"Standing up to the osteoporosis hype"
age 53, in 2004, I had my first bone density scan and was
diagnosed with osteopenia, the precursor of osteoporosis. For
years I have been aware that my small 5'3" build could be a risk
factor for osteoporosis, and now it seemed my fears were finally
My doctor didn't tell me that I had to take Fosamax, but she
said that it would prevent further bone loss. By that point I
had read a book called Selling Sickness: How the World's Biggest
Pharmaceutical Companies Are Turning Us All into Patients. The
fact that osteoporosis seemed overly hyped by the pharmaceutical
industry, along with my reluctance to take any medication, left
me wary and uncomfortable. But, despite my instincts, I began
Many years prior, I had decided to become a vegetarian. I had
also decided to stop drinking milk at every meal (in an effort
to lose weight), but I continued to eat cheese and other dairy
foods on a regular basis. I had never even considered eating
pizza without cheese or a baked potato without sour cream and
butter. I was eating an "osteoporosis-prevention" diet according
to commonly held doctrine about dairy foods.
After becoming a vegetarian I also began taking lots of
vitamins and supplements because I, along with my friends and
family, was concerned that I would not be getting sufficient
nutrients without meat in my diet (one of my supplements was a
mega dose of minerals, including calcium). My parents thought
for sure I would perish without red meat. I, too, wanted to make
sure that I wasn't doing myself any harm.
Later, after starting Fosamax, I began reading more about
diet and health and learned about Dr. McDougall from my
boyfriend, Bob Whelan. I decided to shift to a low-fat,
low-sodium vegan diet in an effort to get off the Fosamax. In
addition to my previous concerns, I often wondered why the
advisory about this drug warned against lying down when taking
it—what was that stuff doing in my body?
So I stopped taking Fosamax after a couple of months, as well
as all my vitamins and supplements, including the calcium.
However, I was still concerned due to all the media hype about
osteoporosis, so I emailed Dr. McDougall. In addition to
providing me with some literature on osteoporosis that supported
my decision to discontinue Fosamax, he assured me that, given my
current diet and lifestyle, I would be fine without it.
At age 55, in 2006, I had my second bone scan, which clearly
showed that my bone density had improved. Although the
improvement was slight, it was very significant to me. I was
thrilled and encouraged. I continued with my diet and exercise
routine, and felt confident to be on the right track, finally.
Bob and I later attended a McDougall weekend workshop in
Santa Rosa to continue our education. It was a fascinating
experience and helped us strengthen our commitment to a healthy
diet. When I met Bob, we were both vegetarian and physically
fit, but over the past five years we have both further modified
our diets and our exercise routines, supporting each other in
our individual quests for optimal health. Committing to a
low-fat, low-sodium vegan diet, helped Bob lose 40 pounds in
about five months, and he has kept it off for several years now.
He was also able to discontinue his blood pressure medication
and now only needs a small dose of diuretic.
I also read The China Study by T. Colin Campbell. This
enlightening book provided additional reassurance that dairy
products were not necessary, or even desirable, for good health.
The book cites correlations between populations that eat a lot
of dairy and increased incidences of multiple sclerosis. The
book also notes higher incidences of hip fractures in countries
where women consume a lot of dairy products.
In addition, Campbell discusses the consumption of animal
proteins and how they affect one's ability to properly utilize
calcium (and actually leach the calcium from the bones). So,
meat and dairy in combination is "a dietary double jeopardy". It
is striking that in China osteoporosis is practically unheard
of, and most people, until recently, have consumed little or no
dairy. (They certainly aren't taking supplements and Fosamax,
I think that our society in general wants the "quick fix."
People don't want to take personal responsibility for their own
health if it involves more than the slightest effort. I made a
lifestyle change, and it requires daily choices: I choose to eat
right, I choose to exercise, and I choose to educate myself.
People often tell me that they could not do what I do because
they love to eat. Well, I really love to eat too, and that is
what first led me to become vegetarian, then vegan. In counting
calories, I quickly figured out that I would rather eat a big
bowl of cauliflower than a small piece of meat. It is really
quite simple: Vegetables are not as calorie dense, and therefore
I can eat more of them.
Practically everything I buy at the grocery store now can be
found in the produce and health food sections. With the aid of
several McDougall cookbooks, the meals we prepare are easy and
delicious. In fact, we love our own simple, home-made meals so
much that we seldom eat out. We do try new products, but if
something is not flavorful we don't buy it again—we love to eat
too much to waste our calories on tasteless foods.
We eat lots of vegetables and stick to whole grain breads and
pastas. Non-fat hummus is our favorite bread spread. We follow
the processed food buying rules we learned at the McDougall
workshop: No more than 10% of calories per serving should be fat
calories and the milligrams of sodium per serving should be very
close to, or less than, the number of calories per serving. We
can now tell at a glance if an item meets our criteria. We avoid
all milk and dairy products, including caseins (milk proteins)
and seek out food items that do not contain any added oil.
I work out on an elliptical glider almost every day for 20
minutes and lift weights three times a week. I also enjoy
recreational workouts like bike riding and cross-country skiing.
In a couple of weeks I will be participating in a 50-mile bike
ride. I intend to continue this level of activity for many years
to come, as exercise has been shown to be very important in
maintaining bone health.
In 2008, at age 57, I had another bone scan, and my hip is
now at 101% for women my age, and my spine has improved as well:
There has been a 6% improvement in the hip and a 3.6%
improvement in the spine over the past two years. There can be
no doubt that I am rebuilding bone without medication, dairy
products, or supplements. My diet also gives me the bonus of no
cholesterol and being able to maintain a healthy weight.
I am 5'3" and weigh 109 pounds. Lest you think this is a skimpy
diet, Bob is a former national-champion heavyweight wrestler. He
is 6'2" and weighs a healthy 195 pounds. We both eat as much as
we want and are never hungry. I feel terrific, and I no longer
worry about osteoporosis. I love that I am in control of my own
health. I tell people that I intend to live to the age of 120,
so at 57 I am not even middle-aged yet! Of course, I want all of
those years to be healthy and active.
To those who ask about me about osteoporosis, I say keep an
open mind and take charge of your own wellbeing. Quit hoping for
the quick fix and learn healthy lifetime habits. Bob has a
favorite quote: "I will do today what others will not do, so
that tomorrow I can do what others cannot do." We are doing it
today and everyday!
Dr. McDougall's Comments
A person's bones were meant to last a lifetime (about 85
functional years—some people live longer for better or worse).
Bones age quicker when poorly nourished. An animal-food based
diet lacks minerals (for example, meat has essentially no
calcium and too little potassium, and dairy products have no
iron) and vitamins (one example: meat, poultry, and dairy are
totally deficient in vitamin C).
Animal foods are sold to the consumer because they are high
in protein—proteins are made of amino acids. Very acidic amino
acids, known as sulfur-containing amino acids, are abundant in
animal foods. The net effect is; consuming a diet focused on
meat, poultry, fish, seafood, eggs, and /or cheese results in
the intake of heavy loads of acid at three or more meals a day.
The body must neutralize all this extra acid; and the primary "buffering system" of the body is the bones. Over many years,
the bones are destroyed in the process of releasing alkaline
structural materials in an attempt to neutralize these excess
dietary acids. Fruits and vegetables are alkaline.* Consuming
these plant foods reverses bone loss, and thereby osteoporosis
and osteopenia can be cured—as Mary and many other people with
bone loss have discovered. Exercise has been proven t o reverse
There is no financial incentive to teach the above message.
However, there are great profits in bone mineral tests, calcium
supplements, and drugs like HRT and bisphosphonates (Fosamax,
Actonel and Boniva). Even though HRT (estrogen with progestin)
does build bones, these drugs have recently lost favor because
they have been shown to increase the risk of developing breast
and uterine cancer, and heart disease and strokes. For this
reason, very expensive bisphosphonates are now the number one
prescribed treatment for osteoporosis and osteopenia. I will not
prescribe this class of drugs because they do very little to
prevent fractures, and have terrible side effects, including,
gastritis, esophagitis, bone necrosis, failure of fractures to
heal, heart disease (atrial fibrillation), and severe bone,
joint, and muscle pain. (I do on rare occasions prescribe
estrogen with proges terone for osteoporosis.)
The BMD (bone mineral density) test is a flawed measurement
that gets most women "hooked" on a lifetime of drug therapy.
This test uses the amount of mineral commonly found in the bones
of a young woman as the "normal" value. A woman stores large
amounts of calcium and other minerals in her bones during her
reproductive years in order to provide for the development of
her fetus and nursing infant. In post-reproductive years she no
longer has this biologic need. This reserve of minerals is
naturally lost, and the BMD lessens—this is a normal process,
not a disease. The supporting structural bone materials should
remain healthy and strong during this mid-life change. But they
often don't for women burdened by the high-acid, high-animal
protein Western diet.
Now that you understand that the extra mineral in the bone is
to provide for reproductive needs, and has little to do with
bone strength, you now understand why the correlation between
BMD and fracture risk is very poor. Because of the limited
predictive value of the BMD test most non-pharmaceutical-funded
health organizations recommend against routine screening of
women using BMD tests. However, the reason almost all women and
their doctors believe otherwise is because big money from the
drug industry controls most of the information they receive from
research, advertising, and the, supposedly legitimate, media.
You can learn more by reading from my Hot Topics
read this important article: Drugs for pre-osteoporosis:
prevention or disease mongering?
BMJ. 2008 Jan
*Legumes and grains are slightly acidic and should be limited
in a diet intended to optimally alkalinize the body. Meals from
the McDougall Diet that contain these ingredients are, overall,
alkaline because they also contain plentiful amounts of fruits
and vegetables. Consider; cheese is 10 times more acidic than
beans or wheat—beef 6 times, chicken 7 times, and fish 9 times