Individual participant data (IPD)-level meta-analysis of randomised controlled trials to estimate the vitamin D dietary requirements in dark-skinned individuals resident at high latitude
European Journal of Nutrition (2021) https://doi.org/10.1007/s00394-021-02699-6
Kevin D. Cashman, Mairead E. Kiely, Rikke Andersen, Ida M. Grønborg, Inge Tetens, Laura Tripkovic, Susan A. Lanham-New, Christel Lamberg-Allardt, Folasade A. Adebayo, J. Christopher Gallagher, Lynette M. Smith, Jennifer M. Sacheck, Qiushi Huang, Kimmie Ng, Chen Yuan, Edward L. Giovannucci, Kumaravel Rajakumar, Charity G. Patterson, Inger Öhlund, Torbjörn Lind, Pia Karlsland Åkeson & Christian Ritz
Context and purpose
There is an urgent need to develop vitamin D dietary recommendations for dark-skinned populations resident at high latitude. Using data from randomised controlled trials (RCTs) with vitamin D3-supplements/fortified foods, we undertook an individual participant data-level meta-regression (IPD) analysis of the response of wintertime serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among dark-skinned children and adults residing at ≥ 40° N and derived dietary requirement values for vitamin D.
Methods
IPD analysis using data from 677 dark-skinned participants (of Black or South Asian descent; ages 5–86 years) in 10 RCTs with vitamin D supplements/fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D intake estimates across a range of 25(OH)D thresholds.
Results
To maintain serum 25(OH)D concentrations ≥ 25 and 30 nmol/L in 97.5% of individuals, 23.9 and 27.3 µg/day of vitamin D, respectively, were required among South Asian and 24.1 and 33.2 µg/day, respectively, among Black participants. Overall, our age-stratified intake estimates did not exceed age-specific Tolerable Upper Intake Levels for vitamin D.
The vitamin D intake required by dark-skinned individuals to maintain 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L was 66.8 µg/day. This intake predicted that the upper 2.5% of individuals could potentially achieve serum 25(OH)D concentrations ≥ 158 nmol/L, which has been linked to potential adverse effects in older adults in supplementation studies.
Note by VitamindDWiki - A dose of Vitamin D is <1/2 as available in seniors, so senior toxicity is not a problem
Conclusions
Our IPD-derived vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25, 30 and 50 nmol/L are substantially higher than the equivalent estimates for White individuals. These requirement estimates are also higher than those currently recommended internationally by several agencies, which are based predominantly on data from Whites and derived from standard meta-regression based on aggregate data. Much more work is needed in dark-skinned populations both in the dose–response relationship and risk characterisation for health outcomes.
Trail registration
PROSPERO International Prospective Register of Systematic Reviews (Registration Number: CRD42018097260)
Code availability
The R code for fitting linear and nonlinear models is presented in Cashman KD, Ritz C (2019). Individual participant data (IPD)-level meta-analysis of randomised controlled trials among dark-skinned populations to estimate the dietary requirement for vitamin D. Syst Rev 8:128. https://doi.org/10.1186/s13643-019-1032-6.
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VitaminDWiki
- Hypertension not controlled by 26 ng of Vitamin D (50,000 IU bi-weekly A-A) – RCT Nov 2017
- 5,000 IU daily or 50,000 IU Vitamin D weekly repleted many dark skinned adolescents – RCT Dec 2015
- Many healthy African Americans got above 33 ng with 4,000 IU of vitamin D – RCT March 2014
Overview Dark Skin and Vitamin D contains the following summary
FACT - - People with dark skins have more health problems and higher mortality rate than those with light skins
FACT - - People with dark skins have low levels of vitamin D
FACT - - People with light skins who have low vitamin D have health problems
OBSERVATION - - The health problems of whites with low level of vitamin D are similar to those with dark skins
CONCLUSION - - People with dark skins have more health problems due to low levels of vitamin D
African American Health Disparities are associated with low Vitamin D - Grant Feb 2021
Low Vitamin D increases health problems - independent of skin color
Other
- Suspect >2X larger dose would be needed to get to 40 ng
- Suspect >2X larger dose would be needed if also obese or elderly
- Predict Vitamin D category listing has
82 items - Vitamin D Nutrigenomics - High, Medium, and Low Responders - March 2019
Note: Vitamin D levels need to be >30 ng in those with poor Vitamin D Genes
Genes and Dark Skin- - - - - - -
- Race changes the risk of various health problems, but many questions remain – Sept 2018
- Colon cancer more likely in blacks due to differences in Vitamin D genes (wonder if more Vitamin D would help) – May 2014
- Increased risk of multiple sclerosis risk in African Americans due to genes – June 2013
- Lupus in blacks associated with low vitamin D AND short telomeres – May 2013
- Genes in white blood cells of blacks associated with vitamin D deficiency – May 2013
- Vitamin D Receptor genes bb and BB and Osteoporosis, esp. for blacks – meta-analysis Nov 2012
- Genes may account for some of AA Breast Cancer – April 2012
- Genetic differences explain some of vitamin D variation in African-Americans Dec 2011
- Race vs vitamin D level - Veith May 2011
- Blacks may not need as much Vitamin D (for their bones)
- Hypothesis of Diet disease and pigment variation in humans – April 2010
- The more the African Ancestry, the lower the vitamin D level – July 2010
- Epigenetics and vitamin D – June 2010 clips from the web
Vitamin D Binding Protein and Dark Skin- - - - - - -
- T1 Diabetes 6.5 X more likely in South African Blacks if poor Vitamin D Binding Protein – July 2022
- Sweat types, folate, binding protein, lighter skin in females and Vitamin D – Jan 2020
- 10 reasons for poor response to Vitamin D (race, binding protein, etc.) – Nov 2017
- Prostate Cancer risk in black men increased 2X having poor Vitamin D Binding Protein – July 2017
- 5,000 IU daily or 50,000 IU Vitamin D weekly repleted many dark skinned adolescents – RCT Dec 2015
- Bioavailable Vitamin D is the same blacks and whites, but measured vit D is not – Oct 2014
- Blacks have lower vitamin D levels, but OK active vitamin D levels (VDBP) - Feb 2015
- Vitamin D-binding protein and vitamin D status of black Americans and white Americans – Nov 2013
Vitamin D Receptor and Dark Skin- - - - - - -
- Cancers and Vitamin D Receptors, including change with race – Feb 2021
- TB risk in Blacks increased 20 percent having poor Vitamin D Receptors – Sept 2017
- Raised skin scars (keloid) have fewer Vitamin D Receptors – Aug 2017
- Prostate cancer in black men is 1.6 times more likely if a poor Vitamin D Receptor – Feb 2017
- Aggressive Prostate Cancer in blacks with low vitamin D – 7X more likely if added Calcium – Jan 2017
- 2X less prostate cancer in A-A with low Calcium is due vitamin D receptor gene – July 2013
- Vitamin D Receptor genes bb and BB and Osteoporosis, esp. for blacks – meta-analysis Nov 2012
2700 IU of vitamin D needed to get above 20 ng if dark-skinned and high latitude – Oct 2021Printer Friendly Follow this page for updates8135 visitors, last modified 17 Nov, 2022, This page is in the following categories (# of items in each category)Attached files
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