Is there anything more American than milk and apple pie? Maybe the apple pie contains too many calories, but milk, particularly 2 percent or fat free is the perfect drink. High in the best quality protein, rich in vitamins and not too many calories. It also contains 300 mg of calcium per glass. In almost every developed country, two to three glasses of milk are recommended daily. In young children, high milk intake promotes growth, assuring maximum height potential. After the World War II, milk, in significant amount, was introduced to the Japanese diet. Almost immediately the average height of children increased. Today the Japanese are much taller than they were. 

Not only does milk promote optimal growth, but research published in the Journal Science in 2009 showed that increased milk consumption reduced risk of deaths from heart disease, stroke and cancer. Milk is also a good source of Vitamin D that helps build bone.

Some recommend against too much milk. A famous epidemiologist suggests that high milk consumption may not reduce fractures in older people. 

And now comes a really alarming study. Before I start, however, always understand that what is considered best evidence of the pros and cons of any nutrient or therapy can change quickly with new information. In health care always take surprising data with a grain of salt.

In a study published in the British Journal of Medicine, researchers in Sweden followed 61,000 women and 45,000 men for 20 years and found that there was no reduction in risk of fractures in those who consumed three or more glasses of milk daily. Moreover, in women, the risk of fracture was higher and they were twice as likely to die younger than those who did not consume milk. The effects were less serious in men with risk of early death in milk drinkers increasing by only 10 percent.

As yet the link between early death and milk is unclear. Some suggest that D. Galactose, found in high concentrations in milk, accounts for the adverse effect. This sugar is supposed to induce inflammation and act as an oxidant contributing to cell damage. 

The study does suggest that neither cheese nor yogurt shortens life expectancy, although this cannot be stated with certainty. There is also no information if fat content or the way the milk is produced affects life expectancy.

While there may be many nutritional benefits of milk, the most important indication for more milk consumption is to assure adequate calcium intake in order to help prevent osteoporosis that afflicts millions of older people. Osteoporosis leads to severe bone thinning that is the most important risk factor for fractures.

So why not stop drinking milk and take calcium supplements? But not so fast. Numerous recent studies have shown that taking 1000 mg of calcium daily as supplements significantly increases the risk of heart attack, stroke and other vascular disease in men. And newer studies indicate that heart and vascular disease risk is also increased in women.

It seems as if we are caught between a rock and a hard place. Osteoporosis is a worldwide epidemic in both men and in women. Once present, the risk of fractures that cause severe disability and early death is a major health threat. The answer is to assure lifelong strong bones by consuming adequate calcium intake from a young age, to eat healthy and to exercise in order to build muscle and bone. 

Based on all the confusion surrounding calcium and milk, here are my suggestions. Throughout life consume adequate calcium but do not consume more than one glass of milk daily. Consider adding a cup of yogurt or an ounce of cheese.  A healthy prudent diet plus limited dairy products will provide all your calcium needs. If you do not consume any dairy products, do not take more than a single 500 mg calcium supplement daily.

We must also avoid the high risk of Vitamin D deficiency that affects a large segment of the population over the age of 50. At this age, Vitamin D levels should be measured and replaced with a supplement to assure normal values.

Life is always about moderation. Too much of a good thing may be too much. Prudence seems to be the key to living long and aging well.

Dr. David Lipschitz is the director of the Dr. David Health and Wellness Center in Little Rock. To find out more about Dr. David Lipschitz, visit www.drdavidhealth.com