In my busy practice as an orthopedic surgeon, I’m often asked the question, “How much milk should I drink every day to ensure against bone fractures”?  When I tell them they don’t have to drink any, they look at me in disbelief. In fact, the health of their bones may be served better by turning to the “CRAS” alternatives to ward off fractures rather than drinking milk.  Let me tell you what CRAS is and why you should be drinking them.

How to Kick The Cow and Avoid a Fracture

Now, don’t misunderstand.  I have nothing against dairy milk.  I tell my patients, if you like it and aren’t having problems with cholesterol, high blood sugar, are not lactose intolerant, or have IBS, or Crohn disease, or other problems that cow’s milk can aggravate, enjoy it.  Yet, many of my patients tell me that the only reason they drink cow’s milk anymore is to keep their bones strong.  I tell them that this is not a good reason to drink dairy and, in fact, they may be setting their bones up for fracture.  Why?

Cow’s milk, because it has lactose, or milk sugar, in it, causes the acid levels in your blood to rise.  Calcium is the perfect de-acidifier.  Your body starts pulling extra calcium into the blood to neutralize these acids in an attempt to regain acid/alkali homeostasis, or balance.  Your body pulls calcium from its largest storage areas – your bones – to perform this balancing act. So, if you’re not eating enough alkalizing foods to balance the cow’s milk you drink, the more you will need to pull calcium from your bones to de-acidify your blood.

The bottom line is, you really don’t need to drink cow’s milk to keep your bones strong.  What you do need is calcium – and other minerals and vitamins that support its absorption.  Today, there are 4 alternatives out there that will give your bones the calcium and vitamins they need, and none of the acid and sugar.  I call them the CRAS alternatives – coconut, rice, almond, and soy beverages.  These alternatives look, taste, and work pretty much like nonfat dairy milk without all the damaging lactose and acid. They can all be excellent replacements for dairy milk.  Here are some of the benefits of each:

1.  Coconut:  This is the coconut milk you’ll find in paper cartons in your grocer’s alternative beverage sections, either larger refrigerated versions, or the smaller, slimmer boxes on health food shelves.  Not to be confused with the thick squeezed coconut milk in cans typically used for cooking.  Coconut milk today is fortified with extra calcium containing about 300 mg per serving, the same as cow’s milk.  It can also help raise good HDL cholesterol and contains good levels of the minerals copper, magnesium, potassium, selenium, zinc, folate, vitamins C, E, K, and thiamine, a B vitamin.  In addition to building bone strength, coconut milk is a nonsaturated vegetable fat consisting of medium chain triglycerides.  These MCT’s actually help boost your metabolism and augment your thyroid function as well. One thing coconut milk doesn’t have is protein.  Yet, if you use it to make a protein shake, where you supply the protein via a powder, you’ll remedy that issue and have a very bone and heart healthy, energizing drink.

2.  Soy.  If you’re a post menopausal woman who doesn’t also have thyroid problems (hypothyroidism), soy “milk” can be a big boon to you.  It contains phytoestrogens (plant-based estrogens) that help stimulate bone growth and suppress menopause symptoms.  It is nutritionally very close to nonfat cow’s milk, having about 300 mg of calcium the same as cow’s milk, comparable calories, protein, riboflavin, potassium, Vitamin D, A, B1, B12, magnesium and zinc, yet without the acid or sugar. It has more protein than the other milk alternatives as well. But, if you do have thyroid problems, you’ll want to stay away from soy milk as it can further suppress your thyroid’s function and cause your medication to not absorb correctly.

3.  Rice. This can be a do-able replacement for cow’s milk if you don’t have blood sugar problems as it can raise glycemic levels.  Its taste is remarkably similar to cow’s milk but it, too, has very little protein in it.  It does work well in protein shakes, though, with powdered whey proteins. Commercial rice milk has been fortified with vitamins A, D and calcium to equivocal levels with cow’s milk.  It also contains potassium and is very low in calories.

4.  Almond.  Almond milk has a taste very similar to nonfat cow’s milk and contains actually more calcium and 50% of Vitamin E requirements in each serving.  It is low in calories, the unsweetened variety has no sugar in it, and it is very low in calories and carbohydrates.  It contains potassium comparable to real milk but has very little protein. It’s my personal favorite of the milk alternatives.

The best part of CRAS milk alternatives is that you can pretty much use them the same way as you would cow’s milk – in protein shakes, on cereal, in coffee and tea, in cocoa, in recipes and just for drinking. You can even mix 2 or more types together to create a unique taste and consistency.  Depending on the brand, and whether they’re chocolate or vanilla flavored, some can be a little pricier than regular cow’s milk.

Be sure to shake up the product good before using it as its fortified vitamins/mineral contents can tend to settle at the bottom of the carton.  Because they contain about 300 mg of calcium per serving, to get the recommended 1200 mg for post menopausal women and older men, 4 servings a day, taken in divided servings throughout the day creates the best absorption route.

Stay Well,
Mark Bromson, M.D.

Milk Alternatives, http://blogs.oregonstate.edu/moore/2013/02/milk-and-milk-alternatives-how-do-they-compare/

Coconut Milk,  http://www.livestrong.com/article/113703-coconut-milk-nutrition-information/

Almond, Rice, Soy Milks, http://www.fitday.com/fitness-articles/nutrition/healthy-eating/calcium-levels-in-milk-vs-almond-rice-and-soy-milk.html