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Without sufficient vitamin D, calcium deficiency can occur even if the diet provides enough calcium. The consequences may be serious, resulting in rickets or osteomalacia (softening of the bones). Over the last few years there have been cases of vitamin D deficiency in some large UK cities (Shaw and Pal, 2002). Vegans obtain vitamin D from sunlight and fortified foods such as soya milks, cereals and margarines. It is important to get the balance right between being cautious about exposure to the sun and aware of the need for some exposure. It is recommended to spend at least 15-20 minutes a day outside with exposed face and hands to give the skin a chance to make enough vitamin D for our daily needs and it is now advised by the UK government that we apply sun block only after 10 to 15 minutes exposure to the sun. The skin reacts to daylight even when it’s cloudy so the weather doesn’t need to be sunny for your skin to do its job.

Magnesium, Potassium, Vitamins A, B group, C and K Magnesium, potassium, vitamins A, B group, C and K are all required for good bone health. A healthy diet that includes at least five servings a day of fruit and vegetables should optimise the intake of these and other micronutrients required (Nieves, 2005).

Animal Protein and Osteoporosis Bones consist of a thick outer shell and a strong inner mesh filled with a protein called collagen, calcium salts and other minerals. Osteoporosis (meaning porous bones) occurs when too much calcium is lost from the bones and they become more fragile and prone to fracture. This debilitating condition tends to occur mostly in

postmenopausal women due to a lack of the hormone oestrogen, which helps to regulate the incorporation of calcium into the bones. However, osteoporosis affects men as well. Osteoporosis is sometimes called the silent disease as there are

often no symptoms until a fracture occurs. Although the whole skeleton is usually affected, fractures mostly occur in the wrist, spine and hip. One in two women and one in five men in the UK will suffer a fracture after the age of 50; in fact every three minutes someone has a fracture due to osteoporosis (NOS, 2012). However, osteoporosis has been diagnosed in people as young as 20. The dairy industry has responded to this health scare by

promoting the consumption of milk, cheese and yogurt directly to teenage girls. However, British and Scandinavian women are among the biggest consumers of calcium in the world yet they have one of the highest levels of osteoporosis (Frassetto et al., 2000). African Bantu women, on the other hand, eat almost no dairy products at all; they have a relatively low calcium intake, mainly from vegetable sources, and typically have up to 10 children each. Yet osteoporosis is virtually unknown among Bantu women (Walker et al., 1972). It seems that the more dairy produce we consume, the higher

our risk of fracture. The Harvard Nurses’ Health Study examined whether higher intakes of milk can reduce the risk of osteoporotic fractures. The study observed over 77,000 women for 12 years and concluded that increasing milk consumption did not have a protective effect against hip or forearm fracture. In fact the report showed that for women consuming two or more glasses of milk a day, the risk of hip fracture was 1.5 times bigger than for women who consumed less (Feskanich et al., 1997). It has been shown that calcium loss from the bone is promoted

by a high intake of animal protein. One study of 1,600 older women examined the level of bone loss and found vegetarians had only 18 per cent less bone mineral compared to omnivores who had lost 35 per cent bone mineral by the age of 80 (Marsh et al., 1988). Another study of 1,035 elderly women found that women with diets high in animal and low in plant protein had an almost four times higher rate of bone loss and their risk of hip fracture was 3.7 times that of women who consumed the least animal protein (Sellmeyer et al. 2001). In a similar study that analysed the incidence of hip fracture in relation to the consumption of animal

and vegetable protein in 33 countries it was concluded that the higher the consumption of animal products, the higher the rate of hip fractures (Frassetto et al., 2000). Similarly, an analysis of data on protein intake and fracture rates

from 16 countries revealed strong links between a high animal protein diet, bone degeneration and hip fractures (Abelow et al., 1992). In Professor T. Colin Campbell’s extensive ‘China Study’ (the

largest study in the world of the effects of diet on health) Campbell observed that in rural communities where animal protein made up just 10 per cent of the total protein intake (the other 90 per cent coming from plant-based sources) the bone fracture rate was one-fifth of that in the US, again indicating a link between animal protein and bone degeneration. A study of a high animal protein and low carbohydrate (Atkins-

type) diet showed that after six months on the diet, people excreted 50 per cent more calcium in their urine compared to the starting point (Westman et al., 2002). Later on, Campbell and Tang (2010) warned that high protein diets emphasising animal products lead to bone loss and decreased bone density. But what is the mechanism for this process? As food is digested

acids are released into the blood and the body attempts to neutralise the acid by drawing calcium from the bones. This calcium is then excreted in the urine and only a small fraction can be returned back into the bones. Animal protein has a particularly bad effect because of the greater amount of sulphur-containing amino acids it contains compared to plant protein. As the sulphur content of the diet increases so does the amount of acid it creates in the body and the amount of calcium used to neutralise it (most of which is later lost in the urine). Studies reveal that diets based on animal products confer an

increased risk for uric acid stones (Breslau et al., 1988). Furthermore the animal protein-induced calcium losses in urine may be a risk factor for the development of osteoporosis. The traditional Inuit diet is made up almost entirely of animal protein. Inuits potentially have one of the highest calcium intakes in the world (up to 2,500mg a day) depending on whether they eat whole fish, including the bones, or not. They also have a high rate of osteoporosis, even higher than white Americans (Mazess and Mather, 1975; Mazess and Mather, 1975; Pratt and Holloway, 2001). Although plant protein also produces acid, there is less of it and

alkaline salts produced during the metabolism of fruits and vegetables also neutralise the acidity during digestion. So consumption of fruits and vegetables that produce alkaline salts, such as carbonates and citrates, reduces the need for the bones to provide part of the buffer system (Burns et al., 2003). The overall effect of most fruit and vegetables (including citrus

fruits) is to alkalise the blood; whereas the overall effect of cows’ and goats’ milk, cheese, both red and white meat, fish and eggs is to acidify. For a detailed list of the effect of foods (acid or alkaline) on your

body see the Break Free report: An extensive review by Lanou (2009) resulted in a conclusion

that: ‘bones are better served by attending to calcium balance and focusing efforts on increasing fruit and vegetable intakes, limiting animal protein, exercising regularly, getting adequate sunshine or supplemental vitamin D and getting 500mg Calcium per day from plant sources.’ And as Sahni et al. (2009) showed, long-term intake of

carotenoids (antioxidants found only in fruit and vegetables) is beneficial for bone health and can help prevent osteoporosis. There are many factors linked to bone health that may even be

more important than calcium. For example, when the bone density of 80 young women was monitored over a 10-year period, it showed that exercise was more important than calcium intake (Lloyd et al., 2004). In older people, a 15-year investigation into whether low calcium intake was a risk factor for hip fractures concluded that cutting back on dairy did not increase the risk and that physical activity provided better protection (Wickham et al., 1989). The discovery of 18th-century human bones under a

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