Wednesday, February 13, 2008

How Much Calcium Is Enough? Are Current Recommendations Too High?

Scientists from the National Institutes of Science and renowned universities debated the merits of the current recommendations for calcium intake. Are these levels prudent or excessive?

Calcium is the nutrient most important for attaining peak bone mass and for preventing and treating osteoporosis; although vitamin D, which helps the body absorb the calcium is also important. The attention regarding the prevention of osteoporosis seems to be directed at older women, but it is even more important for children and adolescents to get adequate calcium. It is during these early years that bone mass is significantly accumulated. In fact, 90% of your bone mass is built before age 20, and thereafter, slowly declines with age.

The controversy revolves around the current scientific database. In 1997 the Food and Nutrition Board of the Institute of Medicine issued new, higher intake recommendations for calcium and vitamin D, especially in adults over the age of 50. Currently those recommendations are 1300 mg/day if you are between 9 and 18 years old, 1000 mg/day between 19 and 50 years old, and 1200 mg/day for those 51 and older. In 2001 the National Institutes of Health (NIH) developed a consensus that randomized clinical trials had demonstrated that adequate calcium intake from diet or supplements increased bone mineral density, and that combined treatment with vitamin D and calcium reduced the incidence of hip and other fractures.

Recent large, well-done studies have questioned the ability of calcium intake to prevent hip fractures or falls. These studies did not achieve statistical significance among groups, primarily because the population did not take their calcium regularly over the many years of the study. The ultimate lession from the study should not be to question the benefits of calcium, but to highlight the need to take the product regularly.

We know from a massive government study on dietary intake that less than 10 percent of teenage girls get the amount of calcium they need to build optimal bone mass. Less than 10 percent of adults over 50 consume the amount of calcium they need to slow bone loss during aging. Although more than 10 million Americans over the age of 50 have osteoporosis, almost half of American women over 50 have undiagnosed low bone mineral density.

It seems that the prudent thing to do is not to debate the theoretical 'optimal' levels of calcium and vitamin D intake, but to ardently work to get people to take the supplemental calcium they need. Almost all of the studies in adults showed that increasing calcium intake reduced or stopped age-related bone loss, reduced the rate of bone fractures, or both. Our job should be to encourage the daily intake of those vitamins and minerals that can easily help to prevent the serious public health crisis we are facing.

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