Vitamin D and Health

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FIGURE 4 - Variation of UVB and UVA erythemally effective energy at Chilton, UK 27 (a) Monthly at noon on 21st day of each month (b) Daily at summer & winter solstices 27 Based on the data in Figure 3 21
CIE spectrum for photoconversion of 7-DHC to pre-vitamin D 3.16 The validity of the official CIE action spectrum for the photoconversion of 7-DHC to pre-vitamin D (see Figure 5) has been disputed. However, it continues to be used to calculate the vitamin D efficacy of solar UVB under different climatic conditions and these calculations have been used for risk/benefit assessments. For example, one study concluded that the best time to obtain vitamin D is around noon because the relative efficacy for vitamin D production is greater than that for erythema (Sayre & Dowdy, 2007). The risk-benefit calculations were based on the pre-vitamin D action spectrum and assumed that the action spectrum is accurate and that there is no spectral interaction. There is uncertainty about both these assumptions. FIGURE 5 - CIE action spectra for erythema and the formation of pre-vitamin D (note considerable overlap in the solar UVB region). 3.17 One study using ex vivo neonatal foreskin has suggested that UVA degrades vitamin D (Webb et al., 1989) but this has not been investigated in vivo. Effect of latitude on skin synthesis of vitamin D 3.18 UVB radiation is sufficient for year round vitamin D synthesis at latitudes below ~37ᵒN. At higher latitudes, vitamin D is not synthesised during the winter months (Webb et al., 1988). However, the extent of the effect of latitude on vitamin D synthesis in the UK is not clear. While it probably has some influence, it could be relatively small compared to other factors. A study which compared serum 25(OH)D concentrations in postmenopausal women (< 65y) in the North (Aberdeen; 57ᵒN) and South (Guildford; 51ᵒN) of the UK reported a difference of approximately 10 nmol/L (Macdonald et al., 2011). However, the difference in serum 25(OH)D concentration might not be due to solar radiation. Although UVB (as a proportion of UVR) lessens with increasingly northern latitudes, the weather also gets progressively colder which means that people spend less time outdoors and expose less skin. 22
Page 1 and 2: Vitamin D and Health i 2016
Page 3 and 4: Contents Preface ..................
Page 5 and 6: Preface The Scientific Advisory Com
Page 7 and 8: Adviser (Ultraviolet radiation expo
Page 9 and 10: Ms Gemma Paramor Lay representative
Page 11 and 12: Metabolism S.5 Vitamin D is convert
Page 13 and 14: Two studies reported an increase in
Page 15 and 16: Recommendations S.35 Serum 25(OH)D
Page 17 and 18: 1.8 The terms of reference were: to
Page 19 and 20: 1.18 In assessing the evidence on v
Page 21 and 22: there is not absolute correspondenc
Page 23 and 24: Metabolism Absorption of dietary vi
Page 25 and 26: UVB ▼ SKIN: ▼ Previtamin D 3
Page 27 and 28: 2.49 A number of studies have repor
Page 29 and 30: using a bolus dose (I 2 =77%) compa
Page 31 and 32: 2.75 Another RCT 21 (Cashman et al.
Page 33 and 34: 3. Photobiology of vitamin D Ultrav
Page 35: Erythema and skin cancer 3.10 Two m
Page 39 and 40: Effect of skin pigmentation on skin
Page 41 and 42: increase in mean serum 25(OH)D conc
Page 43 and 44: 4. Measuring vitamin D exposure (fr
Page 45 and 46: the authors cautioned care in the i
Page 47 and 48: 24,25(OH) 2 D 3 which can contribut
Page 49 and 50: 5. Relationship between vitamin D e
Page 51 and 52: latitudes > 49.5 o N or S (which we
Page 53 and 54: increase 25(OH)D concentrations > 5
Page 55 and 56: 22.5 nmol/L (IQR, 16.8-34.3) in sum
Page 57 and 58: 6.7 Although serum 25(OH)D concentr
Page 59 and 60: calcium intake, although this is mo
Page 61 and 62: Evidence considered (Tables 1-5, An
Page 63 and 64: 6.43 Preece et al. (1975) measured
Page 65 and 66: irths (December-February) in the vi
Page 67 and 68: large loss to follow-up 45 and, sin
Page 69 and 70: 6.81 A pilot RCT in India (Khadilka
Page 71 and 72: Evidence considered (Tables 16-18,
Page 73 and 74: Intervention studies 6.107 A 3-year
Page 75 and 76: Compared with men in the top quarti
Page 77 and 78: chair-rising test. Mean baseline se
Page 79 and 80: heterogeneity among trials for dose
Page 81 and 82: the 600 µg (24,000 IU) vitamin D 3
Page 83 and 84: Bone health indices beyond rickets
Page 85 and 86: Intervention studies 6.177 An RCT i
Page 87 and 88:
maternal serum 25(OH)D concentratio
Page 89 and 90:
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
Page 109 and 110:
serum 25(OH)D concentration in neon
Page 111 and 112:
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
Page 163 and 164:
Clarke B (2008) Normal bone anatomy
Page 165 and 166:
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
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Table 5: Intervention studies on ri
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Table 7: Case reports of osteomalac
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Table 9: Cohort studies on associat
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Children and adolescents Table 11:
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Table 13: Intervention studies on e
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Table 16: RCTs on effects of vitami
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Table 22: Meta-analyses of trials o
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Table 24: Prospective studies on as
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Table 25: Meta-analyses of RCTs on
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Table 27: Prospective studies on as
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Table 28: Meta-analyses of RCTs on
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Study Methods Results Author conclu
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NON-MUSCULOSKELETAL HEALTH OUTCOMES
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Table 32: Intervention studies on e
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Table 36: Observational studies on
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Table 38: Meta analyses of RCTs and
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Table 39: Prospective studies on 25
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Study/Country Population Mean follo
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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
Page 251 and 252:
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
Page 259 and 260:
Abbreviations used in studies 25(OH
Page 261 and 262:
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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Page 281 and 282:
Table 15: Average daily intake of V
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Page 285 and 286:
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
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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