As we age, getting enough—but not too much—of these essential nutrients will help us avoid falls and fractures, says a bone expert.
Bess Dawson-Hughes, an expert at the Jean Mayer USDA Human Nutrition Research Center on Aging and the Tufts University School of Medicine, says: As we enter our 50s, it’s time to reassess our intake of calcium, which helps mitigate bone loss, and vitamin D, which helps us absorb calcium.
That’s because women lose about 3% of their bone mass each year during the menopause transition and over about 5 years following the last menstrual period, as their estrogen levels decline. After this time, women’s bone loss continues at about 1% a year. Starting at around age 50, men lose bone at a steady rate of 1% per year.
This bone loss weakens the bones, making them more likely to fracture if we fall. Without enough vitamin D, muscle strength and balance diminish, increasing our risk of falling. For these reasons, hip fractures, which are particularly dangerous, jump dramatically as people move from their 70s into their 80s.
But more and more calcium and vitamin D is not better and better, particularly in older people. If your calcium intake gets too high, you’re set up for kidney stones.
And there’s evidence of mixed effects of vitamin D in older adults. In clinical trials, falls declined in deficient people who received D supplements. But as the dosage in the trials increased, the benefits plateaued—and then began to decline. Older adults with high blood levels of 25-hydroxyvitamin D, the commonly used indicator of vitamin D status, had increased risk of falls and fractures.
Vitamin D appears to have effects on other body systems, including the immune system, respiratory infections, and diabetes risk, but additional research is needed to translate these findings into clinical practice.
According to the Food and Nutrition Board of the National Academies of Sciences, Engineering, and Medicine, the recommended daily allowance of calcium for woman 51 and older and men 71 and older is 1,200 mg, while men 51-70 need 1,000 mg. For vitamin D, it’s 15 mcg for those 51-70, and 20 mcg for those over 70.
So how can older adults make sure they’re meeting these recommendations in their daily lives?
Calcium: Dairy products are the overwhelmingly dominant source of calcium in American diets. That includes milk, cheese, or yogurt. If you’re not getting two servings of dairy each day, then you’re probably not getting enough calcium. If that’s the case, it’s wise to take a 500-milligram calcium supplement each day. If you do eat enough dairy, there is no need to supplement.
Vitamin D: The strongest evidence for vitamin D is bone health, and recommendations are made with that in mind.
If you spend the winter in Florida on the golf course, you probably don’t need to take a vitamin D supplement; down south, ample sunlight triggers vitamin D synthesis in the skin. So if you have light skin and you’re getting a tan, you can probably skip the supplements until your tan starts to fade.
Here in Massachusetts, between October and March, our skin doesn’t make vitamin D because we’re too far north, and the angle of sun is too wide at that time of year. So for five months out of the year, it’s a good idea for older adults to supplement between 800 to 1000 IU daily—and for the rest of the year, too, if you’re not outside enough to get a tan.
It’s important to note that our appetite diminishes as we age. Therefore, we need to be careful and precise in what we eat to get the nutrients we need, including calcium and vitamin D. Many of us will maintain our calcium intake into old age, but a large number will not.
Bess Dawson-Hughes is a senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging, an endocrinologist, and professor of medicine at Tufts University School of Medicine.
Source: Tufts
