Optimum Vitamin D level: Evidence for 30 and 40 ng – Grant Aug 2013

Evidence that the minimum optimal serum 25(OH)D concentration is 30 ng/ml (or 40 ng/ml)
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Evidence that the minimum optimal serum 25(OH)D concentration is 30 ng/ml (or 40 ng/ml)

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center, P.O. Box 641603
San Francisco, CA 94164-1603, USA www.sunarc.org, wbgrant at infionline.net

From my review of the journal literature, 30 ng/ml is the minimum 25(OH)D concentration associated with optimal health. This value has been reported for pregnancy outcomes, breast cancer in case-control studies, colorectal cancer in case-control and cohort studies, cardiovascular disease, all-cause mortality rate, and agreed to in several reviews [Bischoff-Ferrari, 2006, 2008; Holick, 2011; Miller, 2011; Pérez-López, 2012; Souberbielle, 2010; Vieth, 2011].

The Institute of Medicine recommended 20 ng/ml in part since they accepted only randomized controlled trials (RCTs), and then, only for fractures [Ross, 2011]. They were using the tenets of “evidence based medicine”, which puts meta-analyses of RCTs as the strongest evidence. That approach may or may not be appropriate for pharmaceutical drugs [Biesalski et al., 2011; Hickey and Roberts, 2011], but is not appropriate for vitamin D, which is not a drug but a molecule largely derived from the interaction of solar ultraviolet-B (UVB) irradiance on 7-dehydrocholesterol in the skin. Thus, observational and ecological studies can provide much of the evidence.

One of the problems with nested case-control studies with long follow-up times is that serum 25(OH)D concentration changes with time, so the longer the follow-up time, the lower the beneficial effect found for 25(OH)D as I’ve demonstrated in two recent papers [Grant, 2011a, 2012a].

A problem with cross-sectional studies is that the disease state may influence the serum 25(OH)D concentration, for example, by making the person more likely to stay indoors.

The papers listed below provide some of the evidence, based primarily on observational studies with some cross-sectional studies and RCTs, for the minimum optimal serum 25(OH)D concentration is 30 ng/ml:

Arterial calcification [Naves-Diaz, 2013]
Asthma severity [Majak, 2012]
Athletic performance [Larson-Meyer, 2010, 2013; Udowenko, 2010]
Blood pressure [Larsen, 2012]
Bones, fractures [Bonnot, 2011; Carmel, 2012; Dawson-Hughes, 2012; Rizzoli, 2013; von Domarus, 2011]
Breast cancer from case-control studies [Abbas, 2008, 2008; Bilinski and Boyages, 2012; Crew, 2009; Fedirko, 2012; Grant, 2010, 2012b; Lowe, 2005]
Breast cancer survival [Bauer, 2013; Hatse, 2012; Tretli, 2012]
Cardiovascular disease [Anderson, 2010; Brøndum-Jacobsen, 2012; Kim, 2008; Liu, 2012; Riek, 2012; Vacek, 2012; Wang, 2012]
Cognitive decline [Slinin, 2012; Soni, 2012]
Colorectal cancer from case-control and cohort studies [Grant, 2010]
Cystic fibrosis [Tangpricha, 2012]
Dental caries [Grant, 2012; Schroth, 2012]
Diabetes mellitus [González-Molero, 2012; Pittas, 2012]
Function [Sohl, 2013]
Immune status [Dixon, 2012]
Insulin resistance [Heaney, 2013; Kelly, 2011; von Hurst, 2010]
Metabolic syndrome [Pacifico, 2011]
Mobility limitation, disability [Houston, 2012]
Mortality rate, all-cause [Schöttker, 2013; Signorello, 2012; Zittermann, 2012; ]
Multiple sclerosis [Holmøy, 2012]
Osteoarthritis of the hip [Chaganti, 2010]
Physical performance [Wicherts, 2007]
Pregnancy outcomes [Bodnar, 2007, 2009, 2010, 2013; Merewood, 2007; Principi, 2012; Whitehouse, 2012]
Quality of life [Ecemis, 2013]
Respiratory infections [Ginde, 2009; Science, 2013]
Review [Battault, 2012; Bischoff-Ferrari, 2010; Holick, 2011; Hossein-Nezhad, 2013; Pludowski, 2013; Souberbielle, 2010]
Tuberculosis [Nnoaham, 2008]

There is also evidence for beneficial effects near or above 40 ng/ml

Athletic performance [Larson-Meyer, 2013]
Bones [Binkley, 2012; Prieto-Alhambra, 2012]
Cancer [Lappe, 2007]
Chronic kidney disease [Kramer, 2012]
Crohn’s disease [Yang, 2013]
Depression [Jaddou, 2012]
Infections, hospital [Quraishi, 2013]
Multiple sclerosis [Pierrot-Deseilligny, 2012]
PTH [Lu, 2012; Valcour, 2012]
Pregnancy [Hollis, 2011; Hollis and Wagner, 2011; Morales, 2012]
Respiratory infections, acute [Sabetta, 2010]
Review [Grant, 2011b]
Systemic lupus erythematosus [Petri, 2013]

There are few data for health outcomes above 50 ng/ml.

The U-shaped 25(OH)D concentration-health outcomes showing generally do not report statistically significant findings. Other such findings are not supported by other studies for the same outcome, such as pancreatic and prostate cancer. There is one recent study from Denmark showing a J-shaped serum 25(OH)D concentration-all-cause mortality rate relation [Durup, 2012]. In my opinion, that finding was due to older people being informed that they had a vitamin D deficiency, perhaps due to a diagnosis of osteoporosis, and being advised to take vitamin D supplements. In support of this hypothesis, I note that two studies of frailty among elderly Americans determined four years after serum 25(OH)D concentration measurement found a linear inverse relation between frailty status and serum 25(OH)D concentration for men [Ensrud, 2011] but a U-shaped relation for women [Ensrud, 2010]. In the United States, women are much more likely to be diagnosed with osteoporosis and then be told to take vitamin D supplements than are men. As mentioned by Dr. Hypponen, there does not appear to be a mechanism to explain why serum 25(OH)D concentrations between, say, 50 ng/ml and 100 ng/ml, should be associated with increased risk of disease.

References

Abbas S, Chang-Claude J, Linseisen J. Plasma 25-hydroxyvitamin D and premenopausal breast cancer risk in a German case-control study. Int J Cancer. 2009 Jan 1;124(1):250-5.
Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss E, Flesch-Janys D, Chang-Claude J. Serum 25-hydroxyvitamin D and risk of postmenopausal breast cancer - results of a large case-control study. Carcinogenesis. 2008 Jan;29(1):93-9.
Anderson JL, May HT, Horne BD, Bair TL, Hall NL, Carlquist JF, Lappé DL, Muhlestein JB; Intermountain Heart Collaborative (IHC) Study Group. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol. 2010 Oct 1;106(7):963-8.
Battault S, Whiting SJ, Peltier SL, Sadrin S, Gerber G, Maixent JM. Vitamin D metabolism, functions and needs: from science to health claims. Eur J Nutr. 2013 Mar;52(2):429-41
Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL. Plasma Vitamin D Levels, Menopause, and Risk of Breast Cancer: Dose-Response Meta-Analysis of Prospective Studies. Medicine (Baltimore). 2013 May;92(3):123-31.
Biesalski HK, Aggett PJ, Anton R, Bernstein PS, Blumberg J, Heaney RP, Henry J, Nolan JM, Richardson DP, van Ommen B, Witkamp RF, Rijkers GT, Zöllner I. 26th Hohenheim Consensus Conference, September 11, 2010 Scientific substantiation of health claims: evidence-based nutrition. Nutrition. 2011 Oct;27(10 Suppl):S1-20.
Bilinski K, Boyages J. Association between 25-hydroxyvitamin D concentration and breast cancer risk in an Australian population: an observational case-control study. Breast Cancer Res Treat. 2013;137(2):599-607.
Binkley N, Lewiecki EM. Vitamin D and common sense. J Clin Densitom. 2011 Apr-Jun;14(2):95-9.
Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006 Jul;84(1):18-28. Review. Erratum in: Am J Clin Nutr. 2006 Nov;84(5):1253.
Bischoff-Ferrari HA, Shao A, Dawson-Hughes B, Hathcock J, Giovannucci E, Willett WC. Benefit-risk assessment of vitamin D supplementation. Osteoporos Int. 2010 Jul;21(7):1121-32.
Bischoff-Ferrari HA. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes. Adv Exp Med Biol. 2008;624:55-71.
Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92:3517–3522.
Bodnar LM, Catov JM, Zmuda JM, Cooper ME, Parrott MS, Roberts JM, et al. Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women. J Nutr. 2010;140:999–1006.
Bodnar LM, Krohn MA, Simhan HN. Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy. J Nutr. 2009;139:1157–1161.
Bodnar LM, Rouse DJ, Momirova V, Peaceman AM, Sciscione A, Spong CY, Varner MW, Malone FD, Iams JD, Mercer BM, Thorp JM Jr, Sorokin Y, Carpenter MW, Lo J, Ramin SM, Harper M; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations. Obstet Gynecol. 2013 Jun 5. [Epub ahead of print]
Bonnot O, Inaoui R, Raffin-Viard M, Bodeau N, Coussieu C, Cohen D. Children and adolescents with severe mental illness need vitamin D supplementation regardless of disease or treatment. J Child Adolesc Psychopharmacol. 2011 Apr;21(2):157-61.
Brøndum-Jacobsen P, Nordestgaard BG, Schnohr P, Benn M. 25-Hydroxyvitamin D and symptomatic ischemic stroke: An original study and meta-analysis. Ann Neurol. 2013 Jan;73(1):38-47.
Carmel AS, Shieh A, Bang H, Bockman RS. The 25(OH)D level needed to maintain a favorable bisphosphonate response is ≥33 ng/ml. Osteoporos Int. 2012 Oct;23(10):2479-87.
Chaganti RK, Parimi N, Cawthon P, Dam TL, Nevitt MC, Lane NE. Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: the osteoporotic fractures in men study. Arthritis Rheum. 2010 Feb;62(2):511-4.
Crew KD, Gammon MD, Steck SE, Hershman DL, Cremers S, Dworakowski E, Shane E, Terry MB, Desai M, Teitelbaum SL, Neugut AI, Santella RM. Association between plasma 25-hydroxyvitamin D and breast cancer risk. Cancer Prev Res (Phila Pa). 2009 Jun;2(6):598-604.
Dawson-Hughes B. What is the optimal dietary intake of vitamin D for reducing fracture risk? Calcif Tissue Int. 2013 Feb;92(2):184-90.
Dixon BM, Barker T, McKinnon T, Cuomo J, Frei B, Borregaard N, Gombart AF. Positive correlation between circulating cathelicidin antimicrobial peptide (hCAP18/LL-37) and 25-hydroxyvitamin D levels in healthy adults. BMC Res Notes. 2012 Oct 24;5:575.
Durup D, Jørgensen HL, Christensen J, Schwarz P, Heegaard AM, Lind B. A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD Study. J Clin Endocrinol Metab. 2012 Aug;97(8):2644-52.
Ecemis GC, Atmaca A. Quality of life is impaired not only in vitamin D deficient but also in vitamin D insufficient premenopausal women. J Endocrinol Invest. 2013 Mar 19. [Epub ahead of print]
Ensrud KE, Blackwell TL, Cauley JA, Cummings SR, Barrett-Connor E, Dam TT, Hoffman AR, Shikany JM, Lane NE, Stefanick ML, Orwoll ES, Cawthon PM; Osteoporotic Fractures in Men Study Group. Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study. J Am Geriatr Soc. 2011 Jan;59(1):101-6.
Ensrud KE, Ewing SK, Fredman L, Hochberg MC, Cauley JA, Hillier TA, Cummings SR, Yaffe K, Cawthon PM; Study of Osteoporotic Fractures Research Group. Circulating 25-hydroxyvitamin D levels and frailty status in older women. J Clin Endocrinol Metab. 2010 Dec;95(12):5266-73.
Fedirko V, Torres-Mejía G, Ortega-Olvera C, Biessy C, Angeles-Llerenas A, Lazcano-Ponce E, Saldaña-Quiroz VA, Romieu I. Serum 25-hydroxyvitamin D and risk of breast cancer: results of a large population-based case-control study in Mexican women. Cancer Causes Control. 2012;23(7): 1149-1162.
Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009 Feb 23;169(4):384-90.
González-Molero I, Rojo-Martínez G, Morcillo S, Gutiérrez-Repiso C, Rubio-Martín E, Almaraz MC, Olveira G, Soriguer F. Vitamin D and incidence of diabetes: a prospective cohort study. Clin Nutr. 2012 Aug;31(4):571-3.
Grant WB. (2010) Relation between prediagnostic serum 25-hydroxyvitamin D level and incidence of breast, colorectal, and other cancers. J Photochem Photobiol B, 2010;101(2):130–6.
Grant WB. (2011a) Effect of interval between serum draw and follow-up period on relative risk of cancer incidence with respect to 25-hydroxyvitamin D level; implications for meta-analyses and setting vitamin D guidelines, Dermatoendocrinol. 2011;3(3):199-204.
Grant WB. (2011b) An estimate of the global reduction in mortality rates through doubling vitamin D levels. Eur J Clin Nutr. 2011 September;65(9):1016-26.
Grant WB. (2012a) Effect of follow-up time on the relation between prediagnostic serum 25-hydroxyitamin D and all-cause mortality rate. Dermatoendocrinol. 2012;4(2):198-202.
Grant WB. (2012b) A review of the evidence regarding the solar ultraviolet-B–vitamin D–cancer hypothesis. Standardy Medyczne/Pediatria. 2012;9:610-9.
Grant WB. A review of the role of solar ultraviolet-B irradiance and vitamin D in reducing risk of dental caries. Dermatoendocrinol. 2011 Jul;3(3):193-8.
Hatse S, Lambrechts D, Verstuyf A, Smeets A, Brouwers B, Vandorpe T, Brouckaert O, Peuteman G, Laenen A, Verlinden L, Kriebitzsch C, Dieudonné AS, Paridaens R, Neven P, Christiaens MR, Bouillon R, Wildiers H. Vitamin D status at breast cancer diagnosis: correlation with tumor characteristics, disease outcome and genetic determinants of vitamin D insufficiency. Carcinogenesis. 2012 Jul;33(7):1319-26.
Heaney RP, French CB, Nguyen S, Ferreira M, Baggerly LL, Brunel L, Veugelers P. A novel approach localizes the association of vitamin d status with insulin resistance to one region of the 25-hydroxyvitamin d continuum. Adv Nutr. 2013 May 1;4(3):303-10.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2011 Jul;96(7):1911-30.
Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res. 2011 Oct;26(10):2341-57.
Hollis BW, Wagner CL. Vitamin D requirements and supplementation during pregnancy. Curr Opin Endocrinol Diabetes Obes. 2011 Dec;18(6):371-5.
Holmøy T, Kampman MT, Smolders J. Vitamin D in multiple sclerosis: implications for assessment and treatment. Expert Rev Neurother. 2012 Sep;12(9):1101-12.
Hong Z, Tian C, Zhang X. Dietary calcium intake, vitamin D levels, and breast cancer risk: a dose-response analysis of observational studies. Breast Cancer Res Treat. 2012 Nov;136(1):309-12.
Hossein-Nezhad A, Holick MF. Vitamin D for Health: A Global Perspective. Mayo Clin Proc. 2013;88(7):720-55.
Houston DK, Neiberg RH, Tooze JA, Hausman DB, Johnson MA, Cauley JA, Bauer DC, Shea MK, Schwartz GG, Williamson JD, Harris TB, Kritchevsky SB; for the Health ABC Study. Low 25-hydroxyvitamin D predicts the onset of mobility limitation and disability in community-dwelling older adults: The Health ABC Study. J Gerontol A Biol Sci Med Sci. 2013 Feb;68(2):181-187
Jaddou HY, Batieha AM, Khader YS, Kanaan SH, El-Khateeb MS, Ajlouni KM. Depression is associated with low levels of 25-hydroxyvitamin D among Jordanian adults: results from a national population survey. Eur Arch Psychiatry Clin Neurosci. 2012 Jun;262(4):321-7.
Kelly A, Brooks LJ, Dougherty S, Carlow DC, Zemel BS. A cross-sectional study of vitamin D and insulin resistance in children. Arch Dis Child. 2011 May;96(5):447-52.
Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ. Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol. 2008 Dec 1;102(11):1540-4.
Kramer H, Sempos C, Cao G, Luke A, Shoham D, Cooper R, Durazo-Arvizu R. Mortality rates across 25-hydroxyvitamin D (25[OH]D) levels among adults with and without estimated glomerular filtration rate <60 ml/min/1.73 m2: the third national health and nutrition examination survey. PLoS One. 2012;7(10):e47458.
Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91.
Larsen T, Mose FH, Bech JN, Hansen AB, Pedersen EB. Effect of cholecalciferol supplementation during winter months in patients with hypertension: a randomized, placebo-controlled trial. Am J Hypertens. 2012 Nov;25(11):1215-22.
Larson-Meyer E. Vitamin d supplementation in athletes. Nestle Nutr Inst Workshop Ser. 2013;75:109-21.
Larson-Meyer DE, Willis KS. Vitamin D and athletes. Curr Sports Med Rep. 2010 Jul-Aug;9(4):220-6.
Liu L, Chen M, Hankins SR, Nùñez AE, Watson RA, Weinstock PJ, Newschaffer CJ, Eisen HJ; Drexel Cardiovascular Health Collaborative Education, Research, and Evaluation Group. Serum 25-hydroxyvitamin D concentration and mortality from heart failure and cardiovascular disease, and premature mortality from all-cause in United States adults. Am J Cardiol. 2012 Sep 15;110(6):834-9.
Lowe LC, Guy M, Mansi JL, Peckitt C, Bliss J, Wilson RG, Colston KW. Plasma 25-hydroxy vitamin D concentrations, vitamin D receptor genotype and breast cancer risk in a UK Caucasian population. Eur J Cancer. 2005 May;41(8):1164-9.
Lu HK, Zhang Z, Ke YH, He JW, Fu WZ, Zhang CQ, Zhang ZL. High prevalence of vitamin D insufficiency in China: relationship with the levels of parathyroid hormone and markers of bone turnover. PLoS One. 2012;7(11):e47264.
Majak P, Jerzyńska J, Smejda K, Stelmach I, Timler D, Stelmach W. Correlation of vitamin D with Foxp3 induction and steroid-sparing effect of immunotherapy in asthmatic children. Ann Allergy Asthma Immunol. 2012 Nov;109(5):329-35.
Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009;94:940–945.
Miller PD. Vitamin D, calcium, and cardiovascular mortality: a perspective from a plenary lecture given at the annual meeting of the American Association of Clinical Endocrinologists. Endocr Pract. 2011 Sep-Oct;17(5):798-806.
Morales E, Guxens M, Llop S, Rodríguez-Bernal CL, Tardón A, Riaño I, Ibarluzea J, Lertxundi N, Espada M, Rodriguez A, Sunyer J; on behalf of the INMA Project. Circulating 25-hydroxyvitamin D3 in pregnancy and infant neuropsychological development. Pediatrics. 2012 Oct;130(4):e913-e920.
Naves-Díaz M, Cabezas-Rodríguez I, Barrio-Vázquez S, Fernández E, Díaz-López JB, Cannata-Andía JB. Low calcidiol levels and risk of progression of aortic calcification. Osteoporos Int. 2012 Mar;23(3):1177-82.
Nnoaham KE, Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol. 2008 Feb;37(1):113-9.
Pacifico L, Anania C, Osborn JF, Ferraro F, Bonci E, Olivero E, Chiesa C. Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol. 2011 Oct;165(4):603-11.
Pérez-López FR, Brincat M, Erel CT, Tremollieres F, Gambacciani M, Lambrinoudaki I, Moen MH, Schenck-Gustafsson K, Vujovic S, Rozenberg S, Rees M. EMAS position statement: Vitamin D and postmenopausal health. Maturitas. 2012 Jan;71(1):83-8.
Petri M, Bello KJ, Fang H, Magder LS. Vitamin D in Systemic Lupus Erythematosus: Modest Association With Disease Activity and the Urine Protein-to-Creatinine Ratio. Arthritis Rheum. 2013 Jul;65(7):1865-71.
Pierrot-Deseilligny C, Rivaud-Péchoux S, Clerson P, de Paz R, Souberbielle JC. Relationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients before and after vitamin D supplementation. Ther Adv Neurol Disord. 2012 Jul;5(4):187-98.
Pittas AG, Nelson J, Mitri J, Hillmann W, Garganta C, Nathan DM, Hu FB, Dawson-Hughes B; Diabetes Prevention Program Research Group. Plasma 25-hydroxyvitamin D and progression to diabetes in patients at risk for diabetes: an ancillary analysis in the Diabetes Prevention Program. Diabetes Care. 2012 Mar;35(3):565-73.
Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, Shoenfeld Y, Lerchbaum E, Llewellyn DJ, Kienreich K, Soni M. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-A review of recent evidence. Autoimmun Rev. 2013 Mar 28. doi:pii: S1568-9972(13)00040-2.
Prieto-Alhambra D, Servitja S, Javaid MK, Garrigós L, Arden NK, Cooper C, Albanell J, Tusquets I, Diez-Perez A, Nogues X. Vitamin D threshold to prevent aromatase inhibitor-related bone loss: the B-ABLE prospective cohort study. Breast Cancer Res Treat. 2012 Jun;133(3):1159-67.
Principi N, Bianchini S, Baggi E, Esposito S. Implications of maternal vitamin D deficiency for the fetus, the neonate and the young infant. Eur J Nutr. 2013 Apr;52(3):859-67.
Quraishi SA, Litonjua AA, Moromizato T, Gibbons FK, Camargo CA Jr, Giovannucci E, Christopher KB. Association between prehospital vitamin D status and hospital-acquired bloodstream infections. Am J Clin Nutr. 2013 Aug 14. [Epub ahead of print]
Riek AE, Sprague JE, Timpson A, de las Fuentes L, Bernal-Mizrachi L, Schechtman KB, Bernal-Mizrachi C. Vitamin D suppression of endoplasmic reticulum stress promotes an anti-atherogenic monocyte/macrophage phenotype in type 2 diabetic patients. Journal of Biological Chemistry vol. 2011;287 (46):38482-38494.
Rizzoli R, Boonen S, Brandi ML, Bruyère O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin. 2013 Apr;29(4):305-13.
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011 Jan;96(1):53-8.
Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin D and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010 Jun 14;5(6):e11088.
Schöttker B, Haug U, Schomburg L, Köhrle J, Perna L, Müller H, Holleczek B, Brenner H. Strong associations of 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer, and respiratory disease mortality in a large cohort study. Am J Clin Nutr. 2013 Apr;97(4):782-93.
Schroth RJ, Jeal NS, Kliewer E, Sellers EA. The relationship between vitamin D and severe early childhood caries: a pilot study. Int J Vitam Nutr Res. 2012 Feb;82(1):53-62.
Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M. Low Serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infect Dis. 2013 May 15. [Epub ahead of print]
Signorello LB, Han X, Cai Q, Cohen SS, Cope EL, Zheng W, Blot WJ. A prospective study of serum 25-hydroxyvitamin D levels and mortality among African Americans and non-African Americans. Am J Epidemiol. 2013 Jan 15;177(2):171-9.
Slinin Y, Paudel M, Taylor BC, Ishani A, Rossom R, Yaffe K, Blackwell T, Lui LY, Hochberg M, Ensrud KE; Study of Osteoporotic Fractures Research Group. Association between serum 25(OH) vitamin D and the risk of cognitive decline in older women. J Gerontol A Biol Sci Med Sci. 2012 Oct;67(10):1092-8.
Sohl E, van Schoor NM, de Jongh RT, Visser M, Deeg DJH, Lips P. Vitamin D status is associated with functional limitations and functional decline in older individuals. J Clin Endocrinol Metab. July 2013; epub
Soni M, Kos K, Lang IA, Jones K, Melzer D, Llewellyn DJ. Vitamin D and cognitive function. Scand J Clin Lab Invest Suppl. 2012 Apr;243:79-82.
Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guérin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: Recommendations for clinical practice. Autoimmun Rev. 2010 Sep;9(11):709-15.
Tangpricha V, Kelly A, Stephenson A, Maguiness K, Enders J, Robinson KA, Marshall BC, Borowitz D; Cystic Fibrosis Foundation Vitamin D Evidence-Based Review Committee. An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation. J Clin Endocrinol Metab. 2012 Apr;97(4):1082-93.
Tretli S, Schwartz GG, Torjesen PA, Robsahm TE. Serum levels of 25-hydroxyvitamin D and survival in Norwegian patients with cancer of breast, colon, lung, and lymphoma: a population-based study. Cancer Causes Control. 2012;23(2):363-70.
Udowenko M, Trojian T. Vitamin D: extent of deficiency, effect on muscle function, bone health, performance, and injury prevention. Conn Med. 2010 Sep;74(8):477-80.
Vacek JL, Vanga SR, Good M, Lai SM, Lakkireddy D, Howard PA. Vitamin D deficiency and supplementation and relation to cardiovascular health. Am J Cardiol. 2012;109(3):359-63.
Valcour A, Blocki F, Hawkins DM, Rao SD. Effects of age and serum 25-OH-vitamin D on serum parathyroid hormone levels. J Clin Endocrinol Metab. 2012 Nov;97(11):3989-95.
Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Pract Res Clin Endocrinol Metab. 2011 Aug;25(4):681-91.
von Domarus C, Brown J, Barvencik F, Amling M, Pogoda P. How much vitamin D do we need for skeletal health? Clin Orthop Relat Res. 2011 Nov;469(11):3127-33.
von Hurst PR, Stonehouse W, Coad J. Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial. Br J Nutr. 2010 Feb;103(4):549-55
Wang L, Song Y, Manson JE, Pilz S, März W, Michaëlsson K, Lundqvist A, Jassal SK, Barrett-Connor E, Zhang C, Eaton CB, May HT, Anderson JL, Sesso HD. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: A meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012 Nov 1;5(6):819-29.
Whitehouse AJ, Holt BJ, Serralha M, Holt PG, Kusel MM, Hart PH. Maternal serum vitamin D levels during pregnancy and offspring neurocognitive development. Pediatrics. 2012;129(3):485-93.
Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJ, Smit J, Knol DL, Lips P. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab. 2007 Jun;92(6):2058-65.
Yang L, Weaver V, Smith JP, Bingaman S, Hartman TJ, Cantorna MT. Therapeutic effect of vitamin d supplementation in a pilot study of Crohn's patients. Clin Transl Gastroenterol. 2013 Apr 18;4:e33.
Zittermann A, Iodice S, Pilz S, Grant WB, Bagnardi V, Gandini S. Vitamin D deficiency and mortality risk in the general population: A meta-analysis of prospective cohort studies. Am J Clin Nutr. 2012;95(1):91-100.