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We already mentioned electrolytes and potassium is one example. Neither aging nor obesity alters vitamin D absorption from the gut [4]. Fat malabsorption is associated with medical conditions that include some forms of liver disease, cystic fibrosis, celiac disease, Crohns disease, and ulcerative colitis [1,63]. Food additives permitted for direct addition to food for human consumption; vitamin D2 mushroom powder. Effect of vitamin D supplementation on blood pressure: A systematic review and meta-analysis incorporating individual patient data. Clinical trials, however, do not support these findings. [, McDuffie JR, Calis KA, Booth SL, Uwaifo GI, Yanovski JA. In a meta-analysis of 16 prospective cohort studies in a total of 137,567 participants who had 8,345 diagnoses of cancer, 5,755 participants died from cancer [88]. The retention of vitamin D compounds in eggs and margarine during heat treatment in an oven for 40 min at normal cooking temperature showed retention at 39 Nutr Metab Cardiovasc Dis 2016;26:663-73. However, most evidence indicates that vitamin D3 increases serum 25(OH)D levels to a greater extent and maintains these higher levels longer than vitamin D2, even though both forms are well absorbed in the gut [33-36]. [, Malihi Z, Lawes CMM, Wu Z, Huang Y, Waayer D, Toop L, et al. 25-hydroxyvitamin D assays: Standardization, guidelines, problems, and interpretation. Neurology 2012;79:2140-5. It stimulates insulin secretion via the vitamin D receptor on pancreatic beta cells and reduces peripheral insulin resistance through vitamin D receptors in the muscles and liver [143]. Circulating vitamin D and colorectal cancer risk: An international pooling project of 17 cohorts. Jan. 18, 2011. [, Cashman KD, Seamans KM, Lucey AJ, Stocklin E, Weber P, Kiely M, Hill TR. More recently, a 2022 ancillary study of the Vitamin D and Omega-3 Trial (VITAL; described in the Cancer section below) investigated whether supplemental vitamin D3 (50 mcg [2,000 IU]/day) would lower the risk of fractures in 25,871 generally healthy men aged 50 years and older and women aged 55 years and older over a median follow-up of 5.3 years [82]. Ready-to-eat breakfast cereals often contain added vitamin D, as do some brands of orange juice, yogurt, margarine, and other food products. Vitamin D bioavailability: State of the art. Jin, J. Vitamin D and calcium supplements for preventing fractures. Vitamin D, Volume 1: Biochemistry, Physiology and Diagnostics, Fourth Edition. Some expert bodies and vitamin D researchers suggest, for example, that approximately 530 minutes of sun exposure, particularly between 10 a.m. and 4 p.m., either daily or at least twice a week to the face, arms, hands, and legs without sunscreen usually leads to sufficient vitamin D synthesis [13,15,28]. Am J Med 2015;128:1167-70. For example, a meta-analysis of 21 studies that included 11,941 men with prostate cancer and 13,870 controls found a 17% higher risk of prostate cancer for participants with higher levels of 25(OH)D [108]. Most participants had minimal or mild depression, had a low mean baseline 25(OH) level of 33.8 nmol/L (13.5 ng/mL), and were not taking antidepressants. Vitamin D status in the United States remained stable in the decade between 20032004 and 20132014. Here are five. Yao P, Bennett D, Mafham M, Lin X, Chen Z, Armitage J, Clarke R. Vitamin D and calcium for the prevention of fracture: A systematic review and meta-analysis. The easiest way to reintroduce electrolytes into your system is to drink a beverage formulated with them. 290-2007-10055-I. [, Heath AK, Hodge AM, Ebeling PR, Eyles DW, Kvaskoff D, Buchanan DD, et al. 2014 Mar;37(2):289-95. doi: 10.1007/s10545-013-9653-8. The trials administered different amounts of vitamin D (ranging from 10 mcg [400 IU]/day to 1,000 mcg [40,000 IU]/week). Below are brief descriptions of studies of vitamin D and its association with, or effect on, breast, colorectal, lung, pancreatic, and prostate cancers. N Engl J Med 2019:380:33-44. Clinical Science. Steroids In a study published in the journal Clinical Science in 2015, researchers from Penn State University found that when older adults and the elderly were exposed to heat, they were less able to increase blood flow than younger adults. The human body produces vitamin D as a response to sun exposure. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Crit Rev Food Sci Nutr 2015;55:1193-205. [, Yetley EA. Vitamin D synthesis following a single bout of sun exposure in older and younger men and women. Am J Epidemiol 2010;172:4-9. Individuals taking these and other medications on a regular basis should discuss their vitamin D intakes and status with their health care providers. People with conditions that limit fat absorption [, Calvo MS, Whiting SJ, Barton CN. [, Galior K, Grebe S, Singh R. Development of vitamin D toxicity from overcorrection of vitamin D deficiency: A review of case reports. And that means we need better ways of effectively cooling our bodies, especially when we can't avoid being outside on hot days. [, Mousa A, Naderpoor N, de Courten MPJ, Teede H, Kellow N, Walker K, et al. (July 7, 2022) https://bmjopen.bmj.com/content/9/2/e023809, King, Dana E. "Dietary Magnesium and C-reactive Protein Levels." Nutrient composition of human milk. The results of this analysis showed that 0.5 mcg (20 IU) to 214 mcg (8,570 IU)/day vitamin D supplementation (mean of 2,795 IU) for 6 weeks to 3 years reduced serum total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels, but not high-density lipoprotein cholesterol levels [126]. Am J Clin Nutr 2019;110:150-7. J Natl Cancer Inst 2019;111:158-69. [, Zhou R, Wang M, Huang H, Li W, Hu Y, Wu T. Lower vitamin D status is associated with an increased risk of ischemic stroke: A systematic review and meta-analysis. WebSince Vitamin D is fat soluble, toxicity can occur at high levels of oral intake of supplements. Some people with MS eventually lose the ability to write, speak, or walk. "They can also decrease sweating, which leads to a decrease in heat loss." lactose intolerance More information about assay standardization is available from the Vitamin D Standardization Program webpage. Federal Register 2020;85:41916-20. In addition, the Food and Drug Administration (FDA) has approved UV-treated mushroom powder as a food additive for use as a source of vitamin D2 in food products [18]. It doesnt need to be refrigerated. Possible explanations for this increase include genetic differences in vitamin D metabolism, dietary preferences, and behaviors that lead to less sun exposure [45,46]. Another study that compared 200 male smokers in Finland with pancreatic cancer to 400 matched controls found that participants in the highest quintile of 25(OH)D levels (more than 65.5 nmol/L [26.2 ng/mL]) had a threefold greater risk of developing pancreatic cancer over 16.7 years than those in the lowest quintile (less than 32 nmol/L [12.8 ng/mL]) [106]. Vitamin D supplementation for the prevention of depression and poor physical function in older persons: The D-Vitaal study, a randomized clinical trial. Evaluate Evaluate possible intolerance to patient's current statin prescription. [, Jagannath VA, Filippini G, Di Pietrantonj C, Asokan GV, Robak EW, Whamond L, Robinson SA. Rates of breast, prostate, and colorectal cancer did not differ significantly between the vitamin D and placebo groups. N Engl J Med 2019;381:520-30. Screening for vitamin D status is becoming a more common part of the routine laboratory bloodwork ordered by primary-care physicians, irrespective of any indications for this practice [6,52-54]. The largest clinical trial, VITAL, to investigate the effects of vitamin D supplementation on the primary prevention of cancer in the general population gave 50 mcg (2,000 IU)/day vitamin D3 supplements with or without 1,000 mg/day marine omega-3 fatty acids or a placebo for a median of 5.3 years [93]. Vitamin D, Volume 2: Health, Disease and Therapeutics, Fourth Edition. Participants were randomized to take either 30 mcg (1,200 IU)/day vitamin D3 or a placebo for 1 year. However, women with vitamin D intakes higher than 15 mcg (600 IU)/day at the start of the trial and who received the supplements experienced a 28% increased risk of invasive (but not in situ) breast cancer. Several trials have investigated whether vitamin D supplementation can prevent the transition from prediabetes to diabetes in patients with adequate 25(OH)D levels, and all have had negative results. This is a fact sheet intended for health professionals. Sunscreens with an SPF of 8 or more appear to block vitamin D-producing UV rays. No association between circulating concentrations of vitamin D and risk of lung cancer: An analysis in 20 prospective studies in the Lung Cancer Cohort Consortium (LC3). Another recent systematic review also found that vitamin D and calcium supplements had no beneficial effects on fractures, falls, or bone mineral density [79,80]. They then hypothesized that folic acid and its metabolite, 5-methyltetrahydrofolate (5-MTHF), could improve the elderly group's vessel function. Post-treatment levels of plasma 25- and 1,25-dihydroxy vitamin D and mortality in men with aggressive prostate cancer. High serum cholesterol levels and hypertension are two of the main risk factors for CVD. Similarly, in a review of data from nearly 250 studies published between 2009 and 2013, the Agency for Healthcare Research and Quality concluded that no relationship could be firmly established between vitamin D and health outcomes other than bone health [69]. [, Kassi E, Adamopoulos C, Basdra EK, Papavassiliou AG. Int J Cancer 2018;142:1189-201. Other dairy products made from milk, such as cheese and ice cream, are not usually fortified in the United States or Canada. However, clinical trials do not support a cause-and-effect relationship between vitamin D and weight loss. Lancet Diabetes Endocrinol 2018;6:847-58. Vitamin D supplementation has no effect on insulin sensitivity or secretion in vitamin D-deficient, overweight or obese adults: A randomized placebo-controlled trial. Corticosteroid medications, such as prednisone (Deltasone, Rayos, and Sterapred), are often prescribed to reduce inflammation. Observational studies indicate that greater body weights are associated with lower vitamin D status, and individuals with obesity frequently have marginal or deficient circulating 25(OH)D levels [151]. U.S. Department of Health and Human Services. [, Durup D, Jorgensen HL, Christensen J, Tjonnland A, Olsen A, Halkjaer J, et al. Osteoporosis is, in part, a long-term effect of calcium and/or vitamin D insufficiency, in contrast to rickets and osteomalacia, which result from vitamin D deficiency. JAMA Network Open 2019;2(12):e1917789. Vitamin D did not significantly prevent the development of diabetes in comparison with placebo. Association of vitamin D status with arterial blood pressure and hypertension risk: A mendelian randomisation study. Circulating concentrations of vitamin D in relation to pancreatic cancer risk in European populations. [. [, Logan VF, Gray AR, Peddie MC, Harper MJ, Houghton LA. [, Holick MF. JAMA 2018;319:1600-12. The investigators randomly assigned participants to receive either a bolus oral dose of 2,500 mcg (100,000 IU) vitamin D3 followed by 100 mcg (4,000 IU)/day or a placebo for 16 weeks. Statin medications reduce cholesterol synthesis. Heat intolerance happens when your body is unable to regulate its temperature. Ann Intern Med 2014;160:810-1. June 2014. A meta-analysis of prospective studies that evaluated the association between serum 25(OH)D levels and cancer incidence (8 studies) or cancer mortality (16 studies) found that cancer risk decreased by 7% and cancer mortality rates decreased by 2% with each 20 nmol/L (8 ng/mL) increase in serum 25(OH)D levels [89]. [, Schwartz JB. This made the older study participants more at risk for many things, including heat stroke. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Complementary Therapies in Medicine. In another study, 10 mcg (400 IU)/day vitamin D and 1,000 mg/day calcium supplementation slightly, but significantly, reduced weight gain amounts in comparison with placebo in postmenopausal women, especially those with a baseline total calcium intake of less than 1,200 mg/day [153]. CMAJ 2007;177:161-6. Neurol Ther 2018;7:59-85. WebVitamin D supplementation reduced cancer mortality rates by 13%, and most of the benefit occurred with daily supplementation. [, Taylor CL, Thomas PR, Aloia JF, Millard PS. [, Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. [, Sempos CT, Binkley N. 25-hydroxyvitamin D assay standardisation and vitamin D guidelines paralysis. The study included 25,871 men aged 50 years and older and women aged 55 years and older who had no history of cancer, and most had adequate serum 25(OH)D levels at baseline. One study found that when the 25(OH)D content of beef, pork, chicken, turkey, and eggs is taken into account, the total amount of vitamin D in the food is 2 to 18 times higher than the amount in the parent vitamin alone, depending on the food [20]. Taking vitamin D or Q10 supplements may improve your muscle health and alleviate the pain you feel from taking statins. In Canada, milk must be fortified with 0.881.0 mcg/100 mL (3540 IU), and the required amount for margarine is at least 13.25 mcg/100 g (530 IU). Vitamin D and bone density, fractures, and falls: The end of the story? Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D. Many tissues have vitamin D receptors, and some convert 25(OH)D to 1,25(OH)2D. A randomized controlled trial of vitamin D3 supplementation in African American women. [, Jiang X, Dimou NL, Al-Dabhani K, Lewis SJ, Martin RM, Haycock PC, et al. Type B UV (UVB) radiation with a wavelength of approximately 290320 nanometers penetrates uncovered skin and converts cutaneous 7-dehydrocholesterol to previtamin D3, which in turn becomes vitamin D3. [, Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, et al. [, Xu Y, Shao X, Yao Y, Xu L, Chang L, Jiang Z, Lin Z. [, Skversky AL, Kumar J, Abramowitz MK, Kaskel FJ, Melamed ML. [, Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon R. Hypervitaminosis D associated with tanning bed use: A case report. These values, which vary by age and sex, include: An FNB committee established RDAs for vitamin D to indicate daily intakes sufficient to maintain bone health and normal calcium metabolism in healthy people. Chan School of Public Health. Both vitamins D2 and D3 raise serum 25(OH)D levels, and they seem to have equivalent ability to cure rickets [4]. One trial included 65 adult men and women (mean age 32 years) with overweight or obesity who were otherwise healthy, did not have diabetes, and had low serum vitamin D levels (at or below 50 nmol/L [20 ng/mL]) [147]. "Climate Change: Global Temperature." Vitamin D, vitamin B2, and vitamin B12 can also be added to plant-based drinks, depending on the choice of the manufacturer. BMC Proceedings, 2018;12(Suppl 6):6. Nutrients 2020; 12, 2237; doi:10.3390/nu12082237. Individuals who have difficulty absorbing dietary fat might therefore require vitamin D supplementation [63]. Assessing vitamin D status by measuring serum 25(OH)D concentrations is complicated by the considerable variability of the available assays (the two most common ones involve antibodies or chromatography) used by laboratories that conduct the analyses [5,6]. For most people, supplementing with vitamin D is a safe and healthy practice. Cancer In contrast, the United Kingdom government recommends intakes of 10 mcg (400 IU)/day for its citizens aged 4 years and older [16]. [, Shahvazi S, Soltani S, Ahmadi SM, de Souza RJ, Salehi-Abargouei A. In extreme cases, vitamin D toxicity causes renal failure, calcification of soft tissues throughout the body (including in coronary vessels and heart valves), cardiac arrhythmias, and even death. Dietary supplements can contain vitamins D2 or D3. The emerging issue of 25-hydroxyvitamin D in foods. A reverse J-shaped association between serum 25-hydroxyvitamin D and cardiovascular disease mortality: The CopD study. U.S. Department of Agriculture, Agricultural Research Service. Ann Intern Med 2017;166:155-6. Vitamin D fortification in the United States and Canada: Current status and data needs. Paediatr Int Child Health 2017;37:84-98. [, Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Magnesium is the fourth most abundant mineral in your body. [, Skaaby T, Husemoen LLN, Thuesen BH, Pisinger C, Jorgensen T, Roswall N, et al. US Preventive Services Task Force recommendation statement. Type 2 diabetes Have a question? RDAs for vitamin D are listed in both micrograms (mcg) and international units (IU); 1 mcg vitamin D is equal to 40 IU (Table 2). Few foods naturally contain vitamin D. The flesh of fatty fish (such as trout, salmon, tuna, and mackerel) and fish liver oils are among the best sources [17,1]. Vitamin D supplementation had no effect on the incidence rate of myocardial infarction, angina, heart failure, arrhythmia, arteriosclerosis, stroke, venous thrombosis, or death from CVD. flaxseed intolerance causing rectify holadoctor digidexo inlifehealthcare rundt lungene [, Crockett SD, Barry EL, Mott LA, Ahnen DJ, Robertson DJ, Anderson JC, et al. One study included 1,119 men treated for prostate cancer whose plasma 25(OH)D levels were measured 4.9 to 8.6 years after their diagnosis. One nmol/L is equal to 0.4 ng/mL, and 1 ng/mL is equal to 2.5 nmol/L. JAMA 2006;296:2832-8. J Inherit Metab Dis. Surg Obes Relat Dis 2016;12:693-702. Clinical trial evidence on older adults Observational studies support an association between higher serum 25(OH)D levels and a lower risk of CVD incidence and mortality. Vitamin D had no significant effects on glucose homeostasis, insulin secretion or resistance, or hemoglobin A1c levels (a measure of average blood sugar levels over the previous 23 months), irrespective of the study population, vitamin D dose, or trial quality. Weight loss Vitamin D toxicity has been caused by consumption of dietary supplements that contained excessive vitamin D amounts because of manufacturing errors, that were taken inappropriately or in excessive amounts, or that were incorrectly prescribed by physicians, [155-157]. Consumption of human milk alone does not ordinarily enable infants to meet vitamin D requirements, because it provides less than 0.6 to 2.0 mcg/L (25 to 78 IU/L) [1,56,57]. The largest trial to date of vitamin D supplements for diabetes prevention randomized 2,423 men and women aged 25 years and older (mean age 60 years) with prediabetes and overweight or obesity (mean BMI of 32.1) to 100 mcg (4,000 IU)/day vitamin D3 or placebo for a median of 2.5 years [145]. No improvement in depressive symptoms by vitamin D supplementation: Results from a randomised controlled trial. Picciano MF. Am J Cardiol 2007;99:903-5. Beef liver, egg yolks, and cheese have small amounts of vitamin D, primarily in the form of vitamin D3 and its metabolite 25(OH)D3. MS is an autoimmune disease of the central nervous system that damages the myelin sheath surrounding and protecting nerve cells in the brain and spinal cord. Thiazide diuretics (e.g., Hygroton, Lozol, and Microzide) decrease urinary calcium excretion. [, Quesada-Gomez JM, Bouillon R. Is calcifediol better than cholecalciferol for vitamin D supplementation? Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [13,29]. The results showed no association between 25(OH)D levels or vitamin D dose and the risk of falling in the 184 participants who completed the study. Rl, O'Sullivan MJ, et al of 8 or more appear block... Mc, Harper MJ, Houghton LA metabolite, 5-methyltetrahydrofolate ( 5-MTHF ), are not fortified. Radiation is also effective [ 13,29 ] products made from milk, such as cheese and ice cream are! 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