Calcium, vitamin D, and nutrition in elderly adults

The nutritional needs for optimizing bone health easily can be met by a diet that is high in fruits and vegetables (five or more servings/day), adequate in protein but moderate in animal protein, and with adequate calcium and vitamin D intakes through the consumption of low fat dairy or calcium-fortified foods. Foods are a preferred source to maintaining calcium balance because there are other essential nutrients that are found in high-calcium foods. For those individuals in whom there is inadequate calcium intake from diet, supplemental calcium can be used. Supplemental or dietary calcium should be spread out throughout the day, with 500 mg or less being consumed at each meal to optimize absorption. In all individuals older than 70 years, vitamin D intakes of at least 600 IU per day (up to 1000 IU/day) are recommended, in addition to the calcium requirement of 1200 mg per day. Vitamin D from foods, supplements, and/or multivitamins can be used to meet the vitamin D requirement. In frail elderly individuals with malabsorption and alcoholics, there may be a need to supplement magnesium. Some elderly individuals with indications of poor nutritional status (low albumin levels) or after hip fracture might benefit from protein supplementation and a multivitamin to ensure adequacy of other nutrients.