Vitamin D and Health

Review of current DRVs for vitamin D
9.3 The purpose of reviewing the current DRVs for vitamin D intake set by COMA (DH, 1991) was to
consider whether they are still appropriate to ensure vitamin D adequacy of the UK population in the
context of current lifestyles and public health advice (see paragraphs 3.35-3.38). As part of this
review, the evidence on vitamin D and various health outcomes at different life stages and in different
population groups was considered. Evidence from RCTs and prospective cohort studies was preferred
in terms of informing the setting of DRVs, however evidence was also considered from other study
types (including case control and cross sectional studies) when information from RCTs and cohort
studies was lacking.
Selection of health outcomes and serum 25(OH)D concentration to use as the basis for setting DRVs
9.4 Evidence on a range of musculoskeletal and non-musculoskeletal health outcomes was considered
(see Table 2). Detailed analysis of the evidence considered is provided in Chapter 6 and only the
summary conclusions are re-iterated in this section.
TABLE 2: Health outcomes considered in terms of informing DRVs for vitamin D
Musculoskeletal outcomes (relevance to life stage groups)
Rickets (infants and children)
Osteomalacia (all adult age groups)
BMC/BMD (all life stages)
Stress fracture risk (adults < 50y, mainly athletes and military personnel)
Fracture prevention (adults ≥ 50y)
Fall risk (adults ≥ 50y)
Muscle function and power (adults < and ≥ 50y)
Non-musculoskeletal health outcomes
Pregnancy & lactation – non-musculoskeletal health outcomes
Cancers
CVD & hypertension
All-cause mortality
Immune modulation
Infectious diseases
Neuropsychological functioning
Oral health
Age-related macular degeneration
9.5 Evidence on vitamin D and musculoskeletal health outcomes suggests beneficial effects of vitamin D in
reducing the risk of rickets in infants and children, osteomalacia in adults and risk of falling in
adults ≥ 50y and in improving muscle strength and function in adolescents and adults (< and ≥ 50y).
Data on vitamin D and non-musculoskeletal health outcomes were considered insufficient at this time
to inform the setting of DRVs for vitamin D. Musculoskeletal health was therefore selected as the
basis for setting the DRVs for vitamin D.
9.6 As described in Chapter 6, the available data are insufficient to establish a distribution of serum
25(OH)D concentrations for musculoskeletal health, which underpins the establishment of the three
DRV estimates (LRNI, EAR, RNI). However, the evidence is suggestive of an increased risk of poor
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