Do high protein diets leach calcium from the bones?

Acidosis. Acid-base diets. Veg*an pseudo science. All garbage.

Pretty much all the evidence points to increased bone health with high protein diets.

Here’s where this mystery comes from.

First observed in 1920, HC Sherman found that people who eat high-protein diets tend to excrete more calcium in their urine. Since then, over 25 trials have been published showing that increasing dietary protein does increase urinary calcium. 

But, you ask, why do urinary levels of calcium increase on a high protein diet? Doesn’t that mean that the acid-producing diet from all that evil animal protein is leaching calcium from my boes? Shouldn’t I switch to a base-producing diet and ditch all the animal stuff? I’m soooo confusded!

Not so fast, buddy-boo. This doesn’t even begin to explain what’s going on.

So, if high protein diets increase bone loss, howcome all these hunter-gatherer societies with traditional high protein diets actually show no signs of bone loss, and often appear immune to tooth decay, even when they don’t clean their teeth?

Studies looking at the Inuit found nearly complete immunity to tooth decay so long as they were eating their native diet, but also a remarkable degree of muscular and skeletal perfection rarely seen among other peoples.  When they began eating modern refined foods, the Inuit suffered rapid development of tooth decay and general physical degeneration.

Are you even more confused now? Don’t worry, big Dan’s here to make it all nice ‘n’ easy for ya to comprehend!

There are a number of intervention studies that show that high protein diets result in the slowest bone loss and fracture rates over time. Very cool. Now we can start to understand the cause and effect relationships!

Intervention trials such as this one published by a group led by Bess Dawson-Hughes of Tufts University shows that protein intakes far beyond the minimal requirement actually improve bone health. After nine weeks, the group consuming extra protein had lower levels of bone turnover and higher bone mineral density.

This group of studies conducted by Jane Kerstetter’s group at the University of Connecticut showed that an even larger increase in dietary protein increased urinary calcium, but not by leaching it from bone.  Instead, they found that consuming more protein increased calcium absorption from the intestines.

This makes sense now! More calcium is being absorbed into circulation. It’s not coming out of your bones. They are still researching the mechanism that causes this, but the story remains the same. More calcium absorbed = more in circulation = more calcium that may, or may not be used by the body = more calcium in the urine.

But, a caveat to this. You need to also have an adequate intake of vitamins from animal sources to actually utilize that calcium. Enter, vitamin K. It’s the activator vitamin that makes sure calcium gets to your bones, teeth, and other good places. It also makes sure calcium stays out of the bad places, like your arteries.

A lack of vitamin K due to animal deficient diets has been shown to result in poor bone and teeth health, and cardiovascular problems with calcification of the arteries. Yikes.

Where do you get lots of bioavailable vitamin K? Grass fed butter and liver are like the best sources ever. Also cod liver or cod liver oil. The news gets better, wait wait hold on. It’s really getting good now. These foods also have tons of A and D and B and stuff! Woah like crazy man! Liver is a super food!

See, vitamin K is vitally important. Weston Price found that giving people with tooth decay cod liver oil and high vitamin butter oil from grass fed cows, actually reversed their tooth decay! Whaaaaat?!? Yah for realz! Google that shit!

One more thing! Don’t go yet! The increased utilization of calcium with high protein diets is also one more reason you don’t need to drink all that milk. Blech! As long as you get lots of vitamin and protein rich animal foods in ya, and plenty of calcium rich green veggies, you’ll be golden!

Frakking cool dude! Eat more meat. And butter. And yah, tons of it. Your bones, and your muscles, will thank you!

~ Dan

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Alkaline balance diets. Is the science legit?

I’m still seeing a lot of stuff written about balancing out our blood ph levels in an effort to reduce acidity, and therefore improve health, disease markers, and reduse bone loss, etc.

The premise is that consuming too many acid causing foods (I’m not going to list them because there’s many arguments on both sides of the field) causes the ph of our blood to become too acidic, and to compensate our bodies have to leech calcium from our bones in an effort to reduce that acidity and increase alkanine balance. The health consequences of which are said to be cancer, osteoperosis, heart disease, and a host of other problems.

It’s also said that you can measure this change in ph by buying those little ph strips from the pharmacy and checking the levels in your urine or saliva.

The origination of the acid-base theory is often epidemiological studies, which we all know are incapable of determining cause and effect relationships. I talked about that already here. They still try to do it, nonetheless, and everyone gets all excited and starts pointing fingers.

Of couse, the promoters of these “ph balance” diets are predominantly meat-haters (you know who you are), but occasionally I see arguments coming from the Paleo realm. This strikes me as odd. But oh well. I smell bullshit, so I’m going to take a swing at dispelling this acid-base diet myth once and for all.

The science of ph balance

Here’s the scale:

ph_scale

Right, so our blood generally likes a ph of 7.4, right in the middle. Any large variation on that towards acidic or basic results in certain death. This is homeostasis. Luckily we have a series of buffers and mechanisms that regulate this ph. For example, carbon dioxide is the most abundant acid in our bodies, and is a product of regular cellular activity. Our lungs do their job and expell CO2 when we breathe. The kidneys also provide natural acid elimination through the urine. And our blood is constantly circulating to help provide homeostasis.

Now lets look at the digestive process. Everything we eat has to pass through the stomach first. Our stomach environment is highly acidic. It’s full of hydrochloric acid, after all. Almost everything that enters the stomach is broken down by this hydrochloric acid, and therefore takes on the same ph as the stomach. A nice acidic ph of 3.

Once this digested food enters the intestines, digestive enzymes and liquids immediately bring the acidity back down to the same level as the intestines. This means that, after entering the stomach, then the intestines, the initial ph of anything we eat is irrelevant.

The ph of the urine varies naturally as a function of the waste that is being eliminated. But this is unrelated to the ph of the rest of your body. Excess acidity is eliminated in the kidneys, and will vary depending on what you eat, but that’s it. If your blood ph actually correlated to your urine ph, you would easily be dead already.

But cancer only survives in an acid environment, right?

This is a common claim. But does it hold water? Again, our bodies can only survive within a narrow window of ph near 7.4. This is tightly regulated by homeostasis. Leukemia and lymphoma thrive in a blood ph of 7.4. So the claim that cancer only survives in an acid environment is totally bunk, and claims that acidity is the root of all disease is bunk.

But why do we see calcium secretion in the urine of populations eating [insert various food here] diets?

Calcium leeching from the bones happens due to nutrient deficient diets. Certain nutrients play a very crucial role in calcium metabolism, and a defficiency can cause calcium to go where we don’t want, like our teeth as plaque, or our arteries, and not into bones where it’s suposed to. We already know that vitamin D plays a crucial role in making sure calcium is used properly. We can get plenty of calcium from green leafy veggies, and a little bit of gool ol’ sun exposure gives us a great source of D.

Posted in Mother Nature Obeyed.

“Alfred Wallace hypothesized that hypocalcemic tetany from low levels of calcium and vitamin D underlied a phenomenon of hysteria found among Eskimos called pibloktok.  Wallace noted that tetany was common among Inuit who did not have year-round access to fatty fish and fish bones, but that bone diseases were incredibly rare among the Inuit even when they faced seasonal malnutrition. 

So much for the idea that acid-producing diets lead to bone disease among the Inuit.”

Studies conducted by Jane Kerstetter’s group at the University of Connecticut, however, showed that an even larger increase in dietary protein from 0.7 g/kg to 2.1 g/kg did, in fact increase urinary calcium, but not by leaching it from bone.  Instead, they found that consuming more protein increased calcium absorption from the intestines.”

Then there’s this intervention trial, that shows very clearly how protein intakes far beyond the minimal requirement actually improve bone health.

Vitamins K , A and D.

From Weston A Price, Vitamin K-2 synergy.

“Vitamin K-2 is the substance that makes the vitamin A- and vitamin D-dependent proteins come to life. While vitamins A and D act as signaling molecules, telling cells to make certain proteins, vitamin K-2 activates these proteins by conferring upon them the physical ability to bind calcium. In some cases these proteins directly coordinate the movement or organization of calcium themselves; in other cases the calcium acts as a glue to hold the protein in a certain shape. In all such cases, the proteins are only functional once they have been activated by vitamin K…”

“…Vitamin K-2 may also be required for the safety of vitamin D…”

“…Vitamin K1 supplements produce modest decreases in bone loss in the elderly. A number of Japanese trials, on the other hand, have shown that vitamin K2 completely reverses bone loss and in some cases even increases bone mass in populations with osteoporosis…”

“…The balance of the evidence, however, suggests that vitamin K2 is essential to skeletal health and that it is a key substance that modern diets do not adequately provide…”

So it’s obvious that these nutrients are crucial for proper calcium metabolism, they work in synergy. Without enough of one, we have problems with the other potentially forming.

With a poor diet, as is often looked at in epidemiological health studies, we see instances of poor bone health. Attempts to link one type of diet (particularly high protein or high fat or high acid or whatever) to weak bones usually results in weaker correlations. But a closer look reveals stronger associations with diets that are deficient or cause deficiencies in vitamins A, D, and K. Such diets are usually very high in nutrient-void processed foods, and high grain diets also contribute to deficiencies by way of phytates. Avoiding nutrient dense animal foods doesn’t help matters either.

So again. Acid-base ph blood balance vs calium and bone health etc etc. Bullshit. It was a nice theory, but science doesn’t support it. Let’s move on, shall we?

“As long as you are eating properly, and not just downing protein powder as your only source of food, you will be consuming adequate calcium and fat soluble vitamins, like K2, which support proper calcium metabolism.”

Acidosis and bone health. Science or Science Fiction?

This is one of those topics that is pushed hard (mostly by Veg*ans) as the ultimate proof against a protein rich diet.

Their claim is that consuming a diet high in protein causes an acid balance in the blood, leaching calcium from your bones, osteoperosis blah blah blah. The only way to fix this, apparently, is to consume an alkaline diet rich in veggies and fruit, and avoid meat completely (because we all know, meat also causes cancer and heart disease! oooh noooo!)

Ok, lets assume that acidosis is real.

So if an acid balance in the blood is bad, than an alkaline balance in the blood is good, right? Carried to its logical extreme, we would want to avoid acidosis causing foods all together. Their reasoning is that cancer cells can’t survive in an alkaline environment. This is true, but neither can the other cells in your body! The extreme end of the spectrum, metabolic alkalosis, is not suitable for any cells to live. You will die. You must understand that there is a spectrum here, and at either extreme, acidosis or alkalosis, we’re in danger.

Of course, while both acidosis and alkalosis are definitely medical issues, neither are likely and neither dichotomy is the way it really works. Lucky for all of us, evolution equipped the body with a range of ways to keep blood pH in the proper range and you’re not going to outdo your acid-base metabolism by eating too much meat, dairy, grains, or anything else.

The origination of the “acidosis” argument.

The China Study, by Campbell, which has been thoroughly debunked [here], was a pretty awful epidemiological study, full of errors, statistical miscalculations, unfounded conclusions, and straight up fabrication in some instances. The study was conducted and designed to make meat the villain and defame all animal products. The main problem, however, is that correlation does not equal causation.

Anyway, here is what Campell et al concluded:

Animal protein, including that from dairy products, may leach more calcium from the bones than is ingested, said Campbell, professor of nutritional biochemistry at Cornell and director of the Cornell-China-Oxford Project, the most comprehensive project on diet and disease ever conducted.

Campbell [and other collaborators] analyzed the role of dietary calcium in bone density by following closely the diets of 800 women from five counties that have very different diets in China. … Analyses of these data suggest that increased levels of animal-based proteins, including protein from dairy products, “almost certainly contribute to a significant loss of bone calcium while vegetable-based diets clearly protect against bone loss,” Campbell reported.

Interesting. So Campell drew a conclusion and causation from his correlation. A fallacy.

Let’s now turn to the discussion over at Whole Food SOS

“But, do the summaries above match up with the data? First, let’s look at what each county was typically eating:”

“As you can see, Xianghuangqi ate a pretty shabby diet as far as whole-foods veganism is concerned: We’ve got dairy galore, beef, mutton, wheat flour, a mere smattering vegetables, and millet. Their bones should be snapping like peanut brittle! Tuoli’s not much better, what with their milk tea, animal flesh, and decided lack of green leafy veggies. More bone snappage, right?

I’ll let the paper speak for itself:

Analysis by individual for all counties combined showed that [bone mineral content] and [bone mineral density] were correlated positively with total calcium (r = 0.27-0.38, P < 0.0001), dairy calcium (r = 0.34-0.40, P < 0.0001), and to a lesser extent with nondairy calcium (r = 0.06-0.12. P = 0.001-0.100), even after age and/or body weight were adjusted for. The results strongly indicated that dietary calcium, especially from dairy sources, increased bone mass in middle-aged and elderly women by facilitating optimal peak bone mass earlier in life.

Did you catch that? Dairy calcium—far more than plant calcium—was linked with stronger bones. Moreover, the paper notes that “nondairy calcium … showed no association with bone variables after age and/or body weight were adjusted for”

Now, here’s where Campbell makes his unfounded conclusion about non-dairy animal protein (from Whole Food SOS again):

“The associations between bone mass and other nutrients, like dietary protein and phosphorous, were also examined. However, none of these nutrients showed an association with bone mass as significantly as did dietary calcium, although an inverse correlation was observed consistently for nondairy animal protein.”

“Unfortunately, that’s the only blurb in the entire paper that mentions animal protein in relation to bone mass, so we can’t see the data behind the “consistent inverse correlation.” In the context of this study, though, it makes sense: Protein has a complex relationship with bone formation, serving as a synergist when calcium intake is adequate, but as a potential antagonist when calcium intake is low. In other words, the effects of protein on bone health depend on how much calcium you’re taking in.”

Bingo. as long as you are eating properly, and not just downing protein powder as your only source of food, you will be consuming adequate calcium and fat soluble vitamins, like K2, which support proper calcium metabolism.

“In addition, if animal protein was such a bone-killer and plant protein was bone protective, we’d see vegetarians or vegans having the best outcomes in the bone department. But this just ain’t the case. At best, non-meat-eaters are equally matched with their omnivorous counterparts; at worst, they’re more prone to fracture:

So, although the “calcium-leeching” properties of animal protein is a common battle cry in the vegan world, the research just doesn’t support it…”

There is no evidence in the real world that food changes the pH of the blood.

Just like the myth that eating high cholesterol foods raises serum levels of cholesterol. It doesn’t (Even if cholesterol mattered).

Also, there is a persistent myth that ketosis is dangerous: it’s not. People (including some doctors) commonly confuse it with ketoacidosis, a pathological state usually only found in uncontrolled diabetics and (rarely) raging alcoholics.

Acidosis, DEBUNKED!

You may also like to read ths very detailed article by Chris Masterjohn regarding acid/base diets: Does meat really leach calcium from your bones?

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