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Calcium and Vitamin D – You Probably Aren’t Getting Enough
Most people don’t realize that the consequences of osteoporosis fractures cause more deaths each year in Canada than the combined mortality rate for breast and ovarian cancers. The real tragedy is that osteoporosis is a preventable disease, which requires optimal intake of calcium and vitamin D. During the past 10-15 years studies have shown that calcium supplementation can reduce bone loss in postmenopausal women and that the combination of calcium and vitamin D supplementation could significantly reduce fracture occurrence in elderly women. However, there has been much debate as to how much calcium and vitamin D to ingest to derive maximum protection against osteoporosis and related fractures.
A recent study by MF Hitz, JB Jenson and P Eskildsen has shed significant light on this issue. Their double-blind, placebo controlled study (published in the American Journal of Clinical Nutrition -July 2007) involved 122 subjects, over 50 years of age (84% were postmenopausal women), who had sustained a low energy fracture of the hip or upper extremity. These subjects were randomly assigned to ingest 1550 mg of elemental calcium plus 1400 IU of vitamin D or a placebo (containing 200 IU of vitamin D). After 12 months the group receiving the calcium and vitamin D supplements showed reduced bone turnover, and had significantly increased their bone mineral density (primarily in the low back), with the most physically active individuals showing the best overall results. In contrast, subjects in the placebo group showed a further loss of bone density, including those who were physically active.
Based on these results as well as previous studies, I strongly recommend that adults ingest 1500 mg of calcium and 1200-1400 IU of vitamin D per day from food and supplements. These levels of intake not only guard against osteoporosis, but are also associated with a decreased risk of breast, prostate and colon cancer, as well a multiple sclerosis. Vitamin D primarily reduces risk of multiple sclerosis as well as these cancers, with the exception of colon cancer, whereby both vitamin D and calcium have shown protective effects.
As most adults consume only 500 mg per day of calcium from food, on average, and ingest very little vitamin D overall, most individuals would benefit from 1,000 mg of calcium and 1200-1400 IU of vitamin D supplementation on a daily basis. Some exceptions include individuals with hyperparathyroidism, sarcoidosis, and organ transplant patients.