[Show abstract][Hide abstract] ABSTRACT: Despite the Institute of Medicine's commitment to base its nutrient intake recommendations in evidence, the 2004/2005 Dietary Reference Intakes for sodium were not supported by evidence, as the subsequent 2013 Institute of Medicine review admitted. In this review, I suggest an approach to setting nutrient intake requirements based in physiology. Briefly, the requirement of a given nutrient can best be said to be the intake that calls for the least adaptation or compensation by the intact organism. For sodium, evidence indicates that such an intake is typically between 3000 and 5000 mg/d.
[Show abstract][Hide abstract] ABSTRACT: Recently Veugelers and Ekwaru published data  indicating that, in its dietary reference intakes for calcium and vitamin D, the Institute of Medicine (IOM) had made a serious calculation error . Using the same data set as had the IOM panel, these investigators showed that the Recommended Dietary Allowance (RDA) for vitamin D had been underestimated by an order of magnitude. Veugelers and Ekwaru, using the IOM's data, calculated an RDA of 8895 IU per day. They noted that there was some uncertainty in that estimate, inasmuch as this value required an extrapolation from the available data, which did not include individuals receiving daily vitamin D inputs above 2400 IU/day.[...].
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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; 104(8):e1-e8. DOI:10.2105/AJPH.2014.302034 · 4.55 Impact Factor
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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; 144. DOI:10.1016/j.jsbmb.2013.10.014 · 3.63 Impact Factor
[Show abstract][Hide abstract] 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.
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.
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).
We concluded that a serum 25-hydroxyvitamin D level of 20 to 100 nanograms per milliliter has no significant association with kidney stone incidence.
American Journal of Public Health 10/2013; 104(9). DOI:10.2105/AJPH.2013.301368 · 4.55 Impact Factor