[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/betterbones.com\/bone-nutrition\/iom-vitamin-d-recommendations\/#Article","mainEntityOfPage":"https:\/\/betterbones.com\/bone-nutrition\/iom-vitamin-d-recommendations\/","headline":"New IOM vitamin D recommendations \u2014 baby steps and missteps","name":"New IOM vitamin D recommendations \u2014 baby steps and missteps","description":"Print PDF eBook Facebook Twitter Gmail LinkedIn Pinterest You may have heard recently all the news stories that talked about the Institute of Medicine\u2019s (IOM) new guidelines for vitamin D and calcium. These guidelines were updates from those issued in 1997, and the reason for this fuss was that people were surprised and confused by […]","datePublished":"2009-12-16","dateModified":"2026-04-28","author":{"@type":"Person","@id":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/#Person","name":"Dr. Susan E. Brown, PhD","url":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/","identifier":72,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Center for Better Bones","logo":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","width":150,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2019\/01\/osteoporosis-blog.jpg","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2019\/01\/osteoporosis-blog.jpg","height":512,"width":1024},"url":"https:\/\/betterbones.com\/bone-nutrition\/iom-vitamin-d-recommendations\/","about":["Bone Nutrition"],"wordCount":1203,"keywords":["Vitamin D"],"articleBody":" Print PDF eBook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tFacebook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTwitter\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tGmail\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tLinkedIn\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPinterest\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tYou may have heard recently all the news stories that talked about the Institute of Medicine\u2019s (IOM) new guidelines for vitamin D and calcium. These guidelines were updates from those issued in 1997, and the reason for this fuss was that people were surprised and confused by the recommendations related to vitamin D. The message spread far and wide in the media was, \u201cPeople really don\u2019t need that much vitamin D,\u201d which dismayed many people who\u2019d been using supplements. Worse, some news outlets implied that taking any vitamin D supplements wasn\u2019t just unnecessary, but could even be harmful.At the heart of the confusion is the fact that these guidelines attempt to establish values for basic nutritional adequacy (meeting the basic needs of 97\u201398% of the population), not optimum nutrient intake. \u201cAdequate\u201d and \u201coptimum\u201d are very different things \u2014 as different as \u201csurvival\u201d and \u201chealth\u201d! Unfortunately, the way it was presented to the media and the public was \u201cthis amount is all you need to be healthy,\u201d and that message just isn\u2019t supported by all of the ongoing research \u2014 much of which, sadly, wasn\u2019t included in the IOM\u2019s assessment.So we at the Center for Better Bones see the current IOM adjustment to the vitamin D Dietary Reference Intake (DRI) as representing both good and bad news. The good news is that we\u2019ve taken baby steps forward in tripling and doubling the RDA (Recommended Daily Allowance) for adults and children and doubling the safe upper level; the bad news is that the message offers false assurance \u2014 and maybe even some unnecessary fears \u2014 to the general public about their vitamin D intake.The \u201cbaby steps\u201d I referred to are as follows:1. Raising the Recommended Daily AllowancesThe recommendations triple the RDA for individuals age 1 to 70, from 200 IU to 600 IU, and they double the RDA for elderly older than 70 (from 400 IU to 800 IU). I\u2019m thrilled that they recognized that the original recommendations weren\u2019t sufficient, but disappointed that this is as far as they went, given that all the research I\u2019ve seen shows clearly that all people need much, much more than these recommended amounts to be truly healthy.2. Raising the \u201cTolerable Upper Limits\u201dHere again the IOM moved in the right direction: they raised the safe upper limit of vitamin D from 2000 IU to 4000 IU per day for individuals older than 9 years, and also set the upper limit higher for younger children based on their age. We\u2019ve long known that doses over 2000 IU are perfectly safe, and while we often find that even doses above 4000 IU can be beneficial to those who need it, the recommendation moves us forward and confirms the safety of 4000 IU vitamin D for the population as a whole.Here\u2019s where the IOM missed the boat.1. Establishing 20 ng\/mL as \u201cthe level that is needed for good bone health for practically all individuals.\u201dTo put it politely, this conclusion is incorrect. (If I were impolite, I\u2019d call it ridiculous.)\u00a0 In 2009, Bischoff\u2013Ferrari and colleagues published two separate meta-analyses documenting that 20 ng\/mL was not sufficient for either fracture or fall reduction. Furthermore, decades of research have established conclusively that the minimal serum 25(OH)D level conducive to bone health is 30\u201332 ng\/mL. It is noteworthy that both the International Osteoporosis Foundation and Osteoporosis Canada support this higher target level for bone health.2. Basing the vitamin D intake guidelines solely upon the bone health benefits of vitamin DIn their review of the scientific studies, the IOM panel concluded that the evidence supported a role for vitamin D exclusively in bone health. They did not examine a vast body of new research supporting the health benefits of vitamin D because much of it wasn\u2019t the same sort of double-blind, placebo-controlled trials used to prove efficacy of drugs. But there\u2019s plenty of evidence \u2014 solid evidence \u2014 associating higher vitamin D levels with reductions in the rates of cancer, heart disease, diabetes, multiple sclerosis, and other chronic diseases. These studies clearly indicate that vitamin D levels higher than the minimum required for basic bone health are needed for disease prevention. In fact, a panel of 41 expert vitamin D researchers and medical practitioners has set the evidence-based vitamin D target level at 40\u201360 ng\/mL, a level that we at the Center for Better Bones concur with. But the IOM chose to overlook this data.3. Concluding that most North Americans are receiving enough vitamin D and need no additional supplementationThis is what\u2019s called \u201ccircular logic\u201d \u2014 by setting a very low level for vitamin D adequacy (20 ng\/mL), of course they conclude that very few people are deficient! Yet vitamin D levels in this country are well below the therapeutic target set by major vitamin D researchers (40\u201360 ng\/mL), and they are declining. According to the NHANES national survey the average vitamin D level has dropped, from 30 ng\/mL in 1988\u20131994 to 24 ng\/mL in 2001\u20132004. The percentage of those below 10 ng\/mL has increased from 2% to 6%, and the percentage with levels of 30 or above has decreased from 45% to 23%.Moving forward \u2014 don\u2019t wait another decade for the IOM to catch upWe evolved in abundant sunlight, and our genetic coding reflects the longstanding importance of vitamin D \u2014 there are nearly 2800 binding sites for the vitamin D receptor across the length of our genome. A vitamin D level of 40\u201360 ng\/mL would approximate that of our ancestors and \u2014 not coincidentally \u2014 levels associated with protection from today\u2019s most problematic health issues. Obtaining this more natural vitamin D blood level is easy and safe to do \u2014 simply have your vitamin D level tested and then supplement with appropriate vitamin D3 (or sunlight) to reach the target 40\u201360 ng\/mL level. In the end, it\u2019s your health and your life. You could wait another decade for the IOM to seriously review the full scientific data on vitamin D, or you can move forward by raising your awareness and drawing your own conclusions! References:Adit, A., et al. 2009. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch. Intern. Med., 169 (6), 626\u2013632. URL:View study in Archives of Internal Medicine (accessed 12.08.2010).Baggerly, C. 2010. Grassroots Health | Vitamin D action \u2013 GRH Recommendations. URL: http:\/\/ grassrootshealth.net\/recommendation (accessed 12.08.2010).Bischoff-Ferrari, H.A., Willett, W.C., et al. 2009. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: A meta-analysis of randomized controlled trials. Arch. Intern. Med., 169(6), 551\u2013561. URL: View study in Archives of Internal Medicine (accessed 12.08.2010).Bischoff-Ferrari, H.A., Dawson-Hughes, B., et al. 2009. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomized controlled trials. BMJ, 339, b3692. URL: View study in BMJ(accessed 12.08.2010).Dawson-Hughes, B., et al. 2010. IOF position statement: Vitamin D recommendations for older adults. Osteoporos. Int., 21 (7), 1151\u20131154. URL:View research article (accessed 12.08.2010).Ramagopalan, S., et al. 2010. A ChIP-seq defined genome-wide map of vitamin D receptor binding: Associations with disease and evolution. Genome Res., 20 (10), 1352\u20131360. URL; 1352.Long (accessed 09.01.2010). For a complete breakdown of every nutrient your bones need, see our guide to bone health nutrition and the 20+ nutrients your bones need.Our full supplement guide reviews the evidence \u2014 see our guide to bone health supplement guide."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Bone Nutrition","item":"https:\/\/betterbones.com\/bone-nutrition\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"New IOM vitamin D recommendations \u2014 baby steps and missteps","item":"https:\/\/betterbones.com\/bone-nutrition\/iom-vitamin-d-recommendations\/#breadcrumbitem"}]}]