The good news for African Americans is they are at lower risk for osteoporosis and fragility fractures than Caucasians, largely due to genetics. So if this is the case, you may have been asked, whether African Americans benefit from the same amount of dairy foods and calcium recommended for the general U.S. population. We have come to understand that while African Americans can benefit from the nutrients in dairy foods (milk, cheese and yogurt) for bone health -- low consumption of dairy-related nutrients are associated with certain chronic diseases that disproportionately affect African Americans.
Starting with bone health, here’s what we know. African American adults have approximately 10-15 percent higher bone mass throughout life than other populations and African American adolescents absorb and retain the calcium they eat more efficiently than Caucasians. Even so, osteoporosis and bone fracture is still a significant health problem for African Americans. Approximately forty percent of African American women over age 50 have osteoporosis or low bone mass.
According to the National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center, the misperception that osteoporosis is only a concern for Caucasian women can delay management or implementation of lifestyle changes that could help improve bone health over the lifespan. Recommendations to reduce the risk of osteoporosis are the same for everyone and include living a healthy lifestyle, exercising regularly and eating a well-balanced meal plan adequate in calcium and vitamin D. However, the average calcium consumption among African Americans is lower than recommended and many have insufficient vitamin D status, too.
Eating dairy foods and dairy-related nutrients, such as calcium and vitamin D, are also important to help African Americans maintain overall health. Interestingly, as a National Medical Association/National Hispanic Medical Association Consensus Statement points out, some of the same physiological mechanisms that allow African Americans to adapt to low calcium consumption without compromising bone health may lead to high blood pressure and metabolic syndrome. In fact, African Americans have the highest rates of blood pressure in the U.S, putting them at risk for cardiovascular disease and stroke.
The benefit of a meal plan adequate in dairy foods and calcium was demonstrated in the Dietary Approaches to Stop Hypertension (DASH) trial, in which African American participants experienced approximately twice the reduction in systolic blood pressure as Caucasian participants. According to a review on this subject by the late Robert Heaney, “the current adequate intake for calcium may well be correct for blacks, even though it is more than they need for skeletal health.”
Self-reported lactose intolerance is a primary reason why African Americans may limit or avoid dairy foods. A Consensus Statement by the National Medical Association and the National Hispanic Medical Association states that avoiding dairy foods due to a perceived or actual lactose intolerance may lead to shortfalls of essential nutrients and increased susceptibility to chronic disease. If lactose intolerance is suspected, the report recommends objective testing by a physician and suggests strategies for keeping dairy foods in the diet, such as drinking lactose-free milk, eating yogurt with live and active cultures and natural cheeses.
As you work with clients, and talk to family and friends, let them know that recommended amounts of dairy foods and calcium can help support bone health and help maintain health for everyone, including African Americans.