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NCHPAD - Building Healthy Inclusive Communities

The Calcium/Vitamin D Connection


Most of us have heard of the '5-a-Day' campaign, which encourages Americans to consume at least 5 servings of fruits and vegetables per day. But, have you heard of '3-a-Day?' You're not alone; many people have not.

'3-a-Day' is a campaign initiated to encourage consumption of dairy foods, which are rich in calcium and vitamin D. Research has shown that most Americans do not get enough of these key nutrients in their diets. With June being designated as National Dairy Month, it is a good time to remember why we need adequate amounts of calcium and vitamin D.

Calcium is the most abundant mineral in the human body. More than 99% of our total body calcium is stored in bones and teeth, where its function is to keep the structure of bones and teeth strong. The remaining 1% is found throughout the body in blood, muscle, and in the fluid between cells. Calcium is needed for muscle contraction, blood vessel contraction and expansion, secretion of hormones and enzymes, and message transmission through the nervous system.


TABLE 1. Recommended Adequate Intake by the Institutes of Medicine (IOM) for Calcium

Age

Calcium (mg/day)

Pregnancy and Lactation

0 to 6 months

210

N/A

7 to 12 months

270

N/A

1 to 3 years

500

N/A

4 to 8 years

800

N/A

9 to 13 years

1300

N/A

14 to 18 years

1300

1300

19 to 50 years

1000

1000

51+ years

1200

N/A


Vitamin D is a fat-soluble vitamin that is naturally present in very few foods. There are only a few natural food sources of vitamin D: fish, liver, and egg yolks. Most often, foods such as milk, soy drinks, and margarine, are fortified with vitamin D, meaning that vitamin D is added to them. We also get vitamin D from sunlight. It is produced when ultraviolet rays from sunlight strike our skin and trigger vitamin D synthesis. Vitamin D has many important functions. It is essential for promoting calcium absorption in the GI tract and is also needed for bone growth and remodeling.


TABLE 2: Adequate Intakes (AIs) for Vitamin D [5]

Age

Children

Men

Women

Pregnancy

Lactation

Birth to 13 years

5 mcg
(200 IU)

14-18 years

5 mcg
(200 IU)

5 mcg
(200 IU)

5 mcg
(200 IU)

5 mcg
(200 IU)

19-50 years

5 mcg
(200 IU)

5 mcg
(200 IU)

5 mcg
(200 IU)

5 mcg
(200 IU)

51-70 years

10 mcg
(400 IU)

10 mcg
(400 IU)

71+ years

15 mcg
(600 IU)

15 mcg
(600 IU)

Calcium and vitamin D are nutrients that have received much attention in recent years because they work together to prevent several chronic diseases. Research has shown that adequate calcium and vitamin D intake have an effect on the following chronic diseases and conditions:

Osteoporosis

Osteoporosis is a disease of the bone in which bone mineral density is reduced, leading to increased risk of fracture. Adequate intake of calcium and vitamin D has shown to greatly reduce the chances of developing osteoporosis later in life.

High Blood Pressure

High blood pressure, or hypertension, affects more than 50 million Americans and is a major cause of heart disease and stroke. The DASH study (Dietary Approaches to Stop Hypertension) found that a low-fat diet providing 3 servings of low-fat dairy products and 8 to 10 servings of fruits and vegetables significantly lowers blood pressure as much as some medications, especially when combined with low sodium intake.

Obesity

While research on the link between obesity and intake of low-fat dairy foods is not as strong, there is still evidence that adequate intake of calcium and vitamin D (specifically, low-fat dairy foods) can help to lower obesity and aid in weight maintenance. Research has shown that high calcium intake is consistently associated with lower body weight across different populations.

Colon Cancer

Colorectal cancer is one of the most commonly diagnosed cancers worldwide and diet is considered to be an important factor in its risk. Some research has shown that higher intake of calcium and vitamin D lead to a possible protective effect against colorectal cancer.

What Are the Best Sources of Calcium and Vitamin D?
While most of us know that milk is high in calcium and vitamin D, there are many other foods that are good sources as well:

  • Milk and foods made with milk, such as cheese, yogurt, pudding, custard, ice milk, ice cream, and cream soups;
  • Low-fat yogurt and cottage cheese with added calcium;
  • Cheeses (the more firm the cheese, the more calcium it contains); look for lower-fat versions to decrease intake of saturated fat;
  • Canned fish, such as sardines and salmon;
  • Tofu and soymilk;
  • Almonds, dried beans and peas, and dark-green leafy vegetables;
  • Juices fortified with calcium and vitamin D

The following foods provide approximately the same amount of calcium as 1 cup of milk (300 mg):

  • Very firm cheeses (Swiss, Parmesan) - 1 ounce
  • Less firm cheeses (Cheddar, American, Mozzarella and Provolone) - 1-1/2 ounces
  • Cottage cheese - 2 cups
  • Calcium-enriched cottage cheese - 3/4 cup
  • Plain ice milk or frozen yogurt - 1 cup
  • Plain yogurt - 3/4 cup
  • Tofu (cubes) - 1 cup
  • Soybeans (cooked) - 2-1/3 cups
  • Navy beans (cooked) - 1-1/4 cups
  • Pork and beans - 1-3/4 cups
  • Salmon (canned with bones) - 5-1/3 ounces
  • Turnip greens - 1-1/2 cups

If you do not get enough calcium and vitamin D from food, either because you don't particularly like dairy foods, have lactose intolerance, or follow a vegan diet, you may need to take a calcium supplement containing vitamin D. Talk to your doctor about any vitamin or mineral supplements you are taking.

Sources:

The 3-a-Day
http://www.3aday.org/Pages/Welcome.aspx

The National Dairy Council
http://www.nationaldairycouncil.org/nationaldairycouncil/nutrition

Park, S., Murphy, S., Wilkens, L.., Nomura, A., Henderson, B., and Kolonel, L. (2007). Calcium and vitamin D intake and risk of colorectal cancer: The multiethnic cohort study. American Journal of Epidemiology, 165(7), 784-793.


Please send any questions or comments to Gillian Goodfriend at ggoodfri@uic.edu.


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