Coral Calcium And Vitamin D

Vitamin D is the most important additional nutrient shown to enhance calcium’s ability to build and maintain bones  The current RDA (Recommended Daily Allowance) for vitamin D is 400 I.U., although the Institute of Medicine has recently issued a report recommending higher levels in those over the age of 50.  Unlike calcium intake which is well below recommended levels in the general population, the great majority of Americans get adequate vitamin D.  We get vitamin D through our diets and by making it in our bodies in response to sunlight.  The housebound elderly are at increased risk for vitamin D deficiency.  Some segments of the general population in certain areas of the country who do not get sufficient sunlight exposure during the winter months are also at risk.

Milk in the United States is generally fortified with vitamin D, as are other foods such as breakfast cereals, because it is known to enhance intestinal absorption of calcium.  Other good sources of vitamin D are fatty fish and cod liver oil, but the most important source is simply sunlight.  And unlike calcium, vitamin D can be stored by the body, in the liver, for extended periods of time.  It does not have to be taken with calcium to provide its enhancing effect.

Many studies on calcium’s effects in building and protecting bone and preventing fractures have shown a benefit from ensuring adequate vitamin D.  Vitamin D stimulates intestinal calcium absorption and enhances the bone building process itself.  In addition, a recent study showed that additional vitamin D increased the short term absorption of calcium even in healthy individuals with no apparent vitamin D deficiency.

The elderly clearly may benefit from supplemental vitamin D.  In elderly individuals unable or unwilling to obtain sufficient exposure to sunlight, vitamin D supplements of 400 to 800 I.U. per day have shown some benefit.  In a review of the literature on calcium and vitamin D in Clinical Endocrinology, Juliet Compston concludes that, "Overall, the results of these studies support the use of vitamin D supplements to reduce the fracture rate in some elderly populations."  She also points out that despite conflicting data on the benefits of supplemental vitamin D, "there is abundant evidence that calcium supplementation has beneficial effects on bone mass, both in children and in adult women."

For most people, obtaining adequate daily calcium is primary. In the 1994 Report of the National Institutes of Health Consensus Development Panel on Optimal Calcium Intake, the principal recommendation is to increase calcium intake among all groups of Americans.  The authors also recommend that all people get adequate vitamin D and that those at risk of deficiency take a supplement.

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