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Friday, January 10, 2014

Dairy Food, Calcium and Cancer Risk

The topic of dairy foods, calcium and cancer makes me a bit queasy because it is such a grey topic. There is no clear straightforward answer for the person trying to decrease their cancer risk. In some cancers, dairy might be detrimental and in others it may be protective. Conflicting findings and milk politics don't make it any easier. There is the whole question of calcium supplements increasing heart disease, and is it safer to take calcium balanced with other minerals and vitamins? This gets even more complicated as we wrestle with dairy intolerances, allergies, and how our milk is produced.

I struggle with the question frequently in daily practice. I need to find ways to rebuild osteoporotic bone for clients who cannot tolerate dairy or even mineral supplements. I need to make sure my client diagnosed with cancer is getting enough high-quality calories with his liquid diet. There is the young child who subsists only on dairy products these days and wants to eat nothing else. I have clients with metastatic bone disease that needs support, but their blood calcium levels are already through the roof because of bone breakdown. Women ask me what's the best calcium supplement to take. And what about the patient who wants a healthy diet to decrease risk of cancer in the future?

There are some very strongly positioned camps on dairy. One camp is touting the benefits of low-fat dairy products and calcium supplements as part of a balanced diet.  Another camp states that all dairy products should be removed from the diet. Yet another camp believes that conventional milk is harming us, but organic, grass-fed, (even raw) animal milk and cultured dairy products from such milk are beneficial. Others say stand-alone calcium supplements are harmful (perhaps due to impaired absorption issues), but can be helpful when taken as a well-balanced mineral supplement. 

I say there are no clear answers and more studies are needed. In the meantime, we do the best we can with the best information we have, which finally brings me to today's study.

This study was published in the Archives of Internal Medicine/Vol 169 (No.4) on February 23, 2009. The title is "Dairy Food, Calcium, and Risk of Cancer in the NIH-AARP Diet and Health Study" by Park, et al. In 1995 and 1996, a questionnaire was mailed to people aged 50 to 71 years of age. This study looked at almost 300,000 men and 200,000 women.  Here is a summary of what they found...

* Total calcium intake up to 1300 mg/day decreased total cancer incidence in women, but there was no association for men.
* Looking at digestive cancers only, higher total calcium intake AND dairy food intake were related to a lower risk in men and women.
* Dairy food intake was protective for head and neck, digestive cancers, and bladder cancer in men, but it was positively associated with prostate cancer.
*Supplemental calcium was found to increase risk of non-Hodgkin lymphoma (NHL) in women. (Note: Other studies I have read have positively associated dairy and NHL, as well.)

Why and how might dairy/calcium been helpful or harmful? What is the proposed mechanism, you might ask.  Dairy contains calcium, vitamin D, and an essential fatty acid called CLA (high in dairy from grassfed milk), nutrients that have been shown to have anti-cancer effect. Calcium specifically has been show to reduce how cancer cells proliferate. It supports healthy cell differentiation, and it has induced apoptosis (cell death of abnormal cells) in breast and gastrointestinal cells.  The article also discusses the theory that calcium may be binding to bile thereby reducing potential damage to the intestinal mucosa.  On the other hand, dairy has been linked to increase levels of insulin-like growth factor 1 (IGF-1), which  may potentially increase risk of certain cancers. These are just some of the mechanisms proposed by this article.

Does the article clear up the matter or change how I will practice naturopathic health care?  Not much. I will probably not recommend dairy for men at higher risk of prostate cancer. I will be cautious with calcium/dairy with NHL. I will consider recommending calcium/dairy for people at high risk of digestive cancers. Meanwhile, for those that do consume dairy, I advocate choosing the cleanest and healthiest sources available (organic, grass-fed animals). When recommending supplements with calcium, I will remember that healthy bones need much more than just calcium.

There you have it--my 'short' discourse on dairy and calcium. Perhaps I will find some easier articles to discuss next week in my closet. ;)

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