Vitamin D supplementation during pregnancy: Double‐blind, randomized clinical trial of safety and effectiveness
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It is concluded that vitamin D supplementation of 4000 IU/d for pregnant women is safe and most effective in achieving sufficiency in all women and their neonates regardless of race, whereas the current estimated average requirement is comparatively ineffective at achieving adequate circulating 25(OH)D concentrations, especially in African Americans.Abstract:
The need, safety, and effectiveness of vitamin D supplementation during pregnancy remain controversial. In this randomized, controlled trial, women with a singleton pregnancy at 12 to 16 weeks' gestation received 400, 2000, or 4000 IU of vitamin D3 per day until delivery. The primary outcome was maternal/neonatal circulating 25-hydroxyvitamin D [25(OH)D] concentration at delivery, with secondary outcomes of a 25(OH)D concentration of 80 nmol/L or greater achieved and the 25(OH)D concentration required to achieve maximal 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] production. Of the 494 women enrolled, 350 women continued until delivery: Mean 25(OH)D concentrations by group at delivery and 1 month before delivery were significantly different (p < 0.0001), and the percent who achieved sufficiency was significantly different by group, greatest in 4000-IU group (p < 0.0001). The relative risk (RR) for achieving a concentration of 80 nmol/L or greater within 1 month of delivery was significantly different between the 2000- and the 400-IU groups (RR = 1.52, 95% CI 1.24–1.86), the 4000- and the 400-IU groups (RR = 1.60, 95% CI 1.32–1.95) but not between the 4000- and. 2000-IU groups (RR = 1.06, 95% CI 0.93–1.19). Circulating 25(OH)D had a direct influence on circulating 1,25(OH)2D3 concentrations throughout pregnancy (p < 0.0001), with maximal production of 1,25(OH)2D3 in all strata in the 4000-IU group. There were no differences between groups on any safety measure. Not a single adverse event was attributed to vitamin D supplementation or circulating 25(OH)D levels. It is concluded that vitamin D supplementation of 4000 IU/d for pregnant women is safe and most effective in achieving sufficiency in all women and their neonates regardless of race, whereas the current estimated average requirement is comparatively ineffective at achieving adequate circulating 25(OH)D concentrations, especially in African Americans. © 2011 American Society for Bone and Mineral Researchread more
Citations
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Consensus Statement: Global Consensus Recommendations on Prevention and Management of Nutritional Rickets
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TL;DR: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents and implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.
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The Nonskeletal Effects of Vitamin D: An Endocrine Society Scientific Statement
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References
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Journal ArticleDOI
Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline
Michael F. Holick,Neil Binkley,Heike A. Bischoff-Ferrari,Catherine M. Gordon,David A. Hanley,Robert P. Heaney,M. Hassan Murad,Connie M. Weaver +7 more
TL;DR: 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.
Journal Article
Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline (Journal of Clinical Endocrinology and Metabolism (2011) 96, (1911-1930))
Michael F. Holick,Neil Binkley,Heike A. Bischoff-Ferrari,Catherine M. Gordon,David A. Hanley,Robert P. Heaney,M. Hassan Murad,Connie M. Weaver +7 more
TL;DR: The Task Force as discussed by the authors provided 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, based on systematic reviews of evidence and discussions during several conference calls and e-mail communications.
Journal ArticleDOI
Toll-Like Receptor Triggering of a Vitamin D-Mediated Human Antimicrobial Response
Philip T. Liu,Steffen Stenger,Huiying Li,Linda Wenzel,Belinda H. Tan,Stephan R. Krutzik,Maria Teresa Ochoa,Jürgen Schauber,Kent Wu,Christoph Meinken,Diane L. Kamen,Manfred Wagner,Robert Bals,Andreas Steinmeyer,Ulrich Zügel,Richard L. Gallo,David Eisenberg,Martin Hewison,Bruce W. Hollis,John S. Adams,Barry R. Bloom,Robert L. Modlin +21 more
TL;DR: The data support a link between TLRs and vitamin D–mediated innate immunity and suggest that differences in ability of human populations to produce vitamin D may contribute to susceptibility to microbial infection.
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Vitamin D Deficiency and Risk of Cardiovascular Disease
Thomas J. Wang,Michael J. Pencina,Sarah L. Booth,Paul F. Jacques,Erik Ingelsson,Katherine J. Lanier,Emelia J. Benjamin,Ralph B. D'Agostino,Myles Wolf,Ramachandran S. Vasan +9 more
TL;DR: Vitamin D deficiency is associated with incident cardiovascular disease and further clinical and experimental studies may be warranted to determine whether correction of vitamin D deficiency could contribute to the prevention of cardiovascular disease.
Journal ArticleDOI
Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents
Carol L. Wagner,Frank R. Greer +1 more
TL;DR: These revised guidelines for vitamin D intake for healthy infants, children, and adolescents are based on evidence from new clinical trials and the historical precedence of safely giving 400 IU of vitamin D per day in the pediatric and adolescent population.