Should There Be a Dietary Guideline for Calcium Intake? No

In preparing this manuscript I took the privilege of using the minutes of the September 1998 meeting of the Dietary Guidelines Advisory Committee, which was held in Washington, DC (1). During that meeting, Cutberto Garza, in his introductory remarks to the committee, mentioned a list of 5 C’s: confusion, change, complexity, controversy, and challenge. These same words often came to mind when I was synthesizing the information for this article. The five C’s relative to calcium as given below provide a format for the discussion of why there should not be a specific guideline for calcium within the 2000 edition of the dietary guidelines: 1) confusion as to why there should be a separate guideline for calcium, 2) change in the recommended intakes within the guidelines, 3) complexity of the role of diet in explaining bone mass and fracture risk, 4) controversy surrounding fracture data, and 5) challenges in maximizing bone mass and preventing osteoporotic fractures