The role of calcium in builidng strong bones. Priest says calcium has
been way overrated. Much more important is physical
activity and Vit D.

That's probably correct, and is even more correct for children and
young adults than for older ones. A lot of the milk studies are
confounded by the fact that the milk is usually UV irradiated and
therefore supplemented with vitamin D.

Here's one for the pediatricians, a very large meta analysis. Result.
Bonewise, milk per se does little good, but also no harm in kids. Both
boosters and detractors of routine milk for kids as a way to build
strong bones, are going to be unhappy. Doesn't it suck when practically
EVERYBODY is wrong, establishment AND antiestablishment?

Pediatrics. 2005 Mar;115(3):736-43.

Comment in:
   Pediatrics. 2005 Mar;115(3):792-4.

Calcium, dairy products, and bone health in children and young adults:
a
reevaluation of the evidence.

Lanou AJ, Berkow SE, Barnard ND.

Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave NW,
Suite 400,
Washington, DC 20016, USA. alanou@pcrm.org

OBJECTIVE: Numerous nutrition policy statements recommend the
consumption of 800
to 1500 mg of calcium largely from dairy products for osteoporosis
prevention;
however, the findings of epidemiologic and prospective studies have
raised
questions about the efficacy of the use of dairy products for the
promotion of
bone health. The objective of this study was to review existing
literature on
the effects of dairy products and total dietary calcium on bone
integrity in
children and young adults to assess whether evidence supports (1)
current
recommended calcium intake levels and (2) the suggestion that dairy
products are
better for promoting bone integrity than other calcium-containing food
sources
or supplements. METHODS: A Medline (National Library of Medicine,
Bethesda, MD)
search was conducted for studies published on the relationship between
milk,
dairy products, or calcium intake and bone mineralization or fracture
risk in
children and young adults (1-25 years). This search yielded 58 studies:
22
cross-sectional studies; 13 retrospective studies; 10 longitudinal
prospective
studies; and 13 randomized, controlled trials. RESULTS: Eleven of the
studies
did not control for weight, pubertal status, and exercise and were
excluded. Ten
studies were randomized, controlled trials of supplemental calcium, 9
of which
showed modest positive benefits on bone mineralization in children and
adolescents. Of the remaining 37 studies of dairy or unsupplemented
dietary
calcium intake, 27 studies found no relationship between dairy or
dietary
calcium intake and measures of bone health. In the remaining 9 reports,
the
effects on bone health are small and 3 were confounded by vitamin D
intake from
milk fortified with vitamin D. Therefore, in clinical, longitudinal,
retrospective, and cross-sectional studies, neither increased
consumption of
dairy products, specifically, nor total dietary calcium consumption has
shown
even a modestly consistent benefit for child or young adult bone
health.
CONCLUSION: Scant evidence supports nutrition guidelines focused
specifically on
increasing milk or other dairy product intake for promoting child and
adolescent
bone mineralization.

Publication Types:
   Review

PMID: 15741380 [PubMed - indexed for MEDLINE]

The case for milk and calcium as a way to prevent bone loss in type I
osteoporosis is a bit stronger, but confounded with vitamin D, and (as
noted) is mainly based on bone calcium measurements and hasn't been big
enough or long enough to directly show a lower major fracture rate at
hip or arm.

Here's a milk study, but uncontrolled for vitamin D. All you can say is
it provides evidence that milk per se doesn't do harm.

Osteoporos Int. 2003 Oct;14(10):828-34. Epub 2003 Aug 12.

The effect of milk supplementation on bone mineral density in
postmenopausal
Chinese women in Malaysia.

Chee WS, Suriah AR, Chan SP, Zaitun Y, Chan YM.

Department of Nutrition & Dietetics, Faculty of Allied Health Sciences,
National
University of Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur,
Malaysia. winnie@medic.ukm.my

Dietary studies often report low calcium intake amongst post-menopausal
Malaysian women and calcium deficiency has been implicated as part of
the
etiology of age-related bone loss leading to osteoporosis. Therefore,
the
objective of this study was to examine the effectiveness of high
calcium skimmed
milk (Anlene Gold, New Zealand Milk, Wellington, New Zealand) to reduce
bone
loss in Chinese postmenopausal women. Two hundred subjects aged 55-65
years and
who were more than 5 years postmenopausal were randomized to a milk
group and
control group. The milk group consumed 50 g of high calcium skimmed
milk powder
daily, which contained 1200 mg calcium (taken as two glasses of milk a
day). The
control group continued with their usual diet. Using repeated measures
ANCOVA,
the milk supplement was found to significantly reduce the percentage of
bone
loss at the total body compared to the control group at 24 months
(control
-1.04%, milk -0.13%; P<0.001). At the lumbar spine, the percentage of
bone loss
in the control group was significantly higher (-0.90%) when compared to
the milk
(-0.13%) supplemented group at 24 months (P<0.05). Similarly, milk
supplementation reduced the percentage of bone loss at the femoral neck
(control
-1.21%, milk 0.51%) (P<0.01) and total hip (control -2.17%, milk
-0.50%)
(P<0.01). The supplemented group did not experience any significant
weight gain
over the 24 months. The serum 25-hydroxy vitamin D level improved
significantly
(P<0.01) from 69.1 +/- 16.1 nmol/l at baseline to 86.4 +/- 22.0 nmol/l
at 24
months in the milk group. In conclusion, ingestion of high calcium
skimmed milk
was effective in reducing the rate of bone loss at clinically important
lumbar
spine and hip sites in postmenopausal Chinese women in Malaysia.
Supplementing
with milk had additional benefits of improving the serum 25-hydroxy
vitamin D
status of the subjects.

Publication Types:
   Clinical Trial
   Randomized Controlled Trial

PMID: 12915959 [PubMed - indexed for MEDLINE]

Here's much the same kind of study in New England, showing much the
same kind of thing. Note that again, milk is better than placebo, and
just about as good as a calcium supplement. However, again both groups
got vitamin D and this may just as well explain the effect.

J Clin Endocrinol Metab. 1998 Nov;83(11):3817-25.

Calcium supplementation prevents seasonal bone loss and changes in
biochemical
markers of bone turnover in elderly New England women: a randomized
placebo-controlled trial.

Storm D, Eslin R, Porter ES, Musgrave K, Vereault D, Patton C,
Kessenich C,
Mohan S, Chen T, Holick MF, Rosen CJ.

St. Joseph Hospital, Bangor, Maine 04401, USA.

Elderly women are at increased risk for bone loss and fractures. In
previous
cross-sectional and longitudinal studies of women residing in northern
latitudes, bone loss was most pronounced during winter months and in
those
consuming less than 1 g calcium per day. In this study we sought to
test the
hypothesis that calcium supplementation by either calcium carbonate or
dietary
means would prevent seasonal bone loss and preserve bone mass. Sixty
older
postmenopausal women without osteoporosis were randomized to one of
three
treatment arms: Dietary milk supplementation (D-4 glasses of milk/day),
Calcium
carbonate (CaCO3-1000 mg/day in two divided doses), or placebo (P).
After 2 yr,
placebo-treated women consumed a mean of 683 mg/day of calcium and lost
3.0% of
their greater trochanteric (GT) bone mineral density (BMD) (P < 0.03
vs.
baseline); Dietary supplemented women averaged a calcium intake of 1028
mg/day
and sustained minimal loss from the GT (-1.5%; P = 0.30), whereas
CaCO3-treated
women (total Ca intake, 1633 mg/day) suffered no bone loss from the GT
and
showed a significant increase in spinal and femoral neck BMD (P <
0.05). Femoral
bone loss occurred exclusively during the two winters of the study
(i.e. total
loss, -3.2%; P < 0.02 in placebo-treated women) with virtually no
change in GT
BMD during summer. Serum 25-OH vitamin D declined by more than 20% (P <
0.001)
in all groups during the winter months but returned to baseline in
summer; PTH
levels rose approximately 20% (P < 0.001) during winter but did not
return to
baseline during the summers. Urine N-telopeptide and osteocalcin levels
increased significantly but only in the P-treated women and only during
winter.
Serum insulin growth factor binding protein 4, an inhibitory insulin
growth
factor binding protein, rose 15% (P < 0.03) from summer to winter, but
this
increase was significant only in those women consuming <1000 mg/day of
calcium.
By multivariate analysis, total calcium intake was the strongest
predictor of
bone loss from the hip. Urinary N-telopeptide also closely correlated
with GT
BMD but only during winter (P = 0.003). We conclude that calcium
supplementation
prevents bone loss in elderly women by suppressing bone turnover during
the
winter when serum 25-OH vitamin D declines and serum PTH increases. The
precise
amount of calcium necessary to preserve BMD in elderly women requires
further
studies, although in this study, at least 1000 mg/day of supplemental
calcium
was adequate prophylaxis against femoral bone loss.

Publication Types:
   Clinical Trial
   Randomized Controlled Trial

PMID: 9814452 [PubMed - indexed for MEDLINE]

And here's one more prospective study, again with the vitamin D
problem.

J Bone Miner Res. 1995 Jul;10(7):1068-75.

The effects of calcium supplementation (milk powder or tablets) and
exercise on
bone density in postmenopausal women.

Prince R, Devine A, Dick I, Criddle A, Kerr D, Kent N, Price R, Randell
A.

Department of Medicine, University of Western Australia, Nedlands.

The etiology of age-related bone loss is unclear but both lack of
exercise and
dietary calcium deficiency have been implicated in its causation. This
2-year
randomized placebo-controlled study was designed to examine the effects
of
increased dietary calcium and exercise in 168 women who were more than
10 years
postmenopausal. The subjects were randomized into one of 4 groups:
placebo, milk
powder containing 1 g of calcium, calcium tablets 1 g/night, and
calcium tablets
1 g/night and an exercise regimen. The exercise group aimed to
undertake 4 h of
extra weight-bearing exercise per week and were undertaking 10% more
activity
than other groups at 2 years. Bone mineral density at the lumbar spine,
three
hip sites, and two sites of the tibia close to the ankle joint were
measured at
6 month intervals. Dietary intake was evaluated by a weighed food
record,
exercise was evaluated by an exercise diary, and blood and urine
samples were
obtained to examine effects on calcium homeostasis. Individual data
points were
compared using repeated measures ANOVA and least squares regression.
Calcium
supplementation by either the calcium tablets or the milk powder
resulted in
cessation of bone loss at the intertrochanteric hip site (placebo,
calcium
tablets, calcium and exercise, milk powder -0.81, +0.17, +0.23, and
+0.07% per
year, respectively; p < 0.05 for all supplementation groups compared
with
placebo) with similar results at the trochanteric hip site. The calcium
and
exercise group had less bone loss at the femoral neck site when
compared with
calcium supplementation alone (placebo, calcium tablets, calcium and
exercise,
milk powder -0.67, -0.18, +0.28, and -0.18% per year, respectively; p <
0.05 for
calcium and exercise compared with calcium alone). There was a
significant
reduction in the rate of bone loss at the ultradistal site of the tibia
(placebo, calcium tablets, calcium and exercise, milk powder -2.5,
-1.6, -1.0,
and -1.5% per year, respectively; p < 0.05 for all supplementation
groups
compared with placebo). There was no significant bone loss at the spine
site in
any group.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types:
   Clinical Trial
   Randomized Controlled Trial

PMID: 7484282 [PubMed - indexed for MEDLINE]

Final comment:

The reason it's so hard to do milk studies WITHOUT the vitamin D is
that it's almost impossible to find unfortified milk these days, unless
you get it raw and unprocessed.  That's no excuse for not doing a
vitamin D only control in these things, though.

Still, studies like this I think are adequate to put the screws to the
nuts who say processed milk (with its vitamin D) is actually bad for
women with osteoporosis. Clearly, it is not. Clearly, it's better than
water. Sorry, alternative weenies.

SBH