Obese need 2.5 times as much vitamin D as normals
- Normal weight Obese (50 ng = 125 nanomole)
The Importance of Body Weight for the Dose Response Relationship of Oral Vitamin D Supplementation and Serum 25-Hydroxyvitamin D in Healthy Volunteers
PLOS ONE, Published: November 05, 2014DOI: 10.1371/journal.pone.0111265
John Paul Ekwaru, Jennifer D. Zwicker, Michael F. Holick, Edward Giovannucci, Paul J. Veugelers
Unlike vitamin D recommendations by the Institute of Medicine, the Clinical Practice Guidelines by the Endocrine Society acknowledge body weight differentials and recommend obese subjects be given two to three times more vitamin D to satisfy their body's vitamin D requirement. However, the Endocrine Society also acknowledges that there are no good studies that clearly justify this. In this study we examined the combined effect of vitamin D supplementation and body weight on serum 25-hydroxyvitamin (25(OH)D) and serum calcium in healthy volunteers.
We analyzed 22,214 recordings of vitamin D supplement use and serum 25(OH)D from 17,614 healthy adult volunteers participating in a preventive health program. This program encourages the use of vitamin D supplementation and monitors its use and serum 25(OH)D and serum calcium levels. Participants reported vitamin D supplementation ranging from 0 to 55,000 IU per day and had serum 25(OH)D levels ranging from 10.1 to 394 nmol/L. The dose response relationship between vitamin D supplementation and serum 25(OH)D followed an exponential curve.
On average, serum 25(OH)D increased by 12.0 nmol/L per 1,000 IU in the supplementation interval of 0 to 1,000 IU per day
and by 1.1 nmol/L per 1,000 IU in the supplementation interval of 15,000 to 20,000 IU per day.
BMI, relative to absolute body weight, was found to be the better determinant of 25(OH)D.
Relative to normal weight subjects, obese and overweight participants had serum 25(OH)D that were on average 19.8 nmol/L and 8.0 nmol/L lower, respectively (P<0.001).
We did not observe any increase in the risk for hypercalcemia with increasing vitamin D supplementation.
We recommend vitamin D supplementation be 2 to 3 times higher for obese subjects and 1.5 times higher for overweight subjects relative to normal weight subjects.
This observational study provides body weight specific recommendations to achieve 25(OH)D targets.
Weights: 33.4% normal, 1.3% under, 36.9% over, 28.4% obese
'Even more vitamin D needed if
- Dark Skin color - will take longer to reach equilibrium
- Excess toxins such as DDT, PCB, Alcohol
- Health problems which consume Vitamin D
- Health problems which reduce the response of Vitamin D consumed
Especially problems of the Liver (even fatty liver) and Kidney
- Lacking Cofactors such as Magnesium and Omega-3
- Have a high amount of Vitamin A in diet (too much vitamin A blocks vitamin D)
- You are smoking – known to reduce dose/response by 20%
- Recent surgery/trauma – which consumes a lot of vitamin D
- Drugs being taken which reduce vitamin D levels - statins, chemotherapy, etc.
- Senior - Vitamin D is not as bio-available
- Using oil form of vitamin D (needs about 20% more)
- Obese need 2.5 IU of vitamin D per kg to increase 1 ng (about 3.4 X more) – RCT Sept 2013 higher than current study
- Obese need 2X as much vitamin D to get the same response – June 2012 similar to current study
- Obese may need 40 percent more vitamin D - RCT Aug 2014 lower than the current study
- How you might double your response to vitamin D
- Overview Obesity and Vitamin D contains the following summary
- FACT: People who are obese have less vitamin D in their blood
- FACT: Obese need a higher dose of vitamin D to get to the same level of vit D
- FACT: When obese people lose weight the vitamin D level in their blood increases
- FACT: Adding Calcium, perhaps in the form of fortified milk, often reduces weight
- FACT: 153 trials for vitamin D intervention of obesity as of Sept 2020
- FACT: Less weight gain by senior women with > 30 ng of vitamin D
- FACT: Dieters lost additional 5 lbs if vitamin D supplementation got them above 32 ng - RCT
- FACT: Obese lost 3X more weight by adding $10 of Vitamin D
- FACT: Those with darker skins were more likely to be obese Sept 2014
- OBSERVATION: Many mammals had evolved to add fat and vitamin D in the autumn
- and lose both in the Spring - unfortunately humans have forgotten to lose the fat in the Spring
- SUGGESTION: Probably need more than 4,000 IU to lose weight if very low on vitamin D due to
risk factors such as overweight, age, dark skin, live far from equator,shut-in, etc.
- Obesity category has
Obese need more Vitamin D: Volume dilution, IU per pound, or BMI – RCT Dec 2012 has the following chart
English BMI Formula
BMI = ( Weight in Pounds / ( Height in inches x Height in inches ) ) x 703
Metric BMI Formula
BMI = ( Weight in Kilograms / ( Height in Meters x Height in Meters ) )
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