JAMA 2006;296:2832-8. 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. 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. Best gummies: Nordic Naturals Zero Sugar Vitamin D3 Gummies 1,000 IU. [, Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang Y, et al. However, the supplementation had no significant effects on fasting blood glucose, hemoglobin A1c, or fasting insulin levels. Vitamin D & Vitamin K Oral Spray Contributes To Normal Immune Function. The use of sunscreen also limits vitamin D synthesis from sunlight. Sunscreens with an SPF of 8 or more appear to block vitamin D-producing UV rays. Thiazide diuretics (e.g., Hygroton, Lozol, and Microzide) decrease urinary calcium excretion. JAMA 2020;324:471-80. Institute of Medicine, Food and Nutrition Board. Various expert groupsincluding the American Association of Metabolic and Bariatric Surgery, The Obesity Society, and the British Obesity and Metabolic Surgery Societyhave developed guidelines on vitamin D screening, monitoring, and replacement before and after bariatric surgery [66,68]. In addition, studies have not consistently shown that vitamin D supplementation tempers the signs and symptoms of active MS or reduces rates of relapse. An animal-free version of vitamin D3 sourced from lichen is also available [32]. The association was substantially stronger in women. 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]. Most trials of the effects of vitamin D supplements on bone health also included calcium supplements, so isolating the effects of each nutrient is difficult. [, Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Krstic G, Wetterslev J, Gluud C. Vitamin D supplementation for prevention of cancer in adults. Poor oral health. A 50 nmol/L (20 ng/mL) increase in 25(OH)D levels was associated with an 11% reduction in total cancer incidence rates and, in women but not men, a 24% reduction in cancer mortality rates. They also help reduce fracture rates in institutionalized older people. [. J Clin Endocrinol Metab 2014;99:3551-60. In contrast to water-soluble vitamins, the body has no easy way of getting rid of fat-soluble vitamins. [, Aloia JF, Rubinova R, Fazzari M, Islam S, Mikhail M, Ragolia L. Vitamin D and falls in older African American women: The PODA randomized clinical trial. Few people near the equator develop the disease, whereas the prevalence is higher further north and south. [, Perez-Castrillon JL, Vega G, Abad L, Sanz A, Chaves J, Hernandez G, Duenas A. Salmon. [, Jorde R, Grimnes G. Vitamin D: No cure for depression. Clinical trial evidence provides some support for the observational findings. Season, time of day, length of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation exposure and vitamin D synthesis. Calcium plus vitamin D supplementation and the risk of colorectal cancer. 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]. Cancer Res 2006;66:10213-9. Calcium plus vitamin D supplementation and the risk of breast cancer. A study of cohorts that included 5,313 participants who developed lung cancer and 5,313 matched controls found no association between serum 25(OH)D levels and risk of subsequent lung cancer, even when the investigators analyzed the data by sex, age, race and ethnicity, and smoking status [104]. 09-E015. Salmon is a great source of protein, omega-3 fatty acids, and vitamin D. Choose wild and eat it raw, baked . Some studies have used dietary supplements containing the 25(OH)D3 form of vitamin D. Per equivalent microgram dose, 25(OH)D3 is three to five times as potent as vitamin D3 [37,38]. Observational studies and clinical trials provide mixed evidence on whether vitamin D intakes or serum levels affect cancer incidence, progression, or mortality risk. 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]. 2. The federal government's 2020-2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. Normal vitamin D levels in the blood are 20 ng/ml or above for adults. CMAJ 2019;191:E390-4. Practitioner 1984;228:312-3. [, Tripkovic L, Wilson LR, Hart K, Johnsen S, de Lusignan S, Smith CP, et al. Vitamin D supplementation for the prevention of depression and poor physical function in older persons: The D-Vitaal study, a randomized clinical trial. [, Aloia JF, Talwar SA, Pollack S, Yeh J. J Cancer Res Clin Oncol 2014;140:1465-77. [, Graeff-Armas LA, Bendik I, Kunz I, Schoop R, Hull S, Beck M. Supplemental 25-hydroxycholecalciferol is more effective than cholecalciferol in raising serum 25-hydroxyvitamin D concentrations in older adults. The second trial included 155 adults aged 6080 years who had clinically relevant depressive symptoms, no major depressive disorder, and serum 25(OH)D levels less than 50 to 70 nmol/L (20 to 28 ng/mL) depending on the season; in addition, they were not taking antidepressants [133,134]. According to the United States Department of Agriculture (USDA) Food Composition Database, one 3.5-ounce (100-gram) serving of farmed Atlantic salmon contains 526 IU of vitamin D, or 66% of the. PLOS ONE 2014;9:e111265. June 2014. [, Malihi Z, Wu Z, Stewart AW, Lawes CMM, Scragg R. Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: A systematic review and meta-analysis. products like plain whole cow's milk (for children 12 months and older), yogurt, cereals, and some 100% juices. Clinical trial evidence on older adults Curr Opin Gastroenterol 2008;24:176-83. Vitamin D without a subscript refers to either D 2 or D 3, or both, and is known collectively as calciferol.. Vitamin D 2 was chemically characterized in 1931. In contrast to observational studies, clinical trials provide little support for the benefits of vitamin D supplementation for glucose homeostasis. Am J Clin Nutr 2012;95:1350-6. History of changes to this fact sheet, U.S. Department of Health & Human Services, Division of Program Coordination, Planning, and Strategic Initiatives, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, Analytical Methods and Reference Materials (AMRM), NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Computer Access to Research on Dietary Supplements (CARDS) Database, Dietary Supplement Ingredient Database (DSID), ODS Funding of Grants & Administrative Supplements: FAQ, Administrative Supplements for Validation Studies of Analytical Methods, Staff Bios, Publications, and Presentations, Federal Working Group on Dietary Supplements, NIH Dietary Supplement Research Coordinating Committee, Dietary Supplements in the Time of COVID-19, Food labeling: Revision of the Nutrition and Supplement Facts labels, The Surgeon General's Call to Action to Prevent Skin Cancer, Percent reporting and mean amounts of selected vitamins and minerals food and beverages and dietary supplements by gender and age, in the United States, 2015-2016, Usual nutrient intake from foods and beverages, by gender and age, Vitamin D and calcium: A systematic review of health outcomes (update), Associated with vitamin D deficiency, which can lead to rickets in infants and children and osteomalacia in adults, Generally considered inadequate for bone and overall health in healthy individuals, Generally considered adequate for bone and overall health in healthy individuals, Linked to potential adverse effects, particularly at >150 nmol/L (>60 ng/mL), Trout (rainbow), farmed, cooked, 3 ounces, Mushrooms, white, raw, sliced, exposed to UV light, cup, Milk, 2% milkfat, vitamin D fortified, 1 cup, Soy, almond, and oat milks, vitamin D fortified, various brands, 1 cup, Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 1 serving, Sardines (Atlantic), canned in oil, drained, 2 sardines, Tuna fish (light), canned in water, drained, 3 ounces, Beef, ground, 90% lean, broiled, 3 ounces. Vitamin D deficiency and depression in adults: Systematic review and meta-analysis. [, Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon R. Hypervitaminosis D associated with tanning bed use: A case report. Gut. Some people are potentially at risk of inadequacy at 30 to 50 nmol/L (1220 ng/mL). About 2.3 million osteoporotic fractures occurred in the United States in 2015 [73]. Rickets occurred mainly in Black children who were breastfed longer, were born with low birthweight, weighed less, and were shorter than other children. Effects of orlistat on fat-soluble vitamins in obese adolescents. Levels of 1,25(OH)2D do not typically decrease until vitamin D deficiency is severe [2]. Very high levels of vitamin D in your blood (greater than 375 nmol/L or 150 ng/mL) can cause nausea, vomiting, muscle weakness, confusion, pain, loss of appetite, dehydration, excessive urination and thirst, and kidney stones. The groups showed no significant differences in measures of muscle strength or performance [85]. The weight-loss drug orlistat (Xenical and alli), together with a reduced-fat diet, can reduce the absorption of vitamin D from food and supplements, leading to lower 25(OH)D levels [164-167]. Lancet Diabetes Endocrinol 2018;6:834-5. The trials administered different amounts of vitamin D (ranging from 10 mcg [400 IU]/day to 1,000 mcg [40,000 IU]/week). J Clin Endocrinol Metab 2013;98:4845-51. Am J Clin Nutr 2017;105:1372-81. However, normal-weight participants had greater reductions in cancer incidence and mortality rates than those with overweight or obesity. Steroids Low blood levels of vitamin D have also been associated with: An impairment in memory and thinking skills in older adults. Washington DC: Wiley-Blackwell, 2012. Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. Int J Cancer 2018;142:1189-201. Consume fatty. Levels of 75 to less than 87.5 nmol/L (30 to less than 35 ng/mL) and 87.5 to less than 100 nmol/L (35 to less than 40 ng/mL) were associated with a 19% and 27% lower risk, respectively. Federal Register 2020;85:41916-20. Pediatrics 2020;145:e20193574. Serum vitamin D and risk of breast cancer within five years. JAMA Intern Med 2015;175:745-54. Vitamin D in foods: An evolution of knowledge. Among postmenopausal women and older men, many clinical trials have shown that supplements of both vitamin D and calcium result in small increases in bone mineral density throughout the skeleton [1,74]. [, Song M, Lee IM, Manson JE, Buring JE, Dushkes R, Gordon D, et al. For this. A review of 71 observational studies in adults with and without type 2 diabetes from 16 countries found a significant inverse relationship between vitamin D status and blood sugar levels in participants who did and did not have diabetes [146]. Horm Metab Res 2019;51:11-21. 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