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Clin Gastroeterol Hepatol 2020; published online ahead of print. Serum concentrations of 25(OH)D and health [, Manson JE, Bassuk SS, Buring JE. J Am Soc Nephrol 2002;13:1608-14. It concluded "with moderate certainty" that vitamin D supplementation does not reduce the numbers of falls or injuries, such as fractures, resulting from falls [77,78]. Here are five. 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]. One trial included 206 adults (mean age 52 years) who were randomized to take a bolus dose of 2,500 mcg (100,000 IU) vitamin D3 followed by 500 mcg (20,000 IU)/week or a placebo for 4 months [132]. Norman AW, Henry HH. JAMA 2018;319:1705-16. DOI: 10.1002/14651858.CD008422.pub3. Vitamin D 20 000 IU per week for five years does not prevent progression from prediabetes to diabetes. Adherence to vitamin D intake guidelines in the United States. Am J Clin Nutr 2012;95:1350-6. (July 7, 2022) https://www.hsph.harvard.edu/nutritionsource/magnesium, Hennessy, Sean. Ann Oncol 2019;30:733-43. [, Peterson L, Zeng X, Caufield-Noll CP, Schweitzer MA, Magnuson TH, Steele KE. The AAP recommends 10 mcg (400 IU)/day vitamin D supplements for exclusively and partially breastfed infants starting shortly after birth and lasting until they are weaned and consume at least 1,000 mL/day vitamin D-fortified formula or whole milk [57]. No association between circulating concentrations of vitamin D and risk of lung cancer: An analysis in 20 prospective studies in the Lung Cancer Cohort Consortium (LC3). 2. Vitamin D supplementation and prevention of type 2 diabetes. Considerations in dietetic counseling for vitamin D. J Acad Nutr Diet 2019;119:901-9. [, Song M, Lee IM, Manson JE, Buring JE, Dushkes R, Gordon D, et al. U.S. Preventive Services Task Force. [, O'Brien KM, Sandler DP, Taylor JA, Weinberg CR. [, Muller DC, Hodge AM, Fanidi A, Albanes D, Mai XM, Shu XO, et al. [, Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Circulation 2013;128:2517-31. (July 7, 2022) https://portlandpress.com/clinsci/article-abstract/129/2/159/71306/Folic-acid-supplementation-improves-microvascular, Walling, Elizabeth. The Endocrine Society states, for example, that to maintain serum 25(OH)D levels above 75 nmol/L (30 ng/mL), adults might need at least 37.5 to 50 mcg (1,5002,000 IU)/day of supplemental vitamin D, and children and adolescents might need at least 25 mcg (1,000 IU)/day [11]. This U-shaped association was most pronounced for men with the most aggressive forms of prostate cancer. They also had different study durations (5 days to 5 years), mean participant ages (range, 22 years to 75 years), and baseline 25(OH)D levels; furthermore, some but not all studies administered concurrent antidepressant medications. July 01, 2021. A few examples are provided below. One nmol/L is equal to 0.4 ng/mL, and 1 ng/mL is equal to 2.5 nmol/L. [, Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang Y, et al. Getting too much vitamin D is rare and hard to achieve, usually requiring you to take a supplement of much more than 10,000 IU a day for several months. [, de Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M, et al. The U.S. Department of Agricultures (USDAs) FoodData Central lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin D arranged by nutrient content and by food name. Serum vitamin D and risk of breast cancer within five years. N Eng J Med 2022;387:299-309. June 28, 2022. 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. Vitamin D might be involved in the pathophysiology of type 2 diabetes through its effects on glucose metabolism and insulin signaling as well as its ability to reduce inflammation and improve pancreatic beta-cell function [1443,145]. U.S. Food and Drug Administration. Most of the studies described in this section measured serum 25(OH)D levels using various methods that were not standardized by comparing them to the best methods. People who avoid all animal-sourced products can contact dietary supplement manufacturers to ask about their sourcing and processing techniques. Ready-to-eat breakfast cereals often contain added vitamin D, as do some brands of orange juice, yogurt, margarine, and other food products. J Inherit Metab Dis. 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]. The effect of vitamin D supplementation on lower-extremity power and function in older adults: a randomized controlled trial. Neurol Ther 2018;7:59-85. US Preventive Services Task Force recommendation statement. As a result, a finding can be falsely low or falsely high, depending on the assay used and the laboratory. The Dietary Guidelines for Americans describes a healthy dietary pattern as one that: This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. An analysis of NHANES 20112014 data on serum 25(OH)D levels found that most people in the United States aged 1 year and older had sufficient vitamin D intakes according to the FNB thresholds [43]. 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]. Circulating vitamin D concentrations and risk of breast and prostate cancer: A Mendelian randomization study. Your blood pressure may also be low and your body temperature elevated. A study of cohorts that included 5,313 participants who developed lung cancer and 5,313 matched controls found no association between serum 25(OH)D levels and risk of subsequent lung cancer, even when the investigators analyzed the data by sex, age, race and ethnicity, and smoking status [104]. 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]. Vitamin D2 is manufactured using UV irradiation of ergosterol in yeast, and vitamin D3 is typically produced with irradiation of 7-dehydrocholesterol from lanolin obtained from the wool of sheep [13,31]. Vitamin D fortification in the United States and Canada: Current status and data needs. For many people, consuming vitamin D-fortified foods and exposing themselves to some sunlight are essential for maintaining a healthy vitamin D status. Horm Metab Res 2019;51:11-21. Few people near the equator develop the disease, whereas the prevalence is higher further north and south. [, Aloia JF, Li-Ng M, Pollack S. Statins and vitamin D. Am J Cardiol 2007;100:1329. 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]. Pancreatic cancer Because vitamin D is fat soluble, its absorption depends on the guts ability to absorb dietary fat [4]. 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]. Ann Intern Med 2015;162:133-40. [, McCullough ML, Zoltick ES, Weinstein SJ, Fedirko V, Wang M, Cook NR, et al. Pediatrics 2003;112:e132-5. Have a question? That's because this group is already at risk for lower potassium levels, and that means they're also at an increased risk of heat stroke, cardiac arrhythmia and even death. Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [13,29]. Moreover, the effects did not vary by baseline serum 25(OH)D levels or whether participants took the trials omega-3 supplement in addition to vitamin D. However, another clinical trial designed to investigate bone fracture risk found that 800 IU/day vitamin D3 (with or without calcium) or a placebo in 5,292 adults aged 70 years and older for a median of 6.2 years offered protection from cardiac failure, but not myocardial infarction or stroke [125]. The emerging issue of 25-hydroxyvitamin D in foods. Thiazide diuretics (e.g., Hygroton, Lozol, and Microzide) decrease urinary calcium excretion. Sunscreens with an SPF of 8 or more appear to block vitamin D-producing UV rays. [, 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. Vitamin D supplementation and risk of toxicity in pediatrics: A review of current literature. [, Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. One reason is that sun exposure affects vitamin D status, so serum 25(OH)D levels are usually higher than would be predicted on the basis of vitamin D dietary intakes alone [1]. Food additives permitted for direct addition to food for human consumption; vitamin D2 mushroom powder. 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]. [, Holick MF. Rockville, MD: Agency for Healthcare Research and Quality, 2009. What constituted a "higher" level varied by study but was typically at least 75 nmol/L (30 ng/mL). They're a common symptom of menopause and can feel like a flare of heat coming out of nowhere. Journal of the American College of Nutrition. In contrast, the United Kingdom government recommends intakes of 10 mcg (400 IU)/day for its citizens aged 4 years and older [16]. Am J Clin Nutr 2019;110:1043-4. [, 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. Global consensus recommendations on prevention and management of nutritional rickets. In some cases, vitamin D deficiency can cause muscle pain and achiness. doi: 10.1002/14651858.CD007469.pub2. Some observational studies support an inverse association between 25(OH)D levels and breast cancer risk and mortality, but others do not [94-97]. Some people with MS eventually lose the ability to write, speak, or walk. Another study randomized 100 community-dwelling men and women aged 60 years and older (most were White) with serum 25(OH)D levels of 50 nmol/L (20 ng/ml) or less to 800 IU vitamin D3 or placebo for 1 year [86]. N Engl J Med 2007;357:266-81. There are no strict guidelines on Vit D supplements, many are anecdotally based.Vitamin D "Magnesium." June 18, 2013. In fact, 20132016 NHANES data showed that 92% of men, more than 97% of women, and 94% of people aged 1 year and older ingested less than the EAR of 10 mcg (400 IU) of vitamin D from food and beverages [40]. Vitamin D and multiple sclerosis: A comprehensive review. Am J Clin Nutr 2019;110:150-7. The data on supplemental vitamin D and cholesterol levels are mixed, as shown in one meta-analysis of 41 clinical trials in a total of 3,434 participants (mean age 55 years). [, Shahvazi S, Soltani S, Ahmadi SM, de Souza RJ, Salehi-Abargouei A. The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. Greater amounts of the pigment melanin in the epidermal layer of the skin result in darker skin and reduce the skins ability to produce vitamin D from sunlight [1]. Studies have also assessed the value of vitamin D supplementation for managing diabetes, and they have found that the vitamin offers limited benefits. Effects of vitamin D supplementation on musculoskeletal health: A systematic review, meta-analysis, and trial sequential analysis. 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]. Or walk, 2009 P, Penninx BWJH, Elders PJM, Heijboer,. Sequential analysis a `` higher '' level varied by study but was typically at least 75 (... L, Zeng X, Caufield-Noll CP, Schweitzer MA, Magnuson TH, Steele KE of 8 more. On musculoskeletal health: a review of Current literature cancer: a comprehensive review a randomized trial. ; published online ahead of print, Greer FR, American Academy of Pediatrics Section on,! 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