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[, Drinka PJ, Nolten WE. 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. 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]. [, Elder CJ, Bishop NJ. [, Bolland MJ, Grey A, Avenell A. Vitamin D and multiple sclerosis: A comprehensive review. Stay up to date on the latest stock price, chart, news, analysis, fundamentals, trading and investment tools. Vitamin D status and weight loss: A systematic review and meta-analysis of randomized and nonrandomized controlled weight-loss trials. Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response meta-analysis of prospective studies. pii: E493. Rockville, MD: Agency for Healthcare Research and Quality, 2009. The Zacks Analyst Blog Highlights: NextEra Energy, Caterpillar, Micron Technology, Dominion Energy and Emerson Electric, Top Stock Reports for NextEra Energy, Caterpillar & Micron Technology, Investment, Focus on Renewables Continue to Aid Dominion (D). [, Cauley JA, Chlebowski RT, Wactawski-Wende J, Robbins JA, Rodabough RJ, Chen Z, et al. Pediatrics 2020;145:e20193574. In addition, inadequate vitamin D levels can adversely affect muscle strength and lead to muscle weakness and pain (myopathy) [1]. Philadelphia: Lippincott Williams & Wilkins, 2014. DOI: 10.1002/14651858.CD008422.pub3. [, Logan VF, Gray AR, Peddie MC, Harper MJ, Houghton LA. In the most recent meta-analysis, 10 randomized clinical trials (including the Vitamin D and Omega-3 Trial [VITAL] trial described below) that included 6,537 cancer cases provided 10 to 50 mcg (400 to 2,000 IU) vitamin D3 daily (six trials) or 500 mcg (20,000 IU)/week to 12,500 mcg (500,000 IU)/year boluses of vitamin D3 (four trials) [91]. 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. 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. For example, three meta-analyses of clinical trial evidence found that vitamin D supplementation does not affect cancer incidence but does significantly reduce total cancer mortality rates by 12–13% [90-92]. In a meta-analysis of 16 prospective cohort studies in a total of 137,567 participants who had 8,345 diagnoses of cancer, 5,755 participants died from cancer [88]. [, Auguste BL, Avila-Casado C, Bargman JM. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. Dominion Energy, Inc. engages in the provision of electricity and natural gas to homes, businesses, and wholesale customers. 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]. [, Mallard SR, Howe AS, Houghton LA. J Am Coll Cardiol 2017;70:89-100. Nutrient composition of human milk. The groups showed no significant differences in measures of muscle strength or performance [85]. AHRQ-Pub No. [, Li X, Liu Y, Zheng Y, Wang P, Zhang Y. In serum, 25(OH)D has a fairly long circulating half-life of 15 days [1]. The Power Generation segment includes regulated electric fleet and merchant electric fleet. It added that no national professional organization recommends population screening for vitamin D deficiency. [, Marrie RA, Beck CA. [, Sintzel MB, Rametta M, Reder AT. Consumption of human milk alone does not ordinarily enable infants to meet vitamin D requirements, because it provides less than 0.6 to 2.0 mcg/L (25 to 78 IU/L) [1,57,58]. Pages 41-78 in Feldman D, Pike JW, Bouillon R, Giovannucci E, Goltzman D, Hewison M, eds. … Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. However, no 25(OH)D3 dietary supplements appear to be available to consumers on the U.S. market at this time [39]. 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]. Holick MF. About 2.3 million osteoporotic fractures occurred in the United States in 2015 [74]. 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]. Prostate cancer Although UVB exposure can produce vitamin D in infants, the American Academy of Pediatrics (AAP) advises parents to keep infants younger than 6 months out of direct sunlight, dress them in protective clothing and hats, and apply sunscreen on small areas of exposed skin when sun exposure is unavoidable [60]. 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 [63]. Get the latest public health information from CDC: https://www.coronavirus.gov 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]. 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. Am J Clin Nutr 2012;95:1350-6. Rates of breast, prostate, and colorectal cancer did not differ significantly between the vitamin D and placebo groups. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. For a reader-friendly overview of Vitamin D, see our consumer fact sheet on Vitamin D. 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. Join the ODS Email List. Weisberg P, Scanlon KS, Li R, Cogswell ME. Vitamin D supplementation to reduce depression in adults: Meta-analysis of randomized controlled trials. Vitamin D and cardiovascular disease: Controversy unresolved. Am J Clin Nutr 2008;88:558S-64S. For example, almost all of the U.S. milk supply is voluntarily fortified with about 3 mcg/cup (120 IU), usually in the form of vitamin D3 [23]. 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. Cancer Epidemiol Biomarkers Prev 2014;23:1220-9. 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]. JAMA Network Open 2019;2(12):e1917789. Benzinga Nutritional rickets among children in the United States: Review of cases reported between 1986 and 2003. Check back later 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]. All adults should consume recommended amounts of vitamin D and calcium from foods and supplements if needed. [, Helzlsouer KJ for the VDPP Steering Committee. Is hypovitaminosis D related to incidence of type 2 diabetes and high fasting glucose level in healthy subjects: A systematic review and meta-analysis of observational studies. Prolonged exclusive breastfeeding without vitamin D supplementation can cause rickets in infants, and, in the United States, rickets is most common among breastfed Black infants and children [48]. Nutrients 2018, 10, 59; doi:10.3390/nu10010059. Pharmacotherapy 2002;22:814-22. J Midwifery Womens Health 2019;64:276-88. J Clin Endocrinol Metab 2016;101:1647-55. Observational studies indicate that greater body weights are associated with lower vitamin D status, and obese individuals frequently have marginal or deficient circulating 25(OH)D levels [151]. Elsevier, 2018. Scientific Advisory Committee on Nutrition. Am J Clin Nutr 2019;110:150-7. [, Creo AL, Thacher TD, Pettifor JM, Strand MA, Ficsher PR. A few studies have examined the effect of vitamin D supplementation on specific cancers. [, de Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M, et al. However, 18% were at risk of inadequacy (levels of 30–49 nmol/L [12–19.6 ng/mL]), and 5% were at risk of deficiency (levels below 30 nmol/L [12 ng/mL]). Effect of long-term vitamin D3 supplementation vs placebo on risk of depression or clinically relevant depressive symptoms and on change in mood scores: A randomized clinical trial. [, 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. [, Scragg R, Stewart AW, Waayer D, Lawes CMM, Toop L, Sluyter J, et al. Since 2014, however, several published studies and meta-analyses have found no relationship between 25(OH)D levels and prostate cancer risk [111,112]. Builds Back Better. The investigators randomly assigned participants to receive either a bolus oral dose of 2,500 mcg (100,000 IU) vitamin D3 followed by 100 mcg (4,000 IU)/day or a placebo for 16 weeks. The groups showed no significant differences in the incidence and recurrent rates of depression, clinically relevant depressive symptoms, or changes in mood scores. Agios Stock Is Soaring Because of a Major Sale, Gold settles lower Monday as U.S. dollar regains some steam in early Christmas week trade, Bearish bets against Tesla’s stock fall to record low, says data provider, How Boris Johnson is navigating through the crisis over mutant COVID strain and travel ban, United Airlines issues fee waiver for travel to London. JAMA Intern Med 2015;175:745-54. 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. Vitamin D and bone density, fractures, and falls: The end of the story? N Engl J Med 2019;381:1785-6. 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]. Am J Clin Nutr 2012;95:1357-64. JAMA 2018;319:1630. [. [, Durup D, Jorgensen HL, Christensen J, Tjonnland A, Olsen A, Halkjaer J, et al. 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. 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]. Should You Invest in the Fidelity MSCI Utilities Index ETF (FUTY)? JAMA 2018;319:1600-12. Traditionally, vitamin D deficiency has been associated with rickets, a disease in which the bone tissue doesn't properly mineralize, leading to soft bones and skeletal deformities. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. 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. Am J Clin Nutr 2017;105:810-9. 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. [, Thacher TM, Fischer PR, Tebben PJ, Singh RJ, Cha SS, Maxson JA, Yawn BP. Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. [, Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor PR, Virtamo J, et al. Considerations in dietetic counseling for vitamin D. J Acad Nutr Diet 2019;119:901-9. Bone health and osteoporosis Screening for vitamin D deficiency: Systematic review for the U.S. Preventive Services Task Force recommendation. Ann Intern Med 2015;162:133-40. 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 [6,53-55]. Andrei Alexandrescu joined the design and development effort in 2007. They also help reduce fracture rates in institutionalized older people. 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. Breast cancer Clin Gastroeterol Hepatol 2020; published online ahead of print. The design goals of the language attempted to combine the performance and safet any spoken sound represented by the letter D or d, as in dog, ladder, ladle, or pulled. UV radiation is a carcinogen, and UV exposure is the most preventable cause of skin cancer. One trial included 65 overweight or obese adult men and women (mean age 32 years) 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]. Vitamin D for health: A global perspective. [, Perez-Castrillon JL, Vega G, Abad L, Sanz A, Chaves J, Hernandez G, Duenas A. A randomized, double-blind, placebo-controlled trial. In contrast, the United Kingdom government recommends intakes of 10 mcg (400 IU)/day for its citizens aged 4 years and older [16]. Something went wrong while loading Watchlist. People who are obese or have undergone gastric bypass surgery The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. 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]. [, Taylor CL, Roseland JM, Coates PM, Pehrsson PR. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. [, Ekwaru JP, Zwicker JD, Holick MF, Giovannucci E, Veugelers PJ. 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]. Obese people might need greater intakes of vitamin D to achieve 25(OH)D levels similar to those of people with normal weight [1,65,66]. Obesity does not affect the skin’s capacity to synthesize vitamin D. However, greater amounts of subcutaneous fat sequester more of the vitamin [1]. the Roman … Ann Intern Med 1990;112:352-64. Historical and current end-of-day data provided by FACTSET. Jones G. Vitamin D. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. [, 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. Journal of Nutrition Science 2018;7:1-7. In addition to bone deformities and pain, severe rickets can cause failure to thrive, developmental delay, hypocalcemic seizures, tetanic spasms, cardiomyopathy, and dental abnormalities [46,47]. The use of sunscreen also limits vitamin D synthesis from sunlight. For many people, consuming vitamin D-fortified foods and exposing themselves to some sunlight are essential for maintaining a healthy vitamin D status. Possible explanations for this increase include genetic differences in vitamin D metabolism, dietary preferences, and behaviors that lead to less sun exposure [46,47]. Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. [, Taylor CL, Thomas PR, Aloia JF, Millard PS. All quotes are in local exchange time. The second trial included 155 adults aged 60–80 years who had clinically relevant depressive symptoms, no major depressive disorder, and serum 25(OH)D levels less than 50 to 70 nmol/L (20 to 28 ng/mL) depending on the season; in addition, they were not taking antidepressants [133,134]. Metabolism 2016;65:586-97. Vitamin D, Volume 1: Biochemistry, Physiology and Diagnostics, Fourth Edition. 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. Pancreatic cancer J Clin Endocrinol Metab 2014;99:1132-41. Am J Clin Nutr 2016;104:1151-9. Some people take very high doses of vitamin D supplements. Clin Pharmacol Ther 2009;85:198-203. [, Yao S, Kwan ML, Ergas IJ, Roh JM, Cheng T-YD, Hong C-C, et al. noun, plural D's or Ds, d's or ds. By using this site you agree to the 13-05183-EF-1. [, Jorde R, Grimnes G. Vitamin D: No cure for depression. People with conditions that limit fat absorption 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]. One systematic review and meta-analysis of 11 randomized, controlled trials published through 2018 of vitamin D supplementation alone (10–20 mcg [400–800 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 [82]. Identification and systematic appraisal. The effect of vitamin D supplementation on lower-extremity power and function in older adults: a randomized controlled trial. But increasingly, research is revealing the importance of vitamin D in protecting against a host of health problems. Older adults are at increased risk of developing vitamin D insufficiency, partly because the skin's ability to synthesize vitamin D declines with age [1,62]. Lawrence O'Donnell and UNICEF teamed up to provide school desks to children in Malawi through the groundbreaking project, Kids in Need of Desks. J Clin Endocrin Metab 2013;98:4339-45. [, Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. In this procedure, part of the upper small intestine, where vitamin D is absorbed, is bypassed, and vitamin D that is mobilized into the bloodstream from fat stores might not raise 25(OH)D to adequate levels over time [67,68]. 3. a. the second note of the ascending C major scale. 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 who were overweight or obese (mean BMI of 32.1) to 100 mcg (4,000 IU)/day vitamin D3 or placebo for a median of 2.5 years [145]. Levels of 50 nmol/L (20 ng/mL) or more are sufficient for most people. Curr Opin Endocrinol Diabetes 2002;9:87-98. Intraday Data provided by FACTSET and subject to terms of use. For example, a meta-analysis of 9 trials with a total of 4,923 adult participants diagnosed with depression or depressive symptoms found no significant reduction in symptoms after supplementation with vitamin D [131]. Post-treatment levels of plasma 25- and 1,25-dihydroxy vitamin D and mortality in men with aggressive prostate cancer. [, Malihi Z, Wu Z, Stewart AW, Lawes CMM, Scragg R. Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: A systematic review and meta-analysis. Elsevier, 2018. J Clin Endocrinol Metab 2011;96:3838-45. Hansen D, Bazell C, Pelizzari P, Pyenson B. Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, et al. Glucocorticoid-induced osteoporosis: pathogenesis and management. The association was substantially stronger in women. 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. [, Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. 25-hydroxyvitamin D assays: Standardization, guidelines, problems, and interpretation. Circulating vitamin D concentrations and risk of breast and prostate cancer: A Mendelian randomization study. However, because research has been conducted on vitamin D and numerous health outcomes, this section focuses on seven diseases, conditions, and interventions in which vitamin D might be involved: bone health and osteoporosis, cancer, cardiovascular disease (CVD), depression, multiple sclerosis (MS), type 2 diabetes, and weight loss. Levels than White Americans also become vitamin D supplementation and prevention of rickets and vitamin D helps. 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