title: Americans are not meeting current calcium recommendations.
abstract: BACKGROUND
  Recent research has raised doubts about the efficacy of calcium supplementation in preventing fractures; however, adequate calcium intake remains important.
  
  
  OBJECTIVE
  Using data from the 1999-2002 National Health and Nutrition Examination Survey, we assessed dietary and supplemental calcium consumption among US men and women according to risk of osteoporosis and stratified by sex, race/ethnicity, and socioeconomic status.
  
  
  METHODS
  We categorized risk of osteoporosis as high (having an osteoporosis diagnosis or treatment), moderate (aged >50 y), or low (aged 19-50 y). Main study outcomes included milligrams of dietary and supplemental calcium intake, likelihood of meeting national calcium adequate intake (AI) levels, and likelihood of taking supplemental calcium.
  
  
  RESULTS
  Mean (95% CI) total calcium consumption was 944 (846, 1043) mg in the high-risk group, 821 (788, 854) mg in the moderate-risk group, and 846 (812, 871) mg in the low-risk group. Overall, 40% of the sample met the calcium AI amount and 48% reported taking supplemental calcium. After adjustment for daily caloric intake, the greater likelihood of meeting calcium AI levels was associated with [odds ratio (95% CI)] low [versus moderate, 1.5 (1.2, 1.7)] and high [versus moderate, 1.9 (1.3, 2.6)] osteoporosis risk, female sex [1.6 (1.3, 1.8)], non-Hispanic white ethnicity [versus nonwhite, 1.9 (1.7, 2.3)], and education beyond high school [versus less than high school, 1.5 (1.2, 1.9)]. These same factors were also associated with an increased likelihood of taking supplemental calcium, except for a consistent increase with higher osteoporosis risk.
  
  
  CONCLUSIONS
  Many Americans--particularly men, ethnic minorities, and the socially disadvantaged--are not meeting the current recommendations for adequate calcium intake through diet alone or with supplements.
authors.affiliation: Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University, Palo Alto, CA 94305, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Johns
authors.forename: Randall S
authors.initials: RS
authors.lastname: Stafford
mesh_terms: D000328:Adult; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D004032:Diet; D019587:Dietary Supplements / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009749:Nutrition Surveys; D009751:Nutritional Requirements; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary