1. Micronutrient Report on Calcium and Vitamin D Frances Collins General Nutrition HS211.XM1.10SPR

2. Calcium and Vitamin D Calcium and vitamin D are two nutrients that are interdependent upon each other and necessary for many body functions. This presentation will give some of those functions as well as intake recommendations, dietary sources, deficiencies, and supplements. A reference page is also included at the end

3. CALCIUM

4. What is calcium and why do we need it? Calcium is a mineral that serves many purposes in the body including: –Formation of strong bones and teeth –Maintenance of regular heart beat and transmission of nerve impulses –Lowering cholesterol –Important in blood clotting –Inhibiting absorption of toxic metals (Balch, 1997, p. 23)

5. How much calcium do I need? Adequate intakes (AI) in mg/day Infants: 210-270 Children: 500-800 Adolescents: 1300 Adults: 1000 Elderly: 1200 (Rolfes, Pinna, & Whitney, 2009, p. B)

6. Nutritional advantages of calcium Helps relieve menstrual cramps (Tkac, 1990, pp. 438, 507) Lowers cholesterol (Tkac, 1990, p. 136) Reduces risk of osteoporosis (Tkac, 1990, p. 465) May help maintain healthy body weight (Rolfes et al, 2009, p. 416)

7. Nutritional disadvantages of calcium 92 percent of kidney stones are made of calcium or calcium products (Tkac, 1990, p. 398) Absorbability varies between foods of similar calcium content (Rolfes et al, 2009, p. 419)

8. Calcium rich food sources Milk and dairy products Greens Broccoli Tofu Sardines and oysters Calcium fortified juice (Rolfes et al, 2009, p. 419-420)

9. Calcium supplements More effective in smaller doses taken throughout the day Less effective if taken in single large dose Promote better sleep if taken before bed Calcium containing antacids not recommended for use as supplement May interfere with certain medications (Balch, 1997, p. 23-24)

10. Do Americans typically get enough calcium? Yes, assuming milk and dairy products are consumed. (Rolfes et al, 2009, p. 419) ?

11. Vitamin D

12. What is vitamin D and why do we need it? Vitamin D is a fat soluble vitamin. –Required for absorption and utilization of calciumand phosphorus –Necessary for Growth Thyroid function Normal blood clotting –Protects against muscle weakness –Involved in regulation of heart beat (Balch, 1997, p. 19)

13. How much vitamin D do I need? Adequate intakes (AI) in μg/day* Infants: 5 Children: 5 Adolescents: 5 Adults: 5 Adults over 50: 10 Elderly: 15 * Assumes inadequate sunlight exposure (Rolfes et al, 2009, p. B)

14. Nutritional deficiency of vitamin D Rickets and osteomalacia are severe deficiencies which effect bones Absorption may be interfered with due to –Disorders of the gallbladder, liver, or intestine –Medicines such as cholesterol lowering drugs, antacids, cortisone, and mineral oil (Balch, 1997, p. 19)

15. Nutritional advantages of Vitamin D are similar to calcium plus it: Can be synthesized from sunlight (Rolfes et al, 2009, p. 377) Improves arthritis when taken as part of fish-oil capsule (Tkac, 1990, p. 24) Improves skin health (Tkac, 1990, p. 507) May protect against tuberculosis, gum inflammation, multiple sclerosis, and some cancers (Rolfes et al, 2009, p. 377)

16. Nutritional disadvantages of vitamin D It is the most likely vitamin to cause toxicity (Rolfes et al, 2009, p. 379) Excessive intake can lead to excessive calcium in the body (Tkac, 1990, p. 400) –Precipitates in soft tissue –Forms stones (especially in kidneys) –Hardens blood vessels (Rolfes et al, 2009, p. 379)

17. Vitamin D rich food sources Vitamin D fortified cereal, milk, and dairy products Fatty fish and fish oil (salmon, herring, sardines) Liver Beef Egg yolks Can also be obtained from sunlight! (Rolfes et al, 2009, p. 381)

18. How much sunlight is adequate? Light skin people need to expose hands, face, and arms for 5-10 minutes (dark skin needs up to an hour) two or three times a week on a clear summer day. (Rolfes et al, 2009, p. 380)

19. Factors that effect sun exposure Season Clothing Sunscreen Time of day Air pollution Indoor lifestyle Geographic location Shade from surroundings (Rolfes et al, 2009, p. 380)

20. Vitamin D supplements Should not be taken without calcium (Balch, 1997, p. 19) May be toxic exceeding 65,000 iu over a period of years (Balch, 1997, p. 19) Should be used with caution (Rolfes et al, 2009, p. 379) Help reduce risk of falls and fractures in elderly (Rolfes et al, 2009, p. 379) Commonly added to milk and dairy producs

21. Do Americans typically get enough vitamin D? Yes and no. We do if we have adequate exposure to sunlight. Without that, we may be deficient, even with consumption of vitamin D fortified foods. In which case, we should drink at lease 2 cups vitamin D fortified milk a day. (Rolfes et al, 2009, p. 379) ?

22. References Balch, James F. MD & Balch, Phyllis A. CNC (1997). Prescription for nutritional healing (2 nd ed.). Garden City Park, NY: Avery Publishing Group. Rolfes, Sharon Rady, Pinna, Kathryn, & Whitney, Ellie (2009). Understanding normal and clinical nutrition (8 th ed.). Belmont, CA: Wadsworth, Cengage Learning. Tkac, Debora (ed.) (1990). The doctors book of home remedies. Emmaus, PA: Rodale Press.