The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine

What clinicians need to know

A. Catharine Ross, Jo Ann 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 journalComment/debate

2085 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume96
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Recommended Dietary Allowances
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Vitamin D
Medicine
Calcium
Nutritional Requirements
North America
Health
Population
Dietary Calcium
Skin Neoplasms
Solar System
Ultraviolet Rays
Medical problems
Type 1 Diabetes Mellitus
Causality
Sun
Nutrients
Skin
Bone

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine : What clinicians need to know. / Ross, A. Catharine; Manson, Jo Ann 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 Clinical Endocrinology and Metabolism, Vol. 96, No. 1, 01.2011, p. 53-58.

Research output: Contribution to journalComment/debate

Ross, AC, Manson, JAE, 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 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: What clinicians need to know', Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 1, pp. 53-58. https://doi.org/10.1210/jc.2010-2704
Ross, A. Catharine ; Manson, Jo Ann 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 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine : What clinicians need to know. In: Journal of Clinical Endocrinology and Metabolism. 2011 ; Vol. 96, No. 1. pp. 53-58.
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