23.5: Nutrient reference values for calcium (23a.5)
- Page ID
- 117186
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)New EAR, RDA and UL levels for calcium were published by the Institute of Medicine in 2011, as shown in Table 23a.3.
| Dietary Reference Intakes Ca (mg/d) IOM (2011) | |||
|---|---|---|---|
| Age/sex groups | EAR | RDA | UL |
| 0–6 mo | – | 200 (AI) | 1000 |
| 6–12 mo | – | 260 (AI) | 1500 |
| 1–3y F & M | 500 | 700 | 2500 |
| 4–8y F & M | 800 | 1000 | 2500 |
| 9–18y F* & M | 1100 | 1300 | 3000 |
| 19–50y F* & M | 800 | 1000 | 2500 |
| 51–70y F | 1000 | 1200 | 2000 |
| 51–70y M | 800 | 1000 | 2000 |
| 71+y M & F | 1000 | 1200 | 2000 |
| World Health Organization (2018) | |||
| Pregnancy | 1500 | ||
Calcium balance studies provided the evidence for values for ages 1–50y, whereas for those over 50y, values were set to prevent bone loss. For infants age 0–6mos, an AI is given based on the average intake of calcium from human milk, whereas at age 7–12mos, the AI assumes 120mg calcium from human milk plus 140mg calcium from complementary food. The values set for the AIs for infants provide enough absorbed calcium to meet the calcium requirements estimated by the factorial method. For children, estimates of desirable bone accrual were considered; EAR values, which start at 500mg for toddlers (age 1–3y), rise to 800mg for children, then peak at 1100mg for adolescents, were based on a new calculation of calcium retention data (Vatanparast et al., 2010). For adults, maintenance of bone through attaining neutral calcium balance is the goal. The EAR values are 800mg for men age 19–70y and for women 19–50y, and the RDA for these age groups is 1000mg. The difference in age cut-offs for men (i.e., 70y) and women (i.e., 50y) reflects data showing that women at 50y experience abrupt bone loss at menopause in contrast to men at this age where bone loss is slow. For women over 50y and men over 70y, EAR values are similar at 1000mg which translates into an RDA value of 1200mg. This higher level set for women over 50y and men over 70y was considered a justified public health measure in the face of supportive yet inconclusive data suggesting a higher intake of calcium would prevent bone loss and protect against fractures. Values during pregnancy and lactation are not different from other women in the same age group in view of the well documented ability of pregnant and lactating women to increase calcium absorption, and hence compensate for their increased needs (Kovacs, 2016).
The IOM Upper Level (UL) for calcium for infants 0–1y was derived from feeding data that indicated no adverse effects on calcium excretion when calcium intakes as high as 1000–1500mg were provided. For all other age groups, the UL for calcium (Table 23a.3) was based on data related to the incidence of kidney stones, largely from the research conducted with post-menopausal women in trials where calcium supplements were provided. In contrast, the European Food Safety Authority (EFSA, 2012)retained their calcium UL of 2500mg for adults, including pregnant and lactating women, on the basis that the new data did not alter their previous adult UL estimates. Further, EFSA was not convinced there were sufficient data to set a UL for infants, children, or adolescents.