Vesanto Melina, Brenda Davis, and Victoria Harrison, Registered Dieticians
Authors of "Becoming Vegetarian" -- by The Book Publishing Company, 1-800-695-2241

Is it possible to build strong bones without cow's milk? If you grew up in North America you'd probably think not. After all, dairy products are one of the four "essential" food groups and we all know that it's hard to plan a well balanced diet when a whole food group is left out.

But wait a minute, if dairy foods are so important for good nutrition and more specifically for strong bones, how can it be that many of the people with the lowest rates of osteoporosis in the world consume little or no dairy at all? It is really quite simple. In addition to positive lifestyle factors such as ample weight bearing exercise, these people eat plant centered diets and therefore need less calcium than people who consume a lot of meat. Animal foods tend to be high in sulfur-containing amino acids, which cause calcium loss in the urine. Thus in countries where the use of animal foods is high, the recommended dairy intake for calcium is often set well above the 400-500 mg intakes typical in these countries.

All that having been said, one may still wonder who people who don't use dairy get dietary calcium. They often have the same calcium sources as large boned animals such as cows and elephants: plant foods. While it is true that dairy products are high in calcium, they are far from being the only good calcium sources. Calcium powerhouses from the plant world include many dark greens, legumes, nuts, and seeds. So, if you have decided to reduce or eliminate dairy from your diet, rest assured that it is possible to get enough calcium without milk. The chart that follows gives a summary of calcium-rich plant foods. Provided in the chart is the following information;

1. Total Calcium Content per serving. This gives the calcium content in mg of calcium per serving. Source: Pennington's Food Values of Portions Commonly Used.

2. Fractional Absorption. This tells us how much calcium we can actually absorb from a food. For example, the figure for broccoli is 53% which means that we can absorb about 53% of the calcium we get from broccoli. The figures were derived from Connie Weaver's work at Purdue University in the U.S.

3. Absorbable Calcium. This figure tells us how much calcium will be absorbed by our bodies. It is obtained by multiplying the total calcium in a serving of food by its fractional absorption.

If you would like to compare your total calcium intake to the RDA, calculate your intake by using the Calcium Content column rather than the Absorbable Calcium column.

How much calcium does an adult need each day? To put things into perspective, here are a variety of recommendations from expert groups in different parts of the globe.

Recommended Dietary Allowances (RDA) US, 1989 recommends 1200 mg for age 11 to 24 years, and 800 mg for age above 24 years.

US National Institute of Health (NIH) Consensus Development Conference, June 1994 recommended 1200-1500 mg for age 11 to 24 years, 800 mg for age 25 to 50 (1000 for women over 50 with estrogen replacement, and 1500 at menopause without estrogen replacement), and increase toward 1500 for both sexes over 50.

Canada, 1990 recommended 700 mg for women 19 to 49, and 800 mg for men over 19 and women over 49.

United Kingdom, 1991 recommended 700 mg for everyone age 19 and over.

Japan, 1992 recommended 600 mg for everyone age 19 and over.

World Health Organization recommends 400-500 mg for all adults. This "Suitable Group Mean Intake" has not changed for the past 30 years.

Why is there such a great range in the opinions of people who have spent their lives studying calcium status and bone health? The exact level of calcium intake that can be considered adequate is clearly a matter of debate. This is because:

1. There is no easy, routine way to access calcium status.

2. The body has the capacity to adapt to a wide range of calcium intakes.

3. Eating patterns and other habits that affect calcium balance differ from place to place in many ways.

In setting the recommendations set above, experts have taken into account the lifestyle factors which exist for their respective population groups. To quote the World Health Organization Technical Report #797 (1990) "Populations in developing countries appear to be at less risk from fractures than those in developing countries, despite their lower body weights and calcium intakes, possibly because they smoke less, drink less alcohol, do more physical work (which promotes bone formation), and consume less protein and salt (both of which increase obligatory calcium loss from the body)."