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Peterson L, Zeng X, Caufield-Noll CP, Schweitzer MA, Magnuson TH, Steele KE. Vitamin D status and supplementation before and after bariatric surgery: A comprehensive literature review. Surg Obes Relat Dis 2016;12:693-702. [ PubMed abstract] Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils. Some people take very high doses of vitamin D supplements. In 2013–2014, an estimated 3.2% of the U.S. adult population took supplements containing 100 mcg (4,000 IU) or more vitamin D [ 41]. The factors that affect UV radiation exposure, individual responsiveness, and uncertainties about the amount of sun exposure needed to maintain adequate vitamin D levels make it difficult to provide guidelines on how much sun exposure is required for sufficient vitamin D synthesis [ 15, 28]. Some expert bodies and vitamin D researchers suggest, for example, that approximately 5–30 minutes of sun exposure, particularly between 10 a.m. and 4 p.m., either daily or at least twice a week to the face, arms, hands, and legs without sunscreen usually leads to sufficient vitamin D synthesis [ 13, 15, 28]. Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [ 13, 29].
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U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Prevent Skin Cancer . Washington, DC: U.S. Dept of Health and Human Services, Office of the Surgeon General; 2014. Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, et al. Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: A systematic review and meta-analysis. Am J Clin Nutr 2012;95:1357-64. [ PubMed abstract] The USPSTF evaluated 11 randomized clinical trials of vitamin D and/or calcium supplementation in a total of 51,419 healthy, community-dwelling adults aged 50 years and older who did not have osteoporosis, vitamin D deficiency, or prior fractures [ 75, 76]. It concluded that the current evidence was insufficient to evaluate the benefits and harms of supplementation to prevent fractures. In addition, the USPSTF recommended against supplementation with 10 mcg (400 IU) or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in this population, but it could not determine the balance of benefits and harms from higher doses.There have been some reports about vitamin D reducing the risk of coronavirus (COVID-19). But there is currently not enough evidence to support taking vitamin D solely to prevent or treat COVID-19. Good sources of vitamin D Taylor CL, Rosen CJ, Dwyer JT. Considerations in dietetic counseling for vitamin D. J Acad Nutr Diet 2019;119:901-9. [ PubMed abstract] The Department of Health and Social Care recommends that adults and children over 4 take a daily supplement containing 10 micrograms of vitamin D throughout the year if they:
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Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot CPGM. Cholecalciferol or 25-hydroxycholecalciferol supplementation does not affect muscle strength and physical performance in prefrail and frail older adults. J Nutr 2018;148:712-20. [ PubMed abstract] A vitamin D intake of 8.5-10mcg (micrograms) per day is recommended for infants less than one year old, and an intake of 10mcg is recommended for everyone else. Experts have provided the following advice about supplementation: Chalcraft JR, Cardinal LM, Wechsler PJ, Hollis BW, Gerow KG, Alexander BM, et al. Vitamin D synthesis following a single bout of sun exposure in older and younger men and women. Nutrients 2020; 12, 2237; doi:10.3390/nu12082237. [ PubMed abstract] Yin L, Ordonez-Mena JM, Chen T, Schottker B, Arndt V, Brenner H. Circulating 25-hydroxyvitamin D serum concentration and total cancer incidence and mortality: A systematic review and meta-analysis. Preventive Medicine 2013;57:753-64. [ PubMed abstract]Assessing vitamin D status by measuring serum 25(OH)D concentrations is complicated by the considerable variability of the available assays (the two most common ones involve antibodies or chromatography) used by laboratories that conduct the analyses [ 5, 6]. As a result, a finding can be falsely low or falsely high, depending on the assay used and the laboratory. The international Vitamin D Standardization Program has developed procedures for standardizing the laboratory measurement of 25(OH)D to improve clinical and public health practice [ 5, 7-10]. For information on vitamin D and COVID-19, see Dietary Supplements in the Time of COVID-19. Introduction From about late March/early April to the end of September, most people should be able to make all the vitamin D they need from sunlight. Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL). One nmol/L = 0.4 ng/mL, and 1 ng/mL = 2.5 nmol/L.
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Vitamin D (also referred to as "calciferol") is a fat-soluble vitamin that is naturally present in a few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet (UV) rays from sunlight strike the skin and trigger vitamin D synthesis. The health and well-being of your family and loved ones is the most important thing for you – so it is for us. Optimal serum concentrations of 25(OH)D for bone and general health have not been established because they are likely to vary by stage of life, by race and ethnicity, and with each physiological measure used [ 1, 13, 14]. In addition, although 25(OH)D levels rise in response to increased vitamin D intake, the relationship is nonlinear [ 1]. The amount of increase varies, for example, by baseline serum levels and duration of supplementation. Recommended Intakes Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: Current status and data needs. Am J Clin Nutr 2004;80:1710S-6S. [ PubMed abstract]
Should I take a vitamin D supplement?
Simon AE, Ahrens KA. Adherence to vitamin D intake guidelines in the United States. Pediatrics 2020;145:e20193574. [ PubMed abstract]
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The combination of high intakes of calcium (about 2,100 mg/day from food and supplements) with moderate amounts of vitamin D (about 19 mcg [765 IU]/day from food and supplements) increased the risk of kidney stones by 17% over 7 years among 36,282 postmenopausal women who were randomly assigned to take 1,000 mg/day calcium and 10 mcg (400 IU)/day vitamin D or a placebo [ 161]. However, other, shorter (from 24 weeks to 5 years) clinical trials of vitamin D supplementation alone or with calcium in adults found greater risks of hypercalcemia and hypercalciuria, but not of kidney stones [ 162, 163]. Some people will not make enough vitamin D from sunlight because they have very little or no sunshine exposure. Davis CD, Dwyer JT. The 'sunshine vitamin': benefits beyond bone? J Natl Cancer Inst 2007;99:1563-5. [ PubMed abstract] Vitamin D keeps our bones healthy by helping to control the amount of calcium and phosphate in our bodies. It also appears to keep our muscles healthy too. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis Overview.
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Logan VF, Gray AR, Peddie MC, Harper MJ, Houghton LA. Long-term vitamin D3 supplementation is more effective than vitamin D2 in maintaining serum 25-hydroxyvitamin D status over the winter months. Br J Nutr 2013;109:1082-8. [ PubMed abstract]
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