Skip to main content

Advertisement

Log in

Vitamin D: do we get enough?

A discussion between vitamin D experts in order to make a step towards the harmonisation of dietary reference intakes for vitamin D across Europe

  • Opinion Paper
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

On September 29, 2011, acknowledged experts in the field of vitamin D, mainly European, were brought together in order to discuss the recent scientific advances in relation to vitamin D: the current requirements and associations with various health outcomes. In this article, the discussions resulting from the meeting are summarized.

Introduction

Several groups at risk for developing vitamin D insufficiency have been identified. Accordingly, reviews indicate that a significant percentage of the population worldwide have serum 25-hydroxyvitamin D levels below 50 nmol/l. In addition to the role of vitamin D in bone health, recent studies suggest that it may play a pivotal role in other systems, e.g., the cardiovascular system, pancreas, muscle, immune system and brain. Most evidence, however, is obtained from observational studies and yet inconclusive.

Methods

To exchange and broaden knowledge on the requirements for vitamin D and its effect on various health outcomes, a workshop entitled “Vitamin D Expert Meeting: Do we get enough?”, was organized.

Results

Despite low vitamin D levels worldwide, consensus on the definition of deficiency is not yet reached. In order to define cut-off points for vitamin D whilst taking into account extraskeletal health effects, randomized controlled trials in these fields are warranted. The experts do emphasize that there is evidence to suggest an important role for vitamin D in the maintenance of optimal bone health at all ages and that vitamin D supplementation, in most studies co-administered with calcium, reduces fracture risk in the senior population.

Conclusion

To reach a serum 25-hydroxyvitamin D level of 50 nmol/l older adults aged ≥65 years are therefore recommended to meet a mean daily vitamin D intake of 20 μg (800 IU), which is best achieved with a supplement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Mithal A, Wahl DA, Bonjour JP et al (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820

    Article  PubMed  CAS  Google Scholar 

  2. Holick MF (2007) Vitamin D deficiency. New Engl J Med 357:266–281

    Article  PubMed  CAS  Google Scholar 

  3. van Schoor NM, Lips P (2011) Worldwide vitamin D status. Best practice & research Clinical endocrinology & metabolism 25:671–680

    Article  Google Scholar 

  4. Bischoff-Ferrari HA, Can U, Staehelin HB, Platz A, Henschkowski J, Michel BA, Dawson-Hughes B, Theiler R (2008) Severe vitamin D deficiency in Swiss hip fracture patients. Bone 42:597–602

    Article  PubMed  CAS  Google Scholar 

  5. LeBoff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J (1999) Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 281:1505–1511

    Article  PubMed  CAS  Google Scholar 

  6. Bouillon R, Bischoff-Ferrari H, Willett W (2008) Vitamin D and health: perspectives from mice and man. J Bone Miner Res 23:974–979

    Article  PubMed  CAS  Google Scholar 

  7. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, Wong JB, Egli A, Kiel DP, Henschkowski J (2009) Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 339:b3692

    Article  PubMed  CAS  Google Scholar 

  8. Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds) (2011) Dietary reference intakes for calcium and vitamin D

  9. Muir SW, Montero-Odasso M (2011) Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 59:2291–2300

    Article  PubMed  Google Scholar 

  10. Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, Lieben L, Mathieu C, Demay M (2008) Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 29:726–776

    Article  PubMed  CAS  Google Scholar 

  11. Balion C, Griffith LE, Strifler L, Henderson M, Patterson C, Heckman G, Llewellyn DJ, Raina P (2012) Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology 79:1397–1405

    Article  PubMed  CAS  Google Scholar 

  12. Mitri J, Muraru MD, Pittas AG (2011) Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr 65:1005–1015

    Article  PubMed  CAS  Google Scholar 

  13. Ascherio A, Munger KL, Simon KC (2010) Vitamin D and multiple sclerosis. Lancet Neurol 9:599–612

    Article  PubMed  Google Scholar 

  14. Grandi NC, Breitling LP, Brenner H (2010) Vitamin D and cardiovascular disease: systematic review and meta-analysis of prospective studies. Preventive medicine 51:228–233

    Article  PubMed  CAS  Google Scholar 

  15. Fleet JC, DeSmet M, Johnson R, Li Y (2012) Vitamin D and cancer: a review of molecular mechanisms. Biochem J 441:61–76

    Article  PubMed  CAS  Google Scholar 

  16. Zittermann A, Iodice S, Pilz S, Grant WB, Bagnardi V, Gandini S (2012) Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies. Am J Clin Nutr 95:91–100

    Article  PubMed  CAS  Google Scholar 

  17. Schottker B, Ball D, Gellert C, Brenner H (2012) Serum 25-hydroxyvitamin D levels and overall mortality. A systematic review and meta-analysis of prospective cohort studies. Ageing Research Reviews

  18. MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76:1536–1538

    Article  PubMed  CAS  Google Scholar 

  19. Holick MF (1995) Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 61:638S–645S

    PubMed  CAS  Google Scholar 

  20. DGE, OGE, SGE, SVE (2012) Referenzwerte für die Nährstoffzufuhr Vitamin D. In. Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung, Bonn

  21. Health Council of Belgium (2009) Voedingsaanbevelingen voor België. Hoge Gezondheidsraad, Brussels

  22. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930

    Article  PubMed  CAS  Google Scholar 

  23. Becker W (2005) New Nordic nutrition recommendations 2004. Physical activity as important as good nourishing food]. Lakartidningen 102:2760–2752

    Google Scholar 

  24. Health Council of the Netherlands (2012) Evaluation of the dietary reference values for vitamin D. In. The Hague, p 90

  25. Doets EL, de Wit LS, Dhonukshe-Rutten RA et al (2008) Current micronutrient recommendations in Europe: towards understanding their differences and similarities. Eur J Nutr 47(Suppl 1):17–40

    Article  PubMed  CAS  Google Scholar 

  26. Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE, Josse RG, Lips P, Morales-Torres J, Yoshimura N (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 21:1151–1154

    Article  PubMed  CAS  Google Scholar 

  27. Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326:469

    Article  PubMed  CAS  Google Scholar 

  28. Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822

    Article  PubMed  CAS  Google Scholar 

  29. Smith H, Anderson F, Raphael H, Maslin P, Crozier S, Cooper C (2007) Effect of annual intramuscular vitamin D on fracture risk in elderly men and women—a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology 46:1852–1857

    Article  PubMed  CAS  Google Scholar 

  30. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J (2009) Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med 169:551–561

    Article  PubMed  CAS  Google Scholar 

  31. Sai AJ, Walters RW, Fang X, Gallagher JC (2011) Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 96:E436–446

    Article  PubMed  CAS  Google Scholar 

  32. Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B (2004) Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med 116:634–639

    Article  PubMed  CAS  Google Scholar 

  33. Lips P, van Schoor NM (2011) The effect of vitamin D on bone and osteoporosis. Best practice & research Clinical endocrinology & metabolism 25:585–591

    Article  CAS  Google Scholar 

  34. Wahl DAC C,Ebeling PR, Eggersdorfer M, Hilger J, Hoffmann K, Josse R, Kanis JA, Mithal A, Pierroz DD, Stenmark J, Stöcklin E, Dawson-Hughes B (2012) A global representation of Vitamin D status in healthy populations. Archives of Osteoporosis

  35. Wang TJ, Zhang F, Richards JB et al (2010) Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet 376:180–188

    Article  PubMed  CAS  Google Scholar 

  36. Hypponen E (2010) Vitamin D and increasing incidence of type 1 diabetes—evidence for an association? Diabetes, obesity & metabolism 12:737–743

    Article  CAS  Google Scholar 

  37. Cooper JD, Smyth DJ, Walker NM et al (2011) Inherited variation in vitamin D genes is associated with predisposition to autoimmune disease type 1 diabetes. Diabetes 60:1624–1631

    Article  PubMed  CAS  Google Scholar 

  38. Hypponen E, Boucher BJ, Berry DJ, Power C (2008) 25-hydroxyvitamin D, IGF-1, and metabolic syndrome at 45 years of age: a cross-sectional study in the 1958 British Birth Cohort. Diabetes 57:298–305

    Article  PubMed  CAS  Google Scholar 

  39. Berry DJ, Hesketh K, Power C, Hypponen E (2011) Vitamin D status has a linear association with seasonal infections and lung function in British adults. Br J Nutr 1–8

  40. Lehouck A, Mathieu C, Carremans C, Baeke F, Verhaegen J, Van Eldere J, Decallonne B, Bouillon R, Decramer M, Janssens W (2012) High doses of vitamin d to reduce exacerbations in chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med 156:105–114

    Article  PubMed  Google Scholar 

  41. Rosen CJ, Abrams SA, Aloia JF et al (2012) IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 97:1146–1152

    Article  PubMed  CAS  Google Scholar 

  42. Bischoff-Ferrari HA, Willett WC, Orav EJ, Kiel DP, Dawson-Hughes B (2011) Re: Fall prevention with Vitamin D. Clarifications needed. http://wwwbmjcom/content/339/bmjb3692?tab=responses (access: Feb132012)

  43. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239

    Article  PubMed  Google Scholar 

  44. Glendenning P, Zhu K, Inderjeeth C, Howat P, Lewis JR, Prince RL (2012) Effects of three monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility and muscle strength in older postmenopausal women: a randomised controlled trial. J Bone Miner Res 27(1):170–176

    Google Scholar 

  45. Boonen S, Lips P, Bouillon R, Bischoff-Ferrari HA, Vanderschueren D, Haentjens P (2007) Need for additional calcium to reduce the risk of hip fracture with vitamin d supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 92:1415–1423

    Article  PubMed  CAS  Google Scholar 

  46. Cranney A, Horsley T, O'Donnell S et al (2007) Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 1–235

  47. Group D (2010) Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 340:b5463

    Article  Google Scholar 

  48. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370:657–666

    Article  PubMed  CAS  Google Scholar 

  49. Bischoff-Ferrari HA, Willett WC, Orav EJ et al (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367:40–49

    Article  PubMed  CAS  Google Scholar 

  50. Gallagher JC, Rosen C (2011) Institute of Medicine responds. Fall prevention with vitamin D. BMJ 342:d4046

    Article  PubMed  Google Scholar 

  51. da Silva JA (2011) Fall prevention with vitamin D. Clarifications needed, please. BMJ 342:d2602

    Article  PubMed  Google Scholar 

  52. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B (2005) Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA: the journal of the American Medical Association 293:2257–2264

    Article  CAS  Google Scholar 

  53. Heaney RP (2012) Vitamin D—baseline status and effective dose. N Engl J Med 367:77–78

    Article  PubMed  CAS  Google Scholar 

  54. Grey A, Bolland MJ, Reid IR (2012) Vitamin D dose requirements for fracture prevention. N Engl J Med 367:1367–1368, author reply 1369–1370

    Article  PubMed  Google Scholar 

  55. Ott SM (2012) Vitamin D dose requirements for fracture prevention. N Engl J Med 367:1367, author reply 1369–1370

    Article  PubMed  Google Scholar 

  56. Paterson CR (2012) Vitamin D dose requirements for fracture prevention. N Engl J Med 367:1368–1369, author reply 1370

    PubMed  Google Scholar 

  57. Rosen CJ, Mayne ST (2012) D IOMCoDRIfV, Calcium Vitamin D dose requirements for fracture prevention. The New England journal of medicine 367:1368, author reply 1369–1370

    PubMed  Google Scholar 

  58. Ceglia L, Harris SS (2012) Vitamin D and its role in skeletal muscle. Calcif Tissue Int

  59. Schott GD, Wills MR (1976) Muscle weakness in osteomalacia. Lancet 1:626–629

    Article  PubMed  CAS  Google Scholar 

  60. Bischoff HA, Stahelin HB, Dick W et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18:343–351

    Article  PubMed  CAS  Google Scholar 

  61. Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H (2009) Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int 20:315–322

    Article  PubMed  CAS  Google Scholar 

  62. Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C (2000) Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 15:1113–1118

    Article  PubMed  CAS  Google Scholar 

  63. Bischoff-Ferrari HA (2011) The role of falls in fracture prediction. Current osteoporosis reports 9:116–121

    Article  PubMed  Google Scholar 

  64. Stockton KA, Mengersen K, Paratz JD, Kandiah D, Bennell KL (2011) Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporos Int 22:859–871

    PubMed  CAS  Google Scholar 

  65. Freedman LP (1999) Transcriptional targets of the vitamin D3 receptor-mediating cell cycle arrest and differentiation. J Nutr 129:581S–586S

    PubMed  CAS  Google Scholar 

  66. Sorensen OH, Lund B, Saltin B, Andersen RB, Hjorth L, Melsen F, Mosekilde L (1979) Myopathy in bone loss of ageing: improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci 56:157–161

    PubMed  CAS  Google Scholar 

  67. Wang Y, DeLuca HF (2011) Is the vitamin d receptor found in muscle? Endocrinology 152:354–363

    Article  PubMed  CAS  Google Scholar 

  68. Baynes KC, Boucher BJ, Feskens EJ, Kromhout D (1997) Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia 40:344–347

    Article  PubMed  CAS  Google Scholar 

  69. Jarrett RJ, Murrells TJ, Shipley MJ, Hall T (1984) Screening blood glucose values: effects of season and time of day. Diabetologia 27:574–577

    Article  PubMed  CAS  Google Scholar 

  70. Pittas AG, Lau J, Hu FB, Dawson-Hughes B (2007) The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92:2017–2029

    Article  PubMed  CAS  Google Scholar 

  71. Brouwer-Brolsma EM, Feskens EJ, Steegenga WT, de Groot LC (2012) Associations of 25-hydroxyvitamin D with fasting glucose, fasting insulin, dementia and depression in European elderly: the SENECA study. Eur J Nutr

  72. Alvarez JA, Ashraf A (2010) Role of vitamin d in insulin secretion and insulin sensitivity for glucose homeostasis. Int J Endocrinol 2010:351385

    PubMed  Google Scholar 

  73. Poole KE, Loveridge N, Barker PJ, Halsall DJ, Rose C, Reeve J, Warburton EA (2006) Reduced vitamin D in acute stroke. Stroke; a journal of cerebral circulation 37:243–245

    Article  PubMed  CAS  Google Scholar 

  74. Llewellyn DJ, Langa KM, Lang IA (2009) Serum 25-hydroxyvitamin D concentration and cognitive impairment. J Geriatr Psychiatry Neurol 22:188–195

    Article  PubMed  Google Scholar 

  75. Llewellyn DJ, Lang IA, Langa KM, Melzer D (2010) Vitamin D and cognitive impairment in the elderly U.S. population. J Gerontol A Biol Sci Med Sci 66:59–65

    PubMed  Google Scholar 

  76. Buell JS, Dawson-Hughes B (2008) Vitamin D and neurocognitive dysfunction: preventing "D"ecline? Mol Aspects Med 29:415–422

    Article  PubMed  CAS  Google Scholar 

  77. Dickens AP, Lang IA, Langa KM, Kos K, Llewellyn DJ (2011) Vitamin D, cognitive dysfunction and dementia in older adults. CNS drugs 25:629–639

    Article  PubMed  CAS  Google Scholar 

  78. Llewellyn DJ, Lang IA, Langa KM, Muniz-Terrera G, Phillips CL, Cherubini A, Ferrucci L, Melzer D (2010) Vitamin D and risk of cognitive decline in elderly persons. Arch Intern Med 170:1135–1141

    Article  PubMed  CAS  Google Scholar 

  79. Slinin Y, Paudel ML, Taylor BC et al (2010) 25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men. Neurology 74:33–41

    Article  PubMed  CAS  Google Scholar 

  80. Bischoff-Ferrari HA, Shao A, Dawson-Hughes B, Hathcock J, Giovannucci E, Willett WC (2010) Benefit-risk assessment of vitamin D supplementation. Osteoporos Int 21:1121–1132

    Article  PubMed  CAS  Google Scholar 

  81. Priemel M, von Domarus C, Klatte TO et al (2010) Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res 25:305–312

    Article  PubMed  CAS  Google Scholar 

  82. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR (2010) Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691

    Article  PubMed  Google Scholar 

  83. Gallagher JC, Sai A, Templin T 2nd, Smith L (2012) Dose response to vitamin d supplementation in postmenopausal women: a randomized trial. Ann Intern Med 156:425–437

    Article  PubMed  Google Scholar 

  84. Jackson RD, LaCroix AZ, Gass M et al (2006) Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354:669–683

    Article  PubMed  CAS  Google Scholar 

  85. Macdonald HM, Mavroeidi A, Fraser WD et al (2010) Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern? Osteoporos Int 22:2461–2472

    Article  PubMed  Google Scholar 

  86. Heaney RP, Recker RR, Grote J, Horst RL, Armas LA (2011) Vitamin D(3) is more potent than vitamin D(2) in humans. J Clin Endocrinol Metab 96:E447–452

    Article  PubMed  CAS  Google Scholar 

  87. Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, Reitz R, Salameh W, Ameri A, Tannenbaum AD (2008) Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab 93:677–681

    Article  PubMed  CAS  Google Scholar 

  88. Haussler MR, Whitfield GK, Kaneko I, Haussler CA, Hsieh D, Hsieh JC, Jurutka PW Molecular mechanisms of vitamin D action. Calcif Tissue Int

  89. Prentice A, Goldberg GR, Schoenmakers I (2008) Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr 88:500S–506S

    PubMed  CAS  Google Scholar 

  90. Phinney KW, Bedner M, Tai SS et al (2012) Development and certification of a standard reference material for vitamin D metabolites in human serum. Anal Chem 84:956–962

    Article  PubMed  CAS  Google Scholar 

  91. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, Nickelsen T (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86:1212–1221

    Article  PubMed  CAS  Google Scholar 

  92. Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806

    Article  PubMed  CAS  Google Scholar 

  93. Hansen KE, Jones AN, Lindstrom MJ, Davis LA, Engelke JA, Shafer MM (2008) Vitamin D insufficiency: disease or no disease? J Bone Miner Res 23:1052–1060

    Article  PubMed  CAS  Google Scholar 

  94. Heaney RP (2007) The case for improving vitamin D status. J Steroid Biochem Mol Biol 103:635–641

    Article  PubMed  CAS  Google Scholar 

  95. Abrams SA, Griffin IJ, Hawthorne KM, Gunn SK, Gundberg CM, Carpenter TO (2005) Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents. J Clin Endocrinol Metab 90:5576–5581

    Article  PubMed  CAS  Google Scholar 

  96. Ooms ME, Lips P, Roos JC, van der Vijgh WJ, Popp-Snijders C, Bezemer PD, Bouter LM (1995) Vitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women. J Bone Miner Res 10:1177–1184

    Article  PubMed  CAS  Google Scholar 

  97. Peacock M, Liu G, Carey M, McClintock R, Ambrosius W, Hui S, Johnston CC (2000) Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab 85:3011–3019

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Dr Llewellyn is supported by the UK National Institute for Health Research (NIHR)-funded Peninsula Collaboration for Leadership in Applied Health Research and Care. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health. This work is also supported by grants to Dr Llewellyn from the Alzheimer's Association (NIRG-11-200737), the James Tudor Foundation, the Sir Halley Stewart Trust, the Norman Family Charitable Trust, Lord Clinton's Charitable Trust, the Royal Devon & Exeter Foundation Trust, the Peninsula Medical School Foundation and the Age Related Diseases and Health Trust. Brouwer-Brolsma is financially supported by Graduate School VLAG.

Attendees

Elske M Brouwer-Brolsma (Minutes secretary), Wageningen University, the Netherlands; Heike Annette Bischoff-Ferrari (Speaker), UniversitätsSpital Zurich, Switzerland; Roger Bouillon (Chair), Katholieke Universiteit Leuven; Edith JM Feskens (Chair), Wageningen University, the Netherlands; Chris J Gallagher (Speaker), Division of Endocrinology Creighton, United States of America; Elina Hypponen (Speaker), Institute of Child Health, United Kingdom; David J Llewellyn (Speaker), Institute of Biomedical and Clinical Sciences Peninsula College of Medicine and Dentistry University of Exeter Royal Devon and Exeter Hospital Barrack Road Exeter, United Kingdom; Elisabeth Stoecklin (Speaker), DSM Nutritional Products, Switserland; Susan Lanham-New (Speaker), University of Surrey, United Kingdom; Jutta Dierkes, University of Bergen, Norway; Arie K Kies, DSM Biotechnology Center, the Netherlands; Frans J Kok, Wageningen University, the Netherlands; Christel Lamberg-Allardt, University of Helsinki, Finland; Ulrich Moser, Switzerland; Henk van den Berg, the Netherlands; Stefan Pilz, Medical University of Graz, Austria; Wim H Saris, DSM Nutritional Products, the Netherlands; Natasja M van Schoor, VU University Medical Center, the Netherlands; Peter Weber, DSM Nutritional Products, Switzerland; Renger Witkamp, Wageningen University, the Netherlands; Armin Zittermann, Ruhr University Bochum, Germany; Lisette CPGM de Groot (Speaker), Wageningen University, the Netherlands.

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. M. Brouwer-Brolsma.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 37 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brouwer-Brolsma, E.M., Bischoff-Ferrari, H.A., Bouillon, R. et al. Vitamin D: do we get enough? . Osteoporos Int 24, 1567–1577 (2013). https://doi.org/10.1007/s00198-012-2231-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-012-2231-3

Keywords

Navigation