#085 How Much Calcium Do You Really Need? You May Be Surprised…

March 21st, 2015 by

How Much Calcium Do You Really Need?

No one wants brittle bones or to be hunched over.  While the American Dairy Association would have us believe that the answer is to drink more milk, some studies suggest that more milk might actually make things worse.  Popping calcium supplements instead may just increase your risk of a heart attack.  In this article, I’m going to share six things you need to do for strong bones and attempt to answer the question, how much calcium do you really need?

My Calcium Story

The milk industry had convinced me that “got milk” meant “got healthy bones.”  My favorite was this commercial where Mr. Miller’s arms fall off because he did not drink his milk.

For years I tried to follow our government’s advice and get my 3 servings of dairy each day for calcium.  Also, for the first 40+ years of my life I suffered from acid reflux.

When I was young I thought heartburn was “normal” so I never mentioned it to my parents.  As an adult I would buy the “Costco packs” of omeprazole (Prilosec) to make sure I always had enough on hand for my heartburn symptoms.

I also frequently got food stuck in my esophagus.  I thought this was something I had to live with as it was present from my earliest childhood memories.

In my early 40s, while racing to finish lunch prior to a surgery, I got a small bean stuck in my esophagus.  I could not dislodge the bean.  I was panicked because my nurse was paging me to start a surgery.

Fortunately, my partner was able to help me with the surgery as I needed an urgent endoscopy to remove the bean.  I had the endoscopy done without any sedation so that I could get back to my patients.  With the endoscope, my gastroenterologist could clearly see that my esophagus was severely inflamed, narrowed, and scarred from years of untreated eosinophilic esophagitis (EE).

I was put on a steroid and a high dose of Nexium.  I was also told that eosinophilic esophagitis is often due to food allergies and that it was usually a waste of time to try and find the specific food allergen.

Shortly after this time I hit my health crisis.  As part of my turn around, I cut out sugar, processed carbs, dairy, and animal meat except for an occasional wild fish.

I’m really not sure what “cured” me of acid reflux and eosinophilic esophagitis.  Perhaps it was the diet or the nearly 40 pound weight loss that came from eating this way.

Regardless, it is interesting to note that both lifelong conditions did go away when I changed my diet.  If I occasionally have dairy, the heartburn symptoms may come back.  While I have never been tested for food allergies, I suspect that I may have a food allergy to dairy.

When I discovered this possible food allergy to dairy, I started taking calcium supplements to ensure I was getting my recommended 1,000 mg of calcium each day.  However, after seeing the studies linking calcium supplements to heart attacks, I stopped these supplements.  Am I putting myself at risk of developing osteoporosis?

How Much Calcium Do You Really Need?cow and milk

Our government recommends 1,000 mg of calcium each day for adults.  Older Americans need to target 1,200 mg.

Having enough calcium is critical for our bones and teeth.  If there is not enough calcium, the body may pull it from our bones. Osteoporosis occurs when our bone mineral density is low.

Interestingly, the U.S. and Northern Europe have the highest dairy intake in the world. Despite this high dairy consumption, the U.S. and Northern Europe also have the highest rates of osteoporosis and hip fractures.  If dairy is the only answer, how do you explain these findings?

Do We Really Need 1,000 mg of Calcium Daily?

Is 1,000 mg of calcium really our daily target?  What will happen if we don’t reach this number?

Of course, there is a certain amount of calcium that we need each day in our diet.  Studies of animals who are deprived of calcium consistently show that they develop osteoporosis.

When researchers have looked at this question, they have been very surprised.  Getting the targeted amount of calcium, either through dairy or calcium supplementation, does not decrease the risk of bone fractures.  Surprisingly, some studies have even shown that getting more calcium may actually increase your risk of fractures.

Non-dairy eating cultures, like Asia, typically get very low amounts of calcium in their diets.  Indeed, in countries like China where 92% of people are lactose intolerant, their risk of fractures may be six times lower than the U.S.!  Of course, these are studies of Chinese eating their ancestral diet, which was real food, rather than a “modern” diet.

The bottom line is that we really don’t what the right amount of calcium is.  For example, some studies suggest that 300 mg may be okay for physically active Asians eating an ancestral diet.  For those of us living in the “modern world,” the number is probably much higher.  As everyone has different calcium needs, please speak with your healthcare provider to determine what the right number is for you.

What Are the Best Non-Dairy Sources of Calcium?stamp printed in Republic of Guinea commemorates the birth of Po

Contrary to what the milk industry would have us believe, there are also natural non-dairy sources of calcium.  For example, the following things are all very high in calcium:

1. Mineral water

2. “Greens” (spinach, broccoli, kale, etc.)

3. Sardines and canned salmon

4. Sesame seeds

5. Almonds

6. Legumes

7. Oranges

To put the recommended 1,000 mg of daily calcium into perspective, you could get 100% of your daily needs from 143 almonds.  Likewise, you could hit the same 1,000 number with either 6 oz of tofu or four cups of cooked spinach.  As you can see, by combining your daily greens with almonds, legumes, and fruit you can easily hit the daily calcium goal.

Since I have been tracking my daily calcium intake with the free Cronometer app on my smartphone, I consistently crush the 1,000 mg goal without the need for dairy.  For example, I hit 165% of my calcium target yesterday (1,675 mg) mainly from lots of greens and natural mineral water with some legumes, almonds, and fruit.

6 Ways to Prevent Osteoporosisbigstock-Fracture-Distal-Radius-forear-78727889

If dairy and calcium supplements are not the only answer to preventing osteoporosis, how can we prevent this debilitating condition?  As no one wants to walk around hunched over, let me suggest six strategies to prevent osteoporosis.

1. Stay Physically Active

Physical activity is the best way to keep your bones strong.  Weight bearing activities like walking, hiking, running, dancing, skiing, weight lifting, etc. are particularly important.

You would think that Tour de France cyclists would have exceptionally strong bones from all of their grueling training.  Interestingly, world class athletes performing non-weight bearing sports, such as swimming or cycling, often have much weaker bones.

The same is true for astronauts.  Within just a few days in space astronauts will lose 20% of their bone mass.

Gravity really is our friend.  Weight bearing exercises are critical for bone health.

2. Get Enough Vitamin D

Vitamin D is critical for healthy bones.  Studies show that your risk of osteoporosis is also determined by your latitude.  For example, the farther you live from the equator the higher your risk of osteoporosis.  Sadly, the strong media messages warning us of the dangers of sun exposure and skin cancer may actually be increasing our risk of osteoporosis.

Unfortunately, if you live in a higher latitude city, like our family in Park City, it is simply impossible to get all of your vitamin D needs from the sun alone.  There are some foods, like salmon, which are very high in vitamin D.  Besides fish, other natural sources of vitamin D include milk, eggs, and mushrooms.

For most people living in higher latitude cities, vitamin D supplements are often required to maintain normal vitamin D levels during portions of the year.  To find out if you are vitamin D deficient, please speak with your physician about getting tested.

3. Get Enough Vitamin K2

An often overlooked aspect of good bone health is vitamin K2.  Most people have simply never even heard of vitamin K2.

The role of vitamin K2 is to put calcium in your bones and keep it out of your arteries where it can cause heart disease.  Indeed, studies have shown that getting enough vitamin K2 in your diet not only strengthens your bones and teeth but also prevents heart disease.

The very best food source of vitamin K2 is natto or fermented soy beans.  Natto is considered a delicacy in Japan. Perhaps this helps to explain why osteoporosis and heart disease are so much lower in Japan than the rest of the world.

We can also get some vitamin K2 from the conversion of vitamin K1 to K2 by our bodies.  Foods high in vitamin K1 are greens like spinach, broccoli, and kale.  Other foods high in vitamin K2 include liver, eggs from grass fed chickens, and some cheeses like gouda and brie.

To read more about vitamin K2 and see if you have these 9 signs of vitamin K2 deficiency, please read the article I wrote on this subject.

4. Get Enough Calcium

While our government recommends at least 1,000 mg of calcium daily for most adults, we really don’t know exactly how much calcium we need each day.  If you do take calcium supplements, some studies suggest that supplementing calcium alone may increase the risk of osteoporosis.  Calcium may be most beneficial when it is consumed with the right amount of vitamins D, K2, A.

When tracking your calcium intake from food, don’t forget about the contribution from water.  Indeed, the “harder” your water, the higher your daily dose is of calcium and magnesium.

5. Avoid Very High Protein Diets

Although the science has not fully been worked out, some studies suggest that diets off the chart in protein may weaken bones.  Indeed, studies show that the excessive amounts of protein that some people eat puts them at higher risk of hip fractures.

6. Avoid Soda Pop

Did your Mom tell you that soda pop was bad for your bones?  It turns out that this advice may be true.

Many researchers feel that the phosphoric acid in soda pop alters the phosphorous/calcium balance in the body.  Perhaps this is why many studies have shown that soda drinkers are more likely to have osteoporosis and fractures.

Instead of soda pop, choose water instead.  Mineral or “hard water” is very high in natural calcium.  As long as you are not drinking reverse osmosis water, you are getting some calcium in every glass you drink.


Please discuss how much calcium, vitamin D, vitamin K2, and vitamin A you need with your physician.  Also, please work with your physician to minimize your risk of osteoporosis.  Do not self diagnose or treat based on anything that you read in this article.

#046 My Top 10 Healthiest Drinks

November 17th, 2014 by

Don’t Drink Your Calories

Do you ever drink fruit juice, sports drinks, energy drinks, or soda pop? If so, you are not alone.

Fully 50% of all Americans consume sugary soda pop, sports drinks, or energy drinks each day. An additional 20% of Americans drink diet drinks each day.

The problem is that our brains don’t register that we are full when we drink our calories. It is almost as if whatever calories we take in with liquids “don’t count” to the brain. Unfortunately, these liquid calories do count toward our waistlines.  Moreover, the effect of all of this sugar to our hunger hormones and metabolism may paradoxically cause us to eat even more.

Do Diet Drinks Help?

Switching to diet drinks does not correct this problem. Study after study has shown that the more diet drinks we take in the more weight we gain.  Even though these diet drinks don’t have any calories, it affects our hunger hormones, metabolism, and gut flora.

NutraSweet and Our Gut Flora

While we don’t get any calories from NutraSweet, disease causing gut bacteria thrive on NutraSweet. These same NutraSweet loving gut bacteria are also the same ones affecting our hormones and metabolism to make us gain weight.

My Former Love of Sugary Drinks

It was hard for me to give up drinking my calories. From a young age I grew up drinking vast quantities of fruit juice. I loved them all; apple juice, orange juice, or grape juice.

Before we knew about all of the dangers of sugar, we thought fruit juice was healthy. We really did not know what were the healthiest drinks.  If fruit juice wasn’t available then we were drinking milk.

Our favorite drink was sugary soda pop. As a child, my parents limited me to just two 12-ounce cans of soda pop each week. However, once I had my driver’s license, I regularly drove to the 7-11 near my high school with my friends to buy the 32-ounce Big Gulp.  In those days the 32-ounce size was the biggest size they offered.

When I became a physician things did not get any better.  For some strange reason, nearly every hospital I have every worked in has offered unlimited free soda pop to physicians and other staff members.

High Fructose Corn Syrup and Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease is projected to be the number one cause of liver failure in the U.S. by 2020.  Approximately one in five Americans now suffers from a fatty liver.

Sugary soft drinks, loaded with high fructose corn syrup, have been strongly linked to fatty liver.  High concentrations of fructose result in excessive fat deposition in our abdomens and can be toxic to the liver.

When I Gave Up Sugary Drinks

By the time I hit my 40s I knew I had to lose weight. At 6’2” and 200 pounds I was overweight with a body mass index of 26. Knowing that sugary soda pop and fruit juice were not helping my weight loss goal, I thought that I would give them up and switch to Diet Coke for “health reasons”.

No Weight Loss with Diet Coke

To my surprise switching from sugary Coke to Diet Coke did not result in any weight loss. I just could not figure it out why I was not losing weight.

Other than changing from sugary Coke to Diet Coke my overall diet had not changed. Why wasn’t I losing weight by cutting out these 384 calories of sugary soda pop each day?

What I did not realize at the time is that my disease and obesity causing gut bacteria were literally feasting on all of the NutraSweet.  By favoring the growth of the wrong gut bacteria, my hunger hormones and metabolism had now been changed for the worse.

Eventually, I came to the realization that I needed to completely cut soda pop out of my life not just to lose weight but to reclaim my health and my energy.  Amazingly, even my near daily headaches went away when I gave up my daily soda pop.

I Still Crave Diet Coke

Although I have, for the most part, given up Diet Coke, I still crave this substance. I, like so many others, had developed a Diet Coke addiction.  Even though I see free Diet Coke all around me at the hospital, knowing how it harms my health helps me to be strong and resist the temptation.

Is Fruit Juice Healthy?

Even though many of us were taught as children that fruit juice is healthy, fruit juice has nearly as much sugar as a Coke and cannot be considered a health drink. The sugar rush we get with fruit juice leads to a corresponding spike in insulin. Insulin then turns all of this sugar into body fat. Even worse, the insulin spike causes our blood sugar to drop and we are just as hungry as ever.

Fruit, on the other hand, is very healthy. The fiber in fruit slows the absorption so we don’t get the same sugar high that we do with fruit juice.  If you love the taste of fruit juice, like me, then blend up the entire fruit and drink it that way.

Learn to Love Water

Clean water is the best drink for our health.  Drinking five glasses of water each day has been shown to decrease your risk of heart disease by 50%.

Even if you don’t like water, like me until recently, you can learn to love the taste.  Indeed, studies show that we can train our brains to love healthy foods including water.

If all you have ever tried is tap or bottled water, branch out and try natural mountain spring water.  You may find that what you don’t like about water is the chlorine or plastic after taste of tap or bottled water.

My Top 10 Healthiest Drinks

If we really want to maintain a healthy weight, we cannot drink our calories. We need to learn to love water and other healthy drinks that do not alter our hormones and metabolism for the worse.

To help you in this process, let me share with you my top 10 healthiest drinks.

1. Water

2. Spruced up water (lemon, lime, cucumber, ginger, mint)

3. Smoothies (fruit, vegetables, nuts, seeds, etc.)

4. Vegetable juice

5. Unsweetened almond milk

6. Unsweetened organic whole bean soy milk

7. Unsweetened coconut milk

8. Unsweetened teas (especially herbal teas)

9. Sparkling water

10. Raw cacao powder to almond, soy, and coconut milk or smoothies

What are your favorite healthy drinks?