To promote strong bones, the Institute of Medicine (IOM) of the National Academies of Sciences recommends the following daily calcium intake:
- Women 51 and older: 1,200 mg
- Men 51 to 70: 1,000 mg
- Men older than 70: 1,200 mg
Older men who have atherosclerosis (when plaque builds up in the arteries) and take calcium supplements need to be cautious, however: Excess calcium deposits may do further harm to already inflamed blood vessels. Postmenopausal women need to be mindful of their daily intake, too: The IOM suggests that those who take supplements may actually be getting too much calcium, putting them at risk for kidney stones.
The IOM recommends the following for daily vitamin D intake:
- Women and men 51 to 70: 600 IU
- Women and men over 70: 800 IU
Your daily calcium intake from food and/or supplements shouldn't exceed 2,000 mg, and your daily vitamin D intake should be no higher than 4,000 IU.
Calcium becomes more difficult to absorb as we age. And getting enough vitamin D from diet alone is especially difficult. But before supplementing, make every attempt to get an adequate amount of calcium and vitamin D from food. You can also get vitamin D from 15 minutes of daily sun exposure without sunscreen.
Michele Bellantoni, M.D., associate professor of medicine and medical director at the Johns Hopkins Bayview Care Center, advises postmenopausal women to consume three servings of calcium a day from food as part of a healthy diet. She suggests cereal with milk or yogurt for breakfast, cottage cheese with fruit for lunch, and skim-milk pudding or frozen yogurt for an evening snack.
"Healthy snack bars, fruit-based smoothies with low-fat yogurt and calcium-fortified orange, cranberry and apple juices are excellent choices, too," she says. "Women who can make this lifestyle change," says Dr. Bellantoni, "don't need to supplement, even on days when they can't get all three servings. But women who can’' change their lifestyles, and who have osteoporosis or osteopenia or a history of fracture in adulthood, should supplement their usual diet with 1,200 mg of calcium daily. I also advise taking vitamin D supplements to obtain normal vitamin D blood levels."
The bottom line
The specific supplement doses the task force studied were too low to protect against osteoporosis. Higher doses may protect against the condition, but there's not enough solid evidence to prove that higher doses aid in prevention, and there may be risk with taking too muchkidney stones and further harm to blood vessels already damaged by atherosclerosis.
Both Drs. Edward Wallach and Bellantoni recommend following the IOM guidelines for the necessary daily intake of calcium and vitamin D and discussing your supplement needs with your primary care provider.
Your doctor may test your blood to look for a calcium or vitamin D deficiency. Also ask your doctor about getting screened for low bone density with a dual-energy x-ray absorptiometry (DEXA) scan if you are a postmenopausal female older than 65 or a male over 70, or if you have any osteoporosis risk factors. And if you're currently taking vitamin D and calcium supplements, don't discontinue them before speaking with your doctor.
Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50