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SUMMARY AND BACKGROUND
"I believe that the evidence supports, very strongly, a higher figure of 30 nanograms per mL, based on the amount of [vitamin] D needed, and the circulating level needed, to lower risk of hip fracture, which is, of course, the main endpoint that everyone agrees with in the report." 2
- Bess Dawson-Hughes
"Even if you take the IOM very low bar, which I disagree with, of 20 [nanograms per mL], there is still, in that report, 11 percent of the European-American population, 54 percent of the African-American population, below that level. And that’s tens of millions of Americans below that level. And, to ignore them and say it’s no problem is a big mistake." 4
- Walter Willett
"We really don’t know enough about that to say anything conclusively right now. It’s one of the areas where we need further research." 8
- Patsy Brannon
"I do want to make the point that the RDAs are population, public health recommendations, which is very different from a medical model of whether a clinician would decide that they want to test an individual patient’s vitamin D level." 3
- JoAnn Manson
A long-awaited report from the Institute of Medicine (IOM), "Dietary Reference Intakes for Calcium and Vitamin D," calls for increasing daily vitamin D intake. Yet some experts say these new recommendations are still too low in vitamin D. Why do these nutrition specialists disagree? This Forum webcast examined the question, "Boosting Vitamin D: Not enough or too much?
Background
- Vitamin D and Prevention of Cancer — Ready for Prime Time?
- Perspective published in the March 23, 2011 issue of The New England Journal of Medicine. The Forum event's Expert Participant JoAnn Manson is lead author.
- Dietary Reference Intakes for Calcium and Vitamin D
- Institute of Medicine Report
- IOM Report Brief
- For Adult Bone Health, Too Low on Vitamin D — and Too Generous on Calcium
- Comment on the IOM Vitamin D and Calcium Recommendations by Heike Bischoff-Ferrari and Walter Willett
- Vitamin D: How Much Do I Need?
- The Nutrition Source, Harvard School of Public Health
- How Much Vitamin D? Why Many Experts Take Issue With The IOM's New Recommendations
- The Huffington Post
- More? Or less? Experts disagree about how much vitamin D and calcium you should get
- Boston.com
I've always found it intuitively wrong to believe that there is a one-size-fits-all 'level' of vitamin D for all ethnic groups or the need for supplementation of any sort. My ancestors, Northern Europeans, lived to a ripe old age without worrying about levels. All of our ancestors protected their skin from the sun and insects with clothing. There were no shorts or tank tops, they would have been thrown in jail for indecency.
Which brings me to my point. My father in law, who is now 93, has spent minimal time outside for the past 12 years. He eats meat, bread and fruit, does not eat dairy and few vegetables. His vitamin D level is normal. That's right, normal. Why? How is that possible, if all the research is correct?
It is an interesting paradox that sunscreen, while protecting from cancer-causing radiation, reduces the skin's capacity to synthesize vitamin D, vital to bone health. This creates a conundrum for dermatologists who, while looking out for one aspect of their patients' health, may be compromising another.
The effects of vitamin D supplementation on health is uncertain