Evidence-based policy on dietary calcium and vitamin D.

The Institute of Medicine's report on calcium and vitamin D makes a positive contribution by grounding its recommendations on the available evidence base. The committee does not substantially change recommended dietary intakes for calcium and modestly increases those for vitamin D based on the need for a median serum 25-hydroxyvitamin D of 40 nmol/L. They do not support the suggestion that all adults should have levels >75 nmol/L. The committee concludes that current evidence does not support nonskeletal benefits for vitamin D or calcium, and notes that higher intakes of both could have adverse health consequences. The present authors are generally in agreement with these conclusions, with some caveats regarding the evidence base used. However, we believe that the central role of sunlight exposure in determining vitamin D status needs to be explicitly reflected in public policy in this area.