In April 2018, the United States Preventive Services Task Force (USPSTF) updated its recommendations on the use of calcium and vitamin D supplements. Based on its findings from the review of the current scientific evidence, it does not recommend calcium doses for osteoporosis or vitamin D supplements in healthy women without vitamin D deficiency. The studies do not show that supplements reduce the risk of fractures.
The USPSTF recommendations are not blanket recommendations for everyone; they say that the evidence presented is not strong enough to suggest that all healthy adults take calcium and vitamin D supplements.
Adults who may need a calcium dose for osteoporosis or vitamin D
Even if an adult gets sufficient calcium from their food, there are situations where calcium may not be adequately absorbed in the body. Vitamin D deficiency is very common in the US, and without sufficient vitamin D, calcium will not be absorbed and benefit the body.
- Adults with intestinal problems like lactose intolerance, Celiac, or Crohn’s disease do not absorb many nutrients efficiently, including calcium, and hence need supplements.
- Women who have premature menopause will experience bone loss and need to be vigilant about their diets, warranting the need for an additional dose of calcium.
- Vegans who do not eat dairy may require help with calcium intake.
- Adults over age 45 who have had a broken bone from a low-impact fall or injury can benefit from supplements whose core component is calcium.
- Adults who have been diagnosed with osteoporosis or low bone density experience difficulty sustaining calcium in their bodies.
What we know about calcium dose for osteoporosis or vitamin D
Calcium and vitamin D are crucial components of good bone health. Calcium is the principal mineral that makes bones strong, and people need enough vitamin D to help get calcium absorbed into the bones. In addition to bone strength, calcium is important for muscle contraction, nerve transmission, and blood clotting.
To meet the current Recommended Dietary Allowance (RDA) of calcium dose for osteoporosis, women ages 18 to 50 and men ages 18 to 70 need 1,000 milligrams (mg) of calcium; this equals two servings of calcium-rich food, like dairy or foods and beverages fortified with calcium. Adults who eat cheese, yogurt, milk, and fortified beverages daily are likely getting sufficient calcium from their food and do not need a supplement. However, it is best to consult an expert on the subject matter.
As we age and hormone levels drop, we need more calcium to make up for the bone loss in the body, leading to the risk of fractures. For women age 50+ and men age 70+, the RDA increases to 1,200 mg daily. This amount equals 2-3 servings of calcium-rich food every day and a balanced diet of fruits and vegetables. Meeting this required calcium dose for osteoporosis can be more challenging in older adults. Only about 30% of women in the US get enough calcium from their diet alone.
Finally, the USPSTF links calcium dose for osteoporosis and vitamin D supplementation to fracture risk reduction. We do not see osteoporosis-related fractures among women until their 50s. The most typical fractures we see in this age group are wrist or upper arm fractures. The average age for hip fractures is 81. Therefore, supplementation at younger ages may be unnecessary.
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