Vitamin D and Calcium

Vitamin D, the sunshine vitamin, has received much attention because of its role in bone health and nonskeletal roles such as cell growth, cell differentiation, and several chronic disorders. Vitamin D deficiency is common worldwide including the USA. Sunlight is a major source for the vitamin, while dietary sources are limited. The clinical manifestations range from the asymptomatic to musculoskeletal pain, gait disturbances, and fracture. Vitamin D is critical for musculoskeletal health, but deficiency is now linked to the development of cancer, cardiovascular disease, heart failure, multiple sclerosis, and autoimmune diseases. Serum 25(OH)D is the best measure of status. Vitamin D is necessary for maximal calcium and phosphorus absorption via the gut. Deficiency is common in geriatric patients due to several factors such as decreased sunlight exposure, decreased skin synthesis, and low intake. New guidelines have been released from Canada and the Institute of Medicine in the USA on intakes of calcium and vitamin D. The preferred intake of calcium is food rather than supplements.