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    Finding Bones in IOM's Calcium and Vitamin D Intake Statement

    December 21, 2010
    “Make no bones about it,” is a phrase meant to prevent doubt. It evolved from the language of 15th century England, when someone who wanted to express their dissatisfaction with something didn’t “make bones about it,” rather they “found bones in it.” This is a reference to the unwelcome discovery of bones in soup, which makes the soup difficult to swallow. In other words, the presence of bones is bad. No bones are good.



    “Make no bones about it,” is a phrase meant to prevent doubt. It evolved from the language of 15th century England, when someone who wanted to express their dissatisfaction with something didn’t “make bones about it,” rather they “found bones in it.” This is a reference to the unwelcome discovery of bones in soup, which makes the soup difficult to swallow. In other words, the presence of bones is bad. No bones are good.

    To bring this back to dairy, we know dairy makes bones strong. Further, the dairy industry is finding bones in a recently released report from the Institute of Medicine (IOM), Washington, D.C., on the two bone-building nutrients - vitamin D and calcium - that milk provides. In the report published on Nov. 30, the IOM committee confirmed the importance of vitamin D and calcium in promoting bone growth and maintenance through various stages of life; however, the message it sent out has created some confusion, as the report says that most people are consuming an adequate amount of calcium and vitamin D.

    This statement conflicts with a recent report of the 2010 Dietary Guidelines Advisory Committee, which noted that calcium and vitamin D, along with potassium and fiber, are considered “shortfall nutrients,” meaning Americans are not consuming enough of them in their diets. The Dietary Guidelines committee found that less than 60% of American adults between the ages of 31 and 50 years are consuming adequate levels of vitamin D. For this same age group, 70% of women and about 40% of men are falling short of calcium-intake recommendations.

    According to Cary Frye, vice president for regulatory and scientific affairs at the International Dairy Foods Association, Washington, D.C., the IOM and Dietary Guidelines Advisory Committee reports used different criteria to evaluate the population adequacy for these nutrients and came up with different conclusions.

    “The U.S. dairy industry has concerns about how these differing recommendations will be understood by the public,” Frye says. “IDFA is working with its dairy industry partners to make sure consumers understand that milk is the most efficient, affordable and available food source of these two nutrients, and that it’s more important than ever for Americans of all ages to ensure they are meeting their nutrient-intake recommendations by including three daily servings of nutrient-rich dairy foods in their diets.”

    How this happened

    Everyone agrees that calcium and vitamin D are two essential nutrients for bone health. However, in IOM’s report, the agency explains that during the past decade the public has heard conflicting messages about other benefits of these nutrients - especially vitamin D - and also about how much calcium and vitamin D they need to be healthy. To help clarify this issue, the U. S. and Canadian governments requested that IOM assess current data on the intake of and the health outcomes associated with these two nutrients. In response, a committee of experts provided an exhaustive review of studies and found that the evidence supported a role for these nutrients in bone health but not in other health conditions.

    Specifically, the committee’s recommendations for calcium ranged from 700 to 1,300 milligrams daily, depending on bone health and age. The daily calcium recommendations are similar to previous Dietary Reference Intakes (DRI) values. In contrast, the committee recommended significant increases in vitamin D for all ages. The committee recommended daily vitamin D intake of 600 international units (IU) for those between the ages of 1 to 70 years and 800 IU for those older than 70 years; this is a significant increase from previous recommendations of 200 to 600 IU.

    These recommendations are not what the dairy industry has a hard time swallowing. It’s the fact that IOM believes, based on its review of literature, that the majority of Americans and Canadians are receiving adequate amounts of both calcium and vitamin D. Further, according to IOM’s report, there is emerging evidence that too much of these nutrients may be harmful. In other words, dairy recommendations do not need to be increased in the 2010 Dietary Guidelines.

    According to Frye, the Dietary Guidelines committee will consider the IOM recommendations, but it remains to be seen how and if they will be incorporated into the final Dietary Guidelines due for release at the end of the year. Further, these new values will not prompt immediate changes to food labeling for vitamin D and calcium, but they will be considered when FDA undertakes changes to the Nutrition Facts panel in the future.

    In the mean time, vitamin D and calcium remain the two most common nutrients to be added to dairy foods, both here and abroad. Other vitamins and minerals being added more frequently to dairy foods include the B vitamins, iron and zinc. Dairy foods remain an ideal delivery vehicle for nutrients the body needs to thrive.  

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