Vitamin D: what is an adequate vitamin D level and how much supplementation is necessary?
ABSTRACT Strong evidence indicates that many or most adults in the United States and Europe would benefit from vitamin D supplements with respect to fracture and fall prevention, and possibly other public health targets, such as cardiovascular health, diabetes and cancer. This review discusses the amount of vitamin D supplementation needed and a desirable 25-hydroxyvitamin D level to be achieved for optimal musculoskeletal health. Vitamin D modulates fracture risk in two ways: by decreasing falls and increasing bone density. Two most recent meta-analyses of double-blind randomised controlled trials came to the conclusion that vitamin D reduces the risk of falls by 19%, the risk of hip fracture by 18% and the risk of any non-vertebral fracture by 20%; however, this benefit was dose dependent. Fall prevention was only observed in a trial of at least 700 IU vitamin D per day, and fracture prevention required a received dose (treatment dose*adherence) of more than 400 IU vitamin D per day. Anti-fall efficacy started with achieved 25-hydroxyvitamin D levels of at least 60 nmol l(-1) (24 ng ml(-1)) and anti-fracture efficacy started with achieved 25-hydroxyvitamin D levels of at least 75 nmol l(-1) (30 ng ml(-1)) and both endpoints improved further with higher achieved 25-hydroxyvitamin D levels. Founded on these evidence-based data derived from the general older population, vitamin D supplementation should be at least 700-1000 IU per day and taken with good adherence to cover the needs for both fall and fracture prevention. Ideally, the target range for 25-hydroxyvitamin D should be at least 75 nmol l(-1), which may need more than 700-1000 IU vitamin D in individuals with severe vitamin D deficiency or those overweight.
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ABSTRACT: The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory.Cochrane database of systematic reviews (Online) 06/2014; 6:CD007469. · 5.70 Impact Factor
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ABSTRACT: The diminished ability of aged muscle to self-repair is a factor behind sarcopenia and contributes to muscle atrophy. Muscle repair depends on satellite cells whose pool size is diminished with aging. A reduction in Notch pathway activity may explain the age-related decrease in satellite cell proliferation, as this pathway has been implicated in satellite cell self-renewal. Skeletal muscle is a target of vitamin D which modulates muscle cell proliferation and differentiation in vitro and stimulates muscle regeneration in vivo. Vitamin D status is positively correlated to muscle strength/function, and elderly populations develop a vitamin D deficiency. The aim of this study was to evaluate how vitamin D deficiency induces skeletal muscle atrophy in old rats through a reduction in Notch pathway activity and proliferation potential in muscle.Nutrition & metabolism. 01/2014; 11(1):47.
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ABSTRACT: Humans should avoid prolonged exposure to the Sun during the warm subperiod of the year with naturally high solar UV level. One of the known recommendations to avoid excessive UV radiation is wearing clothes with UV protection additives. However there is an important question: how do we get an adequate solar UV radiation, which maintains a healthy status of vitamin D, without facing overexposure risks? It is found that some kind of 100% cotton knitted fabric, used in the production of normal daily clothing, has ∼15% transmittance of solar UV. Model studies show that a garment made of this fabric allows larger synthesis of vitamin D3 in human body without the erythema risks (skin redness). Thus the adequate level of vitamin D could be attained safely by a person exposing only small part of the body (face, palms) during the period (May-August) of the year.Journal of Photochemistry and Photobiology B Biology 07/2014; 140C:105-110. · 2.80 Impact Factor