Vitamin D and Health

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Study/ country Population/ sample size Intervention/study design Baseline 25OHD (nmol/L) (SD) Post intervention 25(OH)D (nmol/L) Outcome Results Conclusion Rees et al (2013) USA Simpson et al (2015) Australia Urashima et al (2014) Japan Participants from larger double blind multi centre vitamin D trial on prevention of large bowel adenomas (n=759) Age 45-75 years Adults (n=34) Mean age: 1. 30y 2. 35y Schoolchildren (n=247) Age: 15-18 y 1. D3 (25µg/d) + Ca (1200 mg/d) 2. Placebo Duration: 3y 1. 500 µg D3/week 2. Placebo Duration: 17 wks 1. 50 µg D3/d 2. Placebo 2 months At enrolment 1. 61.9 2. 63.1 At start of study 1. 83.1 2. 62.6 1. 60.5 2. 76.4 (p=0.04) Not reported 1. 100.7 (23.9) 2. 56 (24.2) Number of episodes (winter) URTI 1. 275 (71.1%) 2. 252 (71.8%) Colds 1. 267 (69%) 2. 239 (68.1%) Influenza like illness 1. 46 (11.9%) 2. 51 (14.5%) Frequency, duration and severity of acute infections. Not reported Not reported Incidence of influenza A (diagnosed by a RIDT by medical doctors). URTI RR=0.93 (5% CI, 0.79-1.09) Colds RR=0.93 (95% CI, 0.78-1.10) Influenza like illness RR=0.95 (95% CI, 0.62-1.46) Infection risk All participants HR: 0.83 (95% CI, 0.53-1.31) Participants with baseline 25(OH)D < 40 nmol/L (n=4) HR: 0.56 (95% CI, 0.32-0.96; p=0.007) Clinically verified infections HR: 0.27 (95% CI, 0.07-1.00; p=0.05) Total 2 month period RR=1.11 (95% CI, 0.57-2.18; p=0.75) After first month RR=0.17 (95% CI, 0.04-0.77; p=0.009) Vitamin D supplementation (25µg/d) did not significantly reduce incidence or duration of upper RTI in adults with a baseline serum 25 (OH)D >30 nmol/L. No difference between groups for infection risk, duration or severity. A treatment effect was observed amongst those with 24(OH)D < 40 nmol/L at start of study. However, this only related to 4 participants. Vitamin D supplementation did not decrease the overall incidence of RIDT-positive influenza A. 239
Table 52: Observational studies on 25(OH)D concentration and infectious disease risk Study/Country Population Followup) Mean baseline 25(OH)D (nmol/L) Results Authors’ Conclusions Tuberculosis (TB) Arnedo-Pena et al (2011) Spain Contacts of TB patients (n=202) Mean age: 39.9 y (Spanish); 13 m Cases: 43.7 (14.0) Controls: 64.7(34.2) (p=0.041) Cases with positive TST conversion (n=11) Controls with negative TST results (n=82) Association between 25(OH) Dand TST conversion 25(OH) D ≥ 75 nmol/L associated with significantly reduced risk of TST conversion. 32.0 y (19.9) (non-Spanish) (p> 0.05) ≥ 75 vs
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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
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FIGURE 8: Relation between serum 25
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UK general population aged under 11
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Summary & conclusions 9.59 The RNI
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10. Overall summary and conclusions
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tight homeostatic control. As a mar
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10.30 Evidence from RCTs suggest th
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Serum/plasma 25(OH)D concentration
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10.53 An RNI of 10 µg/d (400 IU/d)
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11. Recommendations 11.1 Serum 25(O
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References Abnet CC, Chen Y, Chow W
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Beadle PC, Burton JL & Leach JF (19
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Brooke OG, Brown IR, Bone CD, Carte
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Clarke B (2008) Normal bone anatomy
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Diffey BL (2010) Modelling the seas
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Ganji V, Milone C, Cody MM, McCarty
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Heaney RP, Armas LA, Shary JR, Bell
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Javaid MK, Crozier SR, Harvey NC, G
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Lappe J, Cullen D, Haynatzki G, Rec
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Mantell DJ, Owens PE, Bundred NJ, M
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Murad MH, Elamin KB, Abu Elnour NO,
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Pirotta S, Kidgell DJ & Daly RM (20
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one mass, and renal function in the
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Sperati F, Vici P, Maugeri-Sacca M,
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Vervel C, Zeghoud F, Boutignon H, T
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Weisse K, Winkler S, Hirche F, Herb
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Annexes ANNEX (1) SACN working proc
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ANNEX (2) Studies considered in rel
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Cardiovascular disease Table 40 Tab
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Study/year/country Population Ricke
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Table 2: Observational studies on r
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Table 3: Before and after studies o
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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
Page 241 and 242: Hypertension Table 42: Meta-analyse
Page 243 and 244: All-cause mortality Table 44: Syste
Page 245 and 246: Immune modulation Table 46: Systema
Page 247 and 248: Table 48: Intervention studies on v
Page 249 and 250: Reference/Country Population Follow
Page 251 and 252: Infectious disease Table 50: Meta-a
Page 253: Table 51: RCTs on vitamin D supplem
Page 257 and 258: Neuropsychological functioning Tabl
Page 259 and 260: Abbreviations used in studies 25(OH
Page 261 and 262: Table 1: Percentage contribution of
Page 263 and 264: Table 2 (continued) Food group a Me
Page 265 and 266: Table 3 (continued) Food group Age
Page 267 and 268: Table 4 (continued) Food group a Ag
Page 269 and 270: Table 5 (continued) Food group a Na
Page 271 and 272: Table 6: Percentage contribution of
Page 273 and 274: Table 7: Average daily intake of vi
Page 275 and 276: Table 9: Average daily intake of Vi
Page 277 and 278: Table 11: Average daily intake of v
Page 281 and 282: Table 15: Average daily intake of V
Page 285 and 286: Serum/plasma 25(OH)D concentrations
Page 287 and 288: Table 20: UK - Adults and children
Page 289 and 290: Table 22: Northern Ireland - adults
Page 291 and 292: Table 24: England - adults 65 years
Page 293 and 294: Table 26: UK - by month blood sampl
Page 295 and 296: Table 29: English regions by season
Page 297 and 298: Table 33: England - by ethnicity, a
Page 299 and 300: Table 36: Scotland - by Body Mass I
Page 301 and 302: Calcitonin A peptide hormone, produ
Page 303 and 304: Osteoclast Osteocyte Osteoid Osteom
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Vitamin D and Health

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