hind gut fermenting herbivores who are adapted to eating starches. If we eat according to our design we do better. It is not a guarantee but stacks the odds in our favor. If you put diesel fuel in a gas engine you have problems. Keep tuned in to NutritionFacts.org as the science keeps coming.

        1. What about the studies that show higher intake of animal protein, with adequate calcium present, increases bone density more than vegan diets? I am confused as to whether I should go back to eating meat for to maintain a higher bmd?

    2. Susan,

      Consider this. When a food is eaten that creates acids upon metabolization, the calcium, or more likely, phosphate in the blood immediately reacts with that acid and neutralizes both into salt and water. The body doesn’t see a change in blood acidity, but it does see a change in blood calcium or phosphate levels. So, calcium or phosphate is pulled from the bones to maintain the blood calcium level.

      When you exercise, your blood calcium and phosphate levels increase as your CO2 levels in your blood increase to maintain pH. If they didn’t, you would enter respiratory acidosis. If you were to hyperventilate, your blood calcium and phosphate levels would drop to maintain pH. If they didn’t, you would enter respiratory alkalosis.

      I wouldn’t call it quackery, I would simply call it misuderstood. Lack of evidence doesn’t mean something is false. There are plenty of people who have cured cancer and many other diseases by eating an alkaline diet. I know I have seen many health benefits.

      1. “There are plenty of people who have cured cancer…”

        Who, and how do you know they had cancer, cured it through their actions, and in particular through a change in dietary pattern? There’s plenty of quackery which relies on the emotionally appealing promise of CURING CANCER but which can only provide the weakest of evidence in favor of that claim.

        1. Anecdotal evidence may not be proof, but it is evidence, and to ignore it is foolish. Most empirical studies are based on the reports of multiple people’s anecdotal experiences.

          There are numrerous studies that show the benefits of a plant-based diet concerning cancer risk and growth. Since most plant-based diets are alkaline, you can draw a parallel hypothesis between an alkaline diet and cancer risk and growth.

          There are many studies that suggest many health benefits are obtained from a alkaline diet. Why is it difficult to believe that it may help prevent, or even cure some peoples cancer?

          1. I agree there is strong evidence to suggest that a plant based diet is the way to go for cancer treatment, prevention and reversal; but I would disagree on the point of anecdotal evidence. Anecdotal evidence is the lowest standard for evidence and is generally not accepted in the scientific community.

            1. Toxins, You will find that most empirical studies first started as reports of anecdotal evidence. If enough people claim that cranberry juice helps prevent UTI’s, then scientists conduct a study to determine if it is a real phenomena or imaginary.

              Of course, anecdotal evidence is the most powerful evidence by whom it is experienced.

    3. Susan I just read your note above and am so glad I did. I am an RN. I think a lot of good science gets lost for the sake of hearsay which in this case is dangerous. I was just about to ask for help to understand how this “lemon theory” is any different from Kombucha which becomes basically vinegar once it ferments. I have osteopenia and want more than anything to stay away from acidic foods, like Kombucha, and I think now I understand that all I need to do is continue a plant based diet, and get away from all the “theories” and hype about acid/base foods. I’m not eating animals and that is the most important issue here. Thanks again for your explaining about PH. I am in agreement.

      1. Thanks for reposting this question, Elizabeth RN. There are four videos that discuss acid/base balance that you may find helpful. There is so much good research on citrus fruits! I can’t speak directly to kombucha and how the stomach breaks it down. It may have some healing properties but there are concerns about its consumption I love what you added and feel it;s very true ” I think now I understand that all I need to do is continue a plant based diet, and get away from all the “theories” and hype about acid/base foods.” YES!

        .

        1. THANK YOU so much and for taking the time so quickly to get back to me. I never saw a video on Kombucha and I do not make mine with mushrooms, but it’s vinegar for sure when I drink it and it’s time to GIVE IT UP. If even a couple of T a day, I’m done.
          The person who taught me drinks 12 ozs. a day and am passing the video on to her.
          Have a wonderful life and thanks for being there for all of us.

          Elizabeth Berry RN

  20. I was trying to play your videos and had no sound. tried several times on my Mac1 the video plays, but no sound. I then tried on my ipad and got some sound then went away. This is the first time I have had trouble. Any thoughts?

  21. But aren’t there studies showing that country-by-country per capita osteoporosis rates correlate highly with per-capita protein consumption rates?

  22. Interesting..makes sense. all that is needed now it work out what really promotes osteoporosis? Just like any disease or symptom there is more than one road that can lead to it.

  23. I’ve been eating vegan for 2 1/2 years (whole plant diet) with lots of cooked kale and green veggies,(as I am hypothyroid) with 1/4 of diet in whole grains, but my urine ph in the morning is always very acidic. After eating, by lunch time I’ve gone up to 6.8-7.0, but don’t seem to sustain this. My question; why is my morning ph so acidic? Is this cause for concern? I’m post menopausal and have osteopenia and I am noticing significant bone loss in my mouth, not at the gum line but the bone above the gum line seems to be diminishing. I have good dental hygiene, but clench my teeth. Do I have a nutritional deficiency. My dentist and periodentist are not interested in this question as there is no bleeding or gingivitis. I went to a bone doc who said, ask your periodentist!

  24. It is certainly more complex than looking at just the calcium portion. However, minerals come from the soil, so they are abundant in plants…the only reason animal flesh has calcium and other limited amounts (vs. plant based) minerals is because they eat plants (used to anyway, now they are supplemented in their feed). Instead of going through an animal for these minerals or nutrients, it makes much more sense to go to the source.

  25. Yes…which is not a good thing…We do not need a lot of protein in the diet. And there is not a single person on the face of the earth who has ever been calcium deficient on a healthy diet

  26. About being calcium deficient on a healthy diet and even having higher osteoporosis risk than standard american diet: More Osteoporosis Seen With Raw Foods Diet. March 28, 2005 — Raw-food vegetarian diets are associated with osteoporosis, a new study shows.

    The study appears in the March 28 Archives of Internal Medicine.

    The study compared the bone health of 18 vegetarians who ate only raw foods with a similar group that ate a standard American diet. All participants were about 54 years old.

    The vegetarians had been following this diet for 18 months to 10 years. Food diaries showed they ate various raw vegetables, fruits, nuts, seeds, sprouted grains, and cereals. They strictly avoided cooked, processed, or animal-based foods. That eliminated dairy products in their diet, a major source of calcium.

    The researchers measured bone mineral density and also took blood and urine samples to measure bone turnover.

    The raw-food vegetarians had low bone mineral densities, indicating osteoporosis.

    http://www.webmd.com/osteoporosis/news/20050328/more-osteoporosis-seen-with-raw-foods-diet

  27. Meta studies show that hip fracture rates are proportional to the amount of per capita dairy consumed in a particular country. What’s causing the additional bone loss in countries that eat more dairy? Other studies have also calculated BMD and determined it is inversely proportional to acid food consumption. Are people who eat less animal products, and hence more fruit and veggies, being protected by micro-nutrients that stimulate osteoblasts?

  28. If you end up absorbing more calcium eating more meat-can’t that access calcium be used to neutralize the acid that is formed from the animal protein? .. and eventually you pee it out? Why is there a question still of how the acid is being neutralized? At the end of the video, Dr. MG claims that just because it is in the urine does not mean it is being used -but it also does not mean that it is not being used to neutralize.,,, correct?

  29. See the following studies showing that the alkaline mineral potassium bicarbonate (KHCO3) attenuates bone loss. Potassium citrate, found in abundance in fruits and vegetables, converts to potassium bicarbonate in the body, and therefore does the same if fruits and vegetables are consumed in sufficient quantities vis-a-vis acid-forming foods, such as meat, legumes and grains.

    IMPROVED MINERAL BALANCE AND SKELETAL METABOLISM IN POSTMENOPAUSAL WOMEN TREATED WITH POTASSIUM BICARBONATE

    http://www.ncbi.nlm.nih.gov/pubmed/8190153?dopt=Abstract

    TREATMENT WITH POTASSIUM BICARBONATE LOWERS CALCIUM EXCRETION AND BONE RESORPTION IN OLDER MEN AND WOMEN

    http://press.endocrine.org/doi/abs/10.1210/jc.2008-1662

    LONG-TERM PERSISTENCE OF THE URINE CALCIUM-LOWERING EFFECT OF POTASSIUM BICARBONATE IN POSTMENOPAUSAL WOMEN

    http://press.endocrine.org/doi/full/10.1210/jc.2004-1350

    I’ve improved my own bone mineral density over a two-year period as demonstrated via dexascan by supplementing my diet with KHCO3 along with ensuring that my urinary pH is kept sufficiently alkaline.

  30. The research done to provide the evidence you site is brilliant and exceptionally useful. As with all things, to resolve any issue you must deal with facts not conjecture. It just goes to prove the point that old beliefs are not correct simply because they are old. Those who have held to the idea of calcium loss is directly associated with bone loss will have to re-educate and re-evaluate. On the other hand, there are still outstanding issues with highly acidic diets as they relate to things like arthritis and cancer. For me being vegan is still the best option.

  31. This is so confusing. Dr. Greger should either withdraw this or explain it more clearly. Just because someone pees dietary calcium doesn’t mean a small percentage isn’t from bone – does it? How much of a small percentage during years beyond menopause ultimately leads to osteoporosis? Does the fact that the National Cattlemen’s Beef Association funded some of this research need to at least be acknowledged by Dr. Greger? Shouldn’t Dr. Greger point to a sentence in the study lauding the increased IGF-1 due to meat consumption as a potential reason to eat meat for bone protection? What am I missing here?

  32. Well strike us down from our vegan high horses! Is this the new combining recommendation: Should we eat our collard greens with beans?

  33. If this is true, then why does adding potassium bicarbonate to one’s diet stop bone loss and even help to restore it? because it does. See for example:

    Frassetto et al. Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women. J Clin Endocrinol Metab 82:254-59 (1997).
    Frassetto et al. Long-term persistence of the urine calcium-lowering effect of potassium bicarbonate in postmenopausal women. J Clin Endocrinol Metab 90:831-4 (2005).
    Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC Jr. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med. 1994 Jun 23;330(25):1776-81

    See the following diagrams at the end of this post: The first diagram (the line graph) shows the effect on urine pH of adding various amounts of potassium bicarbonate to the diet. The more KHCO3, the higher the urine pH. The second diagram (the black bar graph) shows the results for net renal acid excretion, which is a determinant of calcium excretion. Before supplementation, the NEA is high, during supplementation it drops dramatically almost to zero. After supplementation, it again rises to the previously high level.

    Potassium citrate is also effective for preventing and restoring bone loss (although potassium chloride is not):
    M. Marangella, et al.: Effects of Potassium Citrate Supplementation on Bone Metabolism. Calcif Tissue Int (2004) 74:330–335 DOI: 10.1007/s00223-003-0091-8
    Moseley et al. 2013. Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women. JBMR 28(3):497-504.
    See also: “Potassium Citrate Boosts Bone Density in the Elderly” — http://www.medscape.com/viewarticle/733234

    Despite their obvious benefits, these potassium supplements can interact with some medications, including ACE inhibitors, potassium-sparing diuretics, angiotensin receptor blockers and indomethacin, increasing your risk for hyperkalemia, or high potassium — so only take them under the the supervision of your doctor.

    1. I’m trying without success to delete this post, which unfortunately included graphs and diagrams that were not intended to be part of it. But every time I try to edit my own post, the edited result is rejected. I’m baffled as to how correct this. Does anyone know?

  34. Dear Dr. Greger,
    Here is a copy of a question that I posed for Dr. Campbell. I was wondering what you thought about the 10% of the calcium that was not radioactive. In other words, would the calcium(non radioactive portion) urine loss be the same if they fed vegans some radioactive calcium and then a vegan diet? The assumption is that they’d have less radioactive calcium but they would still have the same amount(not percent) of non radioactive calcium in their urine. I was wondering the effect of the protein on only the calcium in the body that was not ingested with the food. Does the protein increase, decrease or have no effect on this fraction? Thank you.

    ————————————————————————————-

    Dr. Campbell indicated that animal protein causes an acidic
    state in the body which is buffered by calcium. The calcium comes from the
    bones which causes increased calcium loss from the bones and contributes to osteoporosis.

    I’d like to present to the TAs and to Dr. Campbell information
    gathered by Dr. Greger that shows a different mechanism for the calcium loss in
    those eating an animal based diet that was elucidated via a radioactive calcium
    study.?
    I’d like to know if Dr. Campbell finds any flaws in this information. I’d also like to know if the 10% of the
    calcium that was lost in the urine that was not radioactive was the normal amount
    of calcium for a person on a WFPB diet. Or did the animal protein not only
    increased calcium absorption from the intestine but also increase calcium loss
    from the bone simultaneously. Thank you.

    1. Hi PaulaE. I am not sure the answer. I don’t think a study like that has been conducted so we can make assumptions, but we won’t know for sure. Have you read all the studies Dr. Greger references? I suggest starting there to understand the research better. Did Dr. Campbell respond?

  35. What is about the bioavailability of the radioactive calcium? Is it the same like natural calcium, so it doesn’t matter?

  36. Does squeezing a lemon or lime in one’s glass of water contribute to acidity in the body? Some say that such citrus acidity once in the body becomes alkaline. Is there any logical explanation as to whether or not this is true?

  37. Calcium does not act as a buffer. In the case of TUMS the buffer is carbonate, in the case of the body it is the phosphate that buffers and the calcium goes with it to keep the charge balance.

  38. Does taking K2 with calcium in a plant based supplement such as Alive brand and spreading it out over 6 or 8 small doses work? I am concerned about the spike in large doses, but am also not sure how good the calcium in fortified foods are( do they use limestone or…???) I try to eat just whole foods and am post-menopausal , small frame and already have osteopenia.

  39. I’ve just joined, so sorry to comment so late in the game.

    I’ve been vegan for over 30 years and had always assumed the “animal protein=bone loss” idea, so I found this video enlightening.

    I’ve just learned of another study (prompting me to come here) that actually goes farther and states that *lower* protein intake is associated with *higher* bone loss in the elderly, and even that lower animal protein intake is associated with increased bone loss.

    The abstract of the study is here:
    http://www.ncbi.nlm.nih.gov/pubmed/11127216

    This seems counter to all I’ve read from sources recommending plant-based diets. I’d appreciate some input from someone more knowledgeable than I am about this.

  40. Dr Greger,
    I went to the ER today with severe chest pain. All tests were negative and all is well (i’ll spare you the details). The DR I saw asked me to read up on acid vs alkaline diets. He said if your diet is alkaline heavy and therefore less acidic, you’ll never get cancer. If you agree with that, I’d love to see a video that explains it in relatively simple terms.
    Thanks very much for all you do.

  41. I’m not understanding this supposed “boost in Ca+2 absorption” which accompanied the acid surge. Can somebody please explain? That Ca+2 wasn’t in the blood before the acid-surge, it was in the soft tissues. If it was in the soft tissues and not in the blood, then, wouldn’t we say it had already been absorbed in the soft tissues. Then the acid-surge desorbed it from the soft tissues? I think you see where I’m confused about the acid “boosting absorption.” Thanks in advance for explanation.

  42. I am 33Yr old Male. I have been following a WF planted based diet for 20 months. I recently broke my fibula. My doctor said I am healing slower than a 90yr old woman. She says it is most likely because I have low Vitamn and Mineral levels (from my diet). I looked at everything I have been eating and I should be getting enough calcium and Vitamn D (infact more then enough). My last blood work was done just under a year ago and according to my doctor everything was in the normal range. I switched to an WFPB diet for health reason but could it be making me have weaker bones?

  43. Why then does America, the leading consumer of meat and dairy products, also lead the world in highest rates of osteoporosis? If not due to leaching calcium from the bones, there has to be some other correlation..?

    1. Above, I posted a suggestion that the dairy and (other) meat industries gamble on a massive investment in truly impartial, methodologically-sound research. That research not only could advance the science by decades, and what has industry to lose from funding the truth (for a change)?

  44. I am consistently amazed at the information shared by Dr. Greger. I’ve been curious about nutrition since I was 12 and my first boy friend broke up with me. I purposed the available teen magazines for beauty tips. The only one that stood out was that beauty starts at the inside. In the early 80’s I reading about health. Just collecting bits that I stored for later. Later, for me, began with my purchase of “How Not to Die,” by Dr. Greger. For 3 years I have been studying his writings and his videos. Scattered all about the living room are pages of notes, recipes and quotes.
    I only give this history because my 62 year old sister has just been diagnosed with pancreatic cancer, which might have
    Thank you, Dr.Greger and team. You have given me the resources to aid in making her cells stronger.

  45. I am left with confusion…

    So, eating sardines is no problem? 100g has 382mg of calcium…with this “40g of protein and 50mg of calcium-rule” I should have a positive net income of calcium..

    1. Andreas, I’m sorry you are confused and wondering if eating sardines is “no problem.” Even if you have a positive net income of calcium from those sardines, remember they are animal protein which comes with some very real health risks, as I’ll encourage you to review
      https://nutritionfacts.org/video/animal-protein-compared-cigarette-smoking/
      This video may also shed some light on this subject: https://nutritionfacts.org/video/is-protein-bad-to-the-bone/
      I hope that’s helpful Andreas

  46. Hello,

    A number of my family members suffer from the joint disease, Arthiritis. I was curious to find out if there were any foods and/or habits that would negate or recover this disease?

    1. Hi, Michael! In general, plant-based diets have been shown to produce significant improvements in arthritis symptoms. Specifically, studies have found acai berries, tart cherries, turmeric, and soy in particular to provide relief. I would recommend checking out the arthritis topic page for more information and links: https://nutritionfacts.org/topics/arthritis/

  47. I did not find the studies to be particularly confusing, although loaded with information. In reading the comments above the people who find the studies confusing admitted they found them that way because they conflicted with things they have taught. I was watching the dates of the studies 2011 and 2012 so this is new information, all of the confusion comes from past conclusions based probably on information people had taken to far through speculation, speculation is NOT SCIENCE!

    One thing sorrily missing from the commentary on the studies and the entire discussion is calcium in water. The history of water sources for drinking around the world has been that mineral water, often containing large amounts of calcium, have been considered to be health bringing waters. When Japan was first found by Western cultures there was a city where everyone was extremely healthy and the visiting foreigners claimed the waters of the local streams loaded with calcium cured their health problems. My source of water is city water from a water treatment plant that blends it’s waters with local sources and I have water filters on the sink, shower, and a big water filter for drinking water. The tap on drinking water filter clearly has calcium deposits on it and my hot water percolator has lots of calcium buildup in the bottom. My drinking water filters are the type that mineralize water as they filter it but the water that I am filtering could also be loaded with calcium as historically drinking water sources are often very high in calcium and that calcium may be so dilute in solution that it is not entirely filtered.

    If in checking the materials and methods sections of those scientific studies they did nothing to normalize the calcium of the drinking water the subjects drank, then I would throw out those result as speculative and highly flawed. Making the test subjects to drink distilled water probably is also not a good idea either because distilled water has been shown widely to be unhealthy and so probably would cause a reaction to human metabolism that would taint the results.

    The way to do good science and create a truly valid study would be to first normalize the test group. That would be done by first running the experiment on everyone in the test group without the radio-isotope to see if you have odd balls show up in the test results who would have normally excessive calcium. Odd balls with be people who calcium metabolic problems, throw these people out based on testing rather than screening the subjects by asking people if they have certain problems would be better science. Doctors can ask screening questions but testing is always much more reliable. Also create a dietary criterion of normal diet including water source with known calcium rates in a known range and put all the test subjects on that diet during the study. Putting the subjects on a normalized diet would allow us to begin to do exactly what we are doing with these studies, compare the results as though all the test subjects were perfectly normal and metabolically the same so the results of the tests actually reflect a change occurring because of the dietary changes in test conducted, and not a result of differing environments. As it is in the current state of the art of science because the current science is not prepared to do what I am suggesting, they would label it as BAD science, because all the setup work would remove the possibility of making it a double blind test. AND the best approach would be to have scientist in health fields agree on what a normalized test subject would be, probably asking to much from scientists of this era, although I am sure many them dream of what I am suggesting.

    So considering the current state of the art in science there is no good reason to take these results overly serious and certainly all the conclusions that come before are much much worse. What I am saying is, EVERYTHING you know and have been taught about health is on very shaky ground, and all the current results are much better than the past but still not very good.

    At this juncture I need to notice that a large number of the women I know, have the 3 diseases, and most women seem to get these. IBS, digestive problems which actually should just be called heart burn every night, and acid re-flux. It is important to notice here that men really do not have these problems, although, if a male gets heart burn then his female partner will generally force him into admitting that he gets it every night, and she may even force him into admitting that he gets the 3 problems listed above. The real truth would be that he gets heart burn once a month or week, and has had acid re-flux once or twice in his life time so he knows what it is but nothing beyond that, and has had burning colon from time to time because he LIKES spicy foods, but it always goes away after a while and is not sure why. Although, the women forcing their partners to exaggerate their claims of these problems, and often times even their adult children into saying these problem are genetic, they get the burn every night.

    So, there are some very important reason for these things to be happening. Number one, women all have odd and unique eating habits because they exclude many foods from a young age for no good reason, conclusions jumped to based on impressions not based ideas that were factually correct. But these conclusions are often adhered to for a lifetime even while they know they were wrong.

    The reason most women get acid reflex is because they believe this wild idea that an alkaline diet is a good idea. The scientist that commented in the discussion above states that normal stomach acid fluctuates within a very narrow PH. One tenth of a PH is a very narrow PH range, while measuring PH wait a few seconds and the PH can change by one tenth. The solution for an acid stomach is to drink something very acid like orange juice, the acid in your stomach is washing up into your esophagus because the sphincter in your esophagus has not closed so drink a strong highly buffered acid and the sphincter closes the acid sensation goes away, taking an antacid will normally just make it worse. Men get much less acid reflux because we eat acid forming foods so that esophagus sphincter closes. I found that when I have acid stomach just drink a little orange juice and I feel much better. The time I did about 1/2 cup of apple cider vinegar it was way to much acid and it burned for a few minutes, until I diluted it with plenty of water but it did work. A big gulp of orange juice just works great and its much more buffered than vinegar so it will work more reliably. I think this indicates that it is possible to go to low in acid in the stomach for a short period of time and during that time many digestion problems will arise because various internal sphincters must close for everything to function properly. Those sphincters are closed by ACID not alkalinity.

    The solution is to eat the 2 to 4 oz. of meat daily recommended for a healthy diet, and if you get acid stomach take a shot of orange juice.

    Those who want to take stomach bugs, BUGS COMMON IN COMMON DIRT, will pay a LOT of MONEY for a solution that may never work. It is a GREAT business opportunity though, the subject of stomach bugs are so complicated and people are willing to pay so much buying so many types of supplements. It looks like a massive growing market of business opportunity to me, many small businesses taking advantage of people.

    I am not a doctor or health professional, I am a software test engineer who has been good at bringing to a head highly contentious arguments amongst intellectuals that seem to go know where, and I am a farmer who grew up on a corporate sized family farm, I am very handy, and I have two bachelor of science degrees and am an engineer by trade.

    The no corporations allowed argument is extremely ignorant because every business entity including tiny to large family farms, science guilds, universities, EVERYTHING, incorporates to minimize the consequences of law suits. If what is intended by the argumentative strategy of saying that science from very large business entities is not allowed because they have to much pull over the scientists that they fund, then you need at least to argue to exclude publicly traded business entities, saying corporations are not allowed is just painfully ignorant and reflected on the business reality, painfully misleading to little children.

    I am in my latter years very healthy, no cavities ever, a meat eater, accept I seem to have a not extreme inflammation problem, and I am a bit of an extreme night owl. I am a highly muscled guy and my musculature is holding very well even when I have stopped all exercise accept walking now and then for a few years now because I want to loose some of my bulk. Exercising when I was young had periods of muscle loss but not at all in my latter years. Exercise recovery since I turned 40 is unpredictable and painful, although I am slowly learning strategies that help a lot like taking red beet pills. My cholesterol and all other tests come within norms. My blood chemistry does go very bad if am eating anything that has triglycerides in it and the doctor then says everything is wrong with my cholesterol, blood chemistry, and I have bad genetics, get rid of the triglyceride food and everything is good again.

    Study triglycerides in general and you will find that they are added to paraffin in candles to lower the cost and raise the melting level. A few, few years ago, I raised squash with my father on the family farm. Our squash gained a good reputation for quality and sold above markets prices because we washed the squash in our packing house and sprayed wax on it to make it look nice and SHINY. To my knowledge we were the only farm that did this with squash. That wax probably had lots of triglycerides in it because if it were pure paraffin during a hot day at an out of doors market, no air conditioning, it could start to sweat, not good.

    The point is there are probably many unexpected sources of triglycerides and they are very bad for you.

  48. I’m confused now.

    If Osteoporotic bone fracture rates are highest in countries that consume the most dairy, calcium, and animal protein. How do we explain this away then?

    1. I’m wondering if the “science” behind the claims that these country have more bone fractures is incorrect?

      Also, if they gave people radioactive calcium and found 93% in their urine, where does the other 7% come from?

      AND, how often do they test them? once, twice? or for days or weeks? What I am asking is…. is it possible that calcium leeching can occur over time, perhaps part of the 7%?, and not show up immediately after a meal… and then when you multiply that by years, ore decades, the results begin to be more clear?

      I’ve tried watching the clip a few times and just never felt like any of those questions were answered and I have no idea how calcium really works either tbh, if it doesn’t leech right away does that mean it never will? and therefore we must look for another source of the higher incidents of bone fracture (assuming, again that it isn’t garbage science and is in fact real, which I am confused about now as well lol)

  49. Very good question. It’s probably more than one factor. Probable causes include lack of weight bearing exercise and inadequate vitamin D.

    Dr. Ben

  50. Since when animal protein contains large amount of calcium to be exerted in urine at all? it almost has no calcium. this research is totally wrong.

  51. The acidic fluids surrounding soft tissue disolve the tissue very slowly. This slow process wouldn’t register in the study with the radioisotopes. Unfortunately, I don’t know a way to test such a gradual tissue loss. Also, do we know what happens when sulfur rich proteins are digested without a (radiated) calcium suppliment, besides the obvious gastroenteritis?

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