Calcium + Vitamin D – How Much is Enough?

calcium-rich foodsNutrition information is constantly changing as research evolves; vitamin and mineral recommendations change based on consensus science. In 2010, the Institute of Medicine (IOM) revised its recommendations for calcium and vitamin D. That same year the Dietary Guidelines for Americans were released. These cited calcium, vitamin D, potassium and fiber as nutrients of concern – because they are often under-consumed.

The IOM’s Recommended Dietary Allowance (RDA), the daily dietary intake level of a nutrient considered sufficient to meet the requirements of nearly all healthy individuals, for calcium and vitamin D are shown in the table below.

2010 Calcium and Vitamin D RDA

Age (years)

RDA Calcium (mg/day)

RDA Vitamin D IU/day

1-3

700

600 IU

4 – 8

1,000

600 IU

9 – 18

1,300

600 IU

19 – 50

1,000

600 IU

51 – 70

1,000

600 IU

71 +

1,200

800 IU

 

Vitamin D deficiency—along with rickets and other bone diseases—has been linked to increased risk of cardiovascular disease, diabetes, weight gain, depressed immune function, Alzheimer’s disease and even cancer, although these studies are not conclusive.

What’s the best way to get enough calcium and vitamin D?

what milk offers compared to other foods

There are many food sources of calcium, including milk, cheese and yogurt as well as leafy green vegetables, fish with bones and fortified foods. Consumers need to be educated, however, that it takes a lot of green leafy vegetables to equal a glass of milk! It is the role of the health educator to make sure clients know which foods and how much they need to eat to meet their requirements.

Vitamin D is a little more difficult to get from food, which is why many people wonder if they should take supplements. As with all nutrients, it’s best to get vitamin D from foods, so it’s worth the extra effort to try to drink three daily servings of milk, which is fortified with vitamin D, and eat whole eggs and fish like salmon, tuna, mackerel and sardines, which all contain vitamin D. Some other products like yogurt are also being fortified with vitamin D to help consumers achieve their requirements.

There is a common misconception among consumers that if a little is good, then a lot is better. This, of course, not true and can even be dangerous if people exceed the tolerable upper level (UL), the highest intake that is considered safe. For calcium, the UL is 2,000 - 3,000 milligrams per day, and for vitamin D, it is 4,000 International Units per day. If consumers take vitamins and eat a lot of fortified foods, it is possible to reach and exceed the upper limit, so it is best to advise consumers to read labels and stay near the recommendation.

Because our bodies can synthesize vitamin D in our skin in the presence of ultraviolet light (direct sunlight), we can boost our vitamin D status by spending time in the sun (without sunscreen). Skin damage is still a concern, however, so limit sun exposure to 10 to 30 minutes two times per week during peak sun hours, typically 10 a.m. to 3 p.m. If you are going to stay in the sun longer, be sure to put on some sunscreen or a cover up after your 10 to 30 minutes.

If, like many people, you spend your working days indoors and your outside time does not include lots of sunshine, a vitamin D supplement might be necessary. But supplements should only be a fallback. Because of the balanced ‘package of nutrients’ that food provides, real effort should go into getting vitamin D, calcium and all essential nutrients from food sources. Taking supplements to fulfill all our nutrition needs is akin to reading a travel guide to fulfill all our desires to explore. It’s just not as complete!

For more information, read our white paper on the basis for the recommendations for calcium and vitamin D available on our website. Also, you may download and duplicate for your clients this tip sheet on vitamin D.

In February 2013, the U.S. Preventive Services Task Force issued final recommendations on Vitamin D and Calcium Supplementation to Prevent Fractures. The report lists the potential benefits and harms of using supplements for this purpose. The overall findings were not positive for supplements and support getting nutrients from foods.