Does cow’s milk make weak bones?

Sun Sentinel Broward Edition - - Movies - Write to Dr. Roach at [email protected] med.cor­nell.edu or mail to 628 Vir­ginia Dr., Or­lando, FL 32803.

Dear Dr. Roach: I read that cow’s milk weak­ens the bones. Is that true? — A.H.

The pre­pon­der­ance of the ev­i­dence is that dairy in­take in­creases bone strength and re­duces frac­ture risk. How­ever, there is not the high­est level of ev­i­dence to sup­port this. In ab­sence of in­ter­ven­tional data (where one group is given cow’s milk and the other given some­thing else), we have to rely on other kinds of ev­i­dence, all of which have some po­ten­tial for bias. Some of these have shown ben­e­fit from drink­ing cow’s milk; oth­ers have not. A 2018 study from the U.S. es­ti­mated a 6 to 8 per­cent re­duc­tion in frac­ture risk from con­sum­ing cheese or milk daily. Reg­u­lar ex­er­cise is an­other way to re­duce risk of os­teo­poro­sis and frac­tures. Un­for­tu­nately, some peo­ple will still be at risk for frac­tures de­spite an ex­cel­lent diet and reg­u­lar ex­er­cise, so those at high risk should be screened, and may re­quire med­i­ca­tion. You can re­duce your chances of need­ing med­i­ca­tion through a good life­style, prefer­ably be­gin­ning in young adult­hood.

Dear Dr. Roach: I am an 89-year-old widow try­ing to stay in my home. Six months ago, I had a bad fall. A neu­rol­o­gist said I had two or three aneurysms in my head but treat­ment might cause more harm than good. Now home, my pri­mary doc­tor is try­ing to help my anx­i­ety. He gave me Zoloft but I got de­pressed. He wants to try Ef­fexor, but the in­struc­tion sheet men­tioned that bleed­ing might oc­cur. — J.M.G.

Ven­lafax­ine (Ef­fexor) has been shown to in­crease the risk of bleed­ing, with only a slight risk for most peo­ple. How­ever, bleed­ing from a brain aneurism is very dan­ger­ous, so I think I would avoid that par­tic­u­lar drug. There are al­ter­na­tives that don’t have that risk. Even if the risk is slight, wor­ry­ing about a drug’s pos­si­ble side ef­fects isn’t go­ing to make your anx­i­ety bet­ter.

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