Although cow milk has been widely recommended in Western countries as necessary for growth and bone health, evidence collected during the past 20 y shows the need to rethink strategies for building and maintaining strong bones. Osteoporotic bone fracture rates are highest in countries that consume the most dairy, calcium, and animal protein. Most studies of fracture risk provide little or no evidence that milk or other dairy products benefit bone. Accumulating evidence shows that consuming milk or dairy products may contribute to the risk of prostate and ovarian cancers, autoimmune diseases, and some childhood ailments. Because milk is not necessary for humans after weaning and the nutrients it contains are readily available in foods without animal protein, saturated fat, and cholesterol, vegetarians may have healthier outcomes for chronic disease if they limit or avoid milk and other dairy products. Bones are better served by attending to calcium balance and focusing efforts on increasing fruit and vegetable intakes, limiting animal protein, exercising regularly, getting adequate sunshine or supplemental vitamin D, and getting approximately 500 mg Ca/d from plant sources. Therefore, dairy products should not be recommended in a healthy vegetarian diet.
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