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IOM report sets new dietary intake levels of calcium, vitamin D
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Daily recommendations for calcium are based on age and range, but a new report said 700 mg to 1,000 mg is sufficient for young children and that adolescents do not require more than 1,300 mg.
According to a new report from the Institute of Medicine (IOM), most Americans and Canadians receive sufficient vitamin D and calcium, but some adolescent girls may not get enough calcium.
“There is abundant science to confidently state how much vitamin D and calcium people need,” IOM committee chair Catharine Ross, PhD, said in a press release. “We scrutinized the evidence, looking for indications of beneficial effects at all levels of intake. Amounts higher than those specified in this report are not necessary to maintain bone health.”
Data show that calcium and vitamin D play key roles in bone health. The current evidence, however, does not support other benefits of the two nutrients.
The committee concluded that daily calcium of 700 mg is sufficient for children aged 1 to 3 years; 1,000 mg is sufficient for children aged 4 to 8 years; and no more than 1,300 mg is sufficient for adolescents aged 9 to 18 years.
Daily requirements
Upper intake levels represent the upper safe boundary and should not be misunderstood as amounts people need or should strive to consume, the committee said. The upper intake levels for vitamin D are 2,500 IU per day for children aged 1 to 3 years; 3,000 IU daily for children 4 to 8 years; and 4,000 IU daily for all others. The upper intake levels for calcium are 2,500 mg per day from age 1 to 8 years; 3,000 mg daily from age 9 to 18 years; 2,500 mg daily from age 19 to 50 years; and 2,000 mg per day for all other age groups.
“While it is too early to make definitive statements about the risks associated with routine high doses of vitamin D and calcium, people don’t need more than the amounts established in this report,” Ross, professor and Dorothy Foehr Huck Chair of the department of nutritional sciences at Pennsylvania State University, said in the release. “Past cases such as hormone replacement therapy and high doses of beta carotene remind us that some therapies that seemed to show promise for treating or preventing health problems, ultimately, did not work out and even caused harm. This is why it is appropriate to approach emerging evidence about an intervention cautiously, but with an open mind.”
Measuring vitamin D deficiency
The measurements of sufficiency and deficiency that clinical laboratories use to report test results have not been based on rigorous scientific studies and are not standardized, the committee stated. This lack of standardization may result in an overestimation of the number of people with vitamin D deficiency because many labs appear to use cut points that are higher than the evidence indicates as appropriate. For example, some labs report vitamin D deficiency as blood levels less than 30 ng/mL.
Based on available data, almost all individuals get sufficient vitamin D when their blood levels are at least 20 ng/mL in the United States or 50 nmol/L in Canada, the committee stated.
Basis for the recommendations
Because of conflicting messages about the benefits of calcium and vitamin D, the US and Canadian governments asked the IOM to assess the current data on health outcomes associated with the two nutrients.
The new dietary reference intakes are based on much more information and higher-quality study results than were available when the intakes for these nutrients were first set in 1997. At that time, limitations in the evidence resulted in take levels called “adequate intakes,” which are rougher estimates of people’s requirements than the new values.
The recommendations in the report take into account nearly 1,000 published articles, as well as testimony from scientists and stakeholders. A large amount of evidence, which formed the basis of the new intake values, confirms the roles of calcium and vitamin D in promoting skeletal health and maintenance and the amounts needed to avoid poor bone health. The committee that wrote the report also reviewed hundreds of studies and reports on other possible health effects of vitamin D, such as protection against diabetes, cancer, heart disease and autoimmune diseases.
For more information, visit www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx.
Disclosures: Ross is a founding director and equity holder in Diurnal Ltd. which is developing new hydrocortisone preparations for patients with congenital adrenal hyperplasia. Dr. Speiser has no direct financial interest in any of the products mentioned in this article nor is she a paid consultant for any companies mentioned.