Recently there was a news-flash from the Unites States Preventive Services Task Force (USPSTF) that stated “The current evidence is insufficient to assess the balance of the benefits or harms of daily supplementation with vitamin D greater than 400units and calcium greater than 1000mg for the primary prevention of fractures in postmenopausal women”. Moreover, “USPSTF recommends against daily supplementation with vitamin D less than 400units and less than 1000mg of calcium.” Yes, the other medical news sources flashed this breaking news in their Tweets and email blasts, but with no analysis or comments on the flawed nature of the USPSTF methods. Then I found what I was looking for that is worthy of posting.
In Endocrine Today (March 2013), they quote Dr. Robert P. Heaney, Professor of Medicine in the Division of Endocrinology at Creighton University, who I view as the “premier bone doc” out there. I read his research ten years ago and came to appreciate the broad knowledge base he has developed from his research and study of the evidence over the years. His claim is that we do not get enough calcium and vitamin D, and that is the lingering issue, not that we should stop taking these vital nutrients, as USPSTF implies. Here are a few quotes from Dr. Heaney: ” The new USPSTF recommendations are not very helpful and might confuse patients and lead some people into not taking supplements that could potentially help them. There’s a heavy reliance in the report on two large systematic reviews; both of which were severely flawed.” “…looking at what was the ancestral intakes of these nutrients….you will find that the vitamin D intake would be several times what we currently have; at least 2 1/2 to 3 times the current levels. The same is true for calcium. The ancestral intake of vitamin D, for example, produces a blood level of about 50ng/ml;”…”entirely safe levels”. Lastly, “The USPSTF approach is simply not well suited to nutrients. Fundamentally, they asked the wrong question and not surprisingly they got the wrong answer”.
So if you study people with inadequate intakes of calcium and vitamin D, and call it “normal”, you’ll get poor outcomes thereby concluding that taking supplements at those levels is not healthy, or not supported by good evidence, when in fact we need to understand that we need even more of these vital supplements to reach “normal” or healthy levels. The recommendation is that older adults, especially those with osteoporosis or low vitamin D levels, get enough calcium and/or vitamin D, which, more often than not, is more than what we’re taking. It should also be noted that nearly half of older adults have low vitamin D levels, yet another reason to consider supplementation.