Why not use supplements to combat vitamin D deficiency?

There have been calls for use of vitamin D supplements as a means of correcting low vitamin D status in European populations. While supplementation has been shown to significantly improve vitamin D intake across a variety of age, race, ethnic and gender groups, with dose-dependent increases (significant amount of vitamin D supplement has to be taken), relying on supplements is not an appropriate public health strategy to increase intakes across the population distribution because supplements are effective only in those who consume them and with uptake usually lower than ∼ 40% (Fulgoni et al . 2011; Whiting et al. 2011; Black et al. 2015). It is important to remember that vitamin D is a nutrient, and many authors now acknowledge that it is best taken in moderate amounts on a regular basis. High dose regimens correct deficiency only in the short term and may have unintended adverse effects (Sanders et al . 2010). While we acknowledge the usefulness of supplements under medical supervision for immediate correction of clinical deficiency, public health strategy must be designed to meet the needs of the unsupervised majority, on an on-going basis.

References:

Black LJ, Walton J, Flynn A et al . (2015) Small increments in vitamin D intake by Irish adults over a decade show that strategic initiatives to fortify the food supply are needed. Journal of Nutri- tion 145: 969–76.

Cashman KD & Kiely M (2011) Towards prevention of vitamin D deficiency and beyond: Knowledge gaps and research needs in vitamin D nutrition and public health. British Journal of Nutrition 106: 1617–27.

Fulgoni VL, Keast DR, Bailey RL et al. (2011) Foods, fortificants, and supplements: Where do Americans get their nutrients? Journal of Nutrition 141: 1–8.

Sanders KM, Stuart AL, Williamson EJ et al. (2010) Annual high- dose oral vitamin D and falls and fractures in older women: A randomized controlled trial. JAMA: The Journal of the American Medical Association 303: 1815–22.

Whiting SJ, Langlois KA, Vatanparast H et al. (2011) The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: An examination in children and adults with and without supplement use. American Journal of Clinical Nutrition 94:128–35.

Whiting SJ, Bonjour JP, Payen FD et al. (2015) Moderate amounts of vitamin D3 in supplements are effective in raising serum 25-hydroxyvitamin D from low baseline levels in adults: A systematic review. Nutrients 7: 2311–23.

 

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