Fortified Malted Milk Drinks Containing Low-Dose Ergocalciferol and Cholecalciferol Do Not Differ in Their Capacity to Raise Serum 25-Hydroxyvitamin D Concentrations in Healthy Men and Women Not Exposed to UV-B

Abstract

Uncertainty remains regarding the efficacy of low intakes of ergocalciferol (vitamin D2 or D2) and cholecalciferol (vitamin D3 or D3) provided in food to increase serum 25-hydroxy-vitamin D (25-OH-D) metabolite concentrations when UV-B exposure is low. We recruited 40 healthy men and women into a double-blind, parallel design, randomized controlled trial. Participants received placebo or 1 of 4 experimental treatments (D2 or D3 at 5 or 10 μg/d) supplied as a malted milk drink for 4 wk during a period of minimal UV-B exposure in the UK. The primary outcome was a change in serum 25-OH-D2 and 25-OH-D3 concentrations measured by ultra-performance liquid chromatography tandem MS. The secondary outcomes were changes in concentrations of plasma parathyroid hormone and serum calcium (Ca(2+)). Baseline concentrations (geometric mean ± SD) of 25-OH-D2, 25-OH-D3, and total 25-OH-D were 3 ± 4, 32 ± 22, and 37 ± 22 nmol/L, respectively. Both D2- and D3-fortified drinks resulted in dose-dependent increases (P < 0.001) in their respective 25-OH metabolites that did not significantly differ in size. Increments from baseline compared with the placebo group following 5 and 10 μg/d of D2 were (mean ± SEM) 9.4 ± 2.5 and 17.8 ± 2.4 nmol/L for 25-OH-D2 and following 5 and 10 μg/d of D3 were 15.1 ± 4.7 and 22.9 ± 4.6 nmol/L for 25-OH-D3, respectively. There was no difference between D2 and D3 groups in the incremental AUC of their respective metabolites. These findings suggest that D2 and D3 are equipotent in increasing 25-OH-D in healthy men and women with negligible UV-B exposure.

Advice to consume 1–2 portions of oily fish per week improves vitamin D status

“…Serum 25(OH)D concentrations at 12 weeks were 9.2 nmol/L (P < 0.001) greater in the CP diet group compared to the C group when adjusted for baseline 25(OH)D, age, BMI, gender, ethnicity and seasonality. This increase is similar to the increase in 25(OH)D found after supplementation with 5 mg vitamin D3 per day for 4 weeks in the winter months (4) . In conclusion, the consumption of oily fish 1-2 times a week improves vitamin D status, and the inclusion of wholegrain cereals (mainly breakfast cereals and bread) as part of a cardioprotective diet does not have an adverse effect on vitamin D status.…”

Association between Subcutaneous White Adipose Tissue and Serum 25-Hydroxyvitamin D in Overweight and Obese Adults

“…Thus, we run the risk of under-reporting our SWAT 25(OH)D in comparison to serum concentrations. Serum concentrations of 25(OH)D 2 are substantially lower than 25(OH)D 3 [26,27,28] unless supplementing with vitamin D 2 or consuming plant sources of vitamin D 2 . Based on the low 25(OH)D concentrations seen in our subjects, we would expect very little vitamin D 2 consumption from supplements and, subsequently, very little 25(OH)D 2 in adipose depots.…”

Vitamin D deficiency as a public health issue: using vitamin D2or vitamin D3in future fortification strategies

“…However, since the 1980s there have been a number of intervention trials, including RCT, published that have investigated specifically this, as shown in Table 1, and these have shown conflicting results. Although the majority of intervention trials comparing the two forms of vitamin D have provided data suggesting that vitamin D 3 is superior to vitamin D 2 in raising 25(OH)D concentrations (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) , there have also been four trials that have produced data supportive of vitamins D 2 and D 3 being equally effective (37)(38)(39)(40) . There are no studies which have shown that vitamin D 2 is more effective than vitamin D 3 .…”

“…Since the 2012 meta-analysis, there have been at least another ten further intervention trials comparing the efficacy of vitamins D 2 and D 3 in raising 25(OH)D concentrations (23,26,27,(29)(30)(31)33,34,38,40) . However, findings remain equivocal with eight of the studies showing vitamin D 3 to be more effective at raising or maintaining 25(OH)D concentrations compared to vitamin D 2 ( 23,26,27,(29)(30)(31)33,34) , and two of these trials reporting no significant difference between the two forms (38,40) . However, a direct comparison between the total change in 25(OH)D concentrations in response to vitamins D 2 and D 3 was not reported in the analysis by Fisk et al which returned neutral findings (38) .…”