A systematic review and meta-analysis of the response of serum 25-hydroxyvitamin D concentration to vitamin D supplementation from RCTs from around the globe
European Journal of Clinical Nutrition (2019)
Minjia Mo, Shijie Wang, Zun Chen, Xiamusiye Muyiduli, Shuojia Wang, Yu Shen, Bule Shao, Minchao Li, Danqing Chen, Zexin Chen & Yunxian Yu
This study accumulated a lot of RCT data for low, medium, and high doses, but apparently decided to not report on the medium and high doses because they could result in >50 ng/ml of vitamin D which they were told could be toxic, even though none of the studies found any evidence of toxicity
Summary of recommended RDA needed to get half of participants >30 ng
1340 IU for Children
2250 IU for Pregnant Women
2519 IU for Adults
797 IU for Seniors
Virtually all other analyses have found that pregnant women and seniors need MORE, not less than adults
- Is 50 ng of vitamin D too high, just right, or not enough
- 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018
- Overview Vitamin D Dose-Response
- Vitamin D math mistakes made by the IoM in 2010 – K Baggerly 2016-2017
- 3,000 IU is needed to get 97.5% of the population to 30ng
Download the PDF from Sci-Hub via VitaminDWiki
Background/Objectives
Optimal doses of vitamin D (VitD) supplement in different populations are unclear. We aim to evaluate the relationship between VitD supplementation and post-intervention serum 25-hydroxyvitamin D [25(OH)D] concentration, to provide a recommended dosage of VitD for achieving an optimal 25(OH)D concentration for different populations.
Subjects/Methods
Literature search was conducted in Embase, etc. Randomized controlled trials about VitD supplemental intakes and their effect on 25(OH)D concentration were enrolled. The effect on 25(OH)D concentration between different supplementation doses in each population group was compared by meta-analysis. Multivariate meta-regression model is utilized to establish reference intake dosage of VitD.
Results
A total of 136 articles were included about children (3–17 years), adults (18–64 years), postmenopausal women, the elderly ( >64 years), pregnant, or lactating women. Overall, intervention groups obtained higher 25(OH)D concentration than controls and there was obvious dose–response effect between intake dose and 25(OH)D concentration. Baseline 25(OH)D concentration and age were significant indicators for 25(OH)D concentration. To reach sufficient 25(OH)D concentration (75 nmol/L), the recommended VitD supplemental intakes was 1340 and 2250 IU/day for children and pregnant women, 2519 and 797 IU/day for European adults aged 18–64 and 65–85 years, 729, 2026, and 1229 IU/day for adults in North America, Asia and Middle East and Africa, respectively.
Conclusions
Regional- and age-specific recommended dosages of VitD supplements for population to achieve optimal 25(OH)D concentrations have been suggested.
Exact text clipped from PDF
Recommended dietary allowance (RDA) (IU/day) for achieving a serum 25(OH)D value of at least 75 nmol/L
With meta-regression models, linear relationships of total VitD supplemental dose, baseline 25(OH)D concentration, and age (for specific continents) vs. achieved 25(OH)D concentration in different populations (adults, children, and pregnant women) and geographical region (Middle East and Africa, Asia, Europe and North America) were produced (mean (95% lower CI) serum 25(OH)D (nmol/L) = p0 (VitD dose (100 IU/day)) + Pj (baseline 25(OH)D concentration (nmol/L)) + p2 (age (1-year-old)) + increment). As the baseline, 25(OH)D concentration of adults varied significantly across three different continents, which was an important factor in prediction of achieved 25(OH)D concentration. Based on the calculations made using multivariate meta-regression modeling, RDA, (the recommended VitD supplement dose needed to reach sufficient 25(OH)D concentrations (of 75 nmol/L)), were established for different populations across different continents for adults.
The WM of baseline 25(OH)D concentration was 54.8 nmol/L for children and the estimated achieved 25(OH)D concentration was 63.2 nmol/L with 600 IU/day VitD supplementation.
We also estimated intakes of VitD3 at a recommended 1340 (95% CI: 1044, 1887) IU/day to achieve adequate 25(OH)D concentrations in children.
For pregnant women with a WM baseline of 25(OH)D of 48.2 nmol/L, 2250 (95% CI: 1765, 3100) IU/day VitD were recommended for achieving sufficiency.
Because the increased 25(OH)D concentrations after supplemental VitD varied markedly with ages in European adults, RDAs were provided for each age group.
While the WM for a baseline 25(OH)D concentration of 50.9 nmol/L, the RDAs were 2519 (95% CI: 2202, 2943) and 797 (95% CI: 697, 931) U/ day for adults aged 18-64 years and 65-85 years, respectively.
For adults in North America and the Middle East and Africa with the WM baseline 25(OH)D concentrations of 65.6 and 45.5 nmol/L, the RDAs were 729 (95% CI: 582, 984) and 1229 (95%CI: 739, 3656) IU/day. With WM baseline of 25(OH)D concentration in Asian adults of 36.5 nmol/L, the RDA was 2026 (95% CI: 1522, 3030) IU/day.
There have actually been
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