Estimation of the dietary requirement for vitamin D in free-living adults ≥64 y of age

Cashman, Kevin D.; Wallace, Julie; Horigan, Geraldine; Hill, Tom R.; Barnes, Maria S.; Lucey, Alice; Bonham, Maxine P.; Taylor, Nicola; Duffy, Emeir M.; Seamans, Kelly M.; Muldowney, Siobhan; Fitzgerald, Anthony P.; Flynn, Albert; Strain, JJ; Kiely, Máiréad

doi:10.3945/ajcn.2008.27334

Cited by 146 publications

(140 citation statements)

References 37 publications

(62 reference statements)

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“…The 7 ng/mL rise in serum 25(OH)D at a vitamin D dose of 400 IU/d of vitamin D 3 is slightly greater than the estimated approximately 1 ng/mL (2.5 nmol/L) rise for every 100 IU/d (2.5 mg) of vitamin D (1) but consistent with other studies where baseline serum 25(OH)D was low and supplemental intake was 400 IU/d. (24,25) In contrast to other vitamin D intervention studies in which PTH is suppressed and 1,25(OH) 2 D 3 levels do not change following vitamin D therapy, (3,22,26) our study showed that ALN þ D increased both 1,25(OH) 2 D 3 and PTH levels. Increases in both 1,25(OH) 2 D 3 and PTH have been reported by others following onset of alendronate therapy.…”

Section: Discussioncontrasting

confidence: 83%

Effect of alendronate and vitamin D3 on fractional calcium absorption in a double-blind, randomized, placebo-controlled trial in postmenopausal osteoporotic women

Shapses

Kendler

Robson

et al. 2011

Journal of Bone and Mineral Research

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Menopause and increasing age are associated with a decrease in calcium absorption that can contribute to the pathogenesis of osteoporosis. We hypothesized that alendronate plus vitamin D 3 (ALN þ D) would increase fractional calcium absorption (FCA). In this randomized, double-blind, placebo-controlled multicenter clinical trial, 56 postmenopausal women with 25-hydroxyvitamin D [25(OH)D] concentrations of 25 ng/mL or less and low bone mineral density (BMD) received 5 weekly doses of placebo or alendronate 70 mg plus vitamin D 3 2800 IU (ALN þ D). Calcium intake was stabilized to approximately 1200 mg/d prior to randomization. FCA was determined using a dual-tracer stable-calcium isotope method. FCA and 25(OH)D were similar between treatment groups at baseline (0.31 AE 0.12 ng/ mL and 19.8 AE 4.7 ng/mL, respectively). After 1 month of treatment, subjects randomized to ALN þ D experienced a significant least squares (LS) mean [95% confidence interval (CI)] increase in FCA [0.070 (0.042, 0.098)], whereas FCA did not change significantly in the placebo group [À0.016 (À0.044, 0.012)]. After ALN þ D treatment, patients had higher 25(OH)D levels (LS mean difference 7.3 ng/mL, p < .001). The rise in serum 1,25-dihydroxyvitamin D 3 ( p < .02) and parathyroid hormone ( p < .001) were greater in the ALN þ D group than in placebo-treated patients. ALN þ D was associated with an increase in FCA of 0.07. To our knowledge, there is no other trial showing such a marked rise in calcium absorption owing to treatment with a bisphosphonate or owing to a small rise in 25(OH)D. This unique response of ALN þ D is important for the treatment of osteoporosis, but the exact mechanism requires further study. ß

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Section: Discussioncontrasting

confidence: 83%

Effect of alendronate and vitamin D3 on fractional calcium absorption in a double-blind, randomized, placebo-controlled trial in postmenopausal osteoporotic women

Shapses

Kendler

Robson

et al. 2011

Journal of Bone and Mineral Research

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“…Of concern, recent data from our group have shown that the dietary requirements for vitamin D to allow 97.5% of the elderly population (that is, RDA (Recommended Dietary Allowances)) to achieve serum 25(OH)D concentrations of 480 nmol/l are 38.7 mg/day (Cashman et al, 2009), which are much higher than that being consumed currently by elderly populations (Finch et al, 1998;Calvo et al, 2004;Andersen et al, 2005).…”

Section: Discussionmentioning

confidence: 94%

Vitamin D status and measures of cognitive function in healthy older European adults

et al. 2010

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Background/Objectives: Data from human studies that have investigated the association between vitamin D status and cognitive function in elderly adults are conflicting. The objective of this study was to assess vitamin D status (reflected by serum 25-hydroxyvitamin D (25(OH)D)) in older European subjects (n ¼ 387; aged 55-87 years) and examine its association with measures of cognitive function. Subjects/Methods: Serum 25(OH)D was assessed using enzyme-linked immunosorbent assay, whereas measures of cognitive function were assessed using a comprehensive Cambridge Neuropsychological Testing Automated Battery (CANTAB). Results: In all, 12, 36 and 64% of subjects had serum 25(OH)D concentrations o30, o50 and o80 nmol/l, respectively, throughout the year. Serum 25(OH)D was significantly and inversely correlated with four assessments within the spatial working memory (SWM) test parameter (SWM between errors (r ¼ À0.166; P ¼ 0.003); SWM between errors 8 boxes (r ¼ À0.134; P ¼ 0.038); SWM strategy (r ¼ À0.246; Po0.0001); and SWM total errors (r ¼ À0.174; Po0.003)). When subjects were stratified on the basis of tertiles (T) of serum 25(OH)D (o47.6 (T 1 ); 47.6-85.8 (T 2 ); and 485.8 (T 3 ) nmol/l), fewer errors in SWM test scores occurred in subjects in the third T when compared with the first T (Po0.05-0.084). Stratification by sex showed that these differences between tertiles strengthened (Po0.001-0.043) in the females, but the differences were not significant (P40.6) in males. Conclusions: Vitamin D insufficiency, but not deficiency, is widespread in the older population of several European countries. Low vitamin D status was associated with a reduced capacity for SWM, particularly in women.

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“…These studies were originally designed to investigate the dietary requirements for vitamin D over the winter months (October-March) and full details have been previously published elsewhere (39,40) . A benefit of this data was that baseline measures were all taken at the end of summer (i.e.…”

Section: Observational Evidencementioning

confidence: 99%

Vitamin D and obesity: current perspectives and future directions

2014

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In recent years, new functional roles of vitamin D beyond its traditional role in calcium homoeostasis and bone metabolism have emerged linking the fat-soluble vitamin to various non-communicable diseases. Vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) < 25-30 nmol/l) and sub-optimal status (25(OH)D < 50-100 nmol/l) are increasingly associated with unfavourable metabolic phenotypes, including insulin resistance, type 2 diabetes and CVD; conditions also commonly linked with overweight and obesity. Early studies reported poor vitamin D status in the morbidly obese. More recently, it has been observed that a graded relationship between vitamin D status and BMI, or specifically adiposity, exists in the general population. A number of hypotheses have been proposed to explain the potential mechanisms whereby alterations in the vitamin D endocrine system occur in the obese state. Plausible explanations include sequestration in adipose tissue, volumetric dilution or negative feedback mechanisms from increased circulating 1,25-dihydroxyvitamin D 3 . Others hypothesise that heavier individuals may partake in less outdoor activity, may also cover-up and wear more clothing than leaner individuals, thus decreasing sun exposure and limiting endogenous production of cholecalciferol in the skin. Moreover, in some but not all studies, BMI and adiposity have been negatively associated with the change in vitamin D status following vitamin D supplementation. It therefore remains unclear if body size and/or adiposity should be taken into account when determining the dietary requirements for vitamin D. This review will evaluate the current evidence linking vitamin D status and supplementation to overweight and obesity, and discuss the implications for setting dietary requirements. Vitamin D: Obesity: BMI: Fat mass: Adipose tissueTraditional roles of vitamin D lie within the musculoskeletal system, maintaining calcium homoeostasis and bone metabolism, with deficiency leading to conditions such as rickets in children, or osteoporosis and osteomalacia in adults (1) . However, obesity is now frequently cited as a cause of vitamin D deficiency (2,3) , which may in fact lead to other co-morbidities, such as diabetes and CVD, conditions commonly linked to obesity (4,5) . Indeed, obesity and vitamin D deficiency have concomitantly reached epidemic levels worldwide and research linking the two has grown extensively over the last number of years. It is reasonable to suggest that this nutritional inadequacy may be driven by the increasing obesity rates within the general population, and may therefore improve with a reversal of the latter. However, despite the plethora of evidence available, the mechanisms remain largely unclear and the area of reverse causality is also commonly debated within the literature: does obesity lead to vitamin D deficiency or vice versa?Vitamin D is not technically a vitamin, but is better classified as an active circulating pre-hormone within the body. Limited amounts of vitamin D are obtained from dietary sourc...

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Estimation of the dietary requirement for vitamin D in free-living adults ≥64 y of age

Cited by 146 publications

References 37 publications

Effect of alendronate and vitamin D3 on fractional calcium absorption in a double-blind, randomized, placebo-controlled trial in postmenopausal osteoporotic women

Effect of alendronate and vitamin D3 on fractional calcium absorption in a double-blind, randomized, placebo-controlled trial in postmenopausal osteoporotic women

Vitamin D status and measures of cognitive function in healthy older European adults

Vitamin D and obesity: current perspectives and future directions

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