Studies & Science
Vitamin D insufficiency & deficiency statistics
Worldwide
“An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency (VDD)”
Nair R, Maseeh A. Vitamin D: The sunshine vitamin. J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506
Singapore
“Prevalence of suboptimal 25(OH)D concentration in the overall population was 76.1% (73.6%–78.5%), comprising 28.4% with insufficiency and 47.8% with deficiency.”
Man REK, Li LJ, Cheng CY, Wong TY, Lamoureux E, Sabanayagam C. Prevalence and determinants of suboptimal vitamin D levels in a multiethnic asian population. Nutrients. 2017;9(3). doi:10.3390/nu9030313
Europe
“According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%.”
Cashman KD, Dowling KG, Škrabáková Z, et al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr. 2016;103(4):1033-1044. doi:10.3945/ajcn.115.120873
USA
“Of the 4962 participants interviewed in this study by NHANES 2011-2012, 1981 (39.92%) were vitamin D deficient (serum levels less than 50 nmol/L)”
Parva NR, Tadepalli S, Singh P, et al. Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus. 2018;10(6). doi:10.7759/cureus.2741
Vitamin D & immune health
“Taking a vitamin D supplement can protect against ARIs. The strongest effects are seen when a daily or weekly supplement is given to people with the lowest vitamin D levels.”
Martineau AR, Jolliffe DA, Greenberg L, et al. Vitamin D supplementation to prevent acute respiratory infections: Individual participant data meta-analysis. Health Technol Assess (Rockv). 2019;23(2):1-44. doi:10.3310/hta23020
“Vitamin D contributes to the normal function of the immune system and healthy inflammatory response.”
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the substantiation of health claims related to vitamin D and normal function of the immune system and inflammatory response (ID 154, 159), maintenance of normal muscle function (ID 155) and maintenance of normal cardiovascular function (ID 159) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010; 8(2):1468.
“Here, we describe 1,25(OH)(2)D(3) as an immunomodulator targeting various immune cells, including monocytes, macrophages, dendritic cells (DCs), as well as T-lymphocytes and B-lymphocytes, hence modulating both innate and adaptive immune responses.”
Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: Modulator of the immune system. Curr Opin Pharmacol. 2010;10(4):482-496. doi:10.1016/j.coph.2010.04.001
“Vitamin D appears to play an important role in the regulation of innate immunity in the upper respiratory tract”
Bartley J. Vitamin D, innate immunity and upper respiratory tract infection. J Laryngol Otol. 2010;124(5):465-469. doi:10.1017/S0022215109992684
Vitamin D participates in the immune responses towards viral infections.
Greiller CL, Martineau AR. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients. 2015;7(6):4240-4270. doi:10.3390/nu7064240
Vitamin D & bone health
“It is clear that vitamin D is essential for bone health; with insufficient intakes resulting not only in the classical deficiency diseases of rickets and osteomalacia but also in increased bone metabolism and enhanced fracture risk”
Laird E, Ward M, McSorley E, Strain JJ, Wallace J. Vitamin D and bone health; Potential mechanisms. Nutrients. 2010;2(7):693-724. doi:10.3390/nu2070693
“Without an adequate calcium–phosphorus product (the value for calcium times the value for serum phosphorus), mineralization of the collagen matrix is diminished, leading to classic signs of rickets in children and osteomalacia in adults.”
Holick MF. Medical progress: Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281. doi:10.1056/NEJMra070553
Vitamin D & muscles
“Vitamin D deficiency is associated with muscle weakness and is common in elderly people.”
Janssen HC, Samson MM, Verhaar HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr . 2002;75(4):611-615. doi: 10.1093/ajcn/75.4.611
“A meta analysis of five randomized clinical trials (with a total of 1237 subjects) revealed that increased vitamin D intake reduced the risk of falls by 22% (pooled corrected odds ratio, 0.78; 95% CI, 0.64 to 0.92) as compared with only calcium or placebo.”
Holick MF. Medical progress: Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281. doi:10.1056/NEJMra070553
VItamin D & general health
“The consequences of vitamin D deficiency cannot be under estimated. There has been an association of vitamin D deficiency with a myriad of acute and chronic illnesses including preeclampsia, childhood dental caries, periodontitis, autoimmune disorders, infectious diseases, cardiovascular disease, deadly cancers, type 2 diabetes and neurological disorders.”
Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153-165. doi:10.1007/s11154-017-9424-1
“In addition to reducing the risk for bone disease, vitamin D plays a role in reduction of falls, as well as decreases in pain, autoimmune diseases, cancer, heart disease, mortality, and cognitive function.”
Stechschulte SA, Kirsner RS, Federman DG. Vitamin D: Bone and Beyond, Rationale and Recommendations for Supplementation. Am J Med. 2009;122(9):793-802. doi:10.1016/j.amjmed.2009.02.029
Who should take Vitamin D supplements
“Nonvertebral fracture prevention with vitamin D is dose dependent, and a higher dose should reduce fractures by at least 20% for individuals aged 65 years or older”
Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: A meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169(6):551-561. doi:10.1001/archinternmed.2008.600
Vitamin D & sunlight
“Clothing and glass absorbs all UVB radiation and therefore prevents vitamin D production during sun exposure”
Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153-165. doi:10.1007/s11154-017-9424-1
Vitamin D & food
Food is a poor source of Vitamin D
Holick MF. Medical progress: Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281. doi:10.1056/NEJMra070553
“Diet can help, but it's very hard to approach the new goals with food alone. Fish and shellfish provide natural vitamin D (oily fish are best), but you'll have to eat about 5 ounces of salmon, 7 ounces of halibut, 30 ounces of cod, or nearly two 8-ounce cans of tuna to get just 400 IU. An egg yolk will provide about 20 IU, but since it also contains nearly a day's quota of cholesterol, you can't very well use eggs to fill your tank with D”
Vitamin D and your health: Breaking old rules, raising new hopes - Harvard Health. https://www.health.harvard.edu/staying-healthy/vitamin-d-and-your-health-breaking-old-rules-raising-new-hopes. Accessed May 15, 2020.
Recommendations on Vitamin D by health authorities
England
“PHE is advising that 10 micrograms of vitamin D are needed daily to help keep healthy bones, teeth and muscles.”
PHE publishes new advice on vitamin D - gov.uk website. https://www.gov.uk/government/news/phe-publishes-new-advice-on-vitamin-d Accessed June 8, 2020.
Northern Ireland
“The Public Health Agency (PHA) is recommending that everyone take vitamin D supplements during the lockdown period to help keep bones, teeth and muscles healthy.”
PHA recommends daily vitamin D supplement during lockdown | Public Health Agency website. https://www.publichealth.hscni.net/news/pha-recommends-daily-vitamin-d-supplement-during-lockdown Accessed June 8, 2020.
Wales
“We are currently advising people to stay at home. For most people, this will mean being indoors for much of the day and it could mean that people are not getting enough vitamin D from exposure to sunshine.”
Vitamin D advice for everyone: coronavirus | gov.wales website. https://gov.wales/vitamin-d-advice-everyone-coronavirus#section-41645. Accessed June 8, 2020.
Scotland
“Everyone (including children) should consider taking a daily supplement containing 10 micrograms of vitamin D.”
Vitamin D: Advice for all age groups - gov.scot website. https://www.gov.scot/publications/vitamin-d-advice-for-all-age-groups/. Accessed June 8, 2020.
Dubai
“Older people aged 65 years and over and those who have little or no exposure to the sun should take a daily supplement containing 400 units (10mcg) of vitamin D”
Dubai Standards of Care-2017 (Management of Vitamin D Deficiency in Children and Adults). Dubai Healthcare Authority. https://www.isahd.ae/content/docs/DSC-management%20of%20vitamin%20D%20deficiency.pdf. Accessed June 8, 2020.
Canada
“If you are over 50 years old, Health Canada recommends that you take a daily vitamin D supplement of 400 IU (equivalent to 10 µg).”
Vitamin D - Health Canada website. https://www.canada.ca/en/health-canada/services/nutrients/vitamin-d.html. Accessed June 8, 2020.
Vitamin D & risk of side effects
“Toxicity from vitamin D supplementation is rare and consists principally of acute hypercalcemia, which usually results from doses that exceed 10,000 IU per day.”
Rosen CJ. Vitamin D insufficiency. N Engl J Med. 2011;364(3):248-254.doi:10.1056/NEJMcp1009570
Vitamin D 1000IU dose
“A circulating level of 25-hydroxyvitaminDof75 nmol/L, or 30 ng/mL, is required to maximize vitamin D’s beneficial effects for health. In the absence of adequate sun exposure, at least 800–1000 IU vitamin D3/d may be needed to achieve this in children and adults.”
Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080S-1086S. doi:10.1093/ajcn/87.4.1080S
“An intake of at least 1000iu is necessary to bring the vitamin D concentration in more than 50% of the population up to 75nmol/L”
“In order to bring at least 50% of the population up to 75 nmol/l, intakes for all adults should be at least 700–1000 IU Vitamin D per day.”
Bischoff-Ferrari HA. The 25-hydroxyvitamin D threshold for better health. J Steroid Biochem Mol Biol. 2007;103(3-5):614-619. doi:10.1016/j.jsbmb.2006.12.016
“Most adults under age 50 need 400-800 international units (IU) daily and most adults age 50 and older need 800-1,000 IU daily”
Get the Facts on Calcium and Vitamin D - National Osteoporosis Foundation website. https://www.nof.org/patients/treatment/calciumvitamin-d/get-the-facts-on-calcium-and-vitamin-d/. Accessed June 8, 2020.
Vitamin D & oil based formulation
“Vitamin D in an oil vehicle produced a greater 25(OH)D response than vitamin D in a powder or an ethanol vehicle in healthy subjects.”
Grossmann RE, Tangpricha V. Evaluation of vehicle substances on vitamin D bioavailability: A systematic review. Mol Nutr Food Res. 2010;54(8):1055-1061. doi:10.1002/mnfr.200900578
“It is concluded that although limited studies are available, vitamin D in an oil vehicle is more bioavailable than when incorporated in a powder-based vehicle (cellulose or lactose) or in ethanol.”
Borel P, Caillaud D, Cano NJ. Vitamin D bioavailability: State of the art. Crit Rev Food Sci Nutr. 2015;55(9):1193-1205. doi:10.1080/10408398.2012.688897