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Vitamin D, Calcium Intakes Guidelines - 3 Reports
  (1) The 2011 Report on Dietary Reference Intakes for Calcium and ...
....The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know - pdf attached- This article summarizes the new 2011 report on dietary requirements for calcium and vitamin D from the Institute of Medicine (IOM)

"The Committee concluded that available scientific evidence supports a key role of calcium and vitamin D in skeletal health, consistent with a cause-and-effect relationship and providing a sound basis for determination of intake requirements.....
Based on bone health, Recommended Dietary Allowances (RDAs; covering requirements of 97.5% of the population) for calcium range from 700 to 1300 mg/d for life-stage groups at least 1 yr of age. For vitamin D, RDAs of 600 IU/d for ages 1-70 yr and 800 IU/d for ages 71 yr and older, corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/ml (50 nmol/liter), meet the requirements of at least 97.5% of the population. RDAs for vitamin D were derived based on conditions of minimal sun exposure due to wide variability in vitamin D synthesis from ultraviolet light and the risks of skin cancer. Higher values were not consistently associated with greater benefit, and for some outcomes U-shaped associations were observed, with risks at both low and high levels. The Committee concluded that the prevalence of vitamin D inadequacy in North America has been overestimated. Urgent research and clinical priorities were identified, including reassessment of laboratory ranges for 25-hydroxyvitamin D, to avoid problems of both undertreatment and overtreatment."

(2) What Do We Tell Our Patients about Calcium and Vitamin D ...

The Journal of Clinical Endocrinology & Metabolism Jan 2011 ... A case in point is the previously simple issue of calcium and vitamin D ... Other than the fact that she should have checked with me before changing ... It is in this context that the 2010 Institute of Medicine (IOM) report on dietary reference intakes for vitamin D

(3) (Vitamin D Guidelines) Evaluation, Treatment, and Prevention of ...

Jun 6, 2011 - (Vitamin D Guidelines) Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guidelines:

"The IOM report (20) suggests that 25(OH)D levels need to be at least 20 ng/ml to maintain skeletal health....Vitamin D deficiency is defined as a 25(OH)D below 20 ng/ml (50 nmol/liter)

25-hydroxyvitamin D level by a reliable assay as the initial diagnostic test in patients at risk for deficiency

"Patients on multiple anticonvulsant medications, glucocorticoids, or AIDS treatment are at increased risk for vitamin D deficiency because these medications increase the catabolism of 25(OH)D (3, 42, 43)."

"Muscle weakness is a prominent feature of the clinical syndrome of severe vitamin D deficiency. Clinical findings in vitamin D-deficiency myopathy include proximal muscle weakness, diffuse muscle pain, and gait impairments such as a waddling way of walking (115, 116). Double-blind RCT demonstrated that 800 IU/d vitamin D3 resulted in a 4-11% gain in lower extremity strength or function (80, 117), an up to 28% improvement in body sway (117, 118), and an up to 72% reduction in the rate of falling (119) in adults older than 65 yr after 5 months of treatment.

Several systematic reviews and meta-analyses have demonstrated a reduction in falls associated with interventions to raise 25(OH)D levels."

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