Vitamin D and Health

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15. Harvey N (Professor of Rheumatology & Clinical Epidemiology) & C Cooper (Professor of Rheumatology & Director) (Southampton University) 16. Health Food Manufacturers’ Association 17. Hewison, M (Professor of Molecular Endocrinology, Birmingham University) 18. Hogler, Dr W (Global consensus recommendations for prevention & management of rickets) 19. Huish, S (Specialist Dietitian, Coventry & Warwickshire NHS Trust) 20. Internis Pharmaceuticals Ltd. 21. Jacobs, Dr B (Consultant Paediatrician, Royal National Orthopaedic Hospital) 22. Macdonald, Professor H (University of Aberdeen) 23. Marshall, A (Paediatric trainee) 24. Martineau, A (Professor of Respiratory Infection & Immunity, Barts & The London School of Medicine & Dentistry) 25. Mawjes, Ms Sile 26. MRC Human Nutrition Research 27. National Osteoporosis Society 28. Newton-Bishop, J (Professor of Dermatology, Leeds Institute of Cancer & Pathology) 29. NHS Health Scotland 30. Northern Ireland Centre for Food & Health (NICHE), Ulster University 31. Norval, M (Professor Emeritus, University of Edinburgh Medical School) 32. Oliver, T (Professor Emeritus in Oncology, Bart’s Cancer Institute) 33. Proprietary Association of Great Britain 34. Rayner, J (Paediatric Dietitian, Bedford Hospital NHS Trust) 35. Rhein, H (General Practitioner, Edinburgh) 36. Rhodes, L (Professor of Experimental Dermatology, University of Manchester) 37. Royal College of Physicians 38. Sexton, S (Specialist Medicines Management Dietitian, Bristol CCG) 39. Tagliaferri S, De Guiseppe R, Cena H; University of Palma & University of Pavia 40. Taylor, H (Clinical Effectiveness Pharmacist, NHS Sheffield CCG) 41. Thompson, P 42. Waitrose 43. Wales Dietetic Leadership Advisory Group (WDLAG) & Public Health Dietitians in Wales (PHDiW) 44. Watson, I 5. The responses can be viewed in full on the GOV.UK website at the following link: https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition 175
ANNEX (2) Studies considered in relation to vitamin D and health outcomes Musculoskeletal health outcomes Rickets Table 1 Table 2 Table 3 Table 4 Table 5 Osteomalacia Table 6 Table 7 Pregnancy & lactation Table 8 Table 9 Infants (0-12 months) Table 10 Children and adolescents Table 11 Table 12 Table 13 Adults under 50 years Table 14 Table 15 Table 16 Table 17 Table 18 Case reports of rickets Observational studies on rickets Before and after studies on rickets Case control studies on rickets Intervention studies on rickets Observational studies on osteomalacia Case reports of osteomalacia RCTs on effect of vitamin D supplementation during pregnany on bone health indices in the offspring Cohort studies on association between maternal 25(OH)D concentration and bone health indices in the offspring RCTs on effect of vitamin D supplementation on bone health indices in infants Systematic review of RCTs on effect of vitamin D supplementation on bone health indices in children and adolescents Intervention studies on effect of vitamin D supplementation on bone health indices in children and adolescents Intervention studies on effect of vitmin D supplementation on muscle strength and function in children and adolescents RCTs on effect of vitamin D supplementation on bone health indices in adults < 50y Meta-analyses on effects of vitamn D supplementation on muscle strength in adults < 50y RCTs on effects of vitamin D supplementation on stress fracture reduction in adults < 50y Meta-analysis of observational studies on the association between serum 25(OH)D concentration amd stress fractures in adults < 50y Cohort studies (not included in above meta-analysis) on the association between serum 25(OH)D concentration and stess fractures in adults < 50y 176
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Vitamin D and Health i 2016
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Contents Preface ..................
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Preface The Scientific Advisory Com
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Adviser (Ultraviolet radiation expo
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Ms Gemma Paramor Lay representative
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Metabolism S.5 Vitamin D is convert
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Two studies reported an increase in
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Recommendations S.35 Serum 25(OH)D
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1.8 The terms of reference were: to
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1.18 In assessing the evidence on v
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there is not absolute correspondenc
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Metabolism Absorption of dietary vi
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UVB ▼ SKIN: ▼ Previtamin D 3
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2.49 A number of studies have repor
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using a bolus dose (I 2 =77%) compa
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2.75 Another RCT 21 (Cashman et al.
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3. Photobiology of vitamin D Ultrav
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Erythema and skin cancer 3.10 Two m
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CIE spectrum for photoconversion of
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Effect of skin pigmentation on skin
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increase in mean serum 25(OH)D conc
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4. Measuring vitamin D exposure (fr
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the authors cautioned care in the i
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24,25(OH) 2 D 3 which can contribut
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5. Relationship between vitamin D e
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latitudes > 49.5 o N or S (which we
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increase 25(OH)D concentrations > 5
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22.5 nmol/L (IQR, 16.8-34.3) in sum
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6.7 Although serum 25(OH)D concentr
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calcium intake, although this is mo
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Evidence considered (Tables 1-5, An
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6.43 Preece et al. (1975) measured
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irths (December-February) in the vi
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large loss to follow-up 45 and, sin
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6.81 A pilot RCT in India (Khadilka
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Evidence considered (Tables 16-18,
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Intervention studies 6.107 A 3-year
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Compared with men in the top quarti
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chair-rising test. Mean baseline se
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heterogeneity among trials for dose
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the 600 µg (24,000 IU) vitamin D 3
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Bone health indices beyond rickets
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Intervention studies 6.177 An RCT i
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maternal serum 25(OH)D concentratio
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Cancers 6.201 Ecological studies ha
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(Gallicchio et al., 2010; Mondul et
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6.226 A systematic review and meta-
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Summary - CVD and hypertension 6.23
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6.251 VDRs are expressed in cells o
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10 nmol/L increase in cord blood 25
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Evidence considered since IOM repor
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difference was not significant (RR=
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6.304 Out of 7 RCTs published subse
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(300 µg/12,000 IU per capsule) for
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serum 25(OH)D concentration in neon
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linked specific VDR gene polymorphi
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factors that affect cancer risk. Ob
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As a result, cut-offs for deficienc
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7.8 The IOM noted the paucity of lo
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years) compared to the placebo grou
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children (n=179) received weekly do
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8. Dietary vitamin D intakes and se
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Food FISH TABLE 1- Vitamin D conten
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Serum/plasma 25(OH)D concentrations
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Serum/plasma 25(OH)D concentration
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9. Review of DRVs for vitamin D Bri
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musculoskeletal health at serum 25(
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Modelling the summer sunshine expos
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9.30 Two possible approaches were c
Page 139 and 140: FIGURE 8: Relation between serum 25
Page 141 and 142: UK general population aged under 11
Page 143 and 144: Summary & conclusions 9.59 The RNI
Page 145 and 146: 10. Overall summary and conclusions
Page 147 and 148: tight homeostatic control. As a mar
Page 149 and 150: 10.30 Evidence from RCTs suggest th
Page 151 and 152: Serum/plasma 25(OH)D concentration
Page 153 and 154: 10.53 An RNI of 10 µg/d (400 IU/d)
Page 155 and 156: 11. Recommendations 11.1 Serum 25(O
Page 157 and 158: References Abnet CC, Chen Y, Chow W
Page 159 and 160: Beadle PC, Burton JL & Leach JF (19
Page 161 and 162: Brooke OG, Brown IR, Bone CD, Carte
Page 163 and 164: Clarke B (2008) Normal bone anatomy
Page 165 and 166: Diffey BL (2010) Modelling the seas
Page 167 and 168: Ganji V, Milone C, Cody MM, McCarty
Page 169 and 170: Heaney RP, Armas LA, Shary JR, Bell
Page 171 and 172: Javaid MK, Crozier SR, Harvey NC, G
Page 173 and 174: Lappe J, Cullen D, Haynatzki G, Rec
Page 175 and 176: Mantell DJ, Owens PE, Bundred NJ, M
Page 177 and 178: Murad MH, Elamin KB, Abu Elnour NO,
Page 179 and 180: Pirotta S, Kidgell DJ & Daly RM (20
Page 181 and 182: one mass, and renal function in the
Page 183 and 184: Sperati F, Vici P, Maugeri-Sacca M,
Page 185 and 186: Vervel C, Zeghoud F, Boutignon H, T
Page 187 and 188: Weisse K, Winkler S, Hirche F, Herb
Page 189: Annexes ANNEX (1) SACN working proc
Page 193 and 194: Cardiovascular disease Table 40 Tab
Page 195 and 196: Study/year/country Population Ricke
Page 197 and 198: Table 2: Observational studies on r
Page 199 and 200: Table 3: Before and after studies o
Page 201 and 202: Table 4: Case control studies on ri
Page 203 and 204: Table 5: Intervention studies on ri
Page 205 and 206: Table 7: Case reports of osteomalac
Page 207 and 208: Table 9: Cohort studies on associat
Page 209 and 210: Children and adolescents Table 11:
Page 211 and 212: Table 13: Intervention studies on e
Page 213 and 214: Table 16: RCTs on effects of vitami
Page 215 and 216: Table 22: Meta-analyses of trials o
Page 217 and 218: Table 24: Prospective studies on as
Page 219 and 220: Table 25: Meta-analyses of RCTs on
Page 221 and 222: Table 27: Prospective studies on as
Page 223 and 224: Table 28: Meta-analyses of RCTs on
Page 225 and 226: Study Methods Results Author conclu
Page 227 and 228: NON-MUSCULOSKELETAL HEALTH OUTCOMES
Page 229 and 230: Table 32: Intervention studies on e
Page 231 and 232: Table 36: Observational studies on
Page 233 and 234: Table 38: Meta analyses of RCTs and
Page 235 and 236: Table 39: Prospective studies on 25
Page 237 and 238: Study/Country Population Mean follo
Page 239 and 240: Cardiovascular disease Table 40: Me
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Hypertension Table 42: Meta-analyse
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All-cause mortality Table 44: Syste
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Immune modulation Table 46: Systema
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Table 48: Intervention studies on v
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Reference/Country Population Follow
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Infectious disease Table 50: Meta-a
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Table 51: RCTs on vitamin D supplem
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Table 52: Observational studies on
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Neuropsychological functioning Tabl
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Abbreviations used in studies 25(OH
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Table 1: Percentage contribution of
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Table 2 (continued) Food group a Me
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Table 3 (continued) Food group Age
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Table 4 (continued) Food group a Ag
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Table 5 (continued) Food group a Na
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Table 6: Percentage contribution of
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Table 7: Average daily intake of vi
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Table 9: Average daily intake of Vi
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Table 11: Average daily intake of v
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Table 15: Average daily intake of V
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Serum/plasma 25(OH)D concentrations
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Table 20: UK - Adults and children
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Table 22: Northern Ireland - adults
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Table 24: England - adults 65 years
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Table 26: UK - by month blood sampl
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Table 29: English regions by season
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Table 33: England - by ethnicity, a
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Table 36: Scotland - by Body Mass I
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Calcitonin A peptide hormone, produ
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Osteoclast Osteocyte Osteoid Osteom
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Vitamin D and Health

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