Vitamin D and Bone Health—Discussion Points Following the Recent Institute of Medicine Recommendations

2011 ◽  
Vol 07 (02) ◽  
pp. 137 ◽  
Author(s):  
Robert P Heaney ◽  
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Calcium Absorption ◽  
Institute Of Medicine ◽  
Vitamin D Status ◽  
Extensive Experience ◽  
Hydroxyvitamin D ◽  
Daily Amount ◽  
Fracture Risk Reduction ◽  
25 Hydroxyvitamin D

The 2011 Institute of Medicine recommendations for vitamin D—both the recommended daily amount (RDA) and the vitamin D status judged adequate for bone health—are too low. Calcium absorption, osteoporotic fracture risk reduction, and healing of histological osteomalacia all require values above 30 ng/ml, and probably even 40 ng/ml. Furthermore, the proposed RDA (600 international units per day up to the age of 70) is not compatible with the blood level of 25-hydroxyvitamin D (i.e., 20 ng/ml) recommended in the same report. Concerns regarding adverse consequences of higher intakes or status levels can be dismissed, in view of our extensive experience with outdoor summer workers (who regularly have values of 60 ng/ml or more) and the virtual certainty that human physiology evolved in—and is attuned to—an environment providing 10,000 IU/day or more.

scholarly journals Vitamin D Binding Protein and Bone Health

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ishir Bhan
Keyword(s):  
Vitamin D ◽  
Bone Density ◽  
Bone Health ◽  
Binding Protein ◽  
Vitamin D Status ◽  
Vitamin D Binding Protein ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Major Carrier ◽  
Osteoclast Activation

Vitamin D binding protein (DBP) is the major carrier protein of 25-hydroxyvitamin D (25(OH) D) in the circulation, where it may serve roles in maintaining stable levels during times of decreased 25(OH) availability and in regulating delivery of 25(OH) D to target tissues. Several genetic polymorphisms of DBP have been described that lead to phenotypic changes in the protein that may affect affinity, activity, and concentration. These polymorphisms have been linked with alterations in bone density in several populations. One of the mechanisms by which DBP may alter bone health involves regulating vitamin D bioavailability. DBP-bound vitamin is thought to be relatively unavailable to target tissues, and thus alterations in DBP levels or affinity could lead to changes in vitamin D bioactivity. As a result, functional vitamin D status may differ greatly between individuals with similar total 25(OH) D levels. Additionally, DBP may have independent roles on macrophage and osteoclast activation. This review will summarize recent findings about DBP with respect to measures of bone density and health.

scholarly journals UV and dietary predictors of serum 25-hydroxyvitamin D concentrations among young shift-working nurses and implications for bone density and skin cancer

2013 ◽  
Vol 17 (4) ◽  
pp. 772-779 ◽  
Author(s):  
Sarah C Wallingford ◽  
Glenville Jones ◽  
Lindsay C Kobayashi ◽  
Anne Grundy ◽  
Qun Miao ◽  
...  
Keyword(s):  
Vitamin D ◽  
White Women ◽  
Full Time ◽  
Institute Of Medicine ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Supplement Use ◽  
Tanning Bed ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

AbstractObjectiveIn 2011, the US Institute of Medicine updated the definition of vitamin D inadequacy to serum 25-hydroxyvitamin D (25(OH)D) concentration of 30–<50 nmol/l and of deficiency to serum 25(OH)D < 30 nmol/l. We describe the prevalence of these conditions according to these definitions, seasonal variation in 25(OH)D and predictors of serum 25(OH)D concentrations among working, white women.DesignParticipants recorded lifestyle factors and dietary intake and provided fasting blood samples for measurement of serum 25(OH)D in both summer and winter. Predictors of serum 25(OH)D variation were analysed using linear regression and generalized linear mixed models.SettingKingston General Hospital in Kingston, Ontario, Canada, from April 2008 to July 2009.SubjectsFemale premenopausal nurses (n83) working full-time rotating shifts.ResultsDeficient or inadequate vitamin D status was observed in 9 % of participants following summer/autumn and in 13 % following winter/spring. Predictors of serum 25(OH)D concentration were vitamin D supplement use, tanning bed use and season. Tanning bed use increased serum 25(OH)D by 23·24 nmol/l (95 % CI 8·78, 37·69 nmol/l,P= 0·002) on average.ConclusionsAccording to the 2011 Institute of Medicine bone health guidelines, over 10 % of nurses had deficient or inadequate vitamin D status following winter. Higher serum concentrations were associated with use of tanning beds and vitamin D supplements. As health promotion campaigns and legal restrictions are successful in reducing tanning bed use among women, our data suggest that increased prevalence of vitamin D inadequacy and deficiency may be a consequence, and that low vitamin D status will need to be countered with supplementation.

scholarly journals Relationships Between Vitamin D Status and PTH over 5 Years After Roux-en-Y Gastric Bypass: a Longitudinal Cohort Study

2020 ◽  
Vol 30 (9) ◽  
pp. 3426-3434
Author(s):  
Stephen Hewitt ◽  
Jon Kristinsson ◽  
Erlend Tuseth Aasheim ◽  
Ingvild Kristine Blom-Høgestøl ◽  
Eirik Aaseth ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Bone Health ◽  
Bone Alkaline Phosphatase ◽  
Vitamin D Status ◽  
Threshold Levels ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D

Abstract Purpose Secondary hyperparathyroidism (SHPT) after obesity surgery may affect bone health. Optimal vitamin D levels have not been established to prevent SHPT postoperatively. We investigated whether SHPT differed across threshold levels of serum 25-hydroxyvitamin D (S-25(OH)D) from 6 months up to 5 years after Roux-en-Y gastric bypass (RYGB). Materials and Methods We included 554 patients at follow-up 5 years postoperatively. Blood samples were analysed for S-25(OH)D, ionized calcium (iCa) and parathyroid hormone (PTH) during follow-up. Results PTH and prevalence of SHPT increased from 6 months to 5 years postoperatively, while S-25(OH)D and iCa decreased (all P < 0.001). PTH and SHPT development are related with S-25(OH)D, and PTH differed between all subgroups of S-25(OH)D. SHPT occurred less frequently across all subgroups of S-25(OH)D ≥ 50 nmol/l during follow-up: odds ratio (OR) 0.44 (95% CI 0.36–0.54) in patients with S-25(OH)D ≥ 50 nmol/l, OR 0.38 (0.30–0.49) with S-25(OH)D ≥ 75 nmol/l and OR 0.19 (0.12–0.31) with S-25(OH) D ≥ 100 nmol/l, all compared with S-25(OH)D < 50 nmol/l. At 5 years, 208/554 patients (38%) had SHPT; SHPT was found in 94/188 patients (50%) with S-25(OH)D < 50 nmol/l, in 69/222 (31%) with S-25(OH)D 50–74 nmol/l, in 40/117 (34%) with S-25(OH)D 75–99 nmol/l and in 5/27 (19%) with S-25(OH)D ≥ 100 nmol/l. An interaction existed between S-25(OH)D and iCa. Bone alkaline phosphatase remained increased with SHPT. Conclusions A significant relationship existed between S-25(OH)D and development of PTH and SHPT. The prevalence of SHPT was lower with threshold levels 25(OH)D ≥ 50 nmol/l and ≥ 75 nmol/l over the 5 years, and lowest with S-25(OH)D ≥ 100 nmol/l.

scholarly journals Comparison of Vitamin D and 25-Hydroxyvitamin D Concentrations in Human Breast Milk between 1989 and 2016–2017

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 573
Author(s):  
Naoko Tsugawa ◽  
Mayu Nishino ◽  
Akiko Kuwabara ◽  
Honami Ogasawara ◽  
Maya Kamao ◽  
...  
Keyword(s):  
Vitamin D ◽  
Breast Milk ◽  
Sun Exposure ◽  
Stepwise Multiple Regression ◽  
Human Breast Milk ◽  
Vitamin D Status ◽  
Human Breast ◽  
Hydroxyvitamin D ◽  
Lactating Mothers ◽  
25 Hydroxyvitamin D

Background: Breast milk is considered the optimal source of nutrition during infancy. Although the vitamin D concentration in human breast milk is generally considered poor for infants, vitamin D in breast milk is an important source for exclusively breastfed infants. Increases in vitamin D insufficiency and deficiency in lactating mothers may reduce vitamin D concentrations in breast milk. This study aimed to compare vitamin D and 25-hydroxyvitamin D (25OHD) concentrations in breast milk collected in 1989 and 2016–2017 and simultaneously analyze them with liquid chromatography-tandem mass spectrometry (LC-MS/MS); the association between the lifestyle of recent lactating mothers (2016–2017) and vitamin D status in human breast milk was also evaluated. Method: Lactating mothers were recruited from three regions of Japan in 1989 (n = 72) and 2016–2017 (n = 90), and milk from 3–4 months was collected in summer and winter. The samples were strictly sealed and stored at −80℃ until measurement. Breast milk vitamin D and 25OHD concentrations were analyzed by LC-MS/MS. Vitamin D intake, sun exposure, and sunscreen use of the lactating mothers in 2016–2017 were assessed. Results: Both vitamin D and 25OHD concentrations in breast milk were higher in the summer regardless of the survey year. Significantly lower vitamin D and 25OHD concentrations were observed in 2016–2017 compared with 1989 in summer, but no survey year difference was observed in winter. The stepwise multiple regression analyses identified season, daily outdoor activity, and suntan in the last 12 months as independent factors associated with vitamin D3 concentrations. Conclusion: The results suggest that low vitamin D status in recent lactating mothers may have decreased vitamin D and 25OHD concentrations in breast milk compared with the 1980s. These results are helpful for developing public health strategies to improve vitamin D status in lactating mothers and infants.

scholarly journals COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1714
Author(s):  
Habiba AlSafar ◽  
William B. Grant ◽  
Rafiq Hijazi ◽  
Maimunah Uddin ◽  
Nawal Alkaabi ◽  
...  
Keyword(s):  
Vitamin D ◽  
United Arab Emirates ◽  
Blood Levels ◽  
Vitamin D Status ◽  
Hospital Visit ◽  
Serum Samples ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
Multiethnic Population ◽  
25 Hydroxyvitamin D

Insufficient blood levels of the neurohormone vitamin D are associated with increased risk of COVID-19 severity and mortality. Despite the global rollout of vaccinations and promising preliminary results, the focus remains on additional preventive measures to manage COVID-19. Results conflict on vitamin D’s plausible role in preventing and treating COVID-19. We examined the relation between vitamin D status and COVID-19 severity and mortality among the multiethnic population of the United Arab Emirates. Our observational study used data for 522 participants who tested positive for SARS-CoV-2 at one of the main hospitals in Abu Dhabi and Dubai. Only 464 of those patients were included for data analysis. Demographic and clinical data were retrospectively analyzed. Serum samples immediately drawn at the first hospital visit were used to measure serum 25-hydroxyvitamin D [25(OH)D] concentrations through automated electrochemiluminescence. Levels < 12 ng/mL were significantly associated with higher risk of severe COVID-19 infection and of death. Age was the only other independent risk factor, whereas comorbidities and smoking did not contribute to the outcomes upon adjustment. Sex of patients was not an important predictor for severity or death. Our study is the first conducted in the UAE to measure 25(OH)D levels in SARS-CoV-2-positive patients and confirm the association of levels < 12 ng/mL with COVID-19 severity and mortality.

scholarly journals Vitamin D Status and Seasonal Variation among Danish Children and Adults: A Descriptive Study

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1801 ◽  
Author(s):  
Louise Hansen ◽  
Anne Tjønneland ◽  
Brian Køster ◽  
Christine Brot ◽  
Rikke Andersen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Seasonal Variation ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Supplement Use ◽  
Wide Range ◽  
Adults And Children ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplement ◽  
Very High

The aim of the present study was to describe vitamin D status and seasonal variation in the general Danish population. In this study, 3092 persons aged 2 to 69 years (2565 adults, 527 children) had blood drawn twice (spring and autumn) between 2012 and 2014. A sub-sample of participants had blood samples taken monthly over a year. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by liquid chromatography mass spectrometry, and information on supplement use was assessed from questionnaires. Seasonal variations in 25(OH)D concentrations were evaluated graphically and descriptively, and status according to age, sex, and supplement use was described. It was found that 86% of both adults and children were vitamin D-sufficient in either spring and or/autumn; however, many had a spring concentration below 50 nmol/L. A wide range of 25(OH)D concentrations were found in spring and autumn, with very low and very high values in both seasons. Among adults, women in general had higher median 25(OH)D concentrations than men. Furthermore, vitamin D supplement use was substantial and affected the median concentrations markedly, more so during spring than autumn. Seasonal variation was thus found to be substantial, and bi-seasonal measurements are vital in order to capture the sizable fluctuations in vitamin D status in this Nordic population.

scholarly journals Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data

2016 ◽  
Vol 20 (10) ◽  
pp. 1857-1864 ◽  
Author(s):  
Sonali Rajan ◽  
Tom Weishaar ◽  
Bryan Keller
Keyword(s):  
Vitamin D ◽  
Body Weight ◽  
Skin Colour ◽  
Vitamin D Status ◽  
Epidemiological Investigation ◽  
Dietary Recommendations ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Nationally Representative ◽  
The Impact

AbstractObjectiveCurrent US dietary recommendations for vitamin D vary by age. Recent research suggests that body weight and skin colour are also major determinants of vitamin D status. The objective of the present epidemiological investigation was to clarify the role of age as a predictor of vitamin D status, while accounting for body weight and skin colour, among a nationally representative sample.DesignWe calculated the mean serum 25-hydroxyvitamin D levels for the US population by age and weight, as well as by weight and race/ethnicity group. Multiple regression analyses were utilized to evaluate age and weight as predictors of vitamin D status: serum 25-hydroxyvitamin D levels with age alone, age and body weight, and age, body weight and their two-way interaction were modelled for the entire sample and each age subgroup. Graphical data were developed using B-spline non-linear regression.SettingNational Health and Nutrition Examination Survey (31 934 unweighted cases).SubjectsIndividuals aged 1 year and older.ResultsThere were highly significant differences in mean vitamin D status among US residents by weight and skin colour, with those having darker skin colour or higher body weight having worse vitamin D status. Although a significant factor, the impact of age on vitamin D status was notably less than the impact of body weight.ConclusionsVitamin D status varied predominantly by body weight and skin colour. Recommendations by nutritionists for diet and supplementation needs should take this into account if vitamin D-related health disparities are to be meaningfully reduced across the USA.

scholarly journals Investigating the Role of Functional Polymorphism of Maternal and Neonatal Vitamin D Binding Protein in the Context of 25-Hydroxyvitamin D Cutoffs as Determinants of Maternal-Neonatal Vitamin D Status Profiles in a Sunny Mediterranean Region

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3082
Author(s):  
Spyridon N. Karras ◽  
Erdinç Dursun ◽  
Merve Alaylıoğlu ◽  
Duygu Gezen-Ak ◽  
Cedric Annweiler ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mediterranean Region ◽  
Binding Protein ◽  
Hypovitaminosis D ◽  
Vitamin D Status ◽  
Vitamin D Binding Protein ◽  
Hydroxyvitamin D ◽  
High Prevalence ◽  
25 Hydroxyvitamin D ◽  
Causative Effect

Recent results indicate that dysregulation of vitamin D-binding protein (VDBP) could be involved in the development of hypovitaminosis D, and it comprises a risk factor for adverse fetal, maternal and neonatal outcomes. Until recently, there was a paucity of results regarding the effect of maternal and neonatal VDBP polymorphisms on vitamin D status during pregnancy in the Mediterranean region, with a high prevalence of hypovitaminosis D. We aimed to evaluate the combined effect of maternal and neonatal VDBP polymorphisms and different maternal and neonatal 25-hydroxyvitamin D (25(OH)D) cut-offs on maternal and neonatal vitamin D profile. Blood samples were obtained from a cohort of 66 mother–child pairs at birth. Our results revealed that: (i) Maternal VDBP polymorphisms do not affect neonatal vitamin D status at birth, in any given internationally adopted maternal or neonatal cut-off for 25(OH)D concentrations; (ii) neonatal VDBP polymorphisms are not implicated in the regulation of neonatal vitamin D status at birth; (iii) comparing the distributions of maternal VDBP polymorphisms and maternal 25(OH)D concentrations, with cut-offs at birth, revealed that mothers with a CC genotype for rs2298850 and a CC genotype for rs4588 tended to demonstrate higher 25(OH)D (≥75 nmol/L) during delivery (p = 0.05 and p = 0.04, respectively), after adjustments for biofactors that affect vitamin D equilibrium, including UVB, BMI and weeks of gestation. In conclusion, this study from Southern Europe indicates that maternal and neonatal VDBP polymorphisms do not affect neonatal vitamin D status at birth, whereas mothers with CC genotype for rs2298850 and CC genotype for rs4588 demonstrate higher 25(OH)D concentrations. Future larger studies are required to establish a causative effect of these specific polymorphisms in the attainment of an adequate (≥75 nmol/L) maternal vitamin D status during pregnancy.

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