R P Heaney

University of Nebraska at Omaha, Omaha, Nebraska, United States

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Publications (355)1737.23 Total impact

  • Robert P Heaney, Laura A G Armas
    Annals of internal medicine 11/2014; · 13.98 Impact Factor
  • R P Heaney
    Journal of endocrinological investigation 10/2014; · 1.65 Impact Factor
  • Robert P Heaney
    JAMA Pediatrics 07/2014; 168(7):682-683. · 4.28 Impact Factor
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    ABSTRACT: We examined the relationship between serum 25-hydroxyvitamin D (25[OH]D) and all-cause mortality. We searched biomedical databases for articles that assessed 2 or more categories of 25(OH)D from January 1, 1966, to January 15, 2013. We identified 32 studies and pooled the data. The hazard ratio for all-cause mortality comparing the lowest (0-9 nanograms per milliliter [ng/mL]) to the highest (> 30 ng/mL) category of 25(OH)D was 1.9 (95% confidence interval = 1.6, 2.2; P < .001). Serum 25(OH)D concentrations less than or equal to 30 ng/mL were associated with higher all-cause mortality than concentrations greater than 30 ng/mL (P < .01). Our findings agree with a National Academy of Sciences report, except the cutoff point for all-cause mortality reduction in this analysis was greater than 30 ng/mL rather than greater than 20 ng/mL. (Am J Public Health. Published online ahead of print June 12, 2014: e1-e8. doi:10.2105/AJPH.2014.302034).
    American journal of public health. 06/2014;
  • Robert P Heaney
    Nutrition Reviews 04/2014; · 4.60 Impact Factor
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    ABSTRACT: The 2013 Santa Fe Bone Symposium included plenary sessions on new developments in the fields of osteoporosis and metabolic bone disease, oral presentations of abstracts, and faculty panel discussions of common clinical conundrums: scenarios of perplexing circumstances where treatment decisions are not clearly defined by current medical evidence and clinical practice guidelines. Controversial issues in the care of osteoporosis were reviewed and discussed by faculty and participants. This is a review of the proceedings of the Santa Fe Bone Symposium, constituting in its entirety an update of advances in the understanding of selected bone disease topics of interest and the implications for managing patients in clinical practice. Topics included the associations of diabetes and obesity with skeletal fragility, the complexities and pitfalls in assessing the benefits and potential adverse effects of nutrients for treatment of osteoporosis, uses of dual-energy X-ray absorptiometry beyond measurement of bone mineral density, challenges in the care of osteoporosis in the very elderly, new findings on the role of osteocytes in regulating bone remodeling, and current concepts on the use of bone turnover markers in managing patients with chronic kidney disease who are at high risk for fracture.
    Journal of Clinical Densitometry 01/2014; · 1.71 Impact Factor
  • Robert P Heaney
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    ABSTRACT: Presented here is a system to standardize clinical studies of nutrient effects, using nutrient-specific physiological criteria. These guidelines are based mainly on analysis of the typical sigmoid curve of biological response to nutrients and are intended for design, interpretation, and pooling of studies of nutrient effects. Five rules have been articulated for individual studies of nutrients, and six for systematic reviews and/or meta-analyses.
    Nutrition Reviews 12/2013; · 4.60 Impact Factor
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    European Food and Feed Law Review. 12/2013;
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    ABSTRACT: Unsupplemented vitamin D status is determined by cutaneous synthesis and food inputs; however, their relative magnitudes are largely unknown. In a cohort of 780 non-supplement-taking adults with a mean serum 25-hydroxyvitamin D [25(OH)D] of 33 (±14) ng/ml we assessed the relationship between serum 25(OH)D and non-food environmental variables. Serum 25(OH)D concentration was adjusted for seasonal influence (which removed 2% of the total variance) and these adjusted values were regressed against factors involved in cutaneous synthesis. Indoor tanning use, sun exposure, and percent of work performed outdoors were significantly positively associated and body mass index (BMI) was significantly negatively associated with 25(OH)D values (P<0.03 for each). Latitude, gender, and age were not significantly correlated (P>0.10). Season and non-food predictors together explained 13% of the total variance in serum 25(OH)D concentration. Non-traditional food sources need to be investigated as possible vitamin D inputs.
    The Journal of steroid biochemistry and molecular biology 10/2013; · 3.98 Impact Factor
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    ABSTRACT: Objectives. Increasing 25-hydroxyvitamin D serum levels can prevent a wide range of diseases. There is a concern about increasing kidney stone risk with vitamin D supplementation. We used GrassrootsHealth data to examine the relationship between vitamin D status and kidney stone incidence. Methods. The study included 2012 participants followed prospectively for a median of 19 months. Thirteen individuals self-reported kidney stones during the study period. Multivariate logistic regression was applied to assess the association between vitamin D status and kidney stones. Results. We found no statistically significant association between serum 25-hydroxyvitamin D and kidney stones (P = .42). Body mass index was significantly associated with kidney stone risk (odds ratio = 3.5; 95% confidence interval = 1.1, 11.3). Conclusions. We concluded that a serum 25-hydroxyvitamin D level of 20 to 100 nanograms per milliliter has no significant association with kidney stone incidence. (Am J Public Health. Published online ahead of print October 17, 2013: e1-e5. doi:10.2105/AJPH.2013.301368).
    American Journal of Public Health 10/2013; · 3.93 Impact Factor
  • Robert P Heaney
    American Journal of Hypertension 10/2013; 26(10):1194-7. · 3.67 Impact Factor
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    ABSTRACT: Context:Guidelines have suggested that obese adults need two to three times more vitamin D than lean adults to treat vitamin D deficiency, but few studies have evaluated the vitamin D dose response in obese subjects.Objective:The purpose of this study was to characterize the pharmacokinetics of 25(OH)D response to 3 different doses of vitamin D3 (cholecalciferol) in a group of obese subjects and to quantify the 25(OH)D dose response relationship.Design, Setting, Intervention, Patients:This was a randomized, single blind study of 3 doses of oral vitamin D3 (1,000 IU, 5,000 IU, or 10,000 IU) given daily to 67 obese subjects for 21 weeks during the winter months.Main Outcome Measures:Serum 25(OH)D levels were measured at baseline and after vitamin D replacement, and 25(OH)D pharmacokinetic parameters were determined, fitting the 25(OH)D concentrations to an exponential model.Results:Mean measured increments in 25(OH)D at week 21 were: 12.4- (SD 9.7) ng/ml in the 1,000 IU/d group, 27.8 (SD10.2) ng/mL in the 5,000 IU/d group, and 48.1(SD 19.6) ng/ml in the 10,000 IU/d group. Steady state increments computed from the model were 20.6 (SD 17.1) ng/ml, 35.2 (SD 14.6) ng/ml, and 51.3 (SD 22.0) ng/ml, respectively. There were no hypercalcuria or hypercalcemia events during the study.Conclusion:Our data show that in obese people the 25(OH)D response to vitamin D3 is directly related to dose and body size with 2.5 IU/kg required for every unit increment in 25(OH)D (ng/ml).
    The Journal of Clinical Endocrinology and Metabolism 09/2013; · 6.31 Impact Factor
  • Robert P Heaney, Laura A G Armas, Christine French
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    ABSTRACT: The magnitude of vitamin D inputs in individuals not taking supplements is unknown; however, there is a great deal of information on quantitative response to varying supplement doses. We reanalyzed individual 25-hydroxyvitamin D [25(OH)D] concentration data from 8 studies involving cholecalciferol supplementation (total sample size = 3000). We extrapolated individual study dose-response curves to zero concentration values for serum 25(OH)D by using both linear and curvilinear approaches and measured seasonal oscillation in the serum 25(OH)D concentration. The total basal input (food plus solar) was calculated to range from a low of 778 iu/d in patients with end-stage renal disease to a high of 2667 iu/d in healthy Caucasian adults. Consistent with expectations, obese individuals had lower baseline, unsupplemented 25(OH)D concentrations and a smaller response to supplements. Similarly, African Americans had both lower baseline concentrations and lower calculated basal, all-source inputs. Seasonal oscillation in 4 studies ranged from 5.20 to 11.4 nmol/L, reflecting a mean cutaneous synthesis of cholecalciferol ranging from 209 to 651 iu/d at the summer peak. We conclude that: 1) all-source, basal vitamin D inputs are approximately an order of magnitude higher than can be explained by traditional food sources; 2) cutaneous, solar input in these cohorts accounts for only 10-25% of unsupplemented input at the summer peak; and 3) the remainder must come from undocumented food sources, possibly in part as preformed 25(OH)D.
    Journal of Nutrition 03/2013; · 4.20 Impact Factor
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    ABSTRACT: BACKGROUND AND OBJECTIVES: Recent understanding of extrarenal production of calcitriol has led to the use of more vitamin D supplementation in CKD populations. This paper reports the effect of cholecalciferol supplementation on calcium absorption. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Paired calcium absorption tests were done before and after 12-13 weeks of 20,000 IU weekly cholecalciferol supplementation in 30 participants with stage 5 CKD on hemodialysis. The study was conducted from April to December of 2011. Calcium absorption was tested with a standardized meal containing 300 mg calcium carbonate intrinsically labeled with (45)Ca; 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were measured. RESULTS: 25-Hydroxyvitamin D rose from 14.2 ng/ml (11.5-18.5) at baseline to 49.3 ng/ml (42.3-58.1) at the end of the study (P<0.001). 1,25-Dihydroxyvitamin D rose from 15.1 (10.5-18.8) pg/ml at baseline to 20.5 (17.0-24.7) pg/ml at the end of the study (P<0.001). The median baseline calcium absorption was 12% (7%-17%) and 12% (7%-16%) at the end of study. CONCLUSIONS: Patients with stage 5 CKD on hemodialysis had very low calcium absorption values at baseline, and cholecalciferol supplementation that raised 25(OH)D levels to 50 ng/ml had no effect on calcium absorption.
    Clinical Journal of the American Society of Nephrology 02/2013; · 5.07 Impact Factor
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    ABSTRACT: Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile  = 0.49; 95% C.I.: 0.315-0.768). Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
    PLoS ONE 01/2013; 8(1):e51543. · 3.53 Impact Factor
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    Robert P Heaney
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    ABSTRACT: Despite repeated emphasis in the Dietary Guidelines for Americans on the importance of calcium in the adult American diet and the recommendation to consume 3 dairy servings a day, dairy intake remains well below recommendations. Insufficient health professional awareness of the benefits of calcium and concern for lactose intolerance are among several possible reasons, This mini-review highlights both the role of calcium (and of dairy, its principal source in modern diets) in health maintenance and reviews the means for overcoming lactose intolerance (real or perceived).
    Advances in Nutrition 01/2013; 4(2):151-156. · 3.20 Impact Factor
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    ABSTRACT: Vitamin D status has been implicated in insulin resistance, type 2 diabetes mellitus, and hypertension, but the range of vitamin D status values over which the association can be found is unknown. Our objective was to define this range in a cohort of nondiabetic adult Canadians. We used a regression modeling strategy, first adjusting insulin-response variables and systolic and diastolic blood pressure for BMI, waist circumference, weight, age, and sex. The resulting residuals were regressed against serum 25-hydroxyvitamin D [25(OH)D] concentration using successive 40% data blocks ranging from the 0th to the 60th percentile of 25(OH)D values. All of the predictor variables were significantly associated with each of the dependent variables, with BMI and waist circumference accounting for >98% of the explained variance. The vitamin D association was localized to the serum 25(OH)D range extending from ∼40 to ∼90 nmol/L (16-36 μg/L). We conclude that vitamin D status is inversely associated with insulin responsiveness and blood pressure. Consistent with the threshold response characteristic typical of nutrients, the association was strongest in a circumscribed region of the range of 25(OH)D values. There was no association at 25(OH)D values >80-90 nmol/L (32-36 μg/L), indicating that the vitamin D association applied principally to values below that level. The differences observed, if they can be further confirmed in prospective studies, are of a magnitude that would be clinically important.
    Advances in Nutrition 01/2013; 4(3):303-310. · 3.20 Impact Factor

Publication Stats

16k Citations
1,737.23 Total Impact Points

Institutions

  • 1991–2014
    • University of Nebraska at Omaha
      Omaha, Nebraska, United States
  • 1985–2014
    • Creighton University
      • • Osteoporisis Research Center
      • • Department of Medicine
      • • Division of General Internal Medicine
      Omaha, Nebraska, United States
  • 2013
    • The Nebraska Medical Center
      Omaha, Nebraska, United States
  • 2012
    • Boston University
      • Department of Medicine
      Boston, MA, United States
  • 2011
    • University of Massachusetts Boston
      Boston, Massachusetts, United States
  • 2006–2010
    • Rutgers, The State University of New Jersey
      • Department of Chemical Biology
      New Brunswick, NJ, United States
  • 2008
    • State of California
      California City, California, United States
  • 2007
    • New Mexico Clinical Research and Osteoporosis Center
      Albuquerque, New Mexico, United States
  • 2004
    • University of California, Davis
      • Department of Nutrition
      Davis, CA, United States
  • 2003
    • Product Safety Labs
      Dayton, New Jersey, United States
  • 1991–1999
    • Purdue University
      West Lafayette, Indiana, United States
  • 1994
    • The Ohio State University
      Columbus, Ohio, United States
  • 1992
    • Columbus University
      Columbus, Ohio, United States
    • Indiana University-Purdue University Indianapolis
      • Department of Orthopaedic Surgery
      Indianapolis, IN, United States
  • 1990
    • University of Adelaide
      Tarndarnya, South Australia, Australia
  • 1988–1989
    • Procter & Gamble
      Cincinnati, Ohio, United States