IOF comments on US Task Force recommendations regarding vitamin D and calcium supplementation

International Osteoporosis Foundation states that vitamin D at recommended dosage reduces risk of falls and fractures; adequate calcium from food sources is necessary for healthy bones at all ages

The International Osteoporosis Foundation (IOF) concurs with the United States Preventive Services Task Force (USPSTF)1 which has stated that daily supplementation with doses of vitamin D ≤ 400 IU and calcium ≤ 1,000 mg has no net benefit for the primary prevention of fractures in non-institutionalized asymptomatic adults without previous history of fractures.

In contrast to the USPSTF, however, IOF finds that a higher dosage of vitamin D, specifically 800 IU per day, does reduce risk of fractures. One means by which vitamin D is effective is that it lowers risk of falling. Falling is a well recognized risk factor for fractures and other serious injuries 2,3,4.

Calcium is clearly necessary for healthy bone. IOF recommends that the needed calcium be obtained from food sources. For those who cannot reach their requirement with foods, supplements may be used to fill the gap.  Intakes in excess of the requirement should generally be avoided.

“As stated by the USPSTF, fracture prevention in seniors is important because fractures are associated with chronic pain, disability, and increased mortality, “said IOF President John Kanis. “IOF recommends a daily dosage of 800 to 1000 IU/day of vitamin D for fall and fracture prevention in adults aged 60 and older. Skin production of vitamin D declines with age, and as vitamin D is difficult to obtain from food sources alone, IOF advises vitamin D supplementation to reach these recommended levels."

References

1. Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement
http://annals.org/article.aspx?articleid=1655858#Abstract

2. Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE, Josse RG, Lips P, Morales-Torres J, Yoshimura N (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 21: 1151-4.

3. Mithal A, Bonjour JP, Boonen S, Burckhardt P, Degens H, El Hajj Fuleihan G, Josse R, Lips P, Morales Torres J, Rizzoli R, Yoshimura N, Wahl DA, Cooper C, Dawson-Hughes B; for the IOF CSA Nutrition Working Group (2013). Impact of nutrition on muscle mass, strength, and performance in older adults. Osteoporos Int. Epub ahead of print, December, 2012.

4. Rizzoli R, Boonen S, Brandi ML, Bruyère O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY. (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
Curr Med Res Opin. 2013 Feb 7. [Epub ahead of print]