How to Get Enough continued...
IOM recommendations for Vitamin D are:
- 600 international units (IU) per day for children from age 1 to adults through age 70
- 800 IU per day for people 71 and older.
To get vitamin D from food, fish is the best option. Six ounces of cooked salmon has more than 600 IU. Other foods containing vitamin D include eggs, liver, fortified dairy products, and fortified juice.
Your doctor may recommend higher levels of calcium and vitamin D, especially if you are at risk for osteoporosis. The National Osteoporosis Foundation recommends that adults under age 50 get 400 to 800 IU of vitamin D every day, and that adults age 50 and older get 800 to 1,000 IU of vitamin D every day.
Should You Supplement?
Experts say ideally you should get the nutrients you need from whole foods and a well-balanced diet rather than from supplements. That way, you're getting the full benefits of the food instead of a single, isolated component.
In practice, it's not always so simple. Calcium and vitamin D supplements can be important for some people. As you get older, it's harder for your body to make new bone as quickly as it's destroyed. If you're a woman, that's especially true after menopause. Getting older also makes it more difficult to absorb calcium and synthesize vitamin D.
Talk to your doctor if you are interested in taking a calcium or vitamin D supplement. Together, you can figure out if it's necessary. Consider these questions:
- How much calcium is in your diet? Your doctor might want you to work out how much calcium you're getting from foods. You can do this by keeping a food journal for a few days.
- Could you be vitamin D deficient? Because most of your vitamin D doesn’t come from diet, a food diary won't help determine your vitamin D levels. If your doctor suspects a deficiency, he or she may order a blood test.
- Should you get more time in the sun? Could sunscreen and wide-brimmed hats explain why some people are deficient in vitamin D? Many experts think so. As we've become more concerned about the risk of skin cancer, we're getting less sun exposure -- and producing less vitamin D as a result. Talk with your doctor about sun exposure and skin cancer risk.
- Are you at risk of getting too much calcium or vitamin D? Very high intake of calcium -- 2,500 mg or more if you're between the ages of 19 and 50 and 2,000 mg or more if you're 51 or older -- may increase the risk of kidney problems and block the absorption of minerals. There's less agreement about how high you can go with vitamin D.
- What sorts of supplements are available? There are different types of calcium supplements and vitamin D supplements available -- such as calcium citrate and calcium carbonate and vitamin D2 (ergocalciferol) and D3 (cholecalciferol). Current evidence suggests that there's not a big difference between them, although some research has found that vitamin D3 might be more effective than D2. Calcium carbonate can be more difficult to absorb on an empty stomach or if you have low levels of stomach acid compared to calcium citrate, so it should be taken with food. Also, since vitamin D is fat soluble, it is best absorbed with a meal that contains fat. Again, your doctor can advise you on the right supplements for you.
- Could you have a hidden calcium or vitamin D deficiency? Even people who seem like they should be getting enough calcium and vitamin D sometimes aren't. For instance, some medicines and health conditions can block the normal absorption of calcium or vitamin D. Talk to your doctor about any potential problems that might put you at risk for low levels of calcium or vitamin D.