Dear Certified Diabetes Educator,

My name is Linda. My doctor told me that there is recent data suggesting that diabetes and its complications can possibly hurt my bone health.  She recommended that I get enough calcium and vitamin D.  Are there specific recommendations for the amounts I should get?  I also see on milk containers and some yogurts that they contain calcium and added vitamin D.  The amounts on the labels are in percent daily values based on a 2000 calorie diet.  How do I make sense of all of this?

Hi Linda,

Yes there is data from Colombia University suggesting that having diabetes can be detrimental to bone health.  It is always wise to ask your physician if you have any special recommendations for amounts of calcium and vitamin D you should strive for in your diet.  If the Recommended Dietary Allowances are suggested, use the following tables.  The information on RDA’s and Upper limits of Safety were  taken from the National Institute of Health’s dietary fact sheets and developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies.

Table 1: Recommended Dietary Allowances (RDAs) for Calcium [1]
Age	Male	Female	Pregnant	Lactating
0–6 months*	200 mg	200 mg
7–12 months*	260 mg	260 mg
1–3 years	700 mg	700 mg
4–8 years	1,000 mg	1,000 mg
9–13 years	1,300 mg	1,300 mg
14–18 years	1,300 mg	1,300 mg	1,300 mg	1,300 mg
19–50 years	1,000 mg	1,000 mg	1,000 mg	1,000 mg
51–70 years	1,000 mg	1,200 mg
71+ years	1,200 mg	1,200 mg

* Adequate Intake (AI)

 

Below you will find the Upper Intake Levels of safety.  More than these limits can be harmful to your health.  These amounts are sometimes reached and exceeded when supplements are taken. It is usually recommended not to take more than 500 mg of calcium at any one time so that you can have maximum absorption and do not go over the tolerable upper intakes levels of safety unless recommended by your medical team.

Tolerable Upper Intake Levels (ULs) for Calcium
Age	Male	Female	Pregnant	Lactating
0–6 months	1,000 mg	1,000 mg
7–12 months	1,500 mg	1,500 mg
1–8 years	2,500 mg	2,500 mg
9–18 years	3,000 mg	3,000 mg	3,000 mg	3,000 mg
19–50 years	2,500 mg	2,500 mg	2,500 mg	2,500 mg
51+ years	2,000 mg	2,000 mg

Vitamin D

Vitamin D is considered the “sunshine vitamin”. It can be made by your body when your skin is exposed to the sun.  Sun exposure increases the risk of skin cancer, so there are recommendations for dietary vitamin D as well as tolerable upper intakes of safety.   Ask your physician to monitor your blood levels of vitamin D.  In this way you and your medical team can assess if you are absorbing adequate amounts.

Life Stage	Recommended Amount
Birth to 12 months	400 IU
Children 1–13 years	600 IU
Teens 14–18 years	600 IU
Adults 19–70 years	600 IU
Adults 71 years and older	800 IU
Pregnant and breastfeeding women	600 IU

 

The upper limits of safety for vitamin D

Infants   1,000 to 1,500 IU/day for infants

Children 1-8 years of age 2,500 to 3,000 IU/day

Those over 9 years of age 4,000 IU/day

 

Food labeling and Calcium and Vitamin D

As you can see from the tables provided for you, there are different recommendations for amounts to consume based on age and sex.  Calcium values on food labels are based on the recommendation for 19-70 year old men which are 1,000 mg per day. Since this is not the recommendation for women, you are going to need to do a little math. 

To figure out the amount of calcium in milligrams (mg) you need to take the percent daily value on the label (for most milk 20%) and figure what that is of 1,000. If the label states 20% then there are 200 mg of calcium in the serving of milk.  If the label states 10% then there are 100 mg of calcium in that food.

 Vitamin D is also given in percents (%).  To figure out the number of IU on the label for Vitamin D only, multiply the amount by 4.  An example would be Vitamin D 25%. Take 25 and multiply by 4 which will give 100 IU. 

 For more information on calcium and vitamin D, please go to the following website: http://fnic.nal.usda.gov/food-composition/individual-macronutrients-phytonutrients-vitamins-minerals/vitamins-minerals