High Prevalence Of Low Dietary Calcium And Low Vitamin D Status In Healthy South Indians by CV Harinarayan MD, DM, T Ramalakshmi MSc and U Venkataprasad MSc

Nutritional factors play a vital role in bone homeostasis during adulthood. During infancy, childhood and adolescence, increasing dietary calcium intake favours bone mineral accrual. Adequate calcium intake along with vitamin D helps to maintain bone mineral mass attained at the end of growth period i.e. peak bone mass. Serum 25 hydroxyvitamin D [25(OH)D] is the most reliable indicator of vitamin D levels of an individual. Vitamin D insufficiency [25(OH)D levels between 10 – 20 ng/ml] is associated with secondary hyperparathyroidism (SHPT). Low dietary calcium intake further amplifies the parathyroid response to vitamin D insufficiency. The SHPT, which ensues, mobilizes mineral and matrix from skeleton leads to a high risk of fracture.

Link : http://apjcn.nhri.org.tw/server/APJCN/13/4/359.pdf