You're at risk of having weaker bones

Almost 90 per cent of the UAE's population either has Vitamin D deficiency or insufficiency, which could caused dipped levels of calcium leading to weaker bones.

With these low Vitamin D levels, the next question is whether the population has sufficient calcium levels, given the link between vitamin D in the body and calcium absorption. 

According to Dr Micheal Hollick, an endocrinologist and professor of medicine, physiology and biophysics and director of the Bone Health Care Clinic and the Heliotherapy, Light, and Skin Research Centre, director of the Vitamin D Skin and Bone Laboratory at Boston University Medical Center, populations that have Vitamin D deficiency are at a high risk of having calcium deficiency as well. 

"Almost 90 per cent of the UAE's population either has Vitamin D deficiency or insufficiency, which means the level of calcium absorbed by the body will be poor. Vitamin D first goes to your body and gets activated and the active form helps increase the absorption of calcium. So, the two step approach is to firstly take steps to increase your Vitamin D levels and secondly to consume sufficient calcium," he said.

He said that it was particularly important for teenagers. "Teenagers really need calcium, 50 per cent of the calcium in our body is generated in the teenage years and teenagers require up to 1,300 milligrammes per day. A glass of milk with eight ounces contains 300 milligrammes, so 3-4 glasses of milk per day is an ideal source of calcium. For younger children, it can be 2-3 glasses per day," Dr Hollick said. 

"Even adults need to sustain their calcium absorption. The amount of calcium is your bones is maximum by the age of 30, but it does not mean you do not need any more calcium," he added. 

The Institute of Medicine recommends 1,000 milligrams a day and if you are over 50, then its 1,200 milligrams per day.

Milk is a very good source of whey protein, since it alkalinises the body just like a plant diet and is a good source of calcium. "People should have three servings of dairy per day, and it can be yogurt, milk or cheese."

For vegans who have made a lifestyle choice to avoid dairy, a cup of broccoli with 100 milligrams and a cup of kale with 100 milligrams are good options. "You cannot get any calcium by eating spinach, because the oxalate in spinach irreversibly binds calcium and increases the risk of kidney stone. So for vegans, it's not ideal to have calcium tablets but it's okay because they need to keep their calcium levels up." 

Stephanie Karl, a nutritionist in Dubai, said: "Dairy is a fantastic food group if you are able to digest and absorb it for its wonderful range of nutrients. I think it is the 'go to' food group and for a number of reasons. Milk is the starting product and it can be sweetened and thickened like in sauces and ice cream; it can be split by acid or enzymes into curds and whey; it can be isolated into specific proteins and also have the lactose sugar removed; and it can have the fat removed to make yet another great product." 

The downside is that some ethnic groups cannot tolerate some of these fragments of milk due to their historical adaptation. In the Mediterranean, Middle East and Asia, where milk could not be stored for long before the days of refrigeration, it was quickly converted to curd and was consumed in such low lactose forms. "Their genetics adapted to stop producing lactase, the digestive enzyme that breaks down lactose and this is probably why so many people are lactose intolerant, but can take curd and cheese," she said.

In colder regions of the world, all parts of milk are better tolerated and that is because it stayed around for longer, especially in the winter months. There is less dairy intolerance in these areas.

"I recommend anyone with hormone issues such as PCOS, and acne go completely dairy free to see if it reduces testosterone. Anyone who has tested positive to lactose intolerance through IgG or allergy IgE should go dairy-free. It is recommended that children with autism spectrum go dairy free, because 90 per cent of them have high intestinal yeast and a compromised digestive system," she said.

"If the gut lining is letting dairy proteins through into the system, it can have a very disruptive effect on behaviour and anxiety. However, unless there is a reason to eliminate any form of dairy, I would not take it out of the diet." 

Dr Hollick added: "Bone density tests can be done once, and if it is normal, it can be repeated every two to four years. If it is abnormal, in a year or two it should be redone and if the person is still losing bone density, then interventional strategies need to be adopted."

"The pounding (from walking) on the pavement actually helps maintain bone density of the hip and spine and also improves muscle function, so that elders are less likely to fall and less likely to have fractures," he added.