Sour Milk: Caucasian Calcium Standards

For decades, the United States Dietary Association (USDA) and its subsidiaries have advocated for us to acquire our daily vitamin D and calcium requirements, in large part through dairy consumption. As an appropriate prelude to this article, check out ‘Milk, an udder mistake?’, for more background on food policy recommendations regarding dairy consumption. In any case, it’s safe to say that dairy products have become a staple food group in most of our lives, whether it’s cheese, ice cream, a bowl of cereal, or a plethora of other milk-based products.

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With dairy products contributing to a significant portion of our daily calcium and vitamin D intake, that leaves a large proportion of American society in a conundrum of either having to deal with the inconvenient symptoms of lactose intolerance or consume fewer dairy products. 

With this seemingly binary decision, a public health concern arises regarding Hispanics and African-Americans being deficient in their acquisition of calcium and vitamin D. One solution to address deficiencies such as these has been to revise the WIC food packages by amending the eligible food items to accommodate better micronutrient supplementation. Although most WIC recipients are of Caucasian descent, Hispanics and African-Americans as a combined group make up the majority of program participants. So, the aim is to help provide this lower-income subset within these respective demographics with better food options. 

However, there seems to be an interesting paradox that has been uncovered by the research community over the last 20 years. Although African-Americans and Hispanics are historically recognized as deficient consumers of dairy with the lowest associated intake of calcium and vitamin D, it is known that these groups are still less predisposed to developing osteoporosis, versus Caucasians. 

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Although recommendations currently call for serum vitamin D levels (vitamin D circulating in the blood) between 20 and 50 ng/ml, black women actually displayed a lower hip fracture risk when they had less than the minimum recommended serum concentration; higher levels correlated with greater fracture risk. 

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Even more, there are correlations that infer a possible association between excess calcium intake for African American men and their alarming rate of U.S. metastatic prostate cancer diagnoses and deaths. Compared to their Caucasian counterparts, African-American men have a 50% higher risk of developing prostate cancer and are twice as likely to die from the disease after diagnosis.

Within this compilation of most recent studies, there are a couple schools of thought that experience some overlap. This includes those that are against lactose consumption (dairy) but comply with current calcium and vitamin D intake guidelines via non-dairy sources, and then there are those that are both against dairy and advocate for lower daily recommendations of the respective micronutrients. 

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For instance, one study showed that a low-lactose, high-calcium, high-vitamin D diet favors a reduced risk of ovarian cancer in African-American women. The interpretation of this study’s results drew controversy, not so much for the suggestion that less dairy may be better, but for the maintenance of the high-calcium mantra.

One of the critics, Dr. Constance Hilliard, has a unique perspective that blends a historian background with a clinical research context, and she has deduced that many people of African-American descent have been evolutionarily and epigenetically adapted to thrive on a low-calcium, low-sodium diet, among other divergent aspects of their when compared to the U.S. dietary guidelines. 

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Dr. Constance Hilliard

This adaptation was acquired in West Africa before any appreciable movement of African populations to the western world, such as the trans-Atlantic slave trade (1500s-1800s) or before any pre-colonial, sea-faring expeditions by West African kingdoms (i.e. Mali Kingdom, led by Mansa Abu Bakari II, during the early 1300s). In Western Africa there has been a prevalence of Tsetse flies that have inhibited the sustenance of cattle grazing in this region, leading to calcium being sourced elsewhere, and in less abundance. According to Dr. Hilliard, these populations lived healthily on 200-400mg/day of calcium vs the 1000-1200mg/day U.S. recommendation.

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More specifically, this evolutionary pressure selected for a unique variant of TRPV6, a calcium channel responsible for dietary uptake of calcium. This channel variant is hypersensitive to calcium, requiring less than other variants which manifest in European haplotypes, for example. Dr. Hilliard suspects that the surplus of calcium in our diet due to guidelines that are set for Europeans and European-descendants, may be one of the major culprits behind the disparate prevalence of certain metastatic cancers, as this excess calcium may essentially be toxic to African Americans and other African-descended peoples.

Dr. Milton Mills

Another proponent of reducing dairy intake is Dr. Milton Mills, who has not only partaken in impassioned reviews and rebuttals regarding the seemingly misleading dietary guidelines but has also confronted the National Food board about the inherent racism that has manifested itself in the representation of the board, and subsequently in the health policies passed down to the public.

Dr. Mills, who also is a staunch advocate for veganism, has noted as a practicing physician that a wide variety of his patients’ symptoms which could normally be attributed to any number of disorders or diseases, have been alleviated by simply recommending removal of dairy from their diets. Depending on whether these patients are equally replacing the dairy with non-dairy supplementation would also provide more insight as to whether their positive response was solely attributed to reduced lactose intake or in conjunction with reduced calcium in their diets, as well.

Based on these findings, there seems to be growing evidence that our national dietary recommendations may need more diversification to fit the melting pot of America that this country has become. It is a sad prospect to suspect that consumers in their own best interest may be following guidelines that unbeknownst to them may have unintended consequences.  If you are interested in exploring non-dairy options to acquire your calcium and vitamin D necessities, be sure to reference this article for more information and sources.

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