The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know (original) (raw)

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1Department of Nutritional Sciences (A.C.R.), Pennsylvania State University, University Park, Pennsylvania 16802

*Address all correspondence and requests for reprints to: Dr. Catharine Ross, Pennsylvania State University, 110 Chandlee Laboratory, University Park, Pennsylvania 16802.

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2Department of Medicine (J.E.M.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02215

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3Department of Pediatrics (S.A.A.), Baylor College of Medicine, Houston, Texas 77030

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4Department of Medicine (J.F.A.), State University of New York at Stony Brook, Stony Brook, New York 11794

5Winthrop University Hospital (J.F.A.), Mineola, New York 11501

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6Division of Nutritional Sciences (P.M.B), Cornell University, Ithaca, New York 14853

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7Division of Hematology and Oncology (S.K.C.), The Ohio State University, Columbus, Ohio 43210

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8Department of Epidemiology and Preventive Medicine (R.A.D.-A.), Loyola University Stritch School of Medicine, Maywood, Illinois 60153

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9Bone Metabolism Unit (J.C.G.), Creighton University Medical Center, Omaha, Nebraska 68131

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10Department of Medicine (R.L.G.), University of California, San Diego, La Jolla, California 92093

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11Department of Biochemistry (G.J.), Queen’s University, Kingston, Ontario, Canada K7L 3N6

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Received:

16 November 2010

Accepted:

16 November 2010

Published:

01 January 2011

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A. Catharine Ross, JoAnn E. Manson, Steven A. Abrams, John F. Aloia, Patsy M. Brannon, Steven K. Clinton, Ramon A. Durazo-Arvizu, J. Christopher Gallagher, Richard L. Gallo, Glenville Jones, Christopher S. Kovacs, Susan T. Mayne, Clifford J. Rosen, Sue A. Shapses, The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 1, 1 January 2011, Pages 53–58, https://doi.org/10.1210/jc.2010-2704
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This article summarizes the new 2011 report on dietary requirements for calcium and vitamin D from the Institute of Medicine (IOM). An IOM Committee charged with determining the population needs for these nutrients in North America conducted a comprehensive review of the evidence for both skeletal and extraskeletal outcomes. The Committee concluded that available scientific evidence supports a key role of calcium and vitamin D in skeletal health, consistent with a cause-and-effect relationship and providing a sound basis for determination of intake requirements. For extraskeletal outcomes, including cancer, cardiovascular disease, diabetes, and autoimmune disorders, the evidence was inconsistent, inconclusive as to causality, and insufficient to inform nutritional requirements. Randomized clinical trial evidence for extraskeletal outcomes was limited and generally uninformative. Based on bone health, Recommended Dietary Allowances (RDAs; covering requirements of ≥97.5% of the population) for calcium range from 700 to 1300 mg/d for life-stage groups at least 1 yr of age. For vitamin D, RDAs of 600 IU/d for ages 1–70 yr and 800 IU/d for ages 71 yr and older, corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/ml (50 nmol/liter), meet the requirements of at least 97.5% of the population. RDAs for vitamin D were derived based on conditions of minimal sun exposure due to wide variability in vitamin D synthesis from ultraviolet light and the risks of skin cancer. Higher values were not consistently associated with greater benefit, and for some outcomes U-shaped associations were observed, with risks at both low and high levels. The Committee concluded that the prevalence of vitamin D inadequacy in North America has been overestimated. Urgent research and clinical priorities were identified, including reassessment of laboratory ranges for 25-hydroxyvitamin D, to avoid problems of both undertreatment and overtreatment.

Copyright © 2011 by The Endocrine Society

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