Emerging Evidence of Thresholds for Beneficial Effects from Vitamin D Supplementation

Scragg, Robert

doi:10.3390/nu10050561

Cited by 74 publications

(58 citation statements)

References 58 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the ViDA study did show that the beneficial effects for some outcomes such as BMD [229], FEV1 [231] and arterial function [230] are more pronounced in subjects with serum 25(OH)D concentrations of <50 nmol/L. These findings are consistent with several previous studies, including VITAL and D2d, which collectively suggest that vitamin D supplementation may only be beneficial in people who are deficient [232].…”

Section: Vida Trialsupporting

confidence: 88%

“…Many observational studies have found that the association of serum 25(OH)D concentration with some outcomes, such as cardiovascular disease and mortality risk, is not linear. Although the threshold level, after which little or no further reduction in risk is observed, has varied between studies (possibly due to the unstandardized 25(OH)D measurement methods), little additional benefit has been observed with concentrations higher than about 75 nmol/L [232]. It is well known that volunteers who participate in clinical trials are in general healthier and more health-conscious than the average population.…”

Section: Limitations Of Large Vitamin D Rctsmentioning

confidence: 99%

See 1 more Smart Citation

Consensus statement from 2nd International Conference on Controversies in Vitamin D

Giustina

Adler

Binkley

et al. 2020

Rev Endocr Metab Disord

219

169

View full text Add to dashboard Cite

The 2 nd International Conference on Controversies in Vitamin D was held in Monteriggioni (Siena), Italy, September 11-14, 2018. The aim of this meeting was to address ongoing controversies and timely topics in vitamin D research, to review available data related to these topics and controversies, to promote discussion to help resolve lingering issues and ultimately to suggest a research agenda to clarify areas of uncertainty. Several issues from the first conference, held in 2017, were revisited, such as assays used to determine serum 25-hydroxyvitamin D [25(OH)D] concentration, which remains a critical and controversial issue for defining vitamin D status. Definitions of vitamin D nutritional status (i.e. sufficiency, insufficiency and deficiency) were also revisited. New areas were reviewed, including vitamin D threshold values and how they should be defined in the context of specific diseases, sources of vitamin D and risk factors associated with vitamin D deficiency. Non-skeletal aspects related to vitamin D were also discussed, including the reproductive system, neurology, chronic kidney disease and falls. The therapeutic role of vitamin D and findings from recent clinical trials were also addressed. The topics were considered by 3 focus groups and divided into three main areas: 1) "Laboratory": assays and threshold values to define vitamin D status; 2) "Clinical": sources of vitamin D and risk factors and role of vitamin D in non-skeletal disease and 3) "Therapeutics": controversial issues on observational studies and recent randomized controlled trials. In this report, we present a summary of our findings.

show abstract

Section: Vida Trialsupporting

confidence: 88%

Section: Limitations Of Large Vitamin D Rctsmentioning

confidence: 99%

Consensus statement from 2nd International Conference on Controversies in Vitamin D

Giustina

Adler

Binkley

et al. 2020

Rev Endocr Metab Disord

219

169

View full text Add to dashboard Cite

show abstract

“…It is important to note that many of the RCTs of vitamin D supplementation for people with MS have had limitations of small sample size (low power), short duration, and including people who are not vitamin D deficient. Studies in other diseases have shown that benefits of vitamin D supplementation are seen only in those who are severely deficient at baseline . Additional studies of vitamin D supplementation in relapsing‐remitting MS and CIS are currently underway.…”

Section: Cause Versus Course – Are the Risk Factors Different?mentioning

confidence: 99%

Environmental and genetic risk factors for MS: an integrated review

Waubant

Lucas

Mowry

et al. 2019

Ann Clin Transl Neurol

219

184

View full text Add to dashboard Cite

Recent findings have provided a molecular basis for the combined contributions of multifaceted risk factors for the onset of multiple sclerosis (MS). MS appears to start as a chronic dysregulation of immune homeostasis resulting from complex interactions between genetic predispositions, infectious exposures, and factors that lead to pro‐inflammatory states, including smoking, obesity, and low sun exposure. This is supported by the discovery of gene–environment (GxE) interactions and epigenetic alterations triggered by environmental exposures in individuals with particular genetic make‐ups. It is notable that several of these pro‐inflammatory factors have not emerged as strong prognostic indicators. Biological processes at play during the relapsing phase of the disease may result from initial inflammatory‐mediated injury, while risk factors for the later phase of MS, which is weighted toward neurodegeneration, are not yet well defined. This integrated review of current evidence guides recommendations for clinical practice and highlights research gaps.

show abstract

“…They are, therefore, not recommended in guidelines or in usual practice because they are associated with oscillations in serum 25OHD concentrations (which means that serum concentrations do not remain above the normal thres-hold throughout the treatment period), and they have become obsolete and ineffective or harmful. Therefore, these designs with this posology should not be included in the meta-analyzes [25][26][27] and, however and surprisingly, have a weight of 50% of the meta-analysis proposed by Bolland et al…”

Section: Quesada Gómez Jm Sosa Henríquez Mmentioning

confidence: 99%

Vitamina D y función muscular

Gómez

Henríquez

2019

Rev Osteoporos Metab Miner

View full text Add to dashboard Cite

In 1922, at Johns Hopkins University in Baltimore, Professor McCollum discovered a factor, which has since been referred to as vitamin D, following the alphabetical order of the other vitamins identified up to that time. It is capable of curing rickets in children and osteomalacia in adults. Diseases in which, as we know from the first scientific descriptions published in London in the midseventeenth century, muscle involvement consisting of weakness and generalized hypotonia is associated with bone involvement, its main characteristic. Therefore, since the discovery of vitamin D, it has been associated not only with bone health but also with muscle health 1 . Paradoxically, at present, there is no consensus on the potential beneficial effects of vitamin D supplementation on muscle function, balance and risk of falls, a situation highlighted in the last meta-analysis published by Bolland et al. 2 , who review in 81 randomized clinical trials (RCTs) that include 53,537 participants the effect of vitamin D on fractures and falls as a primary outcome. The pooled analyses showed that vitamin D supplementation had no effect on falls (37 RCTs, n=34,144, RR=0.97, 95% confidence interval -0.93 to 1.02), what the authors concluded that "vitamin D supplementation does not exert significant effects in falls", affirming that "potential future trials will probably not alter those conclusions, and that, therefore, there is little justification for the use of vitamin D supplements. to maintain or improve musculoskeletal health, indicating that clinical guidelines should reflect these findings" 2 . From this publication, many physicians and patients could mistakenly conclude that they can stop prescribing or taking vitamin D supplements, which is a potentially dangerous message, given the high prevalence of vitamin D deficiency in Spain 3 .Loss of muscle strength and/or function, severe invalidating myopathy predominantly proximal with diffuse muscular or skeletal pain in adults, generalized muscle atrophy and electromyographic abnormalities, such as polyphasic motor unit, potentials with shortened duration and decreased range, involvement of Type II muscle fiber atrophy (of rapid contraction) and marked fatty infiltration are findings in severe and sustained vitamin D deficiency, in severe renal insufficiency, or in the congenital absence of the CYP27B1 gene due to inability to adequately synthesize 1,25 dihydroxyvitamin D (1,25 DHCC), hormonally active metabolite of the endocrine system of vitamin D, with rapid improvement of muscle function after vitamin D or 1,25 DHC supplementation in these patients. More subtle changes in muscle function can be observed in subjects with less severe and perhaps less chronic vitamin D deficiency 4 .In our current issue, Gómez Alonso et al. 5 , present an article in which they observe that in patients of both sexes of the cohort EVOS (European Study of Vertebral Osteoporosis) that maintain serum levels of calcidiol higher than 20 ng/mL present greater grip strength in the hands, maintenance o...

show abstract

Emerging Evidence of Thresholds for Beneficial Effects from Vitamin D Supplementation

Cited by 74 publications

References 58 publications

Consensus statement from 2nd International Conference on Controversies in Vitamin D

Consensus statement from 2nd International Conference on Controversies in Vitamin D

Environmental and genetic risk factors for MS: an integrated review

Vitamina D y función muscular

Contact Info

Product

Resources

About