A. Catharine Ross

Bio: A. Catharine Ross is an academic researcher from Pennsylvania State University. The author has contributed to research in topics: Retinoic acid & Retinol. The author has an hindex of 44, co-authored 169 publications receiving 13558 citations. Previous affiliations of A. Catharine Ross include Drexel University & Center of Molecular Immunology.

The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know

Abstract: This article summarizes the new 2011 report on dietary requirements for calcium and vitamin D from the Institute of Medicine (IOM). An IOM Committee charged with determining the population needs for these nutrients in North America conducted a comprehensive review of the evidence for both skeletal and extraskeletal outcomes. The Committee concluded that available scientific evidence supports a key role of calcium and vitamin D in skeletal health, consistent with a cause-and-effect relationship and providing a sound basis for determination of intake requirements. For extraskeletal outcomes, including cancer, cardiovascular disease, diabetes, and autoimmune disorders, the evidence was inconsistent, inconclusive as to causality, and insufficient to inform nutritional requirements. Randomized clinical trial evidence for extraskeletal outcomes was limited and generally uninformative. Based on bone health, Recommended Dietary Allowances (RDAs; covering requirements of ≥97.5% of the population) for calcium range...

Dietary Reference Intakes for Calcium and Vitamin D

Abstract: The charge to the committee (Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium) was to assess current relevant data and update, as appropriate, the DRIs (Dietary Reference Intakes) for vitamin D and calcium. The review was to include consideration of chronic disease indicators (e.g., reduction in risk of cancer) and other (non-chronic disease) indicators and health outcomes. The definitions of these terms are discussed below. Consistent with the framework for DRI development, the indicators to assess adequacy and excess intake were to be selected based on the strength and quality of the evidence and their demonstrated public health significance, taking into consideration sources of uncertainty in the evidence. Further, the committee deliberations were to incorporate, as appropriate, systematic evidence-based reviews of the literature.Specifically, in carrying out its work, the committee was to: Review evidence on indicators to assess adequacy and indicators to assess excess intake relevant to the general North American population, including groups whose needs for or sensitivity to the nutrient may be affected by particular conditions that are widespread in the population such as obesity or age-related chronic diseases. Special groups under medical care whose needs or sensitivities are affected by rare genetic disorders or diseases and their treatments were to be excluded; Consider systematic evidence-based reviews, including those made available by the sponsors as well as others, and carefully document the approach used by the committee to carry out any of its own literature reviews; Regarding selection of indicators upon which to base DRI values for adequate intake, give priority to selecting indicators relevant to the various age, gender, and life stage groups that will allow for the determination of an Estimated Average Requirement (EAR); Regarding selection of indicators upon which to base DRI values for upper levels of intake, give priority to examining whether a critical adverse effect can be selected that will allow for the determination of a so-called benchmark intake; Update DRI values, as appropriate, using a risk assessment approach that includes (1) identification of potential indicators to assess adequacy and excess intake, (2) selection of the indicators of adequacy and excess intake, (3) intake-response assessment, (4) dietary intake assessment, and (5) risk characterization. Identify research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating their public health implications.

The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D From the Institute of Medicine: What Clinicians Need to Know

Abstract: This report summarizes the findings of the 2011 Institute of Medicine Committee on dietary intake requirements for calcium and vitamin D in North America, and provides updated data from the previous Institute of Medicine report of 1997. The Committee extensively reviewed existing published evidence on dietary and supplemental intake requirements for calcium and vitamin D with respect to both skeletal health and extraskeletal chronic disease outcomes. Calcium and vitamin D intake requirements were examined for several risk indictors of bone and skeletal health as well as extraskeletal outcomes (including cancer, cardiovascular disease, diabetes, and autoimmune disorders, infectious diseases, neuropsychological function, and disorders of pregnancy). Recommended Dietary Allowance (RDA) was defined as the level of intake of calcium or serum 25-hydroxyvitamin D that would meet the requirements of at least 97.5% of the population. The available scientific data supported an important role for calcium and vitamin D in bone and skeletal health outcomes that was consistent with a cause-and-effect relationship. However, data from randomized clinical trials for extraskeletal health outcomes were limited and inconclusive regarding a possible relationship with calcium and vitamin D intake requirements, and no evidence was found for dose-response or other established criteria for cause-and-effect. For bone health outcome, RDAs of calcium ranged from 700 to 1300 mg/d for life-stage groups at ≥1 year of age, and RDAs of vitamin D were 600 IU/d for ages 1 to 70 years and 800 IU/d for ages ≥71 (corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/mL [50 nmol/L]). There was an assumption of minimal or no sun exposure for estimation of RDA levels because of the wide variation in vitamin D synthesis from ultraviolet light and concern over risk of skin cancer. No consistent evidence was found that dietary or supplemental intake of vitamin D levels above the RDA provides additional benefit for bone health or extraskeletal outcomes; several investigators have found an U-shaped curve for several outcomes related to vitamin D intake, with increased risks at both low and high levels. The findings of this report suggest that prevalence of vitamin D deficiency in North America has been overestimated. The data show that almost all individuals in this population meet their RDA for vitamin D.

IOM committee members respond to Endocrine Society vitamin D guideline.

Abstract: In early 2011, a committee convened by the Institute of Medicine issued a report on the Dietary Reference Intakes for calcium and vitamin D. The Endocrine Society Task Force in July 2011 published a guideline for the evaluation, treatment, and prevention of vitamin D deficiency. Although these reports are intended for different purposes, the disagreements concerning the nature of the available data and the resulting conclusions have caused confusion for clinicians, researchers, and the public. In this commentary, members of the Institute of Medicine committee respond to aspects of The Endocrine Society guideline that are not well supported and in need of reconsideration. These concerns focus on target serum 25-hydroxyvitamin D levels, the definition of vitamin D deficiency, and the question of who constitutes a population at risk vs. the general population.

Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline

Abstract: Objective: The objective was to provide guidelines to clinicians for the evaluation, treatment, and prevention of vitamin D deficiency with an emphasis on the care of patients who are at risk for deficiency. Participants: The Task Force was composed of a Chair, six additional experts, and a methodologist. The Task Force received no corporate funding or remuneration. Consensus Process: Consensus was guided by systematic reviews of evidence and discussions during several conference calls and e-mail communications. The draft prepared by the Task Force was reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee, Clinical Affairs Core Committee, and cosponsoring associations, and it was posted on The Endocrine Society web site for member review. At each stage of review, the Task Force received written comments and incorporated needed changes. Conclusions: Considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D, the Task Force recomme...

Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline (Journal of Clinical Endocrinology and Metabolism (2011) 96, (1911-1930))

Abstract: OBJECTIVE The objective was to provide guidelines to clinicians for the evaluation, treatment, and prevention of vitamin D deficiency with an emphasis on the care of patients who are at risk for deficiency. PARTICIPANTS The Task Force was composed of a Chair, six additional experts, and a methodologist. The Task Force received no corporate funding or remuneration. CONSENSUS PROCESS Consensus was guided by systematic reviews of evidence and discussions during several conference calls and e-mail communications. The draft prepared by the Task Force was reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee, Clinical Affairs Core Committee, and cosponsoring associations, and it was posted on The Endocrine Society web site for member review. At each stage of review, the Task Force received written comments and incorporated needed changes. CONCLUSIONS Considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D, the Task Force recommended supplementation at suggested daily intake and tolerable upper limit levels, depending on age and clinical circumstances. The Task Force also suggested the measurement of serum 25-hydroxyvitamin D level by a reliable assay as the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D(2) or vitamin D(3) was recommended for deficient patients. At the present time, there is not sufficient evidence to recommend screening individuals who are not at risk for deficiency or to prescribe vitamin D to attain the noncalcemic benefit for cardiovascular protection.