An Appraisal to Address Health Consequences of Vitamin D Deficiency With Food Fortification and Supplements: Time to Act!

Abstract

A symposium entitled "Vitamin D in Prevention andTherapy" was held on May 4-5, 2022, in Homburg, Germany to discuss important new advances in the field, including identification of new vitamin D signaling pathways, of new biologic effects of vitamin D-compounds (e.g., on the microbiome), and convincing proof of the relevance of vitamin D deficiency for the risk and outcome of many chronic diseases, including cancer, cardio-vascular, auto-immune, metabolic, and infectious diseases. Concerning the COVID-19-pandemic, an inverse association between 25(OH)D serum concentrations and SARS-CoV-2-infections, morbidity, and mortality was shown. In relation to cancer, several meta-analyses recently demonstrated an association of vitamin D-supplementation with significantly decreased mortality rates, which presumably would reduce health care costs. Considering the impressive body of evidence and the high safety of oral supplementation and food fortification with vitamin D, it was concluded that there is now an urgent need to act. In many countries worldwide, health care authorities need to increase efforts to address vitamin Ddeficiency, e.g., via food fortification and/or supplementation with vitamin D, and/or promoting moderate UV-exposure. It was estimated that in many countries, vitamin D intakes of the order of appr. 1,000 IE (25 μg)/day would be needed to bring and/or keep the vast majority of people over a serum 25(OH)D threshold of 20 ng/ml (50 nmol/l), which would be difficult to obtain alone from food fortification. New developments in personalized medicine may represent helpful tools to identify populations at risk for vitamin D deficiency and their responsiveness to vitamin D treatment.

Association between serum 25-hydroxyvitamin D and prostate-specific antigen: a retrospective study in men without prostate pathology

“…However, PSA is not cancer-specific, so it may be elevated in other non-malignant conditions [ 7 ]. Some studies have reported the importance of a good vitamin D status to prevent development and progression of prostate cancer [ 3 ], so we decided to carry out the present work to study this relationship in men without prostatic pathologies or liver or kidney failure. The hypothesis of this work is that vitamin D deficiency may lead to an increase in PSA for two reasons: 1) because low vitamin D concentrations induce prostate cancer and, therefore, in the population with low vitamin D concentrations there are more individuals with undetected prostate cancer than when vitamin D is high and 2) because low vitamin D concentrations increase PSA.…”

“…The active hormone binds to the vitamin D receptor (VDR) to regulate calcium and phosphorus metabolism, which is essential for bone remodeling, reabsorption of calcium in the distal tubule and intestinal absorption of calcium and phosphorus [ 1 , 2 ]. Although 1,25(OH) 2 D is the active hormone, serum concentration of 25(OH)D represents the best laboratory parameter to evaluate the vitamin D status [ 3 ].…”

Asociación entre la 25-hidroxivitamina D y el antígeno prostático específico: un estudio retrospectivo en hombres sin patologías prostáticas

“…Sin embargo, el PSA no es un marcador específico del cáncer, por lo que puede hallarse elevado en otras patologías no malignas [ 7 ]. A la luz de que algunos estudios muestran la importancia de un buen estado de vitamina D para prevenir el desarrollo y progresión del cáncer de próstata [ 3 ], realizamos este estudio para analizar su relación en hombres sin patologías prostáticas ni insuficiencia hepática o renal. Partimos de la hipótesis de que la deficiencia de vitamina D podría provocar un aumento del PSA por dos razones: (1) porque las concentraciones bajas de vitamina D inducen el cáncer de próstata y, por lo tanto, en la población con concentraciones bajas de vitamina D, se encuentra un mayor número de individuos con cáncer de próstata no detectado, a diferencia de cuando la vitamina D es elevada; y (2) porque las concentraciones bajas de vitamina D aumentan los niveles de PSA.…”

“…La hormona activa se une al receptor de la vitamina D (VDR) para regular el metabolismo del calcio y del fósforo, lo que es esencial para la remodelación ósea, la reabsorción del calcio en el túbulo distal y la absorción intestinal del calcio y el fósforo [ 1 , 2 ]. Aunque 1,25(OH) 2 D es la hormona activa, la concentración sérica de 25(OH)D es el parámetro analítico que se utiliza habitualmente para evaluar el estado de vitamina D [ 3 ].…”

Oral supplementation of vitamin D is safe and can be an effective strategy to fill the nutritional gap

“…Food fortification, oral supplementation with vitamin D and/or moderate UV-exposure to stimulate vitamin D production in skin are rated as safe to improve the vitamin D status of the population. Considering the high prevalence of vitamin D deficiency worldwide and the resulting severe consequences for human health, experts recommend that vitamin D deficiency urgently needs to be addressed in many countries by governments and healthcare authorities (5,6,(15)(16)(17) .…”