In 1997, the United States Department of Agriculture (USDA) created a new way to look at Recommended Dietary Allowance (RDA) by creating the Dietary Reference Intake (DRI) system. Since that time, the DRIs for essential nutrients have remained the same. They serve as a guide for healthy eating and provide health professionals like Registered Dietitians with a framework for use when meeting with individuals for dietary evaluation and counseling. Governmental agencies use DRIs as reference for things such as nutrition labeling or setting school meal standards.
The IOM (Institutes of Medicine) was asked by the United States and Canadian governments to evaluate scientific data and health outcome research related to calcium and vitamin D. In response, the IOM and their evaluation committee reviewed nearly one thousand published studies and scientific testimonies and issued their report last month. While the IOM report confirmed that most Americans and Canadians select foods and supplements that supply adequate amounts of both calcium and vitamin D, they did issue updated recommendations for vitamin D. To reduce risks of potential harmful effects related to excessive amounts of the nutrients, safe upper level intake recommendations were also shared. So what do these findings mean for you?
During the last decade, there have been many conflicting studies and reports related to additional health benefits that calcium and vitamin D might provide as well as how much is truly needed for health. In reviewing scientific studies and reports, the IOM found varied, inconclusive and unreliable results related to health outcomes for these nutrients. This perhaps means that calcium and vitamin D will not specifically influence cancer, cardiovascular disease, hypertension, metabolic syndrome, or diabetes outcomes. There may not be improved outcomes in physical performance, reduced incidence of preeclampsia or improved reproductive outcomes with an increased intake of these nutrients. More research in these areas may produce different recommendations in the future. However, the IOM did confirm through a strong body of evidence that both vitamin D and calcium are in fact important in promoting bone growth and maintaining bone mass.
Surveys in both the United States and Canada suggest girls between the ages of 9-18 do not consume enough calcium and postmenopausal women taking supplements may be getting too much. Consuming too little calcium during adolescence can limit bone growth and mass while too much later in life can increase risks for kidney stones. Neither situation is ideal for optimal health and well-being.
The previously recommended amount of calcium for male and female adults, ages 19-50, was 1,000 milligrams daily. The amount increased to 1,200 milligrams daily for those over age 51. The new report confirms a continuation of this recommendation (and indicates a need of 1,300 mg for girls age 9-18). It also adds a safe daily upper intake level is 2,500 mg for individuals, ages 19-50, and 2,000 mg for those over the age of 51.
When seeking to boost calcium intake, keep these tips in mind.
Unlike calcium, Vitamin D not only comes from dietary choices but also through skin synthesis as result of sunlight exposure. Since sun exposure and the ability of the body to synthesize it will vary based on many factors, the committee assumed minimal synthesis contribution when establishing vitamin D DRIs. The report outlines new RDA recommendations for vitamin D to be 600 IU for individuals to the age of 70. Since older adults may have more difficulty with synthesis from changing bodies due to aging, people over the age of 71 should aim for 800 IU per day. This is a slight increase from the previous DRI recommendations for vitamin D which were 200 IU for individuals 19-50 years old, 400 IU for those aged 51-70 and 600 IU for those over age 71. They also provided an upper level intake recommendation for safety against any potential kidney or heart damage. Unless specifically advised by a medical provider, individuals should not consume more than 4,000 IU's per day.
Some vitamin D experts question the new recommendations since they are the same for a baby or pregnant woman as for a middle aged man. However, most health professionals and governmental agencies will begin using these new recommendations immediately. Health professionals and Registered Dietitians suggest the new vitamin D requirements may be tough to meet through diet alone. Even milk drinkers like me would struggle to fit six cups a day into their diet to meet the estimated needs from one food source. There is the practice of our grandparents youth before fortification was available that included a tablespoon of cod liver oil (1,360 IU) each day (before considering this approach please talk with your medical provider because of fish oil's vitamin A content and possible toxicity). Since most of us are not interested in taking that route, other strategies are necessary.
Meeting the increased vitamin D recommendations from food alone will require a focused approach. Fortified sources like milk and soy beverages, orange juice, eggs, and cereals, as well as fatty fish like salmon, mackerel, and tuna would need to be regularly included in meal and snack selections. Here are some vitamin D food specifics to help you with your meal planning.
The Bottom Line
Scientists have confirmed that calcium and vitamin D are important for proper bone health. Adults should continue to include adequate dietary sources of calcium to meet estimated daily needs. The IOM has increased the recommended amount of vitamin D necessary to ensure bone health. Use these keys to help you succeed in your quest to meet these new guidelines.
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