Calcium, Vitamin D and bone health: Tips for senior citizens on National Bone and Joint Day 2023

Calcium and Vitamin D are the two most important nutrients for bone healthat all stages of life. Maintaining adequate levels of these nutrients in the diet ensures that bones stay strong and reduces the risk of fracture in the elderly. As we age, an imbalance occurs between the amount of new bone formation and bone breakdown, which leads to a disease called "Osteoporosis" (weak and porous bones). Adequate calcium and vitamin D supplements are the cornerstone of osteoporosis treatment.

99 per cent of the total calcium content of the body is stored in bones. Dietary sources of calcium include milk, yoghurt, cheese, green leafy vegetables, and fortified foods like cereals. Calcium is present in bones in the form of a molecule called hydroxyapatite, which provides strength to bones. Apart from this, bones act as a reservoir of calcium and maintain a steady calcium level in the blood, which is required for multiple other functions.

In the elderly, the absorption of calcium from food is reduced, and coupled with hormonal changes, this leads to the weakening of the bones. Generally speaking, elderly people need about 1000–1200 mg of calcium in their diet per day. Supplements are often needed to fulfil this requirement.

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Supplements should generally be taken with food. Your doctor will prescribe supplements in an adequate dose and can change to a different type or brand in case they cause side effects like gastric upset and constipation.

Vitamin D actually functions as a hormone. Contrary to calcium, some amount of vitamin D can be produced by the human body. This process starts in the skin and requires sunlight. People with dark skin, who are housebound, and who spend all day at work with little sun exposure are at risk of vitamin D deficiency.

Elderly people need between 800 and 1000 International Units (IU) of vitamin D per day. One of the most important functions of vitamin D is to promote the absorption of calcium from food. It is also required for the functioning of muscles.

Dietary sources include milk and milk products, soymilk, fish, etc. With ageing, the synthesis of vitamin D is reduced in the body, resulting in impaired calcium absorption from food and hence weakening of the bones or osteoporosis.

As dietary sources of vitamin D are few, supplements play an important role. There are numerous dosages and preparations of supplements on the market, either vitamin D alone or in combination with calcium. Your doctor can guide you in making the right choice.

Both vitamin D and calcium play an important role in maintaining bone health, and their functions in the body are interrelated. Maintaining normal levels of these in the body ensures good bone density, which in turn reduces the risk of fractures in the elderly population.

(Inputs by Dr Sahil Gaba, Consultant and Assistant Professor, Department of Orthopaedics, Amrita Hospital, Faridabad)

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