The Real Correlation Between Milk, Calcium, Bone Growth, And Height

There a an age old myth that states that if one drink a lot of milk when one is young, one will grow up to be tall and strong. The general public’s knowledge goes along like “milk has calcium, which is critical to make strong bones. If you get enough calcium from drinking milk, you will increase the rate of your growth and the final height you attain.” The theory around valid but from my research throughout the studies, some have stated that calcium does nothing towards one’s final height attained, but is actually used to make the bones stronger and more dense, not longer.

Let’s just see what the studies really state.

From the website for The Journal Of Endocrinology and Metabolism article entitled “Height and Height Z-Score Are Related to Calcium Absorption in Five- to Fifteen-Year-Old Girls” (Source HERE)…

Abstract

Context: Understanding the relationship between calcium absorption and growth has been limited. We have developed a database of calcium absorption measurements in 315 girls aged 5.0–15.0 yr.

Design: We have used this database to assess the relationship between height, its age- and gender-normalized value (height Z-score), and calcium absorptive efficiency.

Results: Overall, height was significantly related to calcium absorption (corrected for calcium intake, age, Tanner, stage, and ethnicity) (P = 0.001). Similarly, height Z-score was significantly related to calcium absorption (P < 0.007). About 3–3.5% of the variability (η2) of absorption was associated with height or height Z-score. We found that calcium absorption was significantly lower in girls with height Z-score equal to or less than zero compared with those with a height Z-score more than zero (difference, 3.9 ± 1.4%, mean ± SEM; P = 0.007). Limiting the analysis to those girls in which Tanner staging was performed or those age 9 yr or older did not substantively affect these relationships.

Conclusion: These results indicate that a small but significant component of the variability in calcium absorption is due to height. Identifying genetic risk factors for lowered calcium absorption during growth could lead to individual approaches for prevention of inadequate bone mass.

THE RAPID ACQUISITION of bone mineral during pubertal growth usually appears to be supported by an increased absorption of dietary calcium rather than an increased intake of dietary calcium or decreased excretion of calcium (1, 2). This regulatory adaptation is similar to that which occurs during pregnancy and is dependent on an adequate vitamin D status (3, 4). We have demonstrated that a specific polymorphism of the vitamin D receptor Fok1 gene was highly related to calcium absorption in pubertal children (5, 6). Our data further suggested a link between calcium absorption and height during growth, but the database was too small and too limited in age range to clearly identify this relationship (6).

Although it is reasonable to hypothesize that dietary calcium absorptive efficiency during childhood and adolescence is partly regulated by the body’s need for calcium to support longitudinal growth, no data demonstrate this relationship. This is due to the relatively small scale and limited accuracy of many calcium balance studies done before 1950 (1) and the small number of studies performed since then using more accurate techniques (7, 8).

Recently, the importance of understanding this relationship has increased due to confusing data regarding the effects of calcium supplementation in children. Several studies have failed to find benefit to supplementation over a long period of time, especially after the supplements were stopped (9, 10, 11). The longest supplementation study (9) found that a benefit to calcium supplementation was present only for those girls whose height was greater (after the end of their growth phase) than average for the study population. Although previous studies had demonstrated a link between milk supplementation and longitudinal growth, such studies generally were performed in subjects at risk for growth failure or with very low calcium intakes (12, 13, 14).

We have conducted studies of calcium absorption in girls at a single medical center using the reference dual-tracer stable isotope method for more than 13 yr. Most of our studies have involved no interventions other than manipulation of calcium intake and have used virtually identical dietary and absorptive measurement methods. Our database of absorptive measurements is larger than recent studies using reliable methodologies (7, 15). We have pooled the data from our studies for this analysis with the intent of specifically identifying the relationship during growth between calcium absorption and height. We hypothesized that the genetic growth potential, as assessed by the height Z-score, would be significantly related to calcium absorption during growth.

Discussion

Achieving peak bone mass in adolescence is believed to be an important aspect of reducing the ultimate risk of osteoporosis ). Therefore, because urinary calcium excretion slightly increases during puberty, adaptation to meet bone mineral accretion needs must come via increasing the proportion of dietary calcium that is absorbed, i.e. increasing calcium absorptive efficiency.

Our finding of a significant relationship between height Z-score (and height) and calcium absorptive efficiency demonstrates that the increase in absorptive efficiency is partly regulated to meet the needs of the ultimate skeletal size. Height is a highly heritable characteristic that demonstrates close tracking during puberty (28, 29). By using the height Z-score in this analysis, we specifically identified the effects on calcium absorption of being above or below the average population height. Although the percentage of absorptive efficiency variation accounted for by height or its Z-score was small (3–3.5%), this relationship has not been identified previously and was comparable in magnitude with the variation accounted for by previously identified factors such as age and calcium intake. Furthermore, the differences in calcium absorptive efficiency between those with height Z-scores equal to or less than 0 and those with height Z-scores more than 0 of 3.9% would represent a substantial distinction close to that of the increase of calcium absorptive efficiency during early puberty (20).

As expected, Tanner stage was significantly correlated to calcium absorption (Table 1⇑); however, this was not significant when height Z-score rather than actual height was used as the covariate. Although it is apparent that pubertal progression affects calcium absorption efficiency (7), there remains a significant relationship between height and its Z-score and calcium absorption efficiency when pubertal stage is considered.

We did not assess the relationship between calcium absorption efficiency and bone mineralization. Bone mineralization data were not available for many of the subjects in this study. For one of the individual studies that provided 50 subjects to this database, total body bone mineral content Z-scores were available. For these subjects, when combined with 49 boys of similar ages (6), we found a marginal significant relationship between whole body bone mineral content and height Z-score (P = 0.09) (Abrams, S. A., unpublished observation). This lower significance may be related to the smaller sample size and inclusion of males and females but may also reflect the multiple other factors, such as body weight, that are associated with bone mineralization.

Bone mineralization is highly dependent on weight as well as height during childhood (12, 30, 31), and we did not find a significant relationship between weight when used as a covariate with height and calcium absorptive efficiency. Furthermore, the optimal measures of bone mineral status during childhood and adolescence are unclear, and large database Z-score data are not available for whole body or regional bone mineral content (or density) in pediatric populations compared with the well-established globally derived height Z-score data. It is reasonable to hypothesize that calcium absorption efficiency during growth is more closely related to height than bone mineral content, but this would require additional investigation.

The mechanism by which height and height Z-score is related to calcium absorption efficiency is uncertain. Our findings support a genetic component regulating calcium absorption efficiency during childhood, a finding consistent with identified genetic effects such as differences between males and females in skeletal calcium accretion during puberty (30, 31) and ethnic differences in calcium absorption (15). Additional evidence for a genetic regulation of calcium absorptive efficiency is our finding that a specific polymorphism of vitamin D receptor, the Fok1 genotype, was significantly related to both calcium absorption and bone mineralization in a group of pubertal boys and girls (5, 6).

It is also possible that a significant aspect of this relationship is attributable directly to the larger intestinal surface of taller individuals. This is consistent with the findings that a relationship between calcium absorption and height is present as well in adults (Heaney, R. P., personal communication). However, our dataset of growing children in which absorption is linked to both height and height Z-score, but less so with chronological age, suggest a genetic component as well, at least during growth.

Although it has been known for many years that increased calcium intake, such as by milk drinking (13, 14), is associated with an increase in height, such data were collected mostly on individuals with very low calcium intakes or significant malnutrition. Also, results conflict over the benefits of high calcium intakes and even milk drinking for ultimate bone mass in adolescents (32). Several recent studies have not confirmed a substantial long-term benefit to calcium supplementation for increasing bone mineral density (9, 10, 11, 32). One recent study demonstrated that calcium supplementation above a baseline of 800 mg/d enhanced bone mineral density in girls who were above the average height of the group but not for those who were below the average height (9).

Clearly, an adaptive mechanism of increased calcium absorptive efficiency could be inadequate to meet the needs of very tall individuals or those with a severely deficient calcium intake, especially over a prolonged period of time (22). However, the results of recent controlled trials generally suggest that adequate mineralization of the skeleton does not require very high calcium intake levels during growth (11, 32). The ability to adapt calcium absorptive efficiency to biological needs for calcium is likely part of the reason that more moderate calcium intakes are adequate even during pubertal growth (9, 11, 32). Subjects with underlying health problems such as malabsorptive states may not adapt well, however, and could require higher intakes of calcium and vitamin D.

In summary, using a large database of clinical studies, we demonstrated that height and its age- and gender-normalized Z-score are significant predictors of calcium absorptive efficiency in girls during childhood and early adolescence. These findings further support the concept of genetic regulation of calcium absorptive efficiency, especially in supporting skeletal growth. Ultimately, individual risk profiles based on a variety of factors (e.g. gender, parental height, medical conditions, genetic polymorphisms, and family history of osteoporosis) might be used to establish individual risk analyses by which appropriate monitoring and intervention can be proposed at an early age.

Me: In another article written and posted on PubMed on the website for US National Library of Medicine , National Institute of Health (source HERE).

Calcium supplements in healthy children do not affect weight gain, height, or body composition.

Winzenberg T, Shaw K, Fryer J, Jones G.

Source

Menzies Research Institute, Private Bag 23, Hobart, TAS 7001 Australia. tania.winzenberg@utas.edu.au

Abstract

OBJECTIVE:

Calcium intake is a potential factor influencing weight gain and may reduce body weight, but the evidence for this in children is conflicting. The aim of this study was to use data from randomized controlled trials to determine whether calcium supplementation in healthy children affects weight or body composition.

RESEARCH METHODS AND PROCEDURES:

This study is a systematic review. We identified potential studies by searching the following electronic bibliographic databases: CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, MANTIS, ISI Web of Science, Food Science and Technology Abstracts, and Human Nutrition up until April 1, 2005 and hand-searched relevant conference abstracts. Studies were included if they were placebo-controlled randomized controlled trials of calcium supplementation, with at least 3 months of supplementation, in healthy children and with outcome measures including weight. Meta-analyses were performed using fixed effects models and weighted mean differences for weight and height and standardized mean differences (SMDs) for body composition measures.

RESULTS:

There were no statistically significant effects of calcium supplementation on weight [+0.14 kg; 95% confidence interval (CI), -0.28, +0.57 kg], height (+0.22 cm; 95% CI, -0.30, +0.74 cm), body fat (SMD, +0.04; 95% CI, -0.08, +0.15), or lean mass (SMD, +0.14; 95% CI, -0.03, +0.31).

DISCUSSION:

There is no evidence to support the use of calcium supplementation as a public health intervention to reduce weight gain or body fat in healthy children. Although our results do not rule out an effect of dietary supplementation with dairy products on weight gain or body composition, there is little evidence to support this hypothesis.

Me: This study suggest that taking calcium supplements does not increase or decrease weight, HEIGHT, or other anthropomorphic measurements. 

From another article post on the American Journal of Clinical Nutrition website located HERE

Does a LOW Intake of CALCIUM Retard GROWTH or Conduce to STUNTEDNESS?

  1. A. R. P. WALKER, M.SC., PH.D., Head of Human Biochemistry Unit

Author Affiliations

  1. Human Biochemistry Unit, South African Institute for Medical Research, Johannesburg, and South African Council for Scientific and Industrial Research
  2. *South African Institute for Medical Research, Johannesburg, and the South African Council for Scientific and Industrial Research.

Abstract

It is widely accepted that in humans a low intake of calcium prejudices the rate of attainment of height and makes for ultimate stuntedness. There are, however, so many factors, dietary and non-dietary, which influence growth, that a precise assessment of the particular role of calcium is well nigh impossible.

Children from poor homes, and probably with a relatively low calcium intake, are certainly inferior in height compared with better class children of the same race and country. In addition, usually, though not invariably, indigenous children from tropical and semitropical countries, habituated to a low intake of calcium, are inferior in height compared with Western children. In neither case, however, is there evidence that differences in calcium intake are specifically implicated.

Where calcium supplements have been fed for short periods to children and youths accustomed to intakes of calcium less than the recommended allowances, there appears to be no critical evidence that these additions have specifically produced increments in height beyond such observed in controls.

The conclusion is reached that it has not been established that calcium intake per se is of importance in regulating height. It is suggested that apart from gross undernutrition, the critical intake of calcium below which retardation of growth occurs, lies below the wide range of calcium contents of everyday diets consumed in different parts of the world.

Me: What is very important to note about this article was that it was written in 1954, almost 60 years ago so the information and data may be completely different now.

On the Lifesource 4 Life website HERE

Calcium—Good for Teen Growth and Bone Building

Healthnotes Newswire (December 8, 2005)—Teenage boys can increase their bone-mineral content and their height by taking a calcium supplement, according to the Journal of Clinical Endocrinology and Metabolism (2005;90:3153–61).

Osteoporosis is a major contributor to health problems in older people. The severely low bone density that characterizes osteoporosis increases the risk of fractures, which can lead to immobility and complicated recovery that can even result in death. Osteoporosis prevention has a two-pronged approach: maximizing the bone density at the time in life when it reaches its peak (about 25 years old) and minimizing bone loss in later life. A number of nutrients can influence bone density by stimulating proper use of calcium by the body; however, adequate calcium intake and exercise remain the cornerstones of osteoporosis prevention. Several studies have found that supplementing with calcium before and around the time of puberty can lead to increased bone-mineral density. Little is known about the effects of calcium supplementation in adolescents who are past puberty.


In the current study, 143 healthy boys between the ages of 16 and 18 were randomly assigned to take either a calcium supplement (500 mg twice per day in the form of calcium carbonate) or a placebo for 12 months. Bone-mineral status, height, and weight were measured at the beginning, middle, and end of the study. It was determined at the end of the study that overall compliance was about 59%; in the calcium group, the intake of supplemental calcium averaged 652 mg per day. Measurements taken at the middle and end of the study showed that the amount of mineral in the bones (bone-mineral content) increased significantly more in the boys taking calcium than in the boys not taking calcium; the difference was greater at the end of the study. In addition, the boys taking calcium grew significantly more in height than the boys who did not take calcium. This difference was 7 mm, or about 0.28 inches. Finally, when activity level was considered, the boys with a high activity level had more bone mass and increased their bone-mineral content more than boys with a low activity level.

The results of this study show that calcium supplementation can lead to an increase in bone-mineral content and an increase in growth in height in adolescent boys. They also add to the evidence that exercise is beneficial for bone-building during adolescence. In a previous study, adolescent girls who were past puberty (ages 16 to 18) experienced an increase in bone-mineral density but did not increase in height more than girls who did not take calcium. Whether these changes in bone density will have a lasting impact on bone health later in life in either gender should be a topic of future research. Additional research should also focus on whether the short-term height gain seen in boys taking calcium will result in them being taller once they reach their maximum height.

Me: from this resource and study, it seems to show that boys who take calcium supplements might be able to increase their height a little, the average of around 0.25 inches.

From another study done and posted on the American Journal of Clinical Nutrition website located HERE entitled “Effect of cow milk consumption on longitudinal height gain in children” Published in 2004.

Black et al (1) studied prepubertal children who had a long history of avoiding consumption of cow milk and found that such children tend to have short stature and high adiposity. Blanaru et al (2) confirmed that dietary arachidonic acid alters bone mass in piglets fed cow milk–based formula. We are very interested in their results because in a previous prospective study, we examined the effect of cow milk consumption on longitudinal height gain in children (3).

The subjects were 122 children (60 boys and 62 girls) aged 9.5 ± 0.2 y ( ± SD). Standing height and weight were measured, and relative weight was obtained according to the standard weight for sex, age, and height. Three years later, we recruited the subjects for the second part of the study, which included anthropometric measurements and the questionnaire about cow milk consumption. The question was “How much cow milk do you usually drink a day?” The possible answers were “<250 mL,” “250–500 mL,” “500–1000 mL,” and “>1000 mL.” We investigated the relation between cow milk consumption and longitudinal changes in height, weight, and relative weight.

Ninety-two children (47 boys and 45 girls; 75.4% of the original sample) volunteered to participate in the second series of examinations. There were no significant differences in mean height, weight, or relative weight between the participants and the nonparticipants at the first examination. The participants were divided into 2 subgroups according to cow milk consumption: high consumption (>500 mL/d; 16.5%) and low consumption (<500 mL/d; 83.5%). The 3-y changes in height, weight, and relative weight in the high- and low-consumption groups were 18.8 ± 0.5 and 21.3 ± 1.1 cm, 13.3 ± 0.5 and 13.3 ± 0.8 kg, and −2.6 ± 0.8% and −5.6 ± 2.9%, respectively. The difference between the 2 groups was statistically significant for height (P = 0.042, Mann-Whitney U test) but not for weight or relative weight.

Several previous studies showed an effect of milk on height gain in pubertal children. In 1984 Takahashi (4) reported an acceleration of growth in Japan from the 1950s and suggested the importance of milk consumption. And this increase in height was prominent during puberty. In a cross-sectional study, Jirapinyo et al (5) reported that milk intake and parents’ height contributed to adolescent height in females. Bonjour et al (6) found that prepubertal girls who consumed a diet including calcium-enriched foods grew in height in a randomized, double-blind, placebo-controlled study. In our longitudinal study, the mean height gain in the high-consumption group was higher than that in the low-consumption group, and the difference in height gain between the 2 groups was 2.5 cm/3 y.

Calcium itself has an important role in bone health, and many studies have shown the contribution of cow milk or dairy products to bone mass and bone mineral content. However, cow milk may have other components that promote bone health. Insulin-like growth factor I, which is present in much higher concentrations in cow milk than in human milk, is important for bone mineral accrual on periosteal surfaces. It is relatively stable to both heat and acidic conditions; therefore, it survives the conditions of commercial milk processing (7). Milk whey protein, especially milk basic protein, was reported to promote bone formation and to suppress bone resorption, and daily supplementation with milk basic protein significantly increases bone mineral density independently of dietary intake of minerals and vitamins (8). In addition, Blanaru et al (2) showed that whole-body bone mineral content was elevated in piglets fed arachidonic acid and that liver arachidonic acid was positively related to plasma insulin-like growth factor I and calcitriol. Furthermore, transforming growth factor β2 was also well preserved in human milk after holder pasteurization at 56.5 °C (9). Transforming growth factor β2 inhibits the differentiation of human adipocyte precursor cells and reduces the activity of the lipogenic enzyme glycero-3-phosphate dehydrogenase (10). This may explain why Black et al (1) found a high proportion of obese children among the milk-avoiding children in their study. In our longitudinal study, the change in relative weight in the high-consumption group was lower than that in the low-consumption group. Cow milk may also have some effect on adipose tissue.

In summary, in our prospective study, we observed a height gain in the children who consumed a high amount of cow milk. Milk is regarded as the best nutritional support for neonatal growth and development. In pubertal children, cow milk may also be an important nutrient for growth and for achieving optimal bone mass to prevent osteoporosis in later life. Finally, height gain in children may depend not only on the calcium in cow milk but also on some of its bioactive components.

Me: Lastly, from another study done looking at the relationship between milk consumption and height, from Pubmed entitled “Adolescent height: relationship to exercise, milk intake and parents’ height.” (source HERE)

J Med Assoc Thai. 1997 Oct;80(10):642-6.

Adolescent height: relationship to exercise, milk intake and parents’ height.

Jirapinyo P, Wongarn R, Limsathayourat N, Maneenoy S, Somsa-Ad K, Thinpanom N, Vorasanta P.

Source

Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok.

Abstract

The investigators studied the height of adolescents in the age range of 12 to 18 years from 2 schools in Bangkok. Questionnaires asking their rates of organised exercise per week, of milk intake per day and their parental heights were given to a total of 545 male and 615 female students. The completed questionnaires were analyzed. We could categorize these subjects into 3 groups according to their heights which were Group I (height > 97th%-ile), Group II (height between 50-97th%-ile) and Group III (height < 50th%-ile). Those in Group I had parents, whose height was significantly greater than those of the other groups. There was no difference in organized exercise among the 3 groups. Milk intake of female adolescents from Group I was significantly more than the other groups. It is concluded that parents’ height in both males and females and milk intake in females contribute to a greater adolescent height.

Conclusion: This is my guess on the effect of milk on height and human growth. I hypothesize that the affect of milk does have a correlation to the growth rate and final height of individuals. However,the affect of milk on height is small. I note that the last study was done in Bangkok, which is still a developing nation so there are many cases of malnutrition. Giving still growing female milk will obviously help their nutrition level and increase their overall height. 

Calcium is needed and used by the bones to make the bone matrix stronger. I would guess that the rate of chondrocydal ossification and calcification would be slower in the plate layers if there is not enough calcium absorbed into the body. Since plates have been shown to have a sort of life span to them, the calcium that is not gotten from poor nutrition means potential height that is lost once the growth plates become too thin or weak.. However, I would guess that getting enough of the absorption of Vitamin D and Calium (about 1000 mg/day) into the bones means that the ossification and calcification layer of the growth plates have increased their reaction rate so that the rate limiting area is not there but more likely in the proliferation or hypertrophy layer. There is possibility a threshold or plateau which milk can affect overall height. Once that is reached, drinking any more milk will only make the bones stronger, but not longer. 

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