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Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis^1,2,3,4,5

¹ From the Vitamin D, Skin, and Bone Research Laboratory, Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston

The purpose of this review is to put into perspective the many health benefits of vitamin D and the role of vitamin D deficiency in increasing the risk of many common and serious diseases, including some common cancers, type 1 diabetes, cardiovascular disease, and osteoporosis. Numerous epidemiologic studies suggest that exposure to sunlight, which enhances the production of vitamin D₃ in the skin, is important in preventing many chronic diseases. Because very few foods naturally contain vitamin D, sunlight supplies most of our vitamin D requirement. 25-Hydroxyvitamin D [25(OH)D] is the metabolite that should be measured in the blood to determine vitamin D status. Vitamin D deficiency is prevalent in infants who are solely breastfed and who do not receive vitamin D supplementation and in adults of all ages who have increased skin pigmentation or who always wear sun protection or limit their outdoor activities. Vitamin D deficiency is often misdiagnosed as fibromyalgia. A new dietary source of vitamin D is orange juice fortified with vitamin D. Studies in both human and animal models add strength to the hypothesis that the unrecognized epidemic of vitamin D deficiency worldwide is a contributing factor of many chronic debilitating diseases. Greater awareness of the insidious consequences of vitamin D deficiency is needed. Annual measurement of serum 25(OH)D is a reasonable approach to monitoring for vitamin D deficiency. The recommended adequate intakes for vitamin D are inadequate, and, in the absence of exposure to sunlight, a minimum of 1000 IU vitamin D/d is required to maintain a healthy concentration of 25(OH)D in the blood.

Key Words: Vitamin D • sunlight • 25-hydroxyvitamin D • cancer • bone health • diabetes

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				M. F. Holick, E. S. Siris, N. Binkley, M. K. Beard, A. Khan, J. T. Katzer, R. A. Petruschke, E. Chen, and A. E. de Papp Prevalence of Vitamin D Inadequacy among Postmenopausal North American Women Receiving Osteoporosis Therapy J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3215 - 3224. [Abstract] [Full Text] [PDF]

				H. A. Bischoff-Ferrari, W. C. Willett, J. B. Wong, E. Giovannucci, T. Dietrich, and B. Dawson-Hughes Fracture Prevention With Vitamin D Supplementation: A Meta-analysis of Randomized Controlled Trials JAMA, May 11, 2005; 293(18): 2257 - 2264. [Abstract] [Full Text] [PDF]

				J. Lin, S. M. Zhang, N. R. Cook, J. E. Manson, I-M. Lee, and J. E. Buring Intakes of Calcium and Vitamin D and Risk of Colorectal Cancer in Women Am. J. Epidemiol., April 15, 2005; 161(8): 755 - 764. [Abstract] [Full Text] [PDF]

				M. S. Calvo and S. J. Whiting Overview of the Proceedings from Experimental Biology 2004 Symposium: Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency J. Nutr., February 1, 2005; 135(2): 301 - 303. [Full Text] [PDF]

				S. J. Whiting and M. S. Calvo Dietary Recommendations for Vitamin D: a Critical Need for Functional End Points to Establish an Estimated Average Requirement J. Nutr., February 1, 2005; 135(2): 304 - 309. [Abstract] [Full Text] [PDF]

				M. S. Calvo, S. J. Whiting, and C. N. Barton Vitamin D Intake: A Global Perspective of Current Status J. Nutr., February 1, 2005; 135(2): 310 - 316. [Abstract] [Full Text] [PDF]

				M. F Holick Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease Am. J. Clinical Nutrition, December 1, 2004; 80(6): 1678S - 1688S. [Abstract] [Full Text] [PDF]

				M. T. Cantorna and B. D. Mahon Mounting Evidence for Vitamin D as an Environmental Factor Affecting Autoimmune Disease Prevalence Experimental Biology and Medicine, December 1, 2004; 229(11): 1136 - 1142. [Abstract] [Full Text] [PDF]

				J. C. Fleet Rapid, Membrane-Initiated Actions of 1,25 Dihydroxyvitamin D: What Are They and What Do They Mean? J. Nutr., December 1, 2004; 134(12): 3215 - 3218. [Abstract] [Full Text] [PDF]

				D. M. Harris and V. L. W. Go Vitamin D and Colon Carcinogenesis J. Nutr., December 1, 2004; 134(12): 3463S - 3471S. [Abstract] [Full Text] [PDF]

				D. N. Muanza, A. Vasquez, J. Cannell, and W. P. Grant Isoflavones and Postmenopausal Women JAMA, November 17, 2004; 292(19): 2337 - 2337. [Full Text] [PDF]

				M. J. Levine and D. Teegarden 1{alpha},25-Dihydroxycholecalciferol Increases the Expression of Vascular Endothelial Growth Factor in C3H10T1/2 Mouse Embryo Fibroblasts J. Nutr., September 1, 2004; 134(9): 2244 - 2250. [Abstract] [Full Text] [PDF]

				M. F. Holick Vitamin D Deficiency and Chronic Pain: Cause and Effect or Epiphenomenon?-Reply-II Mayo Clin. Proc., May 1, 2004; 79(5): 696 - 696. [PDF]