“You are what you eat” has been an popular aphorism in the many branches of medicine in which nutritional aberrations are suspected to have a role in disease. In the pathophysiology of osteoporosis the nutritional questions have always centred on calcium. The importance of osteoporosis is clear, with the current epidemic of hip fractures increasing as populations worldwide gradually age: the global load of hip fracture is expected to treble to over six million cases a year by 2050.1

In this week's journal Sean Murphy and colleagues confirm the benefit of a high calcium intake (as milk) on bone mineral density (p 939).2 In a community based survey of older women (aged 44-74) they found their milk consumption before the age of 25 correlated positively with current bone mineral density. This relation persisted after numerous potential confounding factors were controlled for statistically. A similar, but weaker, association was found between calcium intake during adulthood and bone mass.

Although peak bone mass is primarily under genetic control, it seems logical that to achieve adequate skeletal maturation during growth requires a plentiful supply of the building blocks of the …