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Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
×

Index*

A

Abscesses, 171

Acceptable Macronutrient Distribution Range (AMDR), 3

Achlorhydria, 37

Acronyms and abbreviations, 523526

Adequate Intake (AI), 3, 8, 20, 2122, 489490.

See also Calcium, AIs;

Vitamin D, AIs

Adipokines, 491

Adipose tissue, 83, 84, 8788, 106, 490, 491, 518

Adiposity, 11, 84, 105106, 143, 152, 156, 490491.

See also Obese or overweight persons;

Weight loss or dieting

Adolescents, 14 through 18 years.

See also Puberty

bone health, 5354, 195, 202208, 218, 226, 280

calcium

absorption, 39, 265

accretion, 61, 269

balance, 58, 61

deposition, 5354

DRIs, 7, 349, 351, 352, 354355, 393394, 464, 1104, 1108, 1114

estimated intake, 465, 466, 467, 480

retention, 268

DRI development, 24, 385387, 393394, 445

EARs, 7, 9, 349, 351, 354355, 385, 387, 393, 394, 464, 469, 11041105

elements, 11081109, 1114–115

growth spurts, 8, 24, 39, 53, 354, 421

lactation, 7, 57, 257, 282, 283, 349, 361, 362, 363, 393, 394, 424, 446, 464, 469

macronutrients, 11101111

multiple sclerosis and serum 25OHD, 173

pregnancy, 56, 57, 250, 257, 278, 361, 362, 393, 394, 424, 446, 469

RDAs, 7, 9, 349, 351, 354355, 385, 387, 393, 394, 464, 469, 1106-1110

ULs, 7, 9, 419, 420, 421, 441, 445, 464, 469, 11121115

vitamin D, 9, 95, 385387, 393394, 441, 445, 469, 470473, 475, 1106, 1112

vitamins, 11041105, 11121115

water, total, 1110

*

Appendixes B through K (pp. 537-1074) are not included in this index.

Page 1076 Cite
Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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Adults, 19 through 30 years

bone health, 218, 242, 270, 382383, 384

calcium, 7, 39, 54, 269, 349, 355, 421424, 464, 465, 466, 467, 1104, 1108, 1114

DRI development, 24, 355356, 387389, 393394, 421422, 423424, 443445

EARs, 7, 9, 349, 355, 387388, 389, 393, 394, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 11101111

RDAs, 7, 9, 349, 355, 387388, 389, 393, 394, 464, 469, 11061110

ULs, 7, 9, 421, 423, 443, 445, 464, 469, 11121115

vitamin D, 9, 95, 387389, 393394, 443445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Adults, 31 through 50 years

bone health, 218219, 242, 382383, 384

calcium, 7, 39, 5455, 349, 355356, 421424, 464, 465, 466, 467, 1104, 1108, 1114

DRI development, 2425, 355356, 387389, 393394, 421424, 443445

EARs, 7, 9, 349, 355, 387388, 389, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 11101111

RDAs, 7, 9, 349, 355, 387388, 389, 464, 469, 11061110

ULs, 7, 9, 421, 423, 443, 445, 464, 469, 11121115

vitamin D, 9, 9596, 387389, 393394, 443445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Adults, 51 through 70 years

bone health, 219, 226234, 235, 382383, 384

calcium, 7, 349, 356359, 421423, 463464, 465, 466, 467, 480481, 1104, 1108, 1114

dementia, 183

DRI development, 2425, 355356, 389, 421423, 443445

EARs, 7, 9, 167, 349, 356, 357, 359, 387388, 389, 392, 393, 394, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 11101111

RDAs, 7, 9, 349, 356, 357, 359, 387388, 389, 393, 394, 464, 469, 11061110

ULs, 7, 9, 421, 423, 443, 445, 464, 469, 11121115

vitamin D, 9, 389, 392394, 443445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Adults, 70+ years.

See also Elderly population

bone health, 219, 226234, 235, 360, 382383, 384, 439

calcium, 7, 349, 356, 359361, 421423, 464465, 466, 467, 1104, 1108, 1114

cognitive function, 183, 185186

DRI development, 359361, 389392, 443445

EARs, 7, 9, 349, 356, 360361, 389, 392, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 11101111

RDAs, 7, 9, 349, 356, 361, 389390, 392, 464, 469, 11061110

ULs, 7, 9, 421, 423, 443, 445, 464, 469, 11121115

vitamin D, 9, 389392, 439, 443445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Adverse effects

calcium, 22, 42, 404, 405424, 481, 488, 500501

chronic, vs. acute toxicity, 404

due to nutrient deficiency. See Calcium, deficiency;

Phosphorus, deficiency;

Vitamin D, deficiency

ethical issues, 404, 425, 488, 518

indicators. See Indicators of adverse outcomes for excess intake

research needs, 517518

in risk assessment approach to DRI development, 27, 403, 515

use in determination of benchmark intake, 17, 418

vitamin D, 6, 10, 404, 405, 424440, 486, 488

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Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
×

African Americans

breast-fed infants and vitamin D, 385, 494495

calcitriol levels, 260261, 296

“calcium economy,” 294, 517

cardiovascular mortality, 438

cognitive function, 186

diabetes, 153

limited data for DRI development, 347

multiple sclerosis, 174

puberty, 24

serum 25OHD levels

atherosclerotic plaque, 438, 444

bone health, 106, 208, 260261, 295, 298, 439, 493

effects of skin pigmentation, 374, 493, 494495

vitamin D dose–response, 431

systemic lupus erythematosus, 177

Africans, 179, 244.

See also Gambians;

Nigerians

Agency for Healthcare Research and Quality (AHRQ)

Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews, 127, 128

overview of AHRQ-Ottawa and AHRQ-Tufts reports, 5, 3031, 9798, 100, 126127

Albumin. See Serum albumin

Alcohol consumption, 64, 140, 143, 230, 434

Allergies, 169, 496498

All-laboratory trimmed mean (ALTM), 109

Alopecia, 94

Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (ATBC), 147, 415, 436

Altitude, 105

Alzheimer’s disease, 183, 185

Amenorrhea, 502

American Academy of Dermatology, 495

American Academy of Pediatrics, 95, 258

American Dietetic Association, 497

American Indians, 197, 439

American Institute for Cancer Research, 415

Amsterdam Growth and Health Longitudinal Study, 274

Anemia, 176

Angiotensin II, 190

Ankylosis, 174

Anorexia, 406, 425

Anti-angiogenic action, 92, 146

Antibody-based assays, 107, 108, 109, 365

Anticonvulsants, 87, 504

Anti-inflammatory action, 92, 146, 184, 517

Antimicrobial activity, 177, 178, 179, 181

Antirachitic, 80

Apoptosis, 77, 92, 140, 143

Appetite loss, 171172

Arrhythmia, 147, 406, 425

Arsenic, 1114

Arthralgia, 176

Arthritis, 176.

See also Osteoarthritis;

Rheumatoid arthritis

Asian ancestry or Asians, 179, 199, 231, 252, 254, 268, 347, 439.

See also Chinese ancestry or Chinese;

East Asian ancestry;

South Asian ancestry or South Asians

Assay shift and drift, 107111, 365366, 460461

Asthma, 4, 129, 168170, 181, 182

Atherosclerosis, 147, 438, 444

Atmospheric conditions, 104, 105, 492

Autism, 4, 129, 182183

Autoimmune disease, 4, 5, 78, 91, 170177, 181182, 189, 192.

See also Crohn’s disease;

Diabetes (type 1);

Inflammatory bowel disease;

Multiple sclerosis;

Osteoarthritis;

Rheumatoid arthritis;

Systemic lupus erythematosus

B

B cells, 91, 170

Background intake. See Benchmark intake

Balance (calcium). See Calcium balance

Balance (physical), 166

Beck Depression Inventory (BDI), 187

Behavior, 182, 184, 186, 295

Benchmark intake (BI), 17, 418, 440, 519

Bioavailability, 29, 37, 39, 6263, 498, 503, 516, 521

Bioequivalence, 29, 516, 521

Biomarkers

for colon carcinogenesis, 144

of effect, 2526

Page 1078 Cite
Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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of exposure, 25

inflammatory, 169170

serum 25OHD as biomarker of vitamin D effect, 1314, 9697, 263264, 291, 293, 439, 484, 517, 520

serum 25OHD as biomarker of vitamin D exposure, 8, 1213, 96, 99, 293, 363, 381382, 384, 480, 483

use of term, 25

Biotin, 1107, 1113

Bloating, 37, 497

Blood pressure, 152, 154, 190.

See also Hypertension

Blood volume, extracellular, 407

Body mass. See Lean body mass or lean mass

Body mass index, 48, 88, 141, 155, 211, 212, 228, 231, 434, 435, 490

Bone.

See also Bone health;

Skeleton

accretion, 4647, 53, 54, 55, 95, 267272, 292294, 351

accretion rate, 268, 269270

calcium content at maturity, 54

composition, 4344

cortical, 45, 46, 249

disorders. See Bone, fracture;

Bone loss;

Osteomalacia;

Osteoporosis;

Rickets

effects of menopause, 4748, 52

formation or mineralization, 4445, 242, 253, 276277, 296

fracture

African Americans, 294, 296, 493

BMD, 50, 51, 273, 285292, 298, 357358

bone loss as risk factor, 48, 60, 359360

calcium supplementation, 285290, 358, 360, 390392

as indicator of adverse outcomes for excess intake, 6, 405

as indicator of nutrient adequacy, 4, 9, 129

from military training, 234n.3, 242, 275

with osteomalacia, 49, 50, 276277

with osteoporosis, 5052

during pregnancy, 278

and serum 25OHD, 195, 215, 226234, 276, 366367, 390

vegans diet and risk for, 497

vitamin D supplementation, 161, 234235, 236242, 275, 277, 290292, 358, 390392, 438439

maintenance, 283284, 292294, 387388

modeling, 45, 53

organic matrix (osteoid), 43, 4950, 62, 94, 275276

pain, 49, 50

remodeling, 4546, 52, 54, 59, 62, 272, 409

resorption during lactation, 45n.3, 57, 96, 256, 259, 281282, 362

serum 25OHD levels and. See Serum 25-hydroxyvitamin D, bone health

trabecular, 45, 46, 249, 270

types, 45

Bone health, as indicator of nutrient adequacy.

See also under specific life-stage groups

African Americans, 208, 294298

bone maintenance, 283284, 292294, 387388

effects of adiposity, 490491

integration of evidence, 262277, 292294, 370371

lactation, 282283, 362

menopausal status, 209218, 226, 234242, 360361

overview, 4, 5, 193194, 298

pregnancy, 277282, 361362

selection as, 298, 345, 480

Bone loss.

See also Osteoporosis

African Americans, 296, 298

age-related, 52, 54, 55, 9596, 193, 284, 285, 356, 361

calcium balance and, 284285

calcium intake and, 35, 40, 274, 285292, 356

effects of caffeine intake, 64

effects of menopause, 4748, 52, 5455, 58, 360361

effects of soft drink intake, 64

integration of evidence, 262277, 292294, 370371

serum 25OHD and, 195

spaceflight, 46

vitamin D intake and, 96, 292294

Bone marrow, 43, 46

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Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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Bone mass

calcium intake and, 35, 47, 53, 54, 273274, 417

measures associated with calcium, 5762.

See also Bone mineral content;

Bone mineral density;

Calcium balance

peak, 47, 54, 250, 270, 282, 296

physical activity and, 46, 54, 273, 287, 490491

protein intake and, 63

reduction. See Bone loss;

Osteoporosis

Bone mineral apparent density (BMAD), 206

Bone mineral content (BMC)

calcium intake and supplementation, 47, 6062, 219226, 270271

definition, 60

effects of adiposity, 491

as indicator of nutrient adequacy, 4, 129

infant, 195, 196201

measurement, 6062

postmenopausal women and elderly men, 214, 216

pregnancy and lactation, 249, 254, 255, 259, 278, 279280, 283

serum 25OHD and, 195, 196205, 218, 219, 393394

vitamin D intake and supplementation, 271, 279280

Bone mineral density (BMD)

African Americans, 295296

bone fracture and, 50, 51, 273, 285292, 298, 357358

calcium intake and supplementation, 6062, 175, 219226, 270271, 273274, 284290, 392393

effects of adolescent pregnancy, 56, 362

effects of lactation, 57, 256, 257, 259, 282, 283

effects of menopause, 4748, 52

effects of oral contraceptive use, 501503

effects of pregnancy, 7, 8, 249, 250, 254, 255, 256, 278, 279280, 361, 362

as indicator of nutrient adequacy, 4, 129

measurement, 6062

serum 25OHD and, 195, 196207, 209, 210216, 218219, 226234, 275, 283, 368369, 386387

use of term, 60

vitamin D intake and supplementation, 95, 175, 271, 274275, 279280, 290292, 386387, 392393

Boron, 1114

Bowel obstruction, 171.

See also Inflammatory bowel disease

Brain development, 182, 184

Brain tissue, 184

Breast cancer, 139142, 435436

Breastfeeding. See Human milk;

Infants, breast-fed;

Lactation

British Paediatric Association, 431, 432, 441

C

Caffeine, 64

Calcidiol. See 25-Hydroxyvitamin D

Calcifediol. See 25-Hydroxyvitamin D

Calcification of soft tissue (calcinosis), 6, 44, 61, 88, 405, 406, 409410, 422, 425, 426

Calcitonin, 40, 41, 90

Calcitriol (1,25-dihydroxyvitamin D).

See also Serum calcitriol

cancer, 77, 9192, 139, 146

cardiovascular disease, 78, 150151

extra-renal production, 90, 177, 189, 518519

falls and physical performance, 157

fetal, 252

formation in the kidney, 77, 84, 90, 481

functions

bone formation, 44

calcium absorption, 35, 38, 39, 89, 253, 260, 264, 267

calcium excretion, 42

calcium regulation, 4041, 8990, 157, 253

cytokine production, 189

glucose transport in the brain, 184

immune response, 167168

phosphorus regulation, 64, 77, 89

vascular reactivity enhanced by, 148

gene regulation, 90, 170

half-life, 97

interactions with prescription drugs, 504

during lactation, 91, 259

multiple sclerosis treatment, 173, 174

not used as a measure of vitamin D nutriture, 97

Page 1080 Cite
Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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in the placenta, 90, 189

in pleural fluid, 177

during preeclampsia, 189

during pregnancy, 56, 96, 174, 250251, 252, 254

rheumatoid arthritis treatment, 175

rickets and osteomalacia, 49, 94

systemic lupus erythematosus treatment, 176

tuberculosis, 178

use of term, 78

vitamin D intoxication, 427

Calcium.

See also Calcium balance;

Serum calcium

absorption.

See also Calcium, bioavailability

adolescents, 95, 352

African Americans, 260261, 296

children, 352

dietary factors, 6364

fractional, 3839

from the gut, and increased risk for nephrolithiasis, 411, 500

impaired with rickets, 94

as indicator of nutrient adequacy, 4, 129

infants, 52, 253, 350, 503, 505

methods of measurement, 264265

overview, 3840

during pregnancy or lactation, 242, 249, 250, 253, 256257, 259, 277, 279, 281282, 292, 361, 424

relationship with vitamin D, 35, 4041, 143, 279

role of calcitriol, 35, 38, 39, 89, 253, 260, 264, 267

and serum 25OHD, 213, 257, 259, 264267, 271, 277, 284, 292, 366, 368, 388389

accretion, 5354, 269, 350, 351353, 354, 503.

See also Bone, accretion

adverse effects with. See Adverse effects, calcium;

Calcium, ULs

AIs, 7, 8, 58n.4, 345, 346, 348351.

See also Calcium balance, studies;

Calcium retention

autism, 183

bioaccumulation, 35, 43

bioavailability, 37, 39, 6263, 498, 503

bone health and, 194, 292.

See also Supplements, calcium, and bone health

cancer, 5, 135, 137, 139, 140, 141, 143, 144145, 147, 414416

cardiovascular disease, 148, 149

cognitive function, 186

deficiency, 35, 40, 4850, 243248, 254, 271, 386

depression, 188

diabetes, 155, 156

DRIs

adolescents, 7, 351, 352, 354355, 1104, 1108, 1114

adults, 7, 355361, 1104, 1108, 1114

background of current report, 346

children, 7, 351, 352, 353355, 1104, 1108, 1114

infants, 7, 348351, 1104, 1108, 1114

in IOM 1997 report, 16, 5860, 61, 346, 350, 351, 404

lactation, 7, 361, 362, 1104, 1108, 1114

pregnancy, 7, 361362, 1104, 1108, 1114

summary tables, 78, 349, 464, 1104, 1108, 1114

EARs.

See also Calcium, AIs

and accretion/retention, 58n.4, 268, 272, 292

adolescents, 7, 351, 354, 356, 357, 359, 1104

adults, 7, 355, 356, 357, 359, 360361, 1104

children, 7, 351, 353, 354, 1104

lactation, 7, 9, 349, 361, 362, 464, 1104

pregnancy, 7, 9, 349, 361, 362, 464, 1104

summary tables, 7, 349, 464, 1104

elemental, 37

excretion

adolescents, 95, 352

children, 352

dietary factors, 6364

infants, 8

during lactation, 256, 257, 282

overview, 4142

postmenopausal women, 55

during pregnancy, 189, 250

reduction with diuretics, 407

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Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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relationship with calcium intake, 42, 256, 257, 413414

relationship with hypercalciuria, 406407

by route, 38, 61, 352

food sources of, 36, 6263, 413, 466, 497, 498

homeostatic regulation, 35, 4041, 49, 56, 84, 8990, 153, 157, 253

in human milk, 39, 5253, 56, 57, 256, 257

intake. See Calcium intake

interactions with other nutrients. See Calcium interactions

ionized, 35, 43, 56, 250, 257, 424

during lactation, 7, 8, 45n.3, 5657, 256257, 362

metabolism, 35, 3842, 43, 56.

See also Calcium balance

mobilization or transport, 153, 177178, 249, 254, 356, 361

physiological role, 35, 4252, 157, 184

during pregnancy, 7, 189, 190, 242, 249250, 361362

RDAs, 7, 272, 292, 351, 353, 354, 355, 356, 357, 359, 361, 1108

retention. See Calcium retention

rheumatoid arthritis, 175

sources, 3637

supplements. See Supplements, calcium

through the life stages, 78

ULs, 7, 8, 418420, 421424, 464, 488, 500501, 11141115

umbilical cord level, 251, 254

units of measurement, 31

Calcium-alkali syndrome, 407409, 418, 422, 423

Calcium balance.

See also Calcium, homeostatic regulation

adolescents, 58

adults, 355

bone remodeling and, 4546, 272

definition, 57

estimation methods, 58, 62

as indicator of nutrient adequacy, 4, 129

infants, 58

models, 5860

negative, 284285

neutral, 272273, 285, 292

outcomes, 58

during pregnancy or lactation, 249, 277278, 282, 362

regulated by calcitriol. See Calcitriol, functions, calcium regulation

studies, 5760, 58n.4, 350, 351, 352

Calcium bicarbonate, 43, 407

Calcium carbonate, 37, 63, 407, 408, 417.

See also Supplements, calcium

Calcium citrate, 37, 43, 63, 417.

See also Supplements, calcium

“Calcium economy,” 294298, 517

Calcium glucoheptonate, 37n.2

Calcium gluconate, 37n.2

Calcium hydroxyapatite, 35, 37n.2, 43, 4445

Calcium intake.

See also Supplements, calcium

absorption of lipids and, 148

assessment

approach, 462463

Canadian estimated, 465468

Canadian surveys, 461462

estimates from national surveys, 10, 458460

from food sources only, 465, 466

summary, 477, 480481

U.S. estimated, 463465, 466

water, 36

assumption of adequacy for vitamin D DRI, 347348

bone health and

BMC/BMD, 47, 6062, 175, 195, 219226, 270274, 285290, 392393

bone accretion, 47, 5354, 292

bone loss, 35, 40, 274, 356

bone mineralization, 276

dose–response relationship, 360

during pregnancy, 278279

skeletal recovery after weaning, 57, 256257, 258, 282, 283, 285

cancer, 144145, 146, 147, 414416

cardiovascular disease, 148

diabetes, 155, 156

excess, 37, 42, 150, 517518.

See also Indicators of adverse outcomes for excess intake

excretion of calcium and, 42, 414

falls and physical performance, 157

inadequate. See Calcium, deficiency

infants, daily, 53, 349, 350351

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Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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for neutral calcium balance, 58, 273, 285

plateau intake, 58

preeclampsia and pregnancy-induced

hypertension, 189, 190, 250

relationship with calcium absorption, 3839, 56

relationship with calcium retention, 269

rheumatoid arthritis, 175

systemic lupus erythematosus, 176

Calcium interactions

foods and food components, 6264

iron, 6, 37, 405, 416417

magnesium, 37

prescription drugs, 422

vitamin D, 5, 6, 35, 60, 136, 358, 360, 369, 388, 484, 517

zinc, 6, 37, 405, 417

Calcium lactate, 37n.2

Calcium retention

adolescents, 5354

bone mass measurements, 6162

calcium intake and, 5860, 269, 270

children, 268, 353

effects of dietary protein, 63

infants, 350, 503

integration of evidence, 292

plateau intake, 58

race considerations, 296, 297

regression modeling, 58

Canada

calcium intake assessment, 37, 465468

changes in diet of indigenous Canadian populations, 11, 498500

compared with the U.S., 474, 476477

national intake surveys, 1011, 110111, 457458, 461462, 521

Recommended Nutrient Intakes, 15

use of DRIs, 15

vitamin D

deficiency, 1314, 486488, 494

in formula, 81

intake assessment and serum 25OHD levels, 1011, 110111, 474477, 478

in milk, 79

supplementation, 81

Canadian Community Health Survey (CCHS), 461, 467, 474, 475

Canadian Food Inspection Agency (CFIA), 79

Canadian Health Measures Survey (CHMS), 462, 474, 476, 478, 499

Canadian Institute for Health Information, 461

Canadian Multicentre Osteoporosis Study, 270

Canadian Nutrient File (CNF), 462

Cancer/neoplasms.

See also specific histological sites

calcitriol and, 77, 9192, 139

calcium and, 136, 137, 139

as indicator of adverse outcomes for excess intake, 6, 405

as indicator of nutrient adequacy, 4, 5, 129, 134139

overview, 134, 135136

serum 25OHD and, 138, 139

vitamin D and, 9192, 135139, 486

Cancer Prevention Study II Nutrition Cohort, 142, 414, 436

Carbohydrate, 83, 1104, 1110, 1111

Carcinogenesis, 9192, 135, 143, 144

Cardiovascular diseases

calcitriol and, 78, 150151

calcium and, 148, 149, 150, 407, 410, 481

as indicator of adverse outcomes for excess intake, 6, 405

as indicator of nutrient adequacy, 4, 5, 129

mortality, 148, 149, 150, 438

overview, 147148

serum 25OHD and, 148149, 150152, 437438

vitamin D and, 88, 148, 149, 425, 426, 437438

Carotenoids, 1113

Cartilage, 44, 48, 94, 174, 175

Caucasian ancestry

calcium accretion, 268269

puberty, 24

serum 25OHD levels, 101, 103, 104, 155, 173, 174, 203, 205206, 211213, 215, 216

Celiac disease, 254

Cell cycle, 91, 140, 143, 146

Cell differentiation, 77, 91, 140, 143, 146, 157, 176

Cell proliferation, 77, 90, 140, 146, 157

Centers for Disease Control and Prevention (CDC), 420, 460, 477

Cerebrovascular disease, 147

Cesarean section, 192

Page 1083 Cite
Suggested Citation:"Index." Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. doi: 10.17226/13050.
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Children, ages 1 through 3 years

bone health, 218, 382383, 384, 386

calcium, 7, 61, 268, 349, 351, 352, 353, 413414, 420, 463, 464, 465, 466, 467, 1104, 1108, 1114

DRI development, 23, 385387, 445

EARs, 7, 9, 349, 351, 353, 385, 387, 464, 469, 11041105

elements, 11081109, 11141115

growth rate, 23

macronutrients, 11101111

RDAs, 7, 9, 349, 351, 353, 385, 387, 464, 469, 11061110

ULs, 7, 9, 420, 441, 445, 464, 469, 11121115

vitamin D, 9, 95, 169, 385387, 441, 445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Children, ages 4 through 8 years

bone health, 195, 202208, 218, 382383, 384, 386

calcium, 7, 47, 53, 61, 265, 268, 349, 351, 353354, 385, 387, 464, 465, 466, 467, 1104, 1108, 1114

DRI development, 24, 385387, 445

EARs, 7, 9, 349, 351, 385, 387, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 11101111

RDAs, 7, 9, 349, 351, 354, 385, 387, 464, 469, 11061110

ULs, 7, 9, 420, 421, 441, 445, 464, 469, 11121115

vitamin D, 9, 95, 169, 385387, 441, 445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Children, ages 9 through 13 years

bone health, 5354, 195, 202208, 218, 226, 280

calcium, 39, 5354, 265, 354355, 386, 417, 465, 466, 467, 1104, 1108, 1114

DRI development, 24, 354355, 385387, 445

EARs, 7, 9, 349, 351, 464, 469

elements, 11081109, 11141115

macronutrients, 11101111

RDAs, 7, 9, 349, 351, 464, 469, 11061110

ULs, 7, 9, 419, 420, 421, 441, 445, 464, 469, 11121115

vitamin D, 9, 385387, 441, 445, 469, 470473, 475, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Chills, 180

Chinese ancestry or Chinese, 188, 216, 228, 268

Chloride, 1109, 1115

Cholecalciferol. See Vitamin D3

Cholestasis, 505

Cholesterol, 83, 84, 148, 434, 435, 1111

Choline, 1107, 1113

Chondrocytes, 44, 175

Chromium, 1108, 1114

Chronic disease and DRI development, 2, 5, 16, 28, 486, 489.

See also specific diseases

Chylomicrons, 8384, 106

Clothing, 81, 100, 105, 494

CLUE, 436

Cognitive function, 4, 129, 183186, 188

Collagen, 43, 44, 175

Colorectal cancer/colon polyps, 135, 142144

Communication deficits, 182

Competitive protein-binding assays (CPBAs), 107, 108, 109

Computed tomography, 61, 62

Constipation, 6, 37, 405, 417, 422

Contraceptives, oral, 11, 501503

Convulsions, 94

Copper, 1105, 1108, 1114

Cord, blood chemistry, 192, 251, 252, 254, 281

Coronary artery disease, 147

Corpuscular indexes, 417

Cramping, 171

Craniotabes, 255, 280

C-reactive protein, 152, 435

Creatinine, 176, 406, 408, 409, 428429, 434

Crohn’s disease, 4, 129, 171173

Cross-cultural differences. See Race/ethnicity

Cubilin-megalin receptor system, 88

Cut-point, 13, 14, 144, 462, 480, 486488, 522

CYP enzymes, 8487, 90

Cytochrome P450, 77, 85

Cytokines, 175, 189, 491

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D

Dairy products

autism, 183

calcium, 36, 62, 414415

cancer risk, 142, 146, 414415

constipation from, 417

diabetes, 155

lactose intolerance or cow’s milk allergy, 496498, 501

protective compound against kidney

stones, 500

vitamin D–fortified, 7980, 431432, 497

Data

assignment of “race” in study design, 295

associations vs. causal or predictive relationships, 263264, 480, 485, 517

challenges

graded doses, 12, 484, 515, 519

isolation of effects of single nutrient, 5, 6, 11, 12, 35, 346, 485

limited or incomplete. See Research needs;

Uncertainties

pre-existing disease conditions, 406, 42

standardization, 109, 516, 521

statistical analysis/synthesis methodology, 158159, 519

extrapolation

from animal studies, 96

from EAR and UL values, 27

from observed data to general population, 404

from one life stage to another, 23, 24, 346, 355, 393

inconsistency in measured outcomes, 181

interpolation, 354, 423

observational, 22, 130

postmortem, 275, 350, 367, 388

quality, and hierarchy of study design, 127, 128, 130, 131132, 133

scaling, 29, 346

uncertainties in analysis, 158159

uncertainties in collection, 1112, 167

weighted, 519

Decision making, 1819, 26

7-Dehydrocholesterol, 75, 81, 95, 100, 101, 104, 496

Dementia, 4, 183186

Deoxyribonucleic acid (DNA), 105, 143

Depression, 4, 129, 186188

Dermatitis, 168

Diabetes (type 1), 4, 5, 170171, 189, 192, 255

Diabetes (type 2), 4, 5, 129, 151, 152156

Diarrhea, 171, 497

DiaSorin, 110111, 111n.12, 476, 476n.17–18

Dietary intake.

See also Supplements;

specific nutrients

assessment. See Intake assessment, dietary

effects on asthma, 168

fat, 83, 148, 168, 498, 1110, 1111

fiber, 62, 417, 1110

of indigenous Canadian populations, 11, 498500

of peoples in the far north, 492

protein, 63, 1104, 1110, 1111

research needs, 521

self-reported, 459, 460, 497

total intake, 457, 459, 474, 483

tuberculosis, 179

use of term, 457

vegetarian or vegan, 11, 63, 179, 496498

Dietary Reference Intakes (DRIs)

AI and, 345

background, 1516, 18

calcium. See Calcium, DRIs

components, 3, 1516, 20.

See also Adequate Intake;

Estimated Average Requirements;

Recommended Dietary Allowance;

Tolerable Upper Intake Levels

criteria for, 3031, 485

decision making, 1819, 26

definitions, 1922

development

and chronic disease, 2, 5, 16, 28, 486, 489

IOM initiative, 1516, 91

and public health. See Public health

considerations, in DRI

development

rationale and assumptions, 1617, 347348, 351, 369, 370, 385.

See also Sun exposure, DRI development, assumption of minimal

risk assessment in, 17, 18, 2629, 30, 32, 345, 403, 481482, 488490, 514516

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EAR and, 2, 17, 2223, 294

elements, 11081109, 11141115

extrapolation. See Data, extrapolation

framework, 1719, 488

IOM committee. See Institute of Medicine, committee

macronutrients, 11101111

measures. See Indicators of adverse outcomes for excess intake;

Indicators of nutrient adequacy

overview, 7, 12, 1819, 2325, 457, 458, 479481

RDA and, 23, 345

total water, 1110

uses, 2, 1920, 2223

vitamin D. See Vitamin D, DRIs

vitamins, 11061107, 11121113

Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (IOM, 1997)

calcium, 16, 5860, 61, 346, 350, 351, 404, 416, 420421

ULs, 404, 420421

vitamin D, 9, 16, 97, 346, 404, 425, 487

Dieting. See Weight loss or dieting

Dietitians of Canada, 497

1,25-Dihydroxyvitamin D. See Calcitriol

24,25-Dihydroxyvitamin D, 78, 86, 109, 504

Diuretics, 407, 409

Dose–response relationships

calcium intake, 269, 360

intake–response assessment, 17, 2829, 31, 403, 418424, 440446, 515516, 519520

public health approach vs. medical approach, 482, 521

research needs, 12, 159, 346, 359, 360, 482, 519520

serum 25OHD

and bone health, 364, 366

and cardiovascular disease, 148, 149, 437438

and vitamin D, 98, 364365, 381, 431, 439

vitamin D

and bone health, 159160, 161, 167, 291, 363, 364, 365383, 390

and colorectal cancer, 145

and serum 25OHD levels, 98, 364365, 381, 431, 439

and type 1 diabetes, 171

Duel-energy X-ray absorptiometry (DXA), 56, 57, 6162, 199201, 205206, 210216, 229, 231, 233

Dyslipidemias, 152

Dysthymic disorder, 186, 187

E

East Asian ancestry, 101, 103

Eating disorders, 406, 407, 425

Eczema, 168, 169, 192

Elderly population.

See also Adults, 70+ years

bone health and serum 25OHD, 209218, 226234, 496

cognitive function, 183186

diabetes, 154

falls, 157, 160161, 166

indoor environment or institution, 11, 37, 241, 496

Elements, 11081109, 11141115

Emesis (vomiting), 407, 409

Encephalomyelitis, 173

Endocrine system, 35, 4041, 84, 89, 153, 156

Endpoints, 25, 158, 263, 489, 505

Energy metabolism, 24

Epidemiological studies, 63, 131, 132, 135, 145, 176177, 185, 278, 361

Epidémiologie de l’Ostéoporose (EPIDOS), 185

Ercalcitriol, 78

Ergocalciferol. See Vitamin D2

Estimated Average Requirements (EARs).

See also specific nutrients

calcium. See Calcium, EARs

coefficient of variation, 21

cut-point method, 462, 480, 486487

definition, 3, 20, 482

development, 2, 89, 2021, 26

DRI and, 2, 17, 2223, 294

of females. See Females, EARs

during lactation. See Lactation, EARs

of males. See Males, EARs

during pregnancy. See Pregnancy, EARS

RDA and, 2, 3, 20, 21, 23, 369

selection of indicators of nutrient adequacy, 2728, 31, 125127, 129, 130134, 298299

serum 25OHD level and, 294

summary table, 11041105

throughout the life cycle. See under specific life stages

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uses, 3

vitamin D. See Vitamin D, EARs

Estonians, 101, 102

Estradiol, 42, 55, 213, 256, 501

Estrogen, 24, 48, 5455, 62, 96, 285, 287, 490, 501503

Ethical considerations, 404, 425, 488, 504, 518

Ethinyl estradiol. See Contraceptives, oral

Ethnic background. See Race/ethnicity

Etiology, 5, 134, 187, 406, 426427, 486

European ancestry, 101, 374, 375

European Prospective Investigation into Cancer and Nutrition (EPIC), 145

Exercise. See Physical activity

F

Falls and physical performance.

See also Physical activity

calcium, 157, 158, 162165

definition and assessment challenges, 158

as indicator of adverse outcomes for excess intake, 6, 161, 405

as indicator of nutrient adequacy, 4, 5, 129, 156167

overview, 156157, 194

serum 25OHD, 157, 158160, 162165, 166, 167, 226, 439

vitamin D, 157165, 167, 438

Far Easterners, 230, 244

Fat, dietary, 83, 148, 168, 498, 1110, 1111

Fatigue, 186, 406

Females.

See also Gender differences;

Women

EARs, 7, 9, 349, 363, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 1110

RDAs, 7, 9, 349, 363, 464, 469, 11061110

serum 25OHD, 202, 476

ULs, 7, 9, 419, 441, 464, 469, 11121115

vitamin D intake assessment, 470473, 475

vitamins, 11061107, 11121113

water, total, 1110

Fetus

asthma, 168

BMC/BMD, 279281.

See also Pregnancy, bone health, BMC/BMD

brain development, 184

calcium needs, 5556, 242, 249, 281, 361, 393394

and non-skeletal reproductive outcomes, 192

phosphorus, 56, 252

preeclampsia, 189

PTH, 252

skeleton development, 5556, 57, 193, 242, 249, 393394

vitamin D, 96, 169, 182, 252256, 279280, 393394

Fever, 180

Fiber, dietary, 62, 417, 1110

Fibroblast-like growth factor-23 (FGF23), 77, 84, 85, 90, 515, 518

Finnish peoples, 169, 191, 203, 206, 225, 232, 372, 374, 376, 383, 437, 492

First Nation peoples, 11, 245, 462, 498500

Flatulence, 37, 417, 497

Fluoride, 16, 1108, 1114

Folate, 1105, 1107, 1113

Food and Drug Regulation, 79

Food and Nutrient Database for Dietary Studies 3.0 (USDA), 459

Food composition databases, 36, 80, 458, 459

Food sources.

See also Fortified foods of calcium, 36, 6263, 413, 466, 497, 498

calcium intake estimates from, 465, 466

of vitamin D, 7981, 498

vitamin D intake estimates from, 470, 474, 475, 476

Forest plot, 209, 217, 234, 238240

Formula, infant, 52, 8081, 95, 431, 503, 505

Fortified foods, 1, 15, 22, 36, 62, 7980, 431432, 466, 497, 498.

See also Formula, infant

Fracture. See Bone, fracture

Framingham Offspring Study, 148, 149, 437

Framingham Osteoporosis Study, 63

Fructose, 415

G

Gambians, 53, 249, 256, 257, 259, 278

Gas chromatography, 109

Gastroenteritis, 180

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Gender differences, 95, 101, 139, 354, 437.

See also Men;

Women

Genetics

assignment of “race” in study design, 295

asthma, 168, 170

bone mass, 46, 55

calcitriol gene expression, 146

calcium content of human milk, 53

genetic variation and serum 25OHD as biomarker, 517

rickets, 49, 94, 254

systemic lupus erythematosus, 176

vitamin D, 140.

See also Vdr gene;

Vdr-null mice

GLA protein, 44

Glomerular filtration rate (GFR), 55, 411, 412, 426, 428429, 435

Glossary, 527536

Glucocorticoids, 62

Glucose, 153154, 155, 156, 170, 184, 505

Greeks, 273, 274

Growth factors, 43, 44, 91, 143, 146, 184.

See also Fibroblast-like growth factor-23;

Vascular endothelial growth factor

Growth hormone, 53

Growth rate, 6, 23, 405, 420, 431, 495

H

Handgrip strength, 166

Hazard characterization, 26, 27, 2829, 345, 403, 514, 515516, 519520, 522

Hazard identification, 26, 2728, 30, 125, 403, 514, 515, 516519, 522

Hazard ratio, 137, 227, 286, 358, 412, 433

Health Canada, 9495, 461, 476

Health Professionals Follow-up Study (HPFS), 138, 147, 148, 151, 415, 436

Heart failure, 147, 150151, 166

Height, 140, 202, 462, 495.

See also Growth rate

Hematocrit, 417

Hemoglobin, 155, 417

Hippocampal cells, 184

Hispanics, 104, 174, 347, 374, 493, 494, 495

Histamine-2 blockers, 37, 407

Hormone replacement therapy (HRT), 210, 213, 286, 358, 393, 501503

Human milk.

See also Infants, breast-fed;

Lactation

calcium content, 8, 39, 5253, 56, 57, 256, 257, 259, 281282, 349, 351, 394, 503

intake volume per day, 53, 349, 351

as optimal source of nutrients, 348349

phosphorus in, 503

25OHD in, 80, 94, 257258

vitamin D content, 80, 94, 96, 257, 494

volume produced, 282

Hydroxyapatite. See Calcium hydroxyapatite

1α-Hydroxycholecalciferol, 157

1α-Hydroxylase

in the brain, 184

calcitriol formation and, 35, 56, 77, 84, 97

expressed in extra-renal tissues, 77

expressed in the colon and rectum, 143

expressed in the kidney, 35, 42, 56, 251, 252

expressed in the placenta, 189, 251, 252

with granulomatous diseases, 431

impaired with vitamin D–dependent rickets type 1, 94

induced by PTH, 35, 56, 84

with inflammatory disease, 177178

molecular cloning, 177

suppression by FGF23, 85

vitamin D2 and, 93

24-Hydroxylase, 85, 86

25-Hydroxylase, 77, 84, 93

1α-Hydroxylase-null mice, 253, 260

25-Hydroxyvitamin D (25OHD).

See also Serum 25-hydroxyvitamin D

assays for, 107111, 476, 484, 516, 521

discovery, 107

formation in the liver, 77, 85

in human milk, 80, 94, 257258

lifetime, 86

during pregnancy, 192, 252

relationship with calcium absorption, 95, 347

use of term, 78

vitamin D intoxication, 89, 427430

Hypercalcemia

calcification associated with, 406, 409410

diseases associated with, 91, 177

excess vitamin D intake and, 88, 406, 425, 426430, 431

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as indicator of adverse outcome for excess intake, 6, 405, 406, 425, 440, 443, 501

in IOM 1997 report, 404

renal insufficiency with, 407409, 410

toxic condition, 140, 174, 406407

Hypercalciuria

increased risk for nephrolithiasis with, 411, 501

as indicator of adverse outcome for excess intake, 6, 405

in IOM 1997 report, 404

during pregnancy, 56, 250, 277, 278279, 424, 501

with sarcoidosis, 91

toxic condition, 406407

Hyperglycemia, 155

Hyperparathyroidism, 48, 49, 55, 9596, 111, 296, 409

Hyperphosphatemia, 407, 409n.1

Hypertension, 4, 5, 129, 147, 151, 189191, 435.

See also Cardiovascular diseases

Hypervitaminosis D, 88, 93, 109, 425, 440, 481, 518

Hypocalcemia, 48, 49, 94, 184, 251, 253, 254, 256

Hypocalciuria, 189

Hypoparathyroidism, 201, 409

Hypophosphatemia, 48, 253, 407

Hypovitaminosis D, 259, 283

I

IARC studies, 141, 143144, 145

Immune function, 78, 91, 167168, 170, 176, 177, 180

Immune responses, 4, 5, 129, 167182

Immunoglobulins, 91, 169170, 176, 497

Indian ancestry or Indians (East Indian), 207, 245, 493494

Indians (North American). See American Indians;

First Nation peoples

Indicator, use of term, 25

Indicators of adverse outcomes for excess intake, 28, 403, 405418, 422, 424440

Indicators of frailty, 434

Indicators of nutrient adequacy.

See also specific indicators, nutrients, and life stages

data examination of, 3, 56

data quality, hierarchy of study design, 127, 128, 130, 131132, 133

process, 2526, 2728, 130, 132134, 135

review and selection, 2728, 31, 125127, 129, 130134, 298299, 515, 516519

summary tables, 4, 129

Indoor environments and institutionalized persons, 37, 241, 496

Infants, 0 to 12 months.

See also Formula, infant;

Human milk

ages 0 to 6 months, 7, 23, 39, 109, 192, 218, 251252, 268, 348, 349, 350, 383, 385, 386, 418, 419420, 440, 441, 442, 464, 469, 11061110, 11121115

ages 6 to 12 months, 7, 23, 348, 349, 350351, 383, 385, 386, 418, 420, 441, 442, 464, 469, 11041110, 11121115

birthweight or length, 192193, 251252, 254, 255, 283

bone health, 195, 196201, 251252, 257258, 283, 386, 394

breast-fed, 39, 52, 94, 201, 348349, 350, 493, 494495

calcium

absorption, 39, 52, 253, 350, 503, 505

accretion, 268

AIs, 7, 345, 348351

balance, 58

bone deposition, 52

DRI development, 24, 418420

intake, 5253, 249, 281282, 349

RDAs, 1108

total body, 268

ULs, 418, 419, 420, 464, 1114

EARs, 11041105

elements, 11081109, 11141115

formula-fed, 23, 39, 52, 201

growth rate, retarded, 6, 405, 431, 495

indicators of adverse outcome for excess intake, 6, 405, 431, 495

macronutrients, 1110

premature, 11, 31, 503505

RDAs, 11061110

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ULs, 418, 419, 420, 464, 11121115

vitamin D, 9495, 96, 258, 383, 385, 431432, 440442, 494495, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Infectious diseases, 4, 5, 78, 177181, 182.

See also Influenza;

Tuberculosis;

Upper respiratory infections;

Vaginosis

Inflammation, 175, 180.

See also Anti-inflammatory action;

Asthma;

utoimmune disease;

Crohn’s disease;

Inflammatory bowel disease

Inflammatory bowel disease (IBD), 4, 37, 171173

Inflammatory markers, 169170

Influenza, 4, 5, 129, 180181

Institute of Medicine (IOM)

committee

approach for intake assessment, 462463

conclusions about vitamin D

deficiency, 1314, 293, 480, 486488

data review for DRI development, 3, 56, 1617, 2932, 135

members’ expertise, 16

process, 2

risk assessment approach for DRI development, 17, 18, 2629, 30, 32, 125, 345, 403, 479, 488490, 514516

summary of uncertainties and research needs, 483486, 513522

1997 report. See Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride

overview of DRI development, 1, 1516

workshops, 2, 97, 127, 404405, 482

Institutionalized people, 37, 241, 496

Insulin, 152, 153, 154155, 156, 170

Intake. See Calcium intake, assessment;

Dietary intake;

Intake assessment, dietary;

Vitamin D intake, assessment

Intake assessment

calcium. See Calcium intake, assessment

dietary, 1011, 110111, 457463, 516, 521

research needs, 516, 520521

in risk assessment approach, 27, 29, 514

vitamin D. See Vitamin D intake, assessment

Intake–response assessment, 17, 2829, 31, 403, 418424, 440446, 515516, 519520

Interactions. See Calcium interactions;

Nutrient–nutrient interactions;

Vitamin D interactions

Interferon, 176, 177

Interleukin 1, 175

International Unit (IU), 78

Iodine, 1105, 1108, 1114

Iowa Women’s Health Study, 175

Iron, 6, 37, 80n.3, 405, 416417, 418, 1105, 1108, 1114

J

Jadad Score, 127, 128, 196198, 203204, 210211, 236

K

Kidney function. See Renal function

Kidney stones. See Nephrolithiasis

Koreans, 186, 200, 201, 255

L

Labor, obstructed, 192

Lactation.

See also Human milk;

Infants, breast-fed

adolescents, 7, 57, 257, 282, 283, 349, 361, 362, 363, 393, 394, 424, 464, 469

calcitriol, 91, 259

calcium, 7, 8, 45n.3, 5657, 256257, 281282, 292, 349, 361, 362, 464, 1104, 1108

DRI development, 24, 362

EARs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 11041105

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elements, 11081109, 11141115

macronutrients, 1110

RDAs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 11061110

serum 25OHD and, 218219, 283, 394

twins, 257

ULs, 7, 9, 419, 424, 441, 446, 464, 469, 11121115

vitamin D, 9, 96, 257260, 282283, 363, 393, 394, 441, 469, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Lactose, 39, 80n.3, 260, 498, 505.

See also Lactose intolerance

Lactose intolerance, 347, 496498, 501

Lean body mass or lean mass, 166, 202, 204, 490, 491

Lesions, 144, 175, 176

Leukopenia, 176

Life stage.

See also Adolescents;

Adults;

Children;

Infants

calcium, 78, 5257, 345, 349, 464

categories, 2325

extrapolation of data from one to another, 23, 24, 346, 355, 393

interpolation of data, 423

research needs, 516517

vitamin D, 9, 9496, 345, 363, 441, 469

Ligand, 77, 89

Linoleic acid, 1110, 1111

α–Linolenic acid, 1110, 1111

Liquid chromatography (LC), 107, 108109, 110, 365, 430

Literature review, 17, 28, 31, 126, 127, 130, 141, 252

Liver, 77, 83, 84, 85, 8687, 105, 106, 492, 498

Longitudinal Aging Study Amsterdam, 166, 434

Lowest observed adverse effect level (LOAEL), 418, 421, 422, 423

Lowest observed effect level (LOEL), 29

Lumisterol, 81, 82

Lupus. See Systemic lupus erythematosus

Lymphadenopathy, 176

M

Macronutrients, 11101111

Macrophage, 44, 90, 91, 175, 177

Magnesium, 16, 37, 168, 1105, 1108, 1115

Magnetic resonance imaging (MRI), 185

Males.

See also Gender differences;

Men

EARs, 7, 9, 349, 363, 464, 469, 11041105

elements, 11081109, 11141115

macronutrients, 1110

RDAs, 7, 9, 349, 363, 464, 469, 11061110

serum 25OHD levels, 476

ULs, 7, 9, 419, 441, 464, 469, 11121115

vitamin D intake assessment, 470473, 475

vitamins, 11061107, 11121113

water, total, 1110

Malnutrition, 254

Manganese, 1108, 1115

Maori peoples, 155

Mass spectrometry, 107, 108109, 110

Melanin. See Skin pigmentation

Men.

See also Gender differences;

Males

age-related bone loss, 52, 55

bone health

BMD, 274, 357

bone loss, 356

fractures, 234242, 356, 359360, 391, 392

and serum 25OHD, 209218, 226234

vitamin D and calcium supplementation, 157, 162, 234242, 393

calcium, 162, 356357

cognitive function, 185

EARs, 356, 357, 359

falls, 157, 162

mean age of puberty, 24

nephrolithiasis incidence rate, 411

RDAs, 356, 357, 359

serum 25OHD level and cardiovascular risk, 437

Menarche, 139.

See also Puberty

Menopausal status

age of onset, 356, 359

bone health, 8, 4748, 52, 5455, 209218, 226, 234242, 360361, 392

calcium absorption, 40

calcium balance, 58, 285

cancer risk, 138, 141

ethinyl estradiol and, 501503

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Metabolic syndrome, 4, 5, 129, 152156.

See also Obese or overweight persons

Methodological considerations.

See also Data;

Indicators of nutrient adequacy

assay for serum 25OHD, 107111, 476, 484, 516, 521

assay shift and drift, 107111, 365366, 460461

assignment of “race,” 295

calcium balance studies, 5758

compliancy, 225, 289, 291

complications in the course of a study, 130

cut-point method, 13, 14, 144, 462, 480, 486488, 522

flaws, biases, and confounding effects in study design, 130

IOM committee data review, 17

IOM committee intake assessment, 462463, 477

quality assurance, 109110

standardization, 109, 516, 521

use of new, 489n.1

Mexican ancestry, 166, 493

Michaelis-Menten constants, 87

Microsome, 87

Middle Eastern ancestry or Middle Easterners, 204, 246, 259, 493494, 495

Milk. See Dairy products;

Formula, infant;

Human milk

Milk-alkali syndrome (MAS), 407.

See also Calcium-alkali syndrome

Mini-Mental State Examination for Koreans (MMSE-K), 186

Models, statistical

calcium retention, 58, 5960, 268, 353

calcium supplement intake, 460

cognitive function, 185

dietary intake, 460

effect of latitude on vitamin D synthesis, 104, 380383

effects of seasonal sun exposure, 496

intake–response assessment, 28

mixed effect model, 380

Monte Carlo approach, 460

public health approach vs. medical

approach, 482, 521

serum 25OHD and BMC/BMD, 212, 214

serum 25OHD and vitamin D intake, 380, 463

Molybdenum, 37, 1105, 1109, 1115

Moroccans, 244

Mortality, 6, 156, 179, 405, 425, 432435, 438, 444

Multiple sclerosis (MS), 4, 129, 173174, 181

Muscles, 43, 49, 50, 84, 156157, 180, 184, 202

Myelin, 173

Myocardial infarction, 147, 148, 149, 151, 437

N

National Cancer Institute (NCI), 459, 460

National Center for Health Statistics (NCHS), 110

National Council on Skin Cancer Prevention, 495496

National Health and Nutrition Examination Survey (NHANES)

calcium intake and BMD, 273

First (NHANES I), 458

overview, 458459

post-2000 data, 150, 437, 458459, 465, 466, 470, 471, 472, 473, 493

Second (NHANES II), 63, 110111, 458

serum 25OHD levels, 169, 365, 404, 405, 460461

Third (NHANES III), 56, 57, 110111, 138, 148149, 166, 185186, 257, 274, 433, 434, 435, 438, 458

National Institute of Standards and Technology (NIST), 110

National Institutes of Health (NIH), 424, 459, 497, 513, 521

National Osteoporosis Foundation, 357

Native Americans. See American Indians;

First Nation peoples

Natriuresis, 407

Nephrocalcinosis, 406, 409, 412

Nephrolithiasis (kidney stones)

association with nephrocalcinosis, 409

as indicator of adverse outcome for excess intake, 6, 405, 422, 423, 500501

during pregnancy, 250, 279

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risk with excess calcium, 286, 410414, 422, 481

risk with excess vitamin D, 286, 426

Nerve transmission, 35, 43, 89, 173

Neuroblastoma cells, 184

Neurological manifestations, 176

Neuropsychological functioning, 4, 5, 182188.

See also Autism;

Cognitive function;

Depression

New York University Women’s Health Study, 436

Niacin, 1104, 1107, 1113

Nickel, 1115

Nigerians, 246248, 265

No observed adverse effect level (NOAEL), 418.

See also Calcium, ULs;

Vitamin D, ULs

No observed effect level (NOEL), 28

Northern Finland Birth Cohort of 1966, 191

Norwegians, 154, 187, 244, 437

Numbness, in the limbs, 173

Nurses’ Health Study (NHS), 141, 142, 155, 177, 412413, 436

Nutrient–nutrient interactions, 5, 6, 7, 11, 12, 35, 37, 346, 405, 416417, 485

O

Obese or overweight persons.

See also Adipose tissue;

Adiposity;

Metabolic syndrome

bariatric surgery, 88, 106, 518

calcium absorption, 39

challenges with bone mass measurement, 62

definition, 490

diabetes, 154, 155156

metabolic syndrome, 152

vitamin D storage, 88, 105106, 156, 490, 518

Organ transplant recipients, 158

Osteoarthritis, 216

Osteoblast, 44, 45, 46, 49, 50, 256, 491

Osteocalcin, 44

Osteoclast, 44, 45, 46, 89, 256, 491

Osteoid. See Bone, organic matrix

Osteomalacia

cannot be corrected by increased calcitriol, 49

as indicator of nutrient adequacy, 4, 129

overview, 4950, 94, 156

during pregnancy, 253

serum 25OHD and, 8, 195, 275, 284, 292, 293, 367, 368, 470471n.16, 494

Osteopenia, 175, 503

Osteophyte, 61

Osteoporosis

with adolescent pregnancy, 250

African Americans, 294295, 296, 493

effects of lactation, 57, 256

FDA primary outcome, 167

fracture risk and, 5052

inclusion in bone health measures, 489

low calcium intake and vitamin D levels, 49

with osteomalacia, 50

postmenopausal, 48, 52

serum PTH as risk factor, 260

serum 25OHD and, 231

Osteoporotic Fractures in Men Study (MrOS), 185, 356, 367

Oxalic acid (oxalate), 62, 411, 413, 498, 500

Ozone, 104, 492

P

Pacific Islanders, 155

Pakistani ancestry or Pakistanis, 202, 209, 218, 244, 275, 493494

Pancreatic cancer, 425, 436437, 486

Pancreatic endocrine function, 153, 156

Pancreatic insufficiency, 254

Pantothenic acid, 1107, 1113

Paralysis, 173

Parathyroid gland (PTG), 35, 40, 41

Parathyroid hormone (PTH)

as biomarker for bone resorption, 55, 111

bone health and

African Americans, 296

children and adolescents, 205

fractures, 276, 390

infants, 198

postmenopausal women and elderly men, 210, 214215, 227

serum 25OHD, 198, 208, 246, 260262

calcitriol regulation, 77, 84, 85

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calcium and, 35, 38, 4041, 42, 49, 56, 62, 89, 407

fetal, 252

as indicator of nutrient adequacy, 4, 129, 260262

multiple sclerosis, 174

osteomalacia, 50

vitamin D and, 111, 426, 518

Parathyroid hormone-related protein (PTHrP), 256, 257

Parkinson’s disease, 158

Periosteal expansion, 44, 46, 53

Peripheral artery disease or peripheral vascular disease, 147, 150, 152, 437

Phosphate, 44, 49, 64, 77, 84, 8990, 407, 409, 426, 500

Phosphorus

absorption, 64

BMD and, 62

bone formation, 44

calcium regulation, 41, 49

deficiency, 44, 48, 50

EARs, 1105

fetal, 56, 252

in human milk, 503

in milk with cream, 407

RDAs, 1109

regulation by calcitriol, 64, 77, 89

serum, 40, 41, 50, 77, 90, 407, 426

ULs, 1115

Physical activity.

See also Falls and physical performance

bone fracture and, 286

bone mass and, 46, 54, 273, 287, 490491

cancer, 140, 141, 142

diabetes, 155

serum 25OHD and, 105

vitamin D synthesis in the skin, 105

Physiotherapy, 160161

Phytic acid, 62

Pigmentation. See Skin pigmentation

Placenta, 52, 55, 90, 189, 251, 252

Pneumonia, 180

Polynesians, 155

Polyuria, 406, 425

Population segments and conditions of interest, 11, 17, 29, 31, 490505

Portuguese, 186, 244, 245

Potassium, 6364, 1109

Preeclampsia and pregnancy-induced hypertension, 4, 5, 189191, 250

Pregnancy.

See also Lactation

adolescents, 56, 57, 250, 257, 278, 361, 362, 393, 394, 424, 469

bone health

BMC/BMD, 249, 250, 254, 255, 256, 278, 279280, 361, 362

fracture, 278

serum 25OHD and, 192193, 205, 218219, 251, 255, 279280, 281

calcium, 7, 8, 39, 5556, 96, 242, 249250, 277278, 279, 292, 349, 361362, 424, 464, 1104, 1108

DRI development, 24, 361362, 393394

EARs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 11041105

elements, 11081109, 11141115

hypercalciuria during, 424, 501

increase in calcitriol, 9091

macronutrients, 1110

multiple sclerosis remission, 174

non-skeletal reproductive outcomes, 192193

preeclampsia and pregnancy-induced hypertension, 4, 5, 189191, 250

RDAs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 11061110

ULs, 7, 9, 419, 424, 441, 446, 464, 469, 11121115

vitamin D, 9, 96, 169, 182, 192, 193, 250260, 279281, 363, 393394, 441, 469, 1106, 1112

vitamins, 11061107, 11121113

water, total, 1110

Prescription drugs, interactions with, 11, 87, 422, 504, 505

Profile of Mood States (POMS), 188

Prohormone, vitamin D as, 75, 84, 481, 484

Proinflammatory state, 152

Project VIVA, 169

Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), 141, 436

Prostate cancer, 6, 145147, 405, 414416, 422, 437

Protein, dietary, 63, 1104, 1110, 1111

Proteinuria, 176, 189

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Prothrombotic state, 152

Proton-pump inhibitors, 37, 407

Provitamin D. See 7-Dehydrocholesterol

Puberty, 8, 24, 39, 47, 262, 354.

See also Adolescents

Public health considerations cancer, 134

cardiovascular disease, 147

in DRI development

calcium, 359, 360, 421, 423, 477

overview, 29, 293, 298, 404, 479, 482, 488489, 522

vitamin D, 370, 388, 420, 440, 442, 445, 483, 485, 488, 494

R

Race/ethnicity

assignment of “race” in study design, 295

breast-fed infants and vitamin D, 385, 494495

calcitriol levels, 260261

“calcium economy,” 294, 517

calcium retention, 296, 297

cardiovascular mortality, 438

clothing and sun exposure, 105, 494

fractures, 439

limited data for DRI development, 347

onset of breast development, 24

relationship between serum 25OHD and PTH, 260261

research needs, 347, 516517

serum 25OHD levels, 101, 103, 104, 106, 174, 260261, 374, 431, 438, 439, 444, 493

Radioimmunoassay (RIA), 110111, 198

Randomised Evaluation of Calcium and/Or vitamin D (RECORD), 154

Recommended Dietary Allowances (RDAs)

applicable population, 21

background, 15

calcium. See Calcium, RDAs

defined, 3, 21, 482

development, 3, 8, 910, 21

EAR and, 2, 3, 20, 21, 23, 369

elements, 11081109

macronutrients, 1110

throughout the life cycle. See under specific life stages

uses, 15

vitamin D. See Vitamin D, RDAs

vitamins, 11061107

water, total, 1110

Recommended Nutrient Intakes (RNIs), 15

Rectal mucosa cancer, 135

Renal function

calcitriol formation and, 77, 84, 90, 481

renal failure, 407, 409n.1

renal insufficiency

cardiovascular disease, 426

chronic kidney disease–mineral disorder, 55

hypercalcemia, 42, 406, 407409, 410, 425

percent of N. Amer. population with, 406

renal dialysis patients, 91

vitamin D intoxication, 88, 426

Reproductive outcomes, non-skeletal, 4, 192193.

See also Preeclampsia and pregnancy-induced hypertension

Research needs

adverse effects of vitamin D, 424425

background diet to calculate total level of intake, 346

calcium intake and BMD, 273

chronic diseases, 5, 486, 489

clinical trials, 5, 12, 22, 135, 404, 486

context, 17, 1819

dose–response relationships, 12, 159, 346, 359, 360, 482, 484, 489, 519520.

See also Sun exposure, DRI development

ethnic/racial considerations, 347, 516517

indicator review and selection, 515, 516519

intake assessment, 22, 516, 520521

intake response–assessment, 519520

isolation of effects of single nutrient, 5, 6, 11, 12, 35, 346, 485

long-term data, 12, 425, 485, 518

reproducibility, 26, 109

serum 25OHD, 12, 139, 181, 517, 518, 519, 520, 521

summary, 513522

sun exposure, 12, 484, 516, 520

vitamin D as a hormone, 12

Rheumatoid arthritis (RA), 4, 129, 174175, 177, 189

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Rhinitis, 169

Riboflavin, 1104, 1107, 1112

Rickets

hereditary vitamin D–resistant (VDDR II), 49, 94, 252, 254, 260, 276

as indicator of nutrient adequacy, 4, 129

neonatal or vitamin D–deficiency, 75, 252, 254, 256, 280281

premature infants, 503

prevention with vitamin D–fortified foods, 79

serum 25OHD, 49, 235, 237, 243248, 271, 293, 366, 368, 386, 470471n.16, 494

vitamin D–dependent (VDDR I), 49, 94, 252, 254, 260, 276

Risk, use of term, 26

Risk analysis, basic assumptions, 1819, 347348

Risk assessment

definition, 18

in DRI development, 17, 18, 2629, 30, 32, 345, 403, 479, 488490, 514516

four steps, 27

overview, 3

population segments and conditions of interest, 11, 490505

role of dietary intake assessment, 457

Risk characterization, 11, 17, 26, 27, 29, 479

Risk communication, 18

Risk management, 18

S

Sarcoidosis, 91, 409

Saudi Arabians, 251, 259, 283

Scarring and scar tissue, 171, 173

Schizophrenia, 182

School meals, 15, 354

Scleroderma, 409

Seasonal affective disorder, 186, 187

Selenium, 1105, 1109, 1115

Sensitive populations. See Special concerns

Serum albumin, 215, 229, 249250, 257, 434, 435

Serum calcitriol, 38, 78, 150151, 177, 191

Serum calcium

colorectal cancer, 143

decline with rickets, 49

diabetes, 153

effects of excess vitamin D, 405, 426, 428429, 430431

hypercalcemia, 38, 406, 408, 426

as indicator of adverse outcomes for excess intake, 6, 405

during lactation, 257, 424

during pregnancy, 56, 249250, 253

regulation, 35, 4041, 77, 8990, 426

Serum 25-hydroxyvitamin D (25OHD)

assays for, 107111, 476, 484, 516, 521

asthma, 169170, 181

autism, 183

as biomarker

of vitamin D effect, 1314, 9697, 263264, 291, 293, 439, 484, 517, 520

of vitamin D exposure, 8, 1213, 96, 99, 293, 363, 381382, 384, 480, 483, 486488, 520

bone health and

African Americans, 106, 208, 260261, 295, 298, 439, 493

BMC, 195, 196205, 210218

BMD, 195, 196207, 209218, 275, 368, 386387

bone loss, fractures, osteomalacia, 195, 275

calcium absorption, 213, 257, 259, 264267, 271, 277, 284, 292, 366, 368, 388389

children and adolescents, 195, 202208, 382383, 384

distribution in healthy populations, 294

DRI development

analysis and outcomes, 263264, 380383

conclusions, 366370, 381382, 486488

integration of evidence, 292294, 370379

interpretation of data in the literature, 365366

non-linear relationship with vitamin D intake, 12, 99, 379383, 384, 484

fractures, 195, 231, 235, 236237, 291292, 366367, 390, 438439

infants, 195, 196201, 257258, 281, 283

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mineralization, 275276

osteomalacia, 195, 275, 284, 292, 293, 367, 368, 470471n.10, 494

overview, 4, 5, 129, 193194

postmenopausal women and elderly men, 209218, 226234

pregnancy and lactation, 192193, 205, 218219, 251, 255, 257259, 279280, 281, 283, 393394

PTH, 198, 208, 246, 260262

rickets, 49, 235, 237, 243248, 271, 293, 366, 368, 386, 470n.10, 494

cancer, 5, 138, 139, 140141, 143145, 146, 436437

cardiovascular disease and hypertension, 148149, 150152

cognitive function, 185186

depression, 187188

desired level for population median, 8, 470471n.16

diabetes, 151, 154156

factors affecting, 88, 97107

falls and physical performance, 157, 158160, 162165, 166, 167

half-life, 263

infants, 195, 196201, 257258, 281, 283, 504505

inflammatory bowel disease and Crohn’s disease, 172173

insulin sensitivity, 154

intake assessment process

levels for U.S. and Canada, 1011, 13, 476

methodological considerations, 463, 476

in national surveys, 460461, 462, 474, 477478

review of national survey data, 31, 477478, 480

vs. plasma 25OHD, 461n.10

interactions with prescription drugs, 504

mortality, all-cause, 425, 432435, 444

multiple sclerosis, 173, 174

neonatal, 109, 258, 280281, 283

population baseline, 99

preeclampsia and pregnancy-induced hypertension, 189, 190, 191

public health considerations, 521

race/ethnicity considerations, 101, 103, 104, 106, 174

relationship with BMD, 95

relationship with body fat, 88, 105106

relationship with PTH, 111, 260262

research needs, 517, 518, 519, 520, 521

rheumatoid arthritis, 175

systemic lupus erythematosus, 177

toxicity, 404, 443444

tuberculosis, 178, 179, 180, 494

uncertainties associated with, 12, 13, 97, 381382

units of measurement, 32, 487

vaginosis, 192

vitamin D and

effects of sun exposure. See Sun exposure, relationship between 25OHD and vitamin D

effects of supplementation, 98, 106, 179, 180, 243248, 251252, 266, 379, 381382, 426430, 431

intake, 1011, 97100, 110111, 364, 370383, 386387, 468477

intake assessment data, 468477, 484

intoxication, 426430, 443

Serum 25-hydroxyvitamin D2 (25OHD2), 107, 108

Serum 25-hydroxyvitamin D3 (25OHD3), 107, 108

Serum parathyroid hormone, 111, 174, 260262

Serum phosphate, 407, 409

Serum phosphorus, 40, 41, 50, 77, 90, 407, 426

Serum vitamin D3, 104

Shanghai Women’s and Men’s Health Studies, 436

Signal transduction, 43, 93

Silicon, 1115

Skeleton.

See also Bone;

Bone health

bone types, 45

gestational development, 5556, 57, 193, 242, 249, 281, 393394

three functions, 4243

timeframe for turnover, 45

Skin cancer, 6, 12, 136, 363, 370, 481, 491, 496

Skin eruptions, 176

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Skin pigmentation, 101104, 174, 370, 481, 493495

Smoking, 147, 415, 434, 435, 436

Social withdrawal, 182, 186

Sodium, 62, 6364, 168, 1109, 1115

South Asian ancestry or South Asians, 101, 103, 154, 493494

Special concerns

limited or incomplete data. See Data, challenges;

Uncertainties

population segments and conditions of interest, 11, 17, 29, 31, 490505

Sri Lankans, 244, 493494

Stakeholders, 2, 3, 19, 29, 126, 127, 479, 513, 521

Staphylococcus, 178

STATA regression analysis software, 159

Statistics Canada, 461, 467, 475, 476, 477

Stem cells, 43

Steroids, 53, 58

Stroke, 147, 149, 150, 152, 158, 160, 185

Study of Osteoporotic Fractures, 213, 296

Sugars, 1111.

See also Fructose;

Glucose

Sun exposure

altitude, 105

atmospheric conditions, 104, 105, 492

cardiovascular diseases, 148

Crohn’s disease, 172

DRI development

assumption of minimal, 8, 98, 364, 370371, 378379, 389, 481, 482483

research needs, 12, 484, 516, 520

latitude considerations, 11, 9899, 100, 101, 104105, 136, 170, 174, 202, 371383, 477478, 491492

multiple sclerosis, 173, 174

during pregnancy, 254

prostate cancer, 147

radiation. See Ultraviolet A radiation;

Ultraviolet B radiation

reduced vitamin D synthesis

clothing, 105, 494

indoor environment, 11, 37, 496

skin pigmentation, 11, 100104, 174, 370, 481, 493495, 520

sunscreen, 11, 105, 370, 495496, 516, 520

relationship between serum 25OHD and vitamin D, 98105, 172, 187, 364, 370383, 430, 468, 471473, 477478.

See also Sun exposure, reduced vitamin D synthesis;

Sun exposure, skin cancer;

Vitamin D, synthesis in the skin

seasonal affective disorder, 187

seasonal considerations, 100101, 102, 104, 174, 200, 371, 378383, 471473, 478, 484, 492

skin cancer, 6, 12, 136, 363, 370, 481, 491, 496, 520

type 1 diabetes, 170171

Sun protection factor (SPF), 495

Sunscreen, 11, 105, 370, 495496, 516, 520

Supplements

calcium

adverse effects with, 22, 42, 404, 405424, 481, 500501.

See also Calcium, ULs

bioavailability, 63

and bone health, 209, 210211, 217, 218, 219226, 234242, 243, 246, 274, 285290, 358, 360, 391, 417

cancer, 137, 139, 141, 142, 144145, 147, 414416

cardiovascular disease, 149150

diabetes, 153, 154155

falls and physical performance, 158, 162165

during lactation, 256

percent of population which takes, 37

preeclampsia and pregnancy-induced hypertension, 190, 191, 250

rickets, 49, 243248, 260

role in intake assessment, 460, 463464, 466

and serum 25OHD levels, 243, 266

with vegan diet, 498

dosage issues, 1

phosphate, 414

self-reported use, 36, 37, 460

vitamin D

adverse effects with, 6, 10, 404, 405, 412, 427, 486.

See also Vitamin D, ULs

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and bone health, 196208, 209226, 234235, 236242, 243248, 285286, 290292, 358, 390392

cancer, 136, 137, 141, 142

cardiovascular disease, 148, 149

depression, 187188

diabetes, 153154, 171

dosage issues, 81, 106107

effects on serum 25OHD level, 8789, 98, 106, 179, 180, 243248, 251252, 266, 379, 381382, 426430, 431, 468, 471

falls and physical performance, 157165, 167, 438

and infant birthweight or length, 192, 193, 251252, 283

for infants, 95, 96, 258, 495

influenza and upper respiratory

infections, 180

during lactation, 258

preeclampsia, 190

during pregnancy, 9, 96, 169, 182, 190, 192, 193, 251252

rheumatoid arthritis, 175

tuberculosis, 177, 178179

with vegan diet, 498

Surrogates, 8, 25, 144, 145, 264

Synovial fibroblasts, 175

Synovitis of the joints, 174

Systemic lupus erythematosus (SLE), 4, 129, 176177

T

T cells, 91, 170

Tachysterol, 81, 82

Teeth, 35, 193

Testosterone, 145, 213, 230

Tetany, 49, 94

Thiamin, 1104, 1106, 1112

3-epi series, 86, 109

Threshold effect, 141, 515, 516

Thrombogenicity, 148

Thyroid gland, 40

Toddlers. See Children, ages 1 through 3 years

Tolerable Upper Intake Levels (ULs), 3, 56, 8, 10, 12, 22, 403405, 11121115.

See also Calcium, ULs;

Vitamin D, ULs

Total intake. See Dietary intake, total intake

Transient receptor potential cation channel, vanilloid family member 5 (TRPV5), 42

Transient receptor potential cation channel, vanilloid family member 6 (TRPV6), 38, 253

Triglycerides, 83, 84

Tuberculosis (TB), 4, 5, 91, 177180, 430, 494

Tufts Medical Center Evidence-based Practice Center, 513

Turks, 230, 243, 244

Tympanosotomy tube placement, 181

U

Ulcerative colitis, 172, 173

Ulcers, 407

Ultraviolet A radiation (UVA), 105

Ultraviolet B radiation (UVB), 105, 179, 254, 430, 491492, 494.

See also Sun exposure

Uncertainties.

See also Data;

Research needs

calcium-vitamin D interactions and independent effects, 5, 6, 60, 358, 360, 369, 388, 405, 484

in the context of risk assessment, 3, 18, 19, 29

in data analysis, 158159

in data collection, 1112, 167

dose–response relationships, 12, 159, 346, 355, 359, 360, 482, 484, 489, 515, 519.

See also Sun exposure, DRI development

due to pre-existing disease conditions, 406, 422

meta-regression analysis methods, 158159

methods for serum 25OHD assay, 107111, 476, 484.

See also Methodological considerations, assay shift and drift

need for long-term data, 12, 425, 485, 518

non-linear relationship between serum 25OHD and vitamin D intake, 12, 99, 379383, 384, 484

summary, 483486

UL development, 404405, 485

vitamin D as a prohormone, 75, 84, 481, 484

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Uncertainty factor (UF), 29, 404405, 420, 421, 422, 442

United States

calcium intake assessment, 37, 463465, 466

compared with Canada, 474, 476477

national intake surveys, 1011, 110, 457, 458461, 521

vitamin D deficiency, 1314, 480, 486488

vitamin D intake assessment and serum 25OHD levels, 1011, 110, 468473

Units of measurement, 3132, 78, 487

Upper Levels of Intake (ULs). See Tolerable

Upper Intake Levels

Upper respiratory infections, 4, 5, 129, 169, 180181

U.S. Department of Agriculture (USDA), 36, 38, 79, 458, 459, 462

U.S. Food and Drug Administration (FDA), 80, 167

V

Vaginosis, 192

Vanadium, 1115

Vascular endothelial growth factor (VEGF), 92

Vasodilation, 35, 43, 89

Vdr gene, 140, 168, 170, 172, 173, 178, 182, 184

Vdr-null mice, 91, 143, 148, 171, 173, 184, 251, 253, 259260, 279

Vegetarian or vegan diet, 11, 63, 179, 496498

Vision loss, 173

Vitamin A, 180, 1104, 1106, 1112

Vitamin B6, 1105, 1107, 1113

Vitamin B12, 1105, 1107, 1113

Vitamin C, 1104, 1106, 1112

Vitamin D.

See also Calcitriol;

25-Hydroxyvitamin D;

Serum 25-hydroxyvitamin D

absorption, 8384, 96

adverse effects. See Adverse effects, vitamin D;

Vitamin D, ULs

AIs, 9, 363, 383, 385, 469

anti-bacterial activity, 178, 181

associations vs. causal or predictive relationships, 263264, 480, 485, 517

asthma, 169170, 181

bioaccumulation, 84, 8788

as biomarker of total intake, 1213

calcium regulation, 35, 4041

cancer

breast, 140142, 435436

colorectal, 143

overview, 135139

pancreatic, 425, 436437, 486

prostate, 146147, 437

role in carcinogenesis, 9192

cardiovascular disease, 148, 149, 152

cognitive function, 183–86, 188

deficiency

autism, 182, 183

and bone metabolism, 35.

See also Osteomalacia;

Rickets

and cognitive function, 184, 185

colon cancer, 143

conclusions, 1314, 293, 480, 486488

defined by cut-point value, 480

indoor environments and institutionalized older persons, 241, 496

inflammatory bowel disease, 172

influenza and upper respiratory infections, 180

multiple sclerosis, 173

muscle weakness, 156157

normal calcitriol levels, 97

pregnancy or lactation, 218, 251, 253256, 259260, 279280

prostate cancer, 146147

and serum 25OHD all-cause mortality, 432435

and skin pigmentation, 481, 493495

systemic lupus erythematosus, 176

type 1 diabetes, 171

diabetes and, 153155, 170, 171

DRI development

analysis and outcomes, 380383

conclusions, 366370, 480

integration of evidence, 292294, 370379

interpretation of data in the literature, 292294, 365366, 370379

in IOM 1997 report, 9, 16, 97, 346, 404, 425, 487

DRIs

adolescents, 385387, 469, 1104

adults, 387394, 469, 1104

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background of current report, 16, 346

children, 385387, 469, 1104

in IOM 1997 report, 9, 16, 97, 346, 404, 425, 487

lactation, 9, 363, 393, 394, 441, 446, 469, 1104

pregnancy, 9, 363, 393, 394, 441, 446, 469, 1104

EARs

adolescents, 9, 363, 385, 387, 469, 1104

adults, 9, 363, 389, 392, 393, 394, 469, 1104

children, 9, 363, 385, 387, 469, 1104

lactation, 9, 363, 393, 394, 469, 1104

and outcome of physical performance, 167

pregnancy, 9, 363, 393, 394, 469, 1104

summary tables, 9, 363, 469, 1104

elderly population and, 87, 219, 234235, 496

excretion, 86, 88

food sources of, 7983, 498

formation, 6, 7577, 8485

functions and physiological actions, 7778, 8994, 143, 153, 156, 176, 177, 180, 184, 251

hormonal action and regulation, 6, 12, 515

in human milk, 80, 94

infants, 9, 363, 383, 385, 469, 504

influenza and upper respiratory infections, 180

intake. See Vitamin D intake

intoxication, 6, 10, 8889, 93, 405, 425, 426430, 443, 518

irritable bowel syndrome, 172

during lactation, 9, 96, 257260, 282283, 393, 394

lifetime, 86

media coverage, 1, 16, 480

metabolism, 35, 8389, 9293, 189

multiple sclerosis, 173174

neuroprotective effects, 183184

non-linear relationship with serum 25OHD levels, 12, 99, 379383, 384, 484

during pregnancy, 191, 250256, 279281, 393394

as a prohormone, 75, 84, 481, 484

RDAs

adolescents, 9, 363, 385, 387, 469, 1106

adults, 9, 363, 389390, 392, 393, 394, 469, 1106

children, 9, 363, 385, 387, 469, 1106

infants, 1106

lactation, 9, 363, 393, 394, 469, 1106

pregnancy, 9, 363, 393, 394, 469, 1106

summary tables, 9, 363, 469, 1106

reference value development, 293294, 480

rheumatoid arthritis, 175

serum 25OHD and. See Serum

aaaa25-hydroxyvitamin D, vitamin D and

storage, 84, 8788, 105106, 156, 173, 370, 490, 492, 498, 518

submariners, 83

summary, 810, 363, 480

sun exposure and. See Sun exposure

supplementation. See Supplements, vitamin D

synthesis in the skin, 6, 11, 8183, 95, 100105, 481, 493495, 520

synthetic analogues, 78, 81n.5

systemic lupus erythematosus, 176177

threshold effect, 141, 515, 516

ULs

adolescents, 441, 469, 1112

adults, 441, 443445, 469, 1112

children, 441, 445, 469, 1112

development, 10, 440446, 488

infants, 440442, 1112

lactation, 441, 446, 469, 1112

pregnancy, 441, 446, 469, 1112

summary tables, 9, 441, 469, 1112

uncertainties, 14, 486

units of measurement, 3132

use of term, 78

Vitamin D binding protein (DBP), 77, 84, 86, 88, 107, 251, 427

Vitamin D External Quality Assurance Scheme (DEQAS), 109110, 365

Vitamin D intake

adverse effects. See Adverse effects, vitamin D;

Vitamin D, ULs

assessment

approach, 462463, 483

Canadian estimated, 474, 478

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Canadian surveys, 461462, 499

estimates from national surveys, 1011, 459460

food sources only, 470, 474, 475, 476

summary, 477478

U.S. estimated, 468473

U.S. surveys, 458461

assumption of adequacy for calcium DRI, 347

asthma, 169170, 181

BMC/BMD and, 95, 175, 271, 274275, 279280, 386387, 392393

cardiovascular disease, 148, 149, 152

Crohn’s disease, 172

diabetes, 155

excess, 8889, 424449, 481, 486, 517518.

See also Adverse effects, vitamin D;

Indicators of adverse outcomes for excess intake

falls and physical performance, 157165, 167, 438

fractures, 390, 438439.

See also Bone, fracture, vitamin D supplementation

indigenous Canadian populations, 498499

intoxication, 6, 10, 8889, 93, 405, 425, 426430, 443, 518

during pregnancy, 169, 182, 279281

rheumatoid arthritis, 175

serum 25OHD. See Serum 25-hydroxyvitamin D, vitamin D and;

Sun exposure, relationship between serum 25OHD and vitamin D

from supplements. See Supplements, vitamin D

through the life stages, 810, 9496

tuberculosis, 178, 179, 494

Vitamin D interactions

calcium, 5, 6, 35, 60, 136, 358, 360, 369, 388, 405, 484, 517

prescription drugs, 11, 87, 504, 505

Vitamin D receptor (VDR)

in the brain, 184

cancer, 91, 140, 146, 147

expressed in cells with rheumatoid lesions, 175

expressed in the duodenum, 38

expressed in the fetus, 252253

expressed in the prostate, 146, 147

infants lacking, 254

lactation and, 91

muscle tissue, 157

regulation of expression by calcitriol, 38, 90, 91

rickets due to genetic absence of (VDDR II), 49, 94, 252, 254, 260, 276

use of term, 140n.1

Vitamin D response element (VDRE), 77, 140

Vitamin D2

equivalence issues with vitamin D3, 9293, 97, 519

fortified foods, 80

metabolism, 8687, 9293

overview, 78

serum level as biomarker of total intake, 107, 108

supplementation, 81

toxicity, 93, 426

Vitamin D3

deprivation, and autism, 182

equivalence issues with vitamin D2, 9293, 97, 519

fortified foods, 80

metabolism, 8687, 9293

overview, 78

serum level, not used to estimate synthesis in the skin, 104

serum level as biomarker of total intake, 107, 108

storage, 105

supplementation, 81, 107

synthesis in the skin. See Vitamin D, synthesis in the skin

toxicity, 93, 426

Vitamin E, 180, 1104, 1106, 1112

Vitamin K, 1106, 1112

Vitamins, 11061107, 11141115

Vomiting (emesis), 407, 409

W

Water, 36, 411, 417, 1110

Weight, 140, 153, 192193, 254, 406, 420, 425.

See also Growth rate

Weight loss or dieting, 39, 106, 172, 518

West Indians, 245

What We Eat in America (WWEIA), 459, 473

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White-matter hyperintensity volume, 185

Women.

See also Females;

Gender differences;

Lactation;

Menopausal status;

Pregnancy

bone health

fractures, 234242, 257, 285286, 357358, 391, 392, 438, 439

and serum 25OHD, 209218, 226234, 235

vitamin D and calcium supplementation, 226, 234242

calcium, 40, 58, 162, 226, 234242, 356, 357359, 360361, 477, 480481

cognitive function, 185

depression, 188

EARs, 356, 359, 360361

falls, 157, 161, 162, 166, 438

glucose tolerance, 154

mean age of puberty, 24

nephrolithiasis, 411412

RDAs, 356, 359

rheumatoid arthritis, 175

serum 25OHD level and cardiovascular risk, 437

systemic lupus erythematosus, 177

Women’s Health Initiative (WHI), 138, 141, 185, 220, 234, 285, 298, 358, 393, 411412, 413, 422

World Cancer Research Fund, 415

X

X-ray. See Duel-energy X-ray absorptiometry

Y

Young adults. See Adults, 19 through 30 years

Z

Zinc, 6, 37, 405, 417, 1105, 1109, 1115

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Calcium and vitamin D are essential nutrients for the human body. Establishing the levels of these nutrients that are needed by the North American population is based on the understanding of the health outcomes that calcium and vitamin D affect. It is also important to establish how much of each nutrient may be "too much."

Dietary Reference Intakes for Calcium and Vitamin D provides reference intake values for these two nutrients. The report updates the DRI values defined in Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, the 1997 study from the Institute of Medicine. This 2011 book provides background information on the biological functions of each nutrient, reviews health outcomes that are associated with the intake of calcium and vitamin D, and specifies Estimated Average Requirements and Recommended Dietary Allowances for both. It also identifies Tolerable Upper Intake Levels, which are levels above wish the risk for harm may increase. The book includes an overview of current dietary intake in the U.S. and Canada, and discusses implications of the study. A final chapter provides research recommendations.

The DRIs established in this book incorporate current scientific evidence about the roles of vitamin D and calcium in human health and will serve as a valuable guide for a range of stakeholders including dietitians and other health professionals, those who set national nutrition policy, researchers, the food industry, and private and public health organizations and partnerships.

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