What we know
Calcium and vitamin D are crucial components of good bone health. Calcium is the main mineral that strengthens the bones, and people need enough vitamin D to absorb calcium in the bones. In addition to bone strength, calcium is important for muscle contraction, nerve transmission and blood clotting.
To reach the current recommended daily allowance (RDA) for calcium, women 18 to 50 years of age and men 18 to 70 years of age need 1,000 milligrams (mg) of calcium. This is equivalent to two servings of a calcium-rich food, such as dairy products or calcium-enriched foods and drinks. Adults who eat cheese, yogurt, milk and fortified drinks daily are likely to get enough calcium from their diet and do not need a supplement.
As we get older and hormone levels drop, we need more calcium to reduce the bone loss that can lead to risk of fractures. For women 50 years and older and men 70 years and older, the recommended daily dose increases to 1,200 mg daily. This amount corresponds to 2-3 servings of a calcium-rich food per day and a balanced diet with fruits and vegetables. Meeting these calcium needs can be a bigger challenge in older adults.
Only about 30% of women in the US get enough calcium from their diet alone.
Finally, the USPSTF combines calcium and vitamin D supplementation with a reduction in the risk of fractures. In general, we do not see fractures due to osteoporosis in women until the age of 50. The most typical fractures we see in this age group are wrist or upper arm fractures. The average age for hip fractures is 81 years. Therefore, supplementation may not be necessary in younger years.
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