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Review of vitamin D recommendations around the world – April 2017

Comparative analysis of nutritional guidelines for vitamin D

Nature Reviews Endocrinology (2017), Published online 07 April 2017
Roger Bouillon
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Red = severe deficiency, must be corrected
Orange = mild deficiency, should be corrected
Green = sufficient, no more is needed
(Optimal is not shown)
Endocrine Society Recommentations
IOF = International Osteoporosis Foundation  IOF Position statement of 2010 is on VitaminDWiki
AGS = American Geriatric Society Recommendations

Number of countries recommending each dose for infants and children/youths
         age 0-1                   age 4-18

See also VitaminDWiki

Most countries continue to believe that only low levels of vitamin D are needed, so they only recommend low doses of vitamin D

Infant-Child category starts with

Having a good level of vitamin D cuts in half the amount of:

Need even more IUs of vitamin D to get a good level if;

  • Have little vitamin D: premie, twin, mother did not get much sun access
  • Get little vitamin D: dark skin, little access to sun
  • Vitamin D is consumed faster than normal due to sickness
  • Older (need at least 100 IU/kilogram, far more if obese)
  • Not get any vitamin D from formula (breast fed) or (fortified) milk
    Note – formula does not even provide 400 IU of vitamin D daily

Infants-Children need Vitamin D

Vitamin D is essential for calcium and bone homeostasis. Humans are largely dependent on UVB-radiation-induced photosynthesis of vitamin D, as few foods contain vitamin D. However, the same radiation that produces vitamin D is also carcinogenic, albeit with a long lag time, and causes DNA damage. In view of the increasing life expectancy, avoiding excessive sun exposure is prudent. Several groups of people have a shortfall between their requirements for vitamin D and their combined endogenous synthesis and intake from natural foods, and therefore need vitamin D supplementation. Governments and scientific societies are regularly updating their recommendations for intake of vitamin D, especially for groups that should (infants) or prefer to (especially elderly individuals) avoid direct sunlight. An overview of such guidelines is presented in this Review.

A fairly large consensus exists that all infants should receive 400 international units (IU) (10 μg) daily during their first year of life and that elderly individuals should have access to vitamin D supplementation (at recommended dosages varying from 400 IU to 800 IU daily in most governmental guidelines but at higher dosages in other guidelines).

All guidelines unanimously agree that serum levels of 25-hydroxyvitamin D (25OHD) <25 nmol/l (10 ng/ml) should be avoided at all ages. Children and adults who have limited sun exposure should receive vitamin D supplementation, but the recommended doses vary widely (from 200 IU to 2,000 IU daily), in line with disagreement regarding the minimal desirable serum concentration of 25OHD (which varies from 25 nmol/l to >100 nmol/l).

Attached files

ID Name Comment Uploaded Size Downloads
7917 IOF position statement 2010.pdf PDF admin 14 Apr, 2017 17:31 98.61 Kb 744
7916 Daily dose.jpg admin 13 Apr, 2017 22:17 22.98 Kb 1070
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