Bess Dawson-Hughes, senior scientist and endocrinologist at Tufts, advises that older adults reassess calcium and vitamin D intakes because both nutrients affect bone strength, muscle function and fall risk. During the menopause transition women lose about 3% of bone mass annually and continue to lose around 1% a year thereafter; men begin losing bone at roughly 1% per year from about age 50. Hip fractures increase markedly as people move from their 70s into their 80s.
Evidence from randomized trials is mixed. People who were vitamin D deficient experienced fewer falls with supplements, but as trial doses rose the benefits levelled off and then declined. Older adults with high blood levels of 25-hydroxyvitamin D had higher risks of falls and fractures. Very high calcium intake can raise the risk of kidney stones. Vitamin D may also influence the immune system, respiratory infections and diabetes risk, but more research is needed to guide clinical use.
The Food and Nutrition Board of the National Academies sets specific targets: calcium 1,200 mg daily for women 51 and older and for men 71 and older, and 1,000 mg for men 51–70; vitamin D 15 mcg for ages 51–70 and 20 mcg for those over 70. In practice, dairy products such as milk, cheese or yogurt are the main calcium sources in American diets. If an older adult does not consume two servings of dairy each day, a 500-milligram calcium supplement is a reasonable choice. For vitamin D, sunlight is important: between October and March in Massachusetts the skin does not make vitamin D, so older adults may benefit from about 800–1,000 IU daily during those months and at other times if they are not outdoors enough to tan.
Source: Tufts.
Difficult words
- reassess — check again and change if necessary
- menopause — time when a woman's menstrual cycles stop
- randomize — to assign people by chance in a trialrandomized
- deficient — not having enough of something needed
- 25-hydroxyvitamin D — the blood form of vitamin D measured
- intake — amount of a substance that is consumedintakes
- supplement — a product taken to add missing nutrientssupplements
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Discussion questions
- How could taking too much vitamin D affect an older adult's risk of falls or fractures? Explain using the article.
- What are the advantages and disadvantages of getting calcium mainly from dairy products versus taking a calcium supplement?
- Based on the article, when and why should an older adult consider taking a vitamin D supplement?
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