Vitamin D helps regulate the renin-angiotensin-aldosterone system (and thereby blood pressure), vascular cell growth, and inflammatory and fibrotic pathways [118]. However, 18% were at risk of inadequacy (levels of 3049 nmol/L [1219.6 ng/mL]), and 5% were at risk of deficiency (levels below 30 nmol/L [12 ng/mL]). Office of Dietary Supplements, National Institutes of Health. Allergies, viruses and bacterial infections, auto-immune diseases, any malady that is tissue-related. [, Drincic A, Fuller E, Heaney RP, Armas LAG. Am J Clin Nutr 2014;100:746-55. [, van Duijnhoven FJB, Jenab M, Hveem K, Siersema PD, Fedirko V, Duell EJ, et al. It's a series of online or in-person events that introduce you to amazing smart home technology, including smart security systems, smart lighting, multi-channel audio and video, parts, and more. [, Quesada-Gomez JM, Bouillon R. Is calcifediol better than cholecalciferol for vitamin D supplementation? Hypercalcemia, in turn, can lead to nausea, vomiting, muscle weakness, neuropsychiatric disturbances, pain, loss of appetite, dehydration, polyuria, excessive thirst, and kidney stones. Serum concentration of 25(OH)D is currently the main indicator of vitamin D status. One study, for example, tested 25(OH)D levels in 1,092 women in Finland an average of 9 years before their MS diagnosis and compared their outcomes with those of 2,123 similar women who did not develop MS [139]. Am J Clin Nutr 2017;106:481-90. [, Yin L, Ordonez-Mena JM, Chen T, Schottker B, Arndt V, Brenner H. Circulating 25-hydroxyvitamin D serum concentration and total cancer incidence and mortality: A systematic review and meta-analysis. In contrast to water-soluble vitamins, the body has no easy way of getting rid of fat-soluble vitamins. Some studies have used dietary supplements containing the 25(OH)D3 form of vitamin D. Per equivalent microgram dose, 25(OH)D3 is three to five times as potent as vitamin D3 [37,38]. Among postmenopausal women and older men, many clinical trials have shown that supplements of both vitamin D and calcium result in small increases in bone mineral density throughout the skeleton [1,74]. Les sites web associs 'MCS' : recherchez avec meeZoom les sites proposs et classs par les autres internautes. Other dairy products made from milk, such as cheese and ice cream, are not usually fortified in the United States or Canada. [, Weisberg P, Scanlon KS, Li R, Cogswell ME. In a subsequent investigation for 4.9 years after the study's end, women who had taken the vitamin D and calcium supplements (many of whom continued to take them) still had the same colorectal cancer risk as those who received placebo [100]. Type B UV (UVB) radiation with a wavelength of approximately 290320 nanometers penetrates uncovered skin and converts cutaneous 7-dehydrocholesterol to previtamin D3, which in turn becomes vitamin D3. [, Peterson L, Zeng X, Caufield-Noll CP, Schweitzer MA, Magnuson TH, Steele KE. The vitamin D paradox in Black Americans: A systems-based approach to investigating clinical practice, research, and public healthexpert panel meeting report. The impact of this form on vitamin D status is an emerging area of research. [, Jiang X, Dimou NL, Al-Dabhani K, Lewis SJ, Martin RM, Haycock PC, et al. Researchers have not definitively identified serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and overall health. Vitamin D supplementation to reduce depression in adults: Meta-analysis of randomized controlled trials. The analysis of 20152016 data also showed that 28% of all individuals aged 2 years and older in the United States took a dietary supplement containing vitamin D [39]. Vitamin D3 is more efficient than D2. There. It concluded that the current evidence was insufficient to evaluate the benefits and harms of supplementation to prevent fractures. Vitamin D: moving forward to address emerging science. Journal of AOAC International 2017;100:1223-4. [, Seida JC, Mitri J, Colmers IN, Majumdar SR, Davidson MB, Edwards AL, et al. Talk with your doctor or nurse about vitamin D at your child's next check-up if you have questions. In one meta-analysis of 46 clinical trials that included 4,541 participants, vitamin D supplements (typically 40 mcg [1,600 IU]/day or less) for a minimum of 4 weeks had no significant effects on systolic or diastolic blood pressure [127]. Nutrients 2018, 10, 953. Vitamin D (also referred to as "calciferol") is a fat-soluble vitamin that is naturally present in a few foods, added to others, and available as a dietary supplement. [, Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. Kirkland Signature Vitamin D3, 1000 IU, 2-packs. [, Skaaby T, Husemoen LLN, Thuesen BH, Pisinger C, Jorgensen T, Roswall N, et al. Signs and symptoms of osteomalacia are similar to those of rickets and include bone deformities and pain, hypocalcemic seizures, tetanic spasms, and dental abnormalities [45]. The FNB committee also noted that serum concentrations greater than 125 nmol/L (50 ng/mL) can be associated with adverse effects [1] (Table 1). Lancet Diabetes-Endocrinol 2014;2:719-29. Serum vitamin D and risk of breast cancer within five years. [, Manson JE, Cook NR, Lee I-M, Christen W, Bassuk S, Mora S, et al. Individuals who have difficulty absorbing dietary fat might therefore require vitamin D supplementation [63]. After $3 OFF. Am J Clin Nutr 2019;109:1578-87. Holick MF. However, the results did show an increased risk of pancreatic cancer with 25(OH)D levels of 100 nmol/L (40 ng/mL) or above [107]. Vitamin D status in gastrointestinal and liver disease. [, Creo AL, Thacher TD, Pettifor JM, Strand MA, Ficsher PR. Effect of vitamin D3 supplementation on improving glucose homeostasis and preventing diabetes: A systematic review and meta-analysis. Gut. J Clin Endocrinol Metab 2011;96:1911-30. The incidence rate of rickets in the infants and children (younger than 7) seen by 2,325 pediatricians throughout Canada was 2.9 per 100,000 in 20022004, and almost all patients with rickets had been breastfed [49]. [, Marrie RA, Beck CA. [, Dawodu A, Tsang RC. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. Lancet Diabetes Endocrinol 2018;6:847-58. Nutrients 2018; 10, 277;doi:10.3390/nu10030277. However, higher serum 25(OH)D levels (at a cut point of 75 nmol/L [30 ng/mL]) were linked to a modestly higher risk of slow-growth prostate cancer and a more substantial lower risk of aggressive disease. It may help prevent depression, inflammatory disease, and heart disorders. Depression Thiazide diuretics Again, the pattern was similar for the risk of inadequacy. The amount of increase varies, for example, by baseline serum levels and duration of supplementation. [, Helzlsouer KJ for the VDPP Steering Committee. [, Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Krstic G, Wetterslev J, Gluud C. Vitamin D supplementation for prevention of cancer in adults. In contrast, another meta-analysis of 30 clinical trials in 4,744 participants (mean age 54.5 years) that administered 5 mcg (200 IU) to 300 mcg (12,000 IU)/day vitamin D3 for a mean of 5.6 months showed that more than 20 mcg (800 IU)/day significantly reduced systolic and diastolic blood pressure in normal-weight participants who had hypertension [128]. For example, a 3-year trial in New Zealand randomized 5,110 adults (mean age 65.9 years) to a single dose of 5,000 mcg (200,000 IU) vitamin D3 followed by 2,500 mcg (100,000 IU) each month or a placebo for a median of 3.3 years [124]. [, Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot CPGM. JAMA 2017;317:1217-8. 19.98. Those of African American ancestry, for example, have lower rates of bone fracture and osteoporosis than do Whites (see the section below on bone health and osteoporosis). However, because the extent and frequency of sunscreen use are unknown, the role that sunscreen may play in reducing vitamin D synthesis is unclear [1]. Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. These medications can reduce calcium absorption and impair vitamin D metabolism [171-173]. Vitamin D- fortified. Another study that compared 200 male smokers in Finland with pancreatic cancer to 400 matched controls found that participants in the highest quintile of 25(OH)D levels (more than 65.5 nmol/L [26.2 ng/mL]) had a threefold greater risk of developing pancreatic cancer over 16.7 years than those in the lowest quintile (less than 32 nmol/L [12.8 ng/mL]) [106]. Although 25(OH)D functions as a biomarker of exposure, the extent to which 25(OH)D levels also serve as a biomarker of effect on the body (i.e., relating to health status or outcomes) is not clear [1,3]. Some observational studies show associations between low serum levels of 25(OH)D and increased risks of cancer incidence and death. SHARE. Another meta-analysis of genetic studies in 146,581 participants (primarily adults) found that a low vitamin D status increased blood pressure and hypertension risk in people with genetic variants associated with low endogenous production of 25(OH)D [129]. Vitamin D status and weight loss: A systematic review and meta-analysis of randomized and nonrandomized controlled weight-loss trials. People with obesity or who have undergone gastric bypass surgery In addition, 26% of participants aged 25 years and 14% of those aged 611 years took supplements; rates increased with age from 10% of those aged 1219 years to 49% of men and 59% of women aged 60 and older. [, Pittas A, Dawson-Hughes B, Staten M. The authors reply: Vitamin D supplementation and prevention of type 2 diabetes. One systematic review and meta-analysis of 11 randomized, controlled trials published through 2018 of vitamin D supplementation alone (1020 mcg [400800 IU]/day or more at least every week or as rarely as once a year) for 9 months to 5 years found that the supplements provided no protection from fractures in 34,243 older adults [81]. N Engl J Med 2006;354:669-82. Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [13,29]. Vitamin D alone did not significantly affect the development of new serrated polyps, but the combination of vitamin D with calcium increased the risk almost fourfold. - Vitamin D is made in the body when your skin absorbs ultraviolet light, but most people don't get enough sunlight to reach adequate levels Nutr Rev 2018;76:380-94. Possible explanations for this increase include genetic differences in vitamin D metabolism, dietary preferences, and behaviors that lead to less sun exposure [45,46]. Levels of 1,25(OH)2D do not typically decrease until vitamin D deficiency is severe [2]. [, Kassi E, Adamopoulos C, Basdra EK, Papavassiliou AG. Considerations in dietetic counseling for vitamin D. J Acad Nutr Diet 2019;119:901-9. It's also termed hypervitaminosis D. Vitamin D is a fat-soluble vitamin. One nmol/L is equal to 0.4 ng/mL, and 1 ng/mL is equal to 2.5 nmol/L. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. Three trials conducted since that meta-analysis also found no effect of vitamin D supplementation on depressive symptoms. The results showed an association between 25(OH)D levels lower than 30 nmol/L (12 ng/mL) and a 31% higher colorectal cancer risk. Bone health and osteoporosis RDAs for vitamin D are listed in both micrograms (mcg) and international units (IU); 1 mcg vitamin D is equal to 40 IU (Table 2). J Clin Endocrinol Metab 2014;99:1132-41. [, Munger K, Hongell K, Aivo J, Soilu-Hanninen M, Surcel H-M, Ascherio A. The combination of these diuretics with vitamin D supplements (which increase intestinal calcium absorption) might lead to hypercalcemia, especially among older adults and individuals with compromised renal function or hyperparathyroidism [167,175,176]. Toxicity of vitamin D leads to hypercalcemia and imbalance in the regulation of bone metabolism; the resultant hypercalcemia leads to clinical manifestations and symptoms of toxicity. Low blood levels of vitamin D have also been associated with: An impairment in memory and thinking skills in older adults. 25-hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort. [, Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, et al. Screening for vitamin D status is becoming a more common part of the routine laboratory bloodwork ordered by primary-care physicians, irrespective of any indications for this practice [6,52-54]. JAMA 2020;324:471-80. Further research is needed to determine whether vitamin D inadequacy increases cancer risk, whether greater exposure to the nutrient can prevent cancer, and whether some individuals could have an increased risk of cancer because of their vitamin D status over time. [, Yetley EA. Optimal serum concentrations of 25(OH)D for bone and general health have not been established because they are likely to vary by stage of life, by race and ethnicity, and with each physiological measure used [1,13,14]. Int J Obes (Lond) 2012;36:387-96. Environ Health Perspect 2017;125(7):077004. Drug-vitamin D interactions: A systematic review of the literature. In addition, the USPSTF recommended against supplementation with 10 mcg (400 IU) or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in this population, but it could not determine the balance of benefits and harms from higher doses. Total vitamin D intakes were three times higher with supplement use than with diet alone; the mean intake from foods and beverages alone for individuals aged 2 and older was 4.8 mcg (192 IU) but increased to 19.9 mcg (796 IU) when dietary supplements were included. The vitamin D supplements were associated with serum 25(OH)D levels of 54 to 135 nmol/L (21.6 to 54 ng/mL). More information about assay standardization is available from the Vitamin D Standardization Program webpage. Association of glucocorticoid use and low 25-hydroxyvitamin D levels: Results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006. J Nutr 2016;146:855-6. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. Curr Opin Endocrinol Diabetes 2002;9:87-98. Vitamin D isn't naturally found in many foods, but you can get it from fortified milk, fortified cereal, and fatty fish such as salmon, mackerel and sardines. [, de Sevaux RGL, Hoitsma AJ, Corstens FHM, Wetzels JFM. Studies show that 25(OH)D appears to be approximately five times more potent than the parent vitamin for raising serum 25(OH)D concentrations [17,20,21]. Studies have also assessed the value of vitamin D supplementation for managing diabetes, and they have found that the vitamin offers limited benefits. People aged 1-70 years should aim to get at least 15 mcg or 600 IU of vitamin D per day. Ready-to-eat breakfast cereals often contain added vitamin D, as do some brands of orange juice, yogurt, margarine, and other food products. Am J Clin Nutr 2017;105:1372-81. [. Vitamin D supplementation and prevention of type 2 diabetes. In addition, most steps in the metabolism and actions of vitamins D2 and D3 are identical. [, Malihi Z, Lawes CMM, Wu Z, Huang Y, Waayer D, Toop L, et al. Another recent systematic review also found that vitamin D and calcium supplements had no beneficial effects on fractures, falls, or bone mineral density [79,80]. The results showed no significant differences in rates of progression to type 2 diabetes; in serum glucose, insulin, or hemoglobin A1c levels; or in measures of insulin resistance. J Am Geriatr Soc 1984;32:405-7. [, Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, et al. Taylor CL, Sempos CT, Davis CD, Brannon PM. For example, a meta-analysis included 34 observational studies that followed 180,667 participants (mean age greater than 50 years) for 1.3 to more than 32 years. The human body produces vitamin D as a response to sun exposure. Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL). [, Skversky AL, Kumar J, Abramowitz MK, Kaskel FJ, Melamed ML. BMC Public Health 2017;17:519. Individuals taking these and other medications on a regular basis should discuss their vitamin D intakes and status with their health care providers. Those who are older or at risk for . Vitamin D obtained from sun exposure, foods, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. [, James WP, Avenell A, Broom J, Whitehead J. Overall, the available research suggests that consuming higher amounts of vitamin D or taking vitamin D supplements does not promote weight loss. N Eng J Med 2022;387:299-309. [, Kahwati LC, Weber RP, Pan H, Gourlay M, LeBlanc E, Coker-Schwimmer M, Viswanathan M. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: Evidence report and systematic review for the US Preventive Services Task Force. Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: Results from the Prostate Cancer Prevention Trial. Nutrition 2015;31:421-9. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. A reverse J-shaped association between serum 25-hydroxyvitamin D and cardiovascular disease mortality: The CopD study. One systematic review and meta-analysis evaluated 35 clinical trials that included 43,407 adults with normal glucose tolerance, prediabetes, or type 2 diabetes who received a median of 83 mcg (3,332 IU)/day vitamin D supplements or placebo for a median of 16 weeks [148]. Add. The federal government's 2020-2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. Vitamin D and bone density, fractures, and falls: The end of the story? Breastfed infants In 20132014, an estimated 3.2% of the U.S. adult population took supplements containing 100 mcg (4,000 IU) or more vitamin D [41]. For this. Modern Nutrition in Health and Disease, 11th ed. Federal agencies and national organizations advise taking photoprotective measures to reduce the risk of skin cancer, including using sunscreen with a sun protection factor (SPF) of 15 or higher, whenever people are exposed to the sun [28,30]. J Clin Endocrinol Metab 2016;101:394-415. Between September and April, sun protection is recommended (shade, clothing coverage and a hat that shades the face and neck, sunscreen and sunglasses), especially between 10am and 4pm. [, Sowah D, Fan X, Dennett L, Hagtvedt R, Straube S. Vitamin D levels and deficiency with different occupations: A systematic review. However, a post hoc analysis showed a 62% lower incidence of diabetes among participants with low baseline serum 25(OH)D levels (less than 30 nmol/L [12 ng/mL]) who took the vitamin D supplement than among those who took the placebo [145,150]. Search for: Menu. Effects of vitamin D supplementation in atorvastatin-treated patients: A new drug interaction with an unexpected consequence. Metabolism 2016;65:586-97. Intake recommendations for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by expert committees of NASEM [1]. [, Song M, Lee IM, Manson JE, Buring JE, Dushkes R, Gordon D, et al.
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