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CME / CE

Current Recommended Vitamin D Intake May Not Be Optimal

  • Authors: News Author: Laurie Barclay, MD
    CME Author:
    Désirée Lie, MD, MSEd
  • CME / CE Released: 7/19/2006; Reviewed and Renewed: 7/19/2007
  • THIS ACTIVITY HAS EXPIRED FOR CREDIT
  • Valid for credit through: 7/19/2008, 11:59 PM EST
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Target Audience and Goal Statement

This article is intended for primary care clinicians, gynecologists, geriatricians, and other specialists who care for patients at risk for vitamin D deficiency.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  • List standards used for determining desirable serum 25(OH)D levels and vitamin D intake.
  • Describe recommendations for 25(OH)D levels and vitamin D intake to prevent fractures, falls, periodontal disease, and colorectal cancer.


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Author(s)

  • Laurie Barclay, MD

    Laurie Barclay is a freelance reviewer and writer for Medscape.

    Disclosures

    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Reviewer(s)

  • Gary Vogin, MD

    Senior Medical Editor, Medscape

    Disclosures

    Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.

CME Author(s)

  • Désirée Lie, MD, MSEd

    Clinical Professor of Family Medicine; Director, Division of Faculty Development, University of California, Irvine School of Medicine, Irvine, California

    Disclosures

    Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.


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CME / CE

Current Recommended Vitamin D Intake May Not Be Optimal

Authors: News Author: Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / CE Released: 7/19/2006; Reviewed and Renewed: 7/19/2007

Valid for credit through: 7/19/2008, 11:59 PM EST

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July 19, 2006 — A review published in the July issue of the American Journal of Clinical Nutrition identifies the optimal blood level of vitamin D. The investigators suggest that with the current recommended daily allowance, the optimal level is not attainable for most.

"Recent evidence suggests that vitamin D intakes above current recommendations may be associated with better health outcomes," write Heike A. Bischoff-Ferrari, from the Harvard School of Public Health in Boston, Massachusetts, and colleagues. "However, optimal serum concentrations of 25-hydroxyvitamin D [25(OH)D] have not been defined."

The authors review findings from studies that evaluated thresholds for serum 25(OH)D concentrations in relation to bone mineral density (BMD), lower extremity function, dental health, and risk of falls, fractures, and colorectal cancer.

For these end points, the most advantageous serum concentrations of 25(OH)D begin at 75 nmol/L (30 ng/mL), and the best range from 90 to 100 nmol/L (36-40 ng/mL). In most persons, these concentrations could not be reached with the currently recommended daily intakes of 200 IU vitamin D for younger adults and 600 IU vitamin D for older adults.

After comparing vitamin D intakes with achieved serum concentrations of 25(OH)D for the purpose of estimating optimal intakes, the authors suggest that an increase in the currently recommended intake of vitamin D is warranted for better bone health in younger adults and for all studied outcomes in older adults.

"An intake for all adults of >/=1000 IU (40 µg) vitamin D (cholecalciferol)/day is needed to bring vitamin D concentrations in no less than 50% of the population up to 75 nmol/L," the authors write. "The implications of higher doses for the entire adult population should be addressed in future studies.... Given the low cost, the safety, and the demonstrated benefit of higher 25(OH)D concentrations, vitamin D supplementation should become a public health priority to combat these common and costly chronic diseases."

The Medical Foundation (Charles A King Trust, Fleet National Bank, Co-Trustee, Boston, MA), the Harvard Hartford Foundation, the Kirkland Scholar Award, Irene and Fredrick Stare Nutrition Education Fund, the International Foundation for the Promotion of Nutrition Research Education, and the Swiss Foundation for Nutrition Research supported this study. The authors report no relevant financial relationships.

Am J Clin Nutr. 2006;84:18-28

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