Elsevier

The Journal of Nutrition

Volume 136, Issue 4, April 2006, Pages 1135-1139
The Journal of Nutrition

Public Health Strategies to Overcome Barriers to Optimal Vitamin D Status in Populations with Special Needs1

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ABSTRACT

In North America, there is increasing public health awareness of the importance of adequate vitamin D intake to the maintenance of optimal vitamin D status and overall health. Experts now define this as circulating levels of 25-hydroxyvitamin D of 75–80 nmol/L. This serum level and high levels of dietary intake have been associated with significantly reduced risk of chronic diseases, such as osteoporosis, cardiovascular disease, diabetes, and some cancers. All of these diseases are more prevalent in the elderly of all races, and some are more prevalent and of greater severity among blacks than whites. Our objective is to review recent actions to increase public awareness of the health importance of maintaining optimal circulating 25(OH)D and potential strategies to increase vitamin D intake. Clinicians and educators are encouraged to promote improved vitamin D intake and status, particularly among the elderly and blacks. This will largely depend on combined efforts to judiciously fortify our food supply and to develop individual supplementation protocols for supplements or controlled use of UV light exposure to maintain optimal serum 25(OH)D, especially in high-risk groups. Growing evidence supports a low risk of toxicity with vitamin D use in fortification or supplementation, despite its past reputation of potential toxicity in excess. The cost to fortify food or supplements with vitamin D is relatively inexpensive compared with developing drugs used to treat or prevent chronic diseases; moreover, there is significant potential for broad health benefits in the reduced risk and prevention of multiple chronic diseases.

KEY WORDS

vitamin D
fortification
supplementation

Abbreviations

NHANES
National Health and Nutrition Examination Surveys
25(OH)D
25-hydroxyvitamin D

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1

Presented as part of the symposium “Optimizing Vitamin D Intake for Populations with Special Needs: Barriers to Effective Mechanisms of Food Fortification and Supplementation” given at the 2005 Experimental Biology meeting on April 4, 2005, San Diego, CA. The symposium was sponsored by the American Society for Nutrition and supported, in part, by educational grants from the Centrum Foundation of Canada, the Coca-Cola Company, and the Natural Ovens Bakery, Inc. The proceedings are published as a supplement to The Journal of Nutrition. This supplement is the responsibility of the guest editors to whom the Editor of The Journal of Nutrition has delegated supervision of both technical conformity to the published regulations of The Journal of Nutrition and general oversight of the scientific merit of each article. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publishers, editor, or editorial board of The Journal of Nutrition, and do not necessarily reflect those of the Food and Drug Administration. The guest editors for this symposium publication are Susan J. Whiting, College of Pharmacy and Nutrition, University of Saskatchewan, SK, Canada and Mona S. Calvo, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD, USA.