**4.2 Adequate calcium and vitamin D intake**

The Institute of Medicine (IOM) prescribes that dietary calcium consumption should be limited to 1000 mg daily for men aged 50–70 years, and 1200 mg daily for women aged 51 years and over [17]. Presently, the impact of calcium supplementation on stone formation is unclear. Large doses of supplemental calcium are likely to lead to stone formation, especially if given separately from a meal. If appropriate, patients with stones should be advised to take a meal with calcium supplements, and further, the disease condition needs to be closely monitored [18].

Vitamin D is a vital component of calcium absorption, which helps in the maintenance of bone health. The IOM recommends 600 IU and 800 IU per day for men and women who are aged 51–70 years and over 70 years, respectively [17]. Earlier reports indicate the fact that combined vitamin D and calcium intake demonstrated a reduction in the risk of fracture in older adults, but the effects varied according to

the study setting, i.e., institution versus community dwellers. The risk of fracture among older adults was lower in the community dwellers than for institutionalized elderly people. However, further research is required for appropriate dose and dosing regimens to end up in a conclusive remark [19].

### **4.3 Adequate protein intake**

Maintaining an appropriate intake of proteins is vital for maintaining musculoskeletal functioning in postmenopausal women and men over the age of 50 years. The recommended protein intake is 0.8 g/kg/day [20].

### **4.4 Reducing the intake of caffeine**

The impact of various caffeinated beverages has been inferred as a trigger of osteoporosis and fragility fracture in individuals; hence, it is recommended to restrict the intake of caffeine [21].
