[, Drinka PJ, Nolten WE. Vitamin D 20 000 IU per week for five years does not prevent progression from prediabetes to diabetes. Vitamin D deficiency. 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]. One trial included 65 adult men and women (mean age 32 years) with overweight or obesity who were otherwise healthy, did not have diabetes, and had low serum vitamin D levels (at or below 50 nmol/L [20 ng/mL]) [147]. Silva MC, Furlanetto TW. [, Travis RC, Perez-Cornago A, Appleby PN, Albanes D, Joshu CE, Lutsey PL, et al. Normal vitamin D levels in the blood are 20 ng/ml or above for adults. 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. [, Yao S, Kwan ML, Ergas IJ, Roh JM, Cheng T-YD, Hong C-C, et al. [, Shahvazi S, Soltani S, Ahmadi SM, de Souza RJ, Salehi-Abargouei A. Clin Gastroeterol Hepatol 2020; published online ahead of print. Rates of deficiency varied by race and ethnicity: 17.5% of non-Hispanic Blacks were at risk of vitamin D deficiency, as were 7.6% of non-Hispanic Asians, 5.9% of Hispanics, and 2.1% of non-Hispanic White people. Twitter. The amount of increase varies, for example, by baseline serum levels and duration of supplementation. J Natl Cancer Inst 2019;111:158-69. pii: E493. [, Rajakumar K. Vitamin D, cod-liver oil, sunlight, and rickets: A historical perspective. Levels of 1,25(OH)2D do not typically decrease until vitamin D deficiency is severe [2]. There are also other websites with similar truths. The geographical distribution of MS around the world is unequal. [, Caan B, Neuhouser M, Aragaki A, Lewis CB, Jackson R, LeBoff MS, et al. Vitamin D is a fat-soluble vitamin that is found in some animal food products and is also synthesized in the human body via exposure to the sun. The FNB established ULs for vitamin D in 2010 (Table 4) [1]. Vitamin D helps you absorb calcium and phosphate from food. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Taken together, studies to date do not indicate that vitamin D with or without calcium supplementation reduces the incidence of cancer, but adequate or higher 25(OH)D levels might reduce cancer mortality rates. No substantial between-group differences in fracture incidence were found by race, ethnic group, BMI, age, baseline 25(OH)D levels, or whether participants took supplemental calcium, were at high fracture risk, or had a history of fragility fractures. [, Malihi Z, Lawes CMM, Wu Z, Huang Y, Waayer D, Toop L, et al. Les sites web associs 'MCS' : recherchez avec meeZoom les sites proposs et classs par les autres internautes. Cholecalciferol or 25-hydroxycholecalciferol supplementation does not affect muscle strength and physical performance in prefrail and frail older adults. Best chewable: NOW Foods Chewable . The results showed that baseline serum 25(OH)D levels were inversely associated with total number of CVD events (including myocardial infarction, ischemic heart disease, heart failure, and stroke) and mortality risk [120]. [, Yetley EA. [, Muller DC, Hodge AM, Fanidi A, Albanes D, Mai XM, Shu XO, et al. Specifically, the power of Vitamin C and the requirement for its daily, dietary supplementation. The first hydroxylation, which occurs in the liver, converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as "calcidiol." Practitioner 1984;228:312-3. Vitamin D supplementation had no effect on the incidence rate of myocardial infarction, angina, heart failure, arrhythmia, arteriosclerosis, stroke, venous thrombosis, or death from CVD. [. [, Singh P, Trivedi N. Tanning beds and hypervitaminosis D: A case report. US Preventive Services Task Force recommendation statement. Experts do not believe that excessive sun exposure results in vitamin D toxicity because thermal activation of previtamin D3 in the skin gives rise to various non-vitamin D forms that limit formation of vitamin D3. JAMA Network Open 2019;2(12):e1917789. J Am Geriatr Soc 1984;32:405-7. Steroids [, Aloia JF, Talwar SA, Pollack S, Yeh J. [, Weisberg P, Scanlon KS, Li R, Cogswell ME. A meta-analysis of prospective studies that evaluated the association between serum 25(OH)D levels and cancer incidence (8 studies) or cancer mortality (16 studies) found that cancer risk decreased by 7% and cancer mortality rates decreased by 2% with each 20 nmol/L (8 ng/mL) increase in serum 25(OH)D levels [89]. Horm Metab Res 2019;51:11-21. Overall, vitamin D supplementation, when compared with placebo administration, had no effect on relevant clinical outcomes, such as recurrent relapse or worsened disability. Effect of vitamin D supplementation on serum lipid profiles: A systematic review and meta-analysis. Ready-to-eat breakfast cereals often contain added vitamin D, as do some brands of orange juice, yogurt, margarine, and other food products. Scientific Advisory Committee on Nutrition. All can be significantly helped with proper amounts of vitamin C. [, Sowah D, Fan X, Dennett L, Hagtvedt R, Straube S. Vitamin D levels and deficiency with different occupations: A systematic review. Roseland JM, Phillips KM, Patterson KY, Pehrsson PR, Taylor CL. However, the incidence of rickets is increasing globally, even in the United States and Europe, especially among immigrants from African, Middle-Eastern, and Asian countries [51]. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Adherence to vitamin D intake guidelines in the United States. [, Shea MK, Fielding RA, Dawson-Hughes B. Having produced a solution of this blue indicator, some researchers suggest its use as an indicator for the presence of Vitamin C. Hossein-nezhad A, Holick MF. Bone is constantly being remodeled. Some observational studies show associations between low serum levels of 25(OH)D and increased risks of cancer incidence and death. [, Xu Y, Shao X, Yao Y, Xu L, Chang L, Jiang Z, Lin Z. Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils. J Am Coll Cardiol 2017;70:89-100. The vitamin D paradox in Black Americans: A systems-based approach to investigating clinical practice, research, and public healthexpert panel meeting report. 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. U.S. Preventive Services Task Force. A 2018 Cochrane review analyzed 12 such trials that had a total of 933 participants with MS; the reviewers judged all of these trials to be of low quality [137]. Vitamin D and multiple sclerosis: A comprehensive review. Talk with your doctor or nurse about vitamin D at your child's next check-up if you have questions. UVB radiation does not penetrate glass, so exposure to sunshine indoors through a window does not produce vitamin D [27]. One clinical trial randomized 260 Black women aged 60 years and older (mean age 68.2 years) to receive 60 to 120 mcg (2,400 to 4,800 IU) per day vitamin D3 supplementation to maintain serum 25(OH)D levels above 75 nmol/L (30 ng/mL) for 3 years [84]. In foods and dietary supplements, vitamin D has two main forms, D2 (ergocalciferol) and D3 (cholecalciferol), that differ chemically only in their side-chain structures. Journal of Nutrition Science 2018;7:1-7. Some people are potentially at risk of inadequacy at 30 to 50 nmol/L (1220 ng/mL). Evidence Report/Technology Assessment No. The FNB recommended avoiding serum 25(OH)D levels above approximately 125150 nmol/L (5060 ng/mL), and it found that even lower serum levels (approximately 75120 nmol/L [3048 ng/mL]) are associated with increases in rates of all-cause mortality, risk of cancer at some sites (e.g., pancreas), risk of cardiovascular events, and number of falls and fractures among older adults. 25-hydroxyvitamin D levels and risk of ischemic heart disease, myocardial infarction, and early death: Population-based study and meta-analyses of 18 and 17 studies. [, Aloia JF, Rubinova R, Fazzari M, Islam S, Mikhail M, Ragolia L. Vitamin D and falls in older African American women: The PODA randomized clinical trial. However, other, shorter (from 24 weeks to 5 years) clinical trials of vitamin D supplementation alone or with calcium in adults found greater risks of hypercalcemia and hypercalciuria, but not of kidney stones [162,163]. The USPSTF also reviewed the seven published studies on the effects of vitamin D supplementation (two of them also included calcium supplementation) on the risk of falls in community-dwelling adults aged 65 years or older who did not have osteoporosis or vitamin D deficiency. One study found that when the 25(OH)D content of beef, pork, chicken, turkey, and eggs is taken into account, the total amount of vitamin D in the food is 2 to 18 times higher than the amount in the parent vitamin alone, depending on the food [20]. Vitamin D supplements are the most common cause of vitamin D toxicity . One meta-analysis of 20 clinical trials compared the effects of 0.5 mcg (20 IU)/day to 1,250 mcg (50,000 IU)/week vitamin D supplementation for 26 months with those of placebo on glycemic control in 2,703 adults from around the world who had diabetes [143]. [, Song M, Lee IM, Manson JE, Buring JE, Dushkes R, Gordon D, et al. However, more than 20 mcg (800 IU)/day vitamin D3, when taken with calcium supplements, significantly increased blood pressure in participants with overweight and obesity. For infants, the FNB committee developed AIs based on the amount of vitamin D that maintains serum 25(OH)D levels above 20 ng/mL (50 nmol/L) and supports bone development. It concluded that the current evidence was insufficient to evaluate the benefits and harms of supplementation to prevent fractures. Assessing vitamin D status by measuring serum 25(OH)D concentrations is complicated by the considerable variability of the available assays (the two most common ones involve antibodies or chromatography) used by laboratories that conduct the analyses [5,6]. [. [, Munger K, Hongell K, Aivo J, Soilu-Hanninen M, Surcel H-M, Ascherio A. Am J Clin Nutr 2008;88:558S-64S. JAMA 2018;319:1696-1704. One might expect a large proportion of the U.S. population to have vitamin D inadequacy on the basis of vitamin D intakes from foods, beverages, and even dietary supplements. Summary. Vitamin D is involved in various brain processes, and vitamin D receptors are present on neurons and glia in areas of the brain thought to be involved in the pathophysiology of depression [130]. Am J Clin Nutr 2017;105:810-9. [, Heath AK, Hodge AM, Ebeling PR, Eyles DW, Kvaskoff D, Buchanan DD, et al. [, Mousa A, Naderpoor N, de Courten MPJ, Teede H, Kellow N, Walker K, et al. [, Drincic A, Fuller E, Heaney RP, Armas LAG. The largest trial to date of vitamin D supplements for diabetes prevention randomized 2,423 men and women aged 25 years and older (mean age 60 years) with prediabetes and overweight or obesity (mean BMI of 32.1) to 100 mcg (4,000 IU)/day vitamin D3 or placebo for a median of 2.5 years [145]. [, de Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M, et al. Jones G. Vitamin D. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. 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]. Am J Clin Nutr 2012;95:1350-6. 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). A 50 nmol/L (20 ng/mL) increase in 25(OH)D levels was associated with an 11% reduction in total cancer incidence rates and, in women but not men, a 24% reduction in cancer mortality rates. Association of vitamin D status with arterial blood pressure and hypertension risk: A mendelian randomisation study. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Brooks SPJ, Sempos CT. Many epidemiological and genetic studies have shown an association between MS and low 25(OH)D levels before and after the disease begins [137]. [, Crowe M, Wollner L, Griffiths RA. Type 2 diabetes Best drops: Thorne Vitamin D/K2. [, Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor PR, Virtamo J, et al. Int J Obes Relat Metab Disord 2001;25:1154-60. Am J Clin Nutr 2016;104:1039-51. 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. Some expert bodies and vitamin D researchers suggest, for example, that approximately 530 minutes of sun exposure, particularly between 10 a.m. and 4 p.m., either daily or at least twice a week to the face, arms, hands, and legs without sunscreen usually leads to sufficient vitamin D synthesis [13,15,28]. In addition, although 25(OH)D levels rise in response to increased vitamin D intake, the relationship is nonlinear [1]. 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. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. JAMA 2017;317:2448-50. 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]. Individuals who have difficulty absorbing dietary fat might therefore require vitamin D supplementation [63]. 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]. Am J Clin Nutr 2017;105:1372-81. Research to date provides mixed evidence on whether levels of 25(OH)D are associated with the development of prostate cancer. Screening for vitamin D deficiency: Systematic review for the U.S. Preventive Services Task Force recommendation. Paediatr Int Child Health 2017;37:84-98. Summary: - Vitamin D is an unusual vitamin because it acts like a hormone in your body. In addition, studies provided different amounts of nutrients and used different dosing schedules. The FNB committee that established DRIs for vitamin D found that the evidence was inadequate or too contradictory to conclude that the vitamin had any effect on a long list of potential health outcomes (e.g., on resistance to chronic diseases or functional measures), except for measures related to bone health. Elsevier, 2018. Vitamin D, Volume 2: Health, Disease and Therapeutics, Fourth Edition. More recently, a 2022 ancillary study of the Vitamin D and Omega-3 Trial (VITAL; described in the Cancer section below) investigated whether supplemental vitamin D3 (50 mcg [2,000 IU]/day) would lower the risk of fractures in 25,871 generally healthy men aged 50 years and older and women aged 55 years and older over a median follow-up of 5.3 years [82]. Vitamin D, Volume 1: Biochemistry, Physiology and Diagnostics, Fourth Edition. One recent clinical trial, for example, randomized 78 frail and near-frail adults aged 65 years and older to receive 20 mcg (800 IU) vitamin D3, 10 mcg 25(OH)D, or placebo daily for 6 months. The combination of high intakes of calcium (about 2,100 mg/day from food and supplements) with moderate amounts of vitamin D (about 19 mcg [765 IU]/day from food and supplements) increased the risk of kidney stones by 17% over 7 years among 36,282 postmenopausal women who were randomly assigned to take 1,000 mg/day calcium and 10 mcg (400 IU)/day vitamin D or a placebo [161]. [, Herrick KA, Storandt RJ, Afful J, Pfeiffer CM, Schleicher RL, Gahche JJ, Potischman N. Vitamin D status in the United States, 2011-2014. Vitamin D supplementation and prevention of type 2 diabetes. Holick MF. Other meta-analyses of prospective studies have found associations between lower vitamin D status measured by serum 25(OH)D levels or vitamin D intakes and an increased risk of ischemic stroke, ischemic heart disease, myocardial infarction, and early death [122,123]. Supports the Immune System. Happy #SelfCareDay with our favourite Vitamin C Skincare Range that comes with Natural Vitamin C Face Wash Natural Vitamin C Face Serum Natural Vi. Home; ABOUT; LEARN ABOUT C . Cochrane Database of Systematic Reviews 2018, issue 9, Art. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. J Am Soc Nephrol 2002;13:1608-14. Vitamin D and calcium: A systematic review of health outcomes. Evidence Synthesis Number 118. Circulating vitamin D and colorectal cancer risk: An international pooling project of 17 cohorts. [, Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017;13:466-79. [, Graeff-Armas LA, Bendik I, Kunz I, Schoop R, Hull S, Beck M. Supplemental 25-hydroxycholecalciferol is more effective than cholecalciferol in raising serum 25-hydroxyvitamin D concentrations in older adults. Calcium plus vitamin D supplementation and health outcomes five years after active intervention ended: The Women's Health Initiative. Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal bone mineralization and to prevent hypocalcemic tetany (involuntary contraction of muscles, leading to cramps and spasms). Prostate cancer A few examples are provided below. Arch Intern Med 2005;165:1618-23. 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) had an 18% lower risk of in situ (noninvasive) breast cancer [100]. Add. No association between vitamin D supplementation and risk of colorectal adenomas or serrated polyps in a randomized trial. Plasma vitamin D and prostate cancer risk: Results from the Selenium and Vitamin E Cancer Prevention Trial. Calcium plus vitamin D supplementation and the risk of colorectal cancer. Pages 41-78 in Feldman D, Pike JW, Bouillon R, Giovannucci E, Goltzman D, Hewison M, eds. For this. In Canada, milk must be fortified with 0.881.0 mcg/100 mL (3540 IU), and the required amount for margarine is at least 13.25 mcg/100 g (530 IU). U.S. Food and Drug Administration. JAMA Intern Med 2015;175:745-54. 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]. N Engl J Med 2019:380:33-44. An analysis of NHANES 20092016 data found that only 20.5% of breastfed infants and 31.1% of infants who were not breastfed ingested these recommended amounts of supplements [60]. Nutrients 2018, 10, 953. In the Women's Health Initiative clinical trial (described above), vitamin D3 and calcium supplements had no effect on rates of colorectal cancer. It reflects vitamin D produced endogenously and that obtained from foods and supplements [1]. The groups showed no significant differences in the incidence and recurrent rates of depression, clinically relevant depressive symptoms, or changes in mood scores. Nutrients 2019;11,2295; doi:10.3390/nu11102295. Institute of Medicine, Food and Nutrition Board. More than 53 million adults in the United States have or are at risk of developing osteoporosis, which is characterized by low bone mass and structural deterioration of bone tissue that increases bone fragility and the risk of bone fractures [72]. However, FoodData Central does not include the amounts of 25(OH)D in foods. In extreme cases, vitamin D toxicity causes renal failure, calcification of soft tissues throughout the body (including in coronary vessels and heart valves), cardiac arrhythmias, and even death. 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). 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. A person can also boost . [, James WP, Avenell A, Broom J, Whitehead J. Older adults are at increased risk of developing vitamin D insufficiency, partly because the skin's ability to synthesize vitamin D declines with age [1,61]. However, whether these lower levels in persons with dark skin have significant health consequences is not clear [14]. Fat malabsorption is associated with medical conditions that include some forms of liver disease, cystic fibrosis, celiac disease, Crohns disease, and ulcerative colitis [1,63]. Below are brief descriptions of studies of vitamin D and its association with, or effect on, breast, colorectal, lung, pancreatic, and prostate cancers. The late biochemist Irwin Stone studied ascorbic acid (vitamin C) for over forty years and is credited with the discovery that man's somewhat unique inability to synthesize our own vitamin C from glucose is due to a genetic liver-enzyme disorder he called hypoascorbemia (too little ascorbate). 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. Maternal vitamin D status: Effect on milk vitamin D content and vitamin D status of breastfeeding infants. Pediatrics 2003;112:e132-5. 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