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American Journal of Clinical Nutrition, Vol. 84, No. 1, 18-28, July 2006
© 2006 American Society for Nutrition

REVIEW ARTICLE

Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes1,2,3

Heike A Bischoff-Ferrari, Edward Giovannucci, Walter C Willett, Thomas Dietrich and Bess Dawson-Hughes

1 From the Department of Nutrition, Harvard School of Public Health, Boston, MA (HAB-F, EG, and WCW); the Department of Rheumatology and the Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland (HAB-F); the Department of Epidemiology and the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA (EG and WCW); the Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA (TD); and the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA (BD-H)

Recent evidence suggests that vitamin D intakes above current recommendations may be associated with better health outcomes. However, optimal serum concentrations of 25-hydroxyvitamin D [25(OH)D] have not been defined. This review summarizes evidence 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 all endpoints, the most advantageous serum concentrations of 25(OH)D begin at 75 nmol/L (30 ng/mL), and the best are between 90 and 100 nmol/L (36–40 ng/mL). In most persons, these concentrations could not be reached with the currently recommended intakes of 200 and 600 IU vitamin D/d for younger and older adults, respectively. A comparison of vitamin D intakes with achieved serum concentrations of 25(OH)D for the purpose of estimating optimal intakes led us to suggest that, for bone health in younger adults and all studied outcomes in older adults, an increase in the currently recommended intake of vitamin D is warranted. An intake for all adults of ≥1000 IU (40 µg) vitamin D (cholecalciferol)/d is needed to bring vitamin D concentrations in no less than 50% of the population up to 75 nmol/L. The implications of higher doses for the entire adult population should be addressed in future studies.

Key Words: 25-Hydroxyvitamin D • vitamin D intake • bone density • lower-extremity strength • colorectal cancer




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 CirculationHome page
T. J. Wang, M. J. Pencina, S. L. Booth, P. F. Jacques, E. Ingelsson, K. Lanier, E. J. Benjamin, R. B. D'Agostino, M. Wolf, and R. S. Vasan
Vitamin D Deficiency and Risk of Cardiovascular Disease
Circulation, January 29, 2008; 117(4): 503 - 511.
[Abstract] [Full Text] [PDF]

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 J. Nutr.Home page
A. H. Lichtenstein, H. Rasmussen, W. W. Yu, S. R. Epstein, and R. M. Russell
Modified MyPyramid for Older Adults
J. Nutr., January 1, 2008; 138(1): 5 - 11.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
S. A Talwar, J. F Aloia, S. Pollack, and J. K Yeh
Dose response to vitamin D supplementation among postmenopausal African American women
Am. J. Clinical Nutrition, December 1, 2007; 86(6): 1657 - 1662.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
A. J Rovner, V. A Stallings, J. I Schall, M. B Leonard, and B. S Zemel
Vitamin D insufficiency in children, adolescents, and young adults with cystic fibrosis despite routine oral supplementation
Am. J. Clinical Nutrition, December 1, 2007; 86(6): 1694 - 1699.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
E. Hypponen, S. Turner, P. Cumberland, C. Power, and I. Gibb
Serum 25-Hydroxyvitamin D Measurement in a Large Population Survey with Statistical Harmonization of Assay Variation to an International Standard
J. Clin. Endocrinol. Metab., December 1, 2007; 92(12): 4615 - 4622.
[Abstract] [Full Text] [PDF]

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 J. Nutr.Home page
M. J. Rowling, C. Gliniak, J. Welsh, and J. C. Fleet
High Dietary Vitamin D Prevents Hypocalcemia and Osteomalacia in CYP27B1 Knockout Mice
J. Nutr., December 1, 2007; 137(12): 2608 - 2615.
[Abstract] [Full Text] [PDF]

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 NEJMHome page
R. Bouillon, A. W. Norman, P. Lips, R. C. Cava, A. N. D. Javier, W. R. Howe, R. Dellavalle, G. I. Baroncelli, and M. F. Holick
Vitamin D Deficiency
N. Engl. J. Med., November 8, 2007; 357(19): 1980 - 1982.
[Full Text] [PDF]

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 JNCI J Natl Cancer InstHome page
D. M. Freedman, A. C. Looker, S.-C. Chang, and B. I. Graubard
Prospective Study of Serum Vitamin D and Cancer Mortality in the United States
J Natl Cancer Inst, November 7, 2007; 99(21): 1594 - 1602.
[Abstract] [Full Text] [PDF]

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 Arch Intern MedHome page
E. Giovannucci
Can Vitamin D Reduce Total Mortality?
Arch Intern Med, September 10, 2007; 167(16): 1709 - 1710.
[Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
S. M Kimball, M. R Ursell, P. O'Connor, and R. Vieth
Safety of vitamin D3 in adults with multiple sclerosis
Am. J. Clinical Nutrition, September 1, 2007; 86(3): 645 - 651.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
I. Laaksi, J.-P. Ruohola, P. Tuohimaa, A. Auvinen, R. Haataja, H. Pihlajamaki, and T. Ylikomi
An association of serum vitamin D concentrations < 40 nmol/L with acute respiratory tract infection in young Finnish men
Am. J. Clinical Nutrition, September 1, 2007; 86(3): 714 - 717.
[Abstract] [Full Text] [PDF]

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 Age AgeingHome page
A. Avenell, J. A. Cook, G. S. MacLennan, and G. C. MacPherson
Vitamin D supplementation to prevent infections: a sub-study of a randomised placebo-controlled trial in older people (RECORD trial, ISRCTN 51647438)
Age Ageing, September 1, 2007; 36(5): 574 - 577.
[Full Text] [PDF]

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 Ann Rheum DisHome page
Y. Arnson, H. Amital, and Y. Shoenfeld
Vitamin D and autoimmunity: new aetiological and therapeutic considerations
Ann Rheum Dis, September 1, 2007; 66(9): 1137 - 1142.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
B. N Ames, J. C McCann, M. J Stampfer, and W. C Willett
Evidence-based decision making on micronutrients and chronic disease: long-term randomized controlled trials are not enough
Am. J. Clinical Nutrition, August 1, 2007; 86(2): 522 - 523.
[Full Text] [PDF]

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 NEJMHome page
M. F. Holick
Vitamin D Deficiency
N. Engl. J. Med., July 19, 2007; 357(3): 266 - 281.
[Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
F. L Weng, J. Shults, M. B Leonard, V. A Stallings, and B. S Zemel
Risk factors for low serum 25-hydroxyvitamin D concentrations in otherwise healthy children and adolescents
Am. J. Clinical Nutrition, July 1, 2007; 86(1): 150 - 158.
[Abstract] [Full Text] [PDF]

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 Nutr Clin PractHome page
P. F. Lata and M. E. Elliott
Patient Assessment in the Diagnosis, Prevention, and Treatment of Osteoporosis
Nutr Clin Pract, June 1, 2007; 22(3): 261 - 275.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. G. Pittas, J. Lau, F. B. Hu, and B. Dawson-Hughes
The Role of Vitamin D and Calcium in Type 2 Diabetes. A Systematic Review and Meta-Analysis
J. Clin. Endocrinol. Metab., June 1, 2007; 92(6): 2017 - 2029.
[Abstract] [Full Text] [PDF]

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 Am. J. Clin. Nutr.Home page
R. Vieth, H. Bischoff-Ferrari, B. J Boucher, B. Dawson-Hughes, C. F Garland, R. P Heaney, M. F Holick, B. W Hollis, C. Lamberg-Allardt, J. J McGrath, et al.
The urgent need to recommend an intake of vitamin D that is effective
Am. J. Clinical Nutrition, March 1, 2007; 85(3): 649 - 650.
[Full Text] [PDF]


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