The Role of Calcium, Phosphorus, and Macronutrients in the Maintenance of Skeletal health

Dietary calcium intakes by females in the US typically average considerably below the RDAs for calcium, starting at age 11 yr. The RDAs for females (and males) are 1200 mg of calcium/d from 11 through 24 yr and 800 from 25 and onward (1). The NIH Consensus Conference on Calcium in 1994 suggested that calcium intakes should be 1000 mg/d for women beginning at menopause and 1500 for postmenopausal women who are not receiving any form of estrogen replacement therapy (2)Probably most nutritionists are not in agreement with the NIH recommendation of 1500 mg/d because it is practically impossible to obtain compliance with such a high intake from a combination of food consumption plus additional calcium via supplements. Furthermore, the scientific evidence of skeletal benefits in support of a daily recommendation of 1500 mg of calcium alone is not convincing. (Calcium plus vitamin D may be more effective.) No harm, of course, would be anticipated from an intake of 1500 mg/d or even as high as 2000, a value now considered the upper limit of safe intake. (Neither the FDA nor the RDA Committee has published specific amounts of calcium consumption beyond which the safety of consumers would be a concern.)