European guidelines vary by country, but a daily intake of at least 1000 mg of calcium, which includes dietary sources of calcium, and 400 to 800 IU of vitamin D is generally recommended. However, most North American osteoporosis guidelines recommend a vitamin D intake of at least 800 to 1000 IU/day (maximum 4000 IU/day) for adults aged 50 years and older. For persons aged 51 years and older, United States (US) dietary guidelines recommend a daily calcium intake of 1200 mg for women and 1000 mg for men and a daily vitamin D intake of 600 mg for both genders. Vitamin D also supports bone growth and remodeling by osteoblasts and osteoclasts. Mineralization of bone requires calcium, and dietary calcium absorption in the gut requires the presence of vitamin D. Recommended strategies for fracture prevention include, among other things, adequate consumption of calcium and vitamin D. Fractures result in pain, deformity, height loss, impaired quality of life, restricted mobility, loss of independence, and, especially in the case of hip fractures, increased mortality. Osteoporotic fractures are often the first sign of the disease, and frequently occur after a low-impact injury or fall, but vertebral fractures can also occur during routine activities in the absence of a fall or injury. According to the International Osteoporosis Foundation, osteoporosis is a worldwide epidemic.
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