Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low 25(OH)D status (below 20 nmol/L [12 ng/mL]) at baseline [93,124]. Observational studies suggest that adequate vitamin D levels might reduce the risk of contracting MS and, once MS is present, decrease the risk of relapse and slow the disease's progression [138]. 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. Among the women with two or more serum 25(OH)D samples taken before diagnosis (which reduced random measurement variation), a 50 nmol/L increase in 25(OH)D was associated with a 41% reduced risk of MS, and 25(OH)D levels less than 30 nmol/L were associated with an MS risk that was twice as high as levels of 50 nmol/L or higher. Endocrine Connections 2018;7:R294-303. Low blood levels of vitamin D have also been associated with: An impairment in memory and thinking skills in older adults. 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. Vitamin D plays a role in glucose metabolism. J Clin Endocrinol Metab 2016;101:1647-55. It is also produced endogenously when ultraviolet (UV) rays from sunlight strike the skin and trigger vitamin D synthesis. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. Ann Oncol 2019;30:733-43. The concurrent presence of fat in the gut enhances vitamin D absorption, but some vitamin D is absorbed even without dietary fat. Corticosteroid medications, such as prednisone (Deltasone, Rayos, and Sterapred), are often prescribed to reduce inflammation. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. Effect of monthly high-dose vitamin D supplementation on cardiovascular disease in the Vitamin D Assessment Study: A randomized clinical trial. However, the evidence on the impact of vitamin D and calcium supplements on fractures in community-dwelling individuals is inconsistent. 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. Steroids A randomized controlled trial of vitamin D3 supplementation in African American women. It is also a fat-soluble vitamin. Les sites web associs 'MCS' : recherchez avec meeZoom les sites proposs et classs par les autres internautes. Individuals who have difficulty absorbing dietary fat might therefore require vitamin D supplementation [63]. [, Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. In contrast, a meta-analysis of 6 trials in 49,282 older adults found that daily vitamin D (10 or 20 mcg [400 IU or 800 IU]/day) and calcium (800 or 1,200 mg/day) supplementation for a mean of 5.9 years reduced the risk of any fracture by 6% and of hip fracture by 16% [81]. Nutr Clin Pract 2013;28:194-208. Because vitamin D increases calcium absorption in the gastrointestinal tract, vitamin D toxicity results in marked hypercalcemia (total calcium greater than 11.1 mg/dL, beyond the normal range of 8.4 to 10.2 mg/dL), hypercalciuria, and high serum 25(OH)D levels (typically greater than 375 nmol/l [150 ng/mL]) [155]. Women with 25(OH)D levels of less than 30 nmol/L (12 ng/mL) had a 43% higher MS risk than women with levels of 50 nmol/L (20 ng/mL) or higher. [, Golzarand M, Shab-Bidar S, Koochakpoor G, Speakman JR, Djafarian K. Effect of vitamin D3 supplementation on blood pressure in adults: An updated meta-analysis. [, Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. Present Knowledge in Nutrition, 10th ed. 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). Crit Rev Food Sci Nutr 2015;55:1193-205. [, Gotfredsen A, Westergren Hendel H, Andersen T. Influence of orlistat on bone turnover and body composition. JAMA 2018;319:1600-12. 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]. [, Song Z-y, Yao Q, Zhuo Z, Ma Z, Chen G. Circulating vitamin D level and mortality in prostate cancer patients: A dose-response meta-analysis. Pediatr Clin North Am 2001;48:53-67. Rickets. doi: 10.3390/nu10040493. An investigation that pooled data from 10 studies of cancer in 12,205 men and women found that concentrations of 25(OH)D greater than 75 nmol/L (30 ng/mL) but less than 100 nmol/L (40 ng/mL) did not reduce the risk of pancreatic cancer. Mushrooms, like humans and animals, produce vitamin D when exposed to . Vitamin D status in gastrointestinal and liver disease. J Natl Cancer Inst 2019;111:158-69. Silva MC, Furlanetto TW. Norman AW, Henry HH. Neurol Ther 2018;7:59-85. J Clin Endocrinol Metab 2014;99:1132-41. 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]. Association of glucocorticoid use and low 25-hydroxyvitamin D levels: Results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006. In addition, inadequate vitamin D levels can adversely affect muscle strength and lead to muscle weakness and pain (myopathy) [1]. The mean age of all participants was 67.1 years; 50.6% were women and 20.2% were Black. The USPSTF evaluated 11 randomized clinical trials of vitamin D and/or calcium supplementation in a total of 51,419 healthy, community-dwelling adults aged 50 years and older who did not have osteoporosis, vitamin D deficiency, or prior fractures [75,76]. [, Sowah D, Fan X, Dennett L, Hagtvedt R, Straube S. Vitamin D levels and deficiency with different occupations: A systematic review. Nutritional rickets among children in the United States: Review of cases reported between 1986 and 2003. Vitamin D and multiple sclerosis: A comprehensive review. Ready-to-eat breakfast cereals often contain added vitamin D, as do some brands of orange juice, yogurt, margarine, and other food products. [. The weight-loss drug orlistat (Xenical and alli), together with a reduced-fat diet, can reduce the absorption of vitamin D from food and supplements, leading to lower 25(OH)D levels [164-167]. This U-shaped association was most pronounced for men with the most aggressive forms of prostate cancer. The impact of this form on vitamin D status is an emerging area of research. Sunscreens with an SPF of 8 or more appear to block vitamin D-producing UV rays. The vitamin D supplements were associated with serum 25(OH)D levels of 54 to 135 nmol/L (21.6 to 54 ng/mL). Thiazide diuretics [. Orlistat [, Munger K, Hongell K, Aivo J, Soilu-Hanninen M, Surcel H-M, Ascherio A. An animals diet affects the amount of vitamin D in its tissues. Assessing the vitamin D status of the US population. Trends in use of high-dose vitamin D supplements exceeding 1000 or 4000 International Units daily, 1999-2014. No. 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. 183 prepared by the Tufts Evidence-based Practice Center under Contract No. [, Crockett SD, Barry EL, Mott LA, Ahnen DJ, Robertson DJ, Anderson JC, et al. 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]. In contrast to the observational studies, clinical trials have provided little support for the hypothesis that supplemental vitamin D reduces the risk of CVD or CVD mortality. At baseline, participants had an adequate mean serum 25(OH)D level of 60 nmol/L (24 ng/mL). Various expert groupsincluding the American Association of Metabolic and Bariatric Surgery, The Obesity Society, and the British Obesity and Metabolic Surgery Societyhave developed guidelines on vitamin D screening, monitoring, and replacement before and after bariatric surgery [66,68]. However, no 25(OH)D3 dietary supplements appear to be available to consumers on the U.S. market at this time [32]. JAMA Network Open 2019;2(12):e1917789. 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. DOI: 10.1002/14651858.CD008422.pub3. If you Google cforyourself vitamin d toxicity, it has answered all of my questions that all the doctor's couldn't. The blog writer is a scientist and it's very interesting to read. It is found in fortified food and some supplements. Vitamin D and cardiovascular disease: Controversy unresolved. Furthermore, the bone health of older Black American women does not appear to benefit from raising serum 25(OH)D levels beyond 50 nmol/L (20 ng/mL) [84]. In one Minnesota county, the incidence rate of rickets in children younger than 3 years in the decade beginning in 2000 was 24.1 per 100,000 [48]. Mushrooms provide variable amounts of vitamin D2 [17]. Am J Clin Nutr 2004;80:1697S-705S. MS is an autoimmune disease of the central nervous system that damages the myelin sheath surrounding and protecting nerve cells in the brain and spinal cord. Vitamin D supplements may interact with several types of medications. Older people and people with dark skin are less able to produce vitamin D from sunlight [1]. 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]. In addition, although 25(OH)D levels rise in response to increased vitamin D intake, the relationship is nonlinear [1]. $12.99. A few studies have examined the effect of vitamin D supplementation on specific cancers. [, Seida JC, Mitri J, Colmers IN, Majumdar SR, Davidson MB, Edwards AL, et al. [, de Sevaux RGL, Hoitsma AJ, Corstens FHM, Wetzels JFM. 6.Mushrooms. 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]. Two earlier prospective studies of similar designone in the United States with 444 non-Hispanic White individuals [140] and the other with 576 individuals in northern Sweden [141]found that levels of 25(OH)D greater than 99.1 nmol/L (39.6 ng/mL) and at least 75 nmol/L (30 ng/mL), respectively, were associated with a 6162% lower risk of MS. No clinical trials have examined whether vitamin D supplementation can prevent the onset of MS, but several have investigated whether supplemental vitamin D can help manage the disease. The emerging issue of 25-hydroxyvitamin D in foods. 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]. Environ Health Perspect 2017;125(7):077004. 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]. Cochrane Database of Systematic Reviews 2018, issue 9, Art. Few foods naturally contain vitamin D. The flesh of fatty fish (such as trout, salmon, tuna, and mackerel) and fish liver oils are among the best sources [17,1]. Colorectal cancer In addition, the Food and Drug Administration (FDA) has approved UV-treated mushroom powder as a food additive for use as a source of vitamin D2 in food products [18]. 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]. Cardiovascular disease US Preventive Services Task Force recommendation statement. Vitamin D supplementation did not lower the risk of total fractures, hip fractures, or nonvertebral fractures as compared with placebo. Ann Intern Med 2015;162:133-40. [, Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon R. Hypervitaminosis D associated with tanning bed use: A case report. 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]. Studies have also assessed the value of vitamin D supplementation for managing diabetes, and they have found that the vitamin offers limited benefits. and some exceptional products like: Butterfat Keto, Advanced Collagen and Altrient C, Neutrient put a group of #CForYourself volunteers onto the 5C Reset and achieved outstanding results. Having produced a solution of this blue indicator, some researchers suggest its use as an indicator for the presence of Vitamin C. Obesity does not affect the skins capacity to synthesize vitamin D. However, greater amounts of subcutaneous fat sequester more of the vitamin [1]. [, Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017;13:466-79. Most people in the United States consume less than recommended amounts of vitamin D. An analysis of data from the 20152016 National Health and Nutrition Examination Survey (NHANES) found that average daily vitamin D intakes from foods and beverages were 5.1 mcg (204 IU) in men, 4.2 mcg (168 IU) in women, and 4.9 mcg (196 IU) in children aged 219 years [39]. However, some groups might need dietary supplements to meet their vitamin D requirements. 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. Maternal vitamin D status: Effect on milk vitamin D content and vitamin D status of breastfeeding infants. No studies have examined whether such screening for vitamin D deficiency results in improved health outcomes [55]. 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]. The results showed no association between 25(OH)D levels or vitamin D dose and the risk of falling in the 184 participants who completed the study. Questions about vitamin D for primary care practice: Input from an NIH conference. So Many Ailments are Helped with Proper C Intake As has become clear from the other areas of Cforyourself, there isn't a lot that enough vitamin C won't help. romanov fortune in swiss banks. 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. 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]. A few examples are provided below. Dietary supplements [, Earthman CP, Beckman LM, Masodkar K, Sibley SD. Possible explanations for this increase include genetic differences in vitamin D metabolism, dietary preferences, and behaviors that lead to less sun exposure [45,46]. Vitamin C Products Cforyourself now sells Nutribiotic vitamin C products. Have a question? 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]. 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]. Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: Results from the Prostate Cancer Prevention Trial. It stimulates insulin secretion via the vitamin D receptor on pancreatic beta cells and reduces peripheral insulin resistance through vitamin D receptors in the muscles and liver [143]. Most trials of the effects of vitamin D supplements on bone health also included calcium supplements, so isolating the effects of each nutrient is difficult. Yao P, Bennett D, Mafham M, Lin X, Chen Z, Armitage J, Clarke R. Vitamin D and calcium for the prevention of fracture: A systematic review and meta-analysis. No improvement in depressive symptoms by vitamin D supplementation: Results from a randomised controlled trial. [, Cashman KD, Seamans KM, Lucey AJ, Stocklin E, Weber P, Kiely M, Hill TR. Studies examining the effects of supplemental vitamin D on muscle strength and on rate of decline in muscle function have had inconsistent results [55]. Type 2 diabetes Nutr Metab Cardiovasc Dis 2016;26:663-73. Intestinal absorption of vitamin D: A systematic review. People with obesity might need greater intakes of vitamin D to achieve 25(OH)D levels similar to those of people with normal weight [1,64,65]. It means you need fats in your body for proper absorption of vitamin D. Since vitamin D maintains calcium and phosphorous levels in our bodies, it is an essential vitamin for good bone, muscle, and teeth health. N Engl J Med 2019:380:33-44. Am J Clin Nutr 2019;110:150-7. [, Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, et al. Vitamin D 20 000 IU per week for five years does not prevent progression from prediabetes to diabetes. Vitamin D3 is more efficient than D2. Vitamin D2 is from plant sources. Am J Clin Nutr 2017;106:481-90. J Nutr 2018;148:712-20. 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]. [, Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, et al. 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]. Three trials conducted since that meta-analysis also found no effect of vitamin D supplementation on depressive symptoms. doi: 10.1001/jamanetworkopen.2019.17789. Mayo Clin Proc 2013;88:720-55. Gut. However, a meta-analysis of 12 vitamin D supplementation trials (including 5 in which body composition measurements were primary outcomes) found that vitamin D supplements without calorie restriction did not affect body weight or fat mass when the results were compared with those of placebo [154]. Am J Clin Nutr 2014;100:746-55. Lancet Diabetes Endocrinol 2018;6:847-58. 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. UV radiation is a carcinogen, and UV exposure is the most preventable cause of skin cancer. [, Muller DC, Hodge AM, Fanidi A, Albanes D, Mai XM, Shu XO, et al. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. 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). 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. The first hydroxylation, which occurs in the liver, converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as "calcidiol." [, Aloia JF, Talwar SA, Pollack S, Yeh J. Vitamin D supplements are another way to help children get enough vitamin D every day. Observational studies have linked lower serum 25(OH)D levels to an increased risk of diabetes, but their results might have been confounded by the fact that many participants were overweight or had obesity and were therefore more predisposed to developing diabetes and having lower 25(OH)D levels [1]. Supplemental vitamin D and incident fractures in midlife and older adults. Pediatrics 2008;122:1142-52. [, Keum N, Lee DH, Greenwood DC, Manson JE, Giovannucci E. Vitamin D supplementation and total cancer incidence and mortality: A meta-analysis of randomized controlled trials. [, Helzlsouer KJ for the VDPP Steering Committee. - 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 The trials administered different amounts of vitamin D (ranging from 10 mcg [400 IU]/day to 1,000 mcg [40,000 IU]/week). [, McNamara M, Rosenberger KD. These values, which vary by age and sex, include: An FNB committee established RDAs for vitamin D to indicate daily intakes sufficient to maintain bone health and normal calcium metabolism in healthy people. US Preventive Services Task Force recommendation statement. Again, the pattern was similar for the risk of inadequacy. Vitamin D deficiency or insufficiency did not increase the risk of prostate cancer, and higher 25(OH)D concentrations were not associated with a lower risk. Laboratory and animal studies suggest that vitamin D might inhibit carcinogenesis and slow tumor progression by, for example, promoting cell differentiation and inhibiting metastasis. [, Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. Int J Obes Relat Metab Disord 2001;25:1154-60. A randomized, double-blind, placebo-controlled trial. [, James WP, Avenell A, Broom J, Whitehead J. (0) May be available In-Warehouse at a lower non-delivered price. BMC Public Health 2017;17:519. [, Rockwell M, Kraak V, Hulver M, Epling J. The effect of vitamin D supplementation on prostate cancer: A systematic review and meta-analysis of clinical trials. Nutritional rickets around the world: An update. [. A variety of foods and their vitamin D levels per serving are listed in Table 3. Homebound individuals; people who wear long robes, dresses, or head coverings for religious reasons; and people with occupations that limit sun exposure are among the groups that are unlikely to obtain adequate amounts of vitamin D from sunlight [62]. One study comparing 738 men who developed pancreatic cancer to 738 matched controls found no relationship between serum 25(OH)D levels and risk of pancreatic cancer [105]. JAMA 2017;317:2448-50. PLOS ONE 2014;9:e111265. Similarly, the VITAL clinical trial described above found that vitamin D supplements did not significantly decrease rates of heart attacks, strokes, coronary revascularization, or deaths from cardiovascular causes [93]. Among the 198 participants who died (41 deaths were due to prostate cancer), 25(OH)D levels were not associated with risk of death from prostate cancer or any cause [114]. The groups showed no significant differences in the incidence and recurrent rates of depression, clinically relevant depressive symptoms, or changes in mood scores. Endocrinol Metab Clin North Am 2017;46:947-82. A systematic review and meta-analysis of 15 weight-loss intervention studies that used caloric restriction, exercise, or both, but not necessarily vitamin D supplementation or other treatments, found that people who lost weight had significantly greater increases in serum 25(OH)D levels than those who maintained their weight [152]. Ann Intern Med 2014;160:810-1. Overall, the risk of CVD events was 10% lower for each 25 nmol/L (10 ng/mL) increase in serum 25(OH)D. Another large observational study that followed 247,574 adults from Denmark for 07 years found that levels of 25(OH)D that were low (about 12.5 nmol/L [5 ng/mL]) and high (about 125 nmol/L [50 ng/mL]) were associated with a greater risk of mortality from CVD, stroke, and acute myocardial infarction [121]. Exposed to nutritional rickets among children in the gut enhances vitamin D when exposed to individuals who have difficulty dietary... Edwards al, et al MB, Edwards al, et al Davidson... In-Warehouse at A lower non-delivered price 63 ] VDPP Steering Committee UV is! Low-Dose corticosteroids in patients with rheumatoid arthritis screening for vitamin D. Nat Rev Endocrinol 2017 ; (... Sclerosis: A randomized controlled trial of vitamin D2 [ 17 ] body composition may interact with several of. ; 2 ( 12 ): 2001-2006 55 ] MJ, et al of cancer... 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