The 2011 Dietary Reference Intakes for Calcium and Vitamin D

What Dietetics Practitioners Need to Know

A. Catharine Ross, Joann E. Manson, Steven A. Abrams, John F. Aloia, Patsy M. Brannon, Steven K. Clinton, Ramon A. Durazo-Arvizu, John Christopher G. Gallagher, Richard L. Gallo, Glenville Jones, Christopher S. Kovacs, Susan T. Mayne, Clifford J. Rosen, Sue A. Shapses

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

The Institute of Medicine Committee to Review Dietary Reference Intakes for Calcium and Vitamin D comprehensively reviewed the evidence for both skeletal and nonskeletal health outcomes and concluded that a causal role of calcium and vitamin D in skeletal health provided the necessary basis for the 2011 Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA) for ages older than 1 year. For nonskeletal outcomes, including cancer, cardiovascular disease, diabetes, infections, and autoimmune disorders, randomized clinical trials were sparse, and evidence was inconsistent, inconclusive as to causality, and insufficient for Dietary Reference Intake (DRI) development. The EAR and RDA for calcium range from 500 to 1,100 and 700 to 1,300 mg daily, respectively, for ages 1 year and older. For vitamin D (assuming minimal sun exposure), the EAR is 400 IU/day for ages older than 1 year and the RDA is 600 IU/day for ages 1 to 70 years and 800 IU/day for 71 years and older, corresponding to serum 25-hydroxyvitamin D (25OHD) levels of 16 ng/mL (40 nmol/L) for EARs and 20 ng/mL (50 nmol/L) or more for RDAs. Prevalence of vitamin D inadequacy in North America has been overestimated based on serum 25OHD levels corresponding to the EAR and RDA. Higher serum 25OHD levels were not consistently associated with greater benefit, and for some outcomes U-shaped associations with risks at both low and high levels were observed. The Tolerable Upper Intake Level for calcium ranges from 1,000 to 3,000 mg daily, based on calcium excretion or kidney stone formation, and from 1,000 to 4,000 IU daily for vitamin D, based on hypercalcemia adjusted for uncertainty resulting from emerging risk relationships. Urgently needed are evidence-based guidelines to interpret serum 25OHD levels relative to vitamin D status and intervention.

Original languageEnglish
Pages (from-to)524-527
Number of pages4
JournalJournal of the American Dietetic Association
Volume111
Issue number4
DOIs
StatePublished - Apr 2011

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Dietary Reference Intakes
Recommended Dietary Allowances
Dietetics
dietetics
vitamin D
Vitamin D
Estimated Average Requirement
Calcium
calcium
Serum
Tolerable Upper Intake Level
renal calculi
Dietary Calcium
hypercalcemia
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Kidney Calculi
randomized clinical trials
Health
Hypercalcemia
Solar System

All Science Journal Classification (ASJC) codes

  • Food Science
  • Nutrition and Dietetics

Cite this

Ross, A. C., Manson, J. E., Abrams, S. A., Aloia, J. F., Brannon, P. M., Clinton, S. K., ... Shapses, S. A. (2011). The 2011 Dietary Reference Intakes for Calcium and Vitamin D: What Dietetics Practitioners Need to Know. Journal of the American Dietetic Association, 111(4), 524-527. https://doi.org/10.1016/j.jada.2011.01.004

The 2011 Dietary Reference Intakes for Calcium and Vitamin D : What Dietetics Practitioners Need to Know. / Ross, A. Catharine; Manson, Joann E.; Abrams, Steven A.; Aloia, John F.; Brannon, Patsy M.; Clinton, Steven K.; Durazo-Arvizu, Ramon A.; Gallagher, John Christopher G.; Gallo, Richard L.; Jones, Glenville; Kovacs, Christopher S.; Mayne, Susan T.; Rosen, Clifford J.; Shapses, Sue A.

In: Journal of the American Dietetic Association, Vol. 111, No. 4, 04.2011, p. 524-527.

Research output: Contribution to journalArticle

Ross, AC, Manson, JE, Abrams, SA, Aloia, JF, Brannon, PM, Clinton, SK, Durazo-Arvizu, RA, Gallagher, JCG, Gallo, RL, Jones, G, Kovacs, CS, Mayne, ST, Rosen, CJ & Shapses, SA 2011, 'The 2011 Dietary Reference Intakes for Calcium and Vitamin D: What Dietetics Practitioners Need to Know', Journal of the American Dietetic Association, vol. 111, no. 4, pp. 524-527. https://doi.org/10.1016/j.jada.2011.01.004
Ross, A. Catharine ; Manson, Joann E. ; Abrams, Steven A. ; Aloia, John F. ; Brannon, Patsy M. ; Clinton, Steven K. ; Durazo-Arvizu, Ramon A. ; Gallagher, John Christopher G. ; Gallo, Richard L. ; Jones, Glenville ; Kovacs, Christopher S. ; Mayne, Susan T. ; Rosen, Clifford J. ; Shapses, Sue A. / The 2011 Dietary Reference Intakes for Calcium and Vitamin D : What Dietetics Practitioners Need to Know. In: Journal of the American Dietetic Association. 2011 ; Vol. 111, No. 4. pp. 524-527.
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