It doesn’t pay to be a Skinny Lizzie
The Duchess has shone a light on what fad diets really do to our bones, says Maria Lally
Two years ago, Karen Dowers, then 37, was taking part in a triathlon when she fell off her bike. “It wasn’t a particularly bad fall, but the pain was excruciating,” says Karen, a biologist at the University of Dundee. “I cycled another hundred yards, but when I got off my bike, I couldn’t stand and realised something was badly wrong.”
Karen had broken her leg, was diagnosed with osteoporosis – and told she had the bones of a 75-year-old.
“The doctors asked if I’d broken anything before and I told them I’d recently slipped on some ice and broken my elbow and several ribs, which concerned them. My paternal grandmother had osteoporosis, and I know there’s a genetic link. But in my case, diet played a huge part.”
Karen, now 39, admits she had an unhealthy relationship with food in her teens and 20s. “When I was 13, I started eating less and making myself sick when I got to school. I was never drastically skinny – I didn’t want my parents to know anything was wrong – but I was a very controlled eater. I was a nervous child, I got picked on, and any big event sent my stress levels through the roof. I was also obsessed with how I looked, with quite bad body insecurities. Controlling what I ate helped me control my anxieties.”
At 16, Karen went to Singapore and picked up a stomach bug that led to IBS (irritable bowel syndrome). “A nutritionist suggested cutting out dairy. There weren’t many milk alternatives back then, and I was a student so I didn’t listen to the advice about getting calcium from other sources. Plus, I was still cautious of my weight, so I was happy to cut something out. I was also drinking quite a bit, which I now know is bad for bone health.”
By her 30s, her eating issues had resolved and Karen regularly took part in fun runs and triathlons. “When I was training for the triathlon I thought I had shin splints, but the doctor who diagnosed me said it was, in fact, a hairline fracture, so the break was waiting to happen. I was 37 and my bone score should have been zero; anything less than minus 2.5 is osteoporosis.
My score was minus 3.1.”
In the last two years, Karen has been put on calcium and vitamin D tablets, collagen supplements, reduced her alcohol intake and eats plenty of non-dairy calcium alternatives, and has reversed her condition to osteopenia, a slightly less serious precursor to osteoporosis. “Young women like me are taught to think about their hearts and breast cancer risk, but not their bones. I hate to think of the damage I did to mine through faddy eating.”
This week, the Duchess of Cornwall also took aim at “ridiculous dieting” and “cutting out dairy”, at a reception for the Royal Osteoporosis Society (ROS). “These girls see ‘Skinny Lizzies’ in a magazine and they all want to be thin. It’s about social media, too,” said the Duchess, whose mother, Rosalind Shand, died from osteoporosis in 1994 when she was just 71 – the same age as Camilla is now. Her maternal grandmother, Sonia Keppel, had also died of the condition eight years earlier.
“Part of the problem now is the wartime generation who didn’t have milk and butter because of rationing, so in their teenage years they deprived their bodies of calcium,” said the Duchess. “But that wasn’t by choice. Teenagers have the choice now, and still seem to be depriving their bodies. It’s the fad diets, they are the worst thing to do.” The ROS says 3.3million people in the UK over the age of 50 have been diagnosed with the disease – however, the number of sufferers in their teens, 20s and 30s is increasing. Which is no surprise, given a recent study that found 20 per cent of 18- to 35-yearolds have severely restricted their intake of dairy in the last few years. Like Camilla, some experts point the finger of blame at the superfood stars of social media, many of whom claim giving up dairy has helped them lose weight. There are currently 8.5million (and counting) dairyfree hashtags on Instagram. But it’s not just impressionable teenagers cutting out dairy in droves. In 2017, Samantha Cameron said: “I’ve been on a no wheat, no sugar, no dairy products, no alcohol diet. Dave [her husband and former prime minister] gave up on the diet on day three, but I have stuck it out all the way through January.” Victoria Beckham also avoids dairy, and Gwyneth Paltrow’s chef has revealed the star avoids “any sugars, anything sweet, no dairy”.
So when did dairy – a one-time health staple, alongside vegetables and protein – get tarred with the same brush as alcohol and sugar? “A lot of young women now get their health advice from Instagram, which has developed a fairly insidious anti-dairy message in the last few years,” says dietitian Helen Bond. “Subtle hashtags like dairyfree and milkalternatives are scattered around glossy-looking posts, and the move towards plantbased eating and veganism has exacerbated things. Then there are the ethical concerns over the dairy industry, which are understandably turning people off.
“However, if you’re going to cut out dairy, you need to ensure you’re getting calcium elsewhere via oily fish, vitamin D and iron-rich foods, dark green vegetables, dried fruits and milk alternatives like soya or hazelnut. And if you don’t need to cut out dairy for health or ethical reasons, then do dairy better with full fat, organic milk, unsweetened Greek yogurt, good quality cheese and organic butter.”
Helen says if things don’t improve, there will be “a generation of young girls and women who aren’t storing enough calcium to see them through to old age. You need to ‘bank a lot of bone’ in your teens and 20s. It’s too late to turn 60 and decide to improve your bone health. Osteoporosis is often described as a ‘silent epidemic’ because it only shows itself when much of the damage has been done.”
Karen says she “absolutely agrees” with the Duchess. “I talk to everybody I know about this, particularly friends with children, to raise awareness.”
Of young women’s attitudes to dairy, Camilla said: “You feel like you are invincible, and it’s about what you look like. Food becomes about what your figure is like, not what it is doing for your body.”
She said that watching their grandmother die caused her own children, Tom and Laura, to become aware of bone health from a young age: “Suddenly, they saw this tiny woman stooped in agony. It is something they will remember for the rest of their lives. But people who haven’t seen their parents or grandparents like that will think: ‘We’re never going to get that.’ It’s the immediacy of youth.”