Should healthy people take a vitamin D supplement in winter months?

Spector, Tim D.; Levy, Louis

doi:10.1136/bmj.i6183

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…In other words, vitamin D supplementation and/or lifestyle modification, such as increased outdoor activity with exposure to sunshine, could be considered in patients with mild OAB and vitamin D deficiency. As it is controversial to recommend vitamin D intake for healthy people in winter , encouraging sunlight exposure might be the best way to increase serum 25‐OH vitamin D level for patients in this clinical situation. In general, regular, short exposure to sunlight with unprotected skin is reported to be the best way for the body to synthesize vitamin D by sunlight exposure ; therefore, these methods could be recommended for these patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of serum 25‐OH vitamin D level on lower urinary tract symptoms in men: a step towards reducing overactive bladder

Yoo

Kim

et al. 2018

BJU International

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Section: Discussionmentioning

confidence: 99%

Impact of serum 25‐OH vitamin D level on lower urinary tract symptoms in men: a step towards reducing overactive bladder

Yoo

Kim

et al. 2018

BJU International

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“…[9] In general, increased exposure to sunshine and intake of food or supplements with high vitamin D content are recommended for maintaining sufficient vitamin D levels. [10] But, adolescents and young adults, who need to maintain maximum bone mass due to low activity and unbalanced dietary intake, are vulnerable to vitamin D deficiency. [1112] However, most studies on this subject have been limited to post-menopausal women and elderly patients and studies on nutritional intake are lack.…”

Section: Introductionmentioning

confidence: 99%

Is There a Difference in Serum Vitamin D Levels and Bone Mineral Density According to Body Mass Index in Young Adult Women?

et al. 2019

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Background: In the life cycle, bone mineral density (BMD) is the most optimal condition in the 20s. In Korea, vitamin D deficiency status is very serious in Korean women due to recent lack of activity, weight polarization, and inadequate nutritional intake. The purpose of this study was to compare serum vitamin D and BMD according to obesity status in Korean young adult women. Methods: A total of 143 female college students participated in the research. Body fat and lean body status were analyzed using a body composition analyzer. Nutrient intakes of the subjects were assessed by 3-days food record method. The BMDs was measured by dual energy X-ray absorptiometry. The subjects were divided into normal weight group and obesity group on their body mass index. Results: Obesity group showed significantly higher weight, body fat (%), and body fat (kg) than normal weight group and T-scores of lumbar-2 spines were significantly lower. Obesity group showed high triglyceride and low-density lipoprotein cholesterol levels and vitamin D levels were significantly lower. Physical fitness and activity status showed that sit and reach and sit up were significantly lower in obesity group. The intake of carbohydrates was higher in the obesity group than in the normal weight group, and the intake of vitamin C and vitamin D was significantly lower. Factors affecting serum vitamin D were analyzed as body fat (%), lumbar-2 T-score, triglyceride, and carbohydrate intake. Conclusions: Obese women need more effort to manage their serum vitamin D status and balanced nutrition to prevent bone loss.

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“…There is a wide difference in the recommended intakes of vitamin D in adults, ranging from 200 to 2000 IU daily [13], and the role of vitamin D in health has been under strong debate even in the UK where the relatively low dosage (400 IU daily) was selected by SACN [14][15][16][17][18][19]. Considering the marked seasonal difference in the association between S-25OHD levels and areal BMD [1], it is possible to interpret that the positive relationship between vitamin D status and areal BMD in many observational studies reflects the situation during summer; physical activity outdoors is a key factor, but its adjustment in the analysis would be difficult because only small number of cycles of mechanical loading is enough to maximally stimulate the skeleton [20].…”

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confidence: 99%

Vitamin D and bone health: interpreting observational studies

Sugiyama

2017

J Intern Med

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In a population-based cohort of approximately 5000 women (mean age 68 years), Micha€ elsson et al. [1] recently showed a marked seasonal difference in the association between serum 25-hydroxyvitamin D (S-25OHD) levels and areal bone mineral density (BMD) at the total hip, femoral neck and lumbar spine as well as of the total body. There was positive association between S-25OHD concentrations up to 40 nmol L À1 and areal BMD during summer. By sharp contrast, during winter, areal BMD was not associated with S-25OHD concentrations and similar between even below 20 nmol L À1 and over 80 nmol L À1. I agree with one reasonable explanation of the seasonal difference that a season-related dynamic process influenced the association between S-25OHD levels and areal BMD [1] and would also like to discuss this important evidence from another point of view.Of note, S-25OHD levels were predominantly linked to season-related ultraviolet type B (UV-B) radiation doses, and the difference during summer in areal BMD was relatively greater at the total hip and femoral neck compared with the lumbar spine [1]. The degree of mechanical loading is higher at the former sites than at the latter site, and skeletal loading from activity outdoors can be a major determinant of areal BMD. Consequently, the obvious seasonal discrepancy [1] seems to suggest that the association during summer could result from physical activity, whilst S-25OHD levels might not directly affect areal BMD.In consistent with the above logic, recent evidence is unlikely to support a cause and effect relationships between vitamin D status and musculoskeletal as well as nonmusculoskeletal [2] health in observational studies. For example, a Mendelian randomization study suggested that the association between genetically low vitamin D status and areal BMD was not causal [3], which agrees with the effect of vitamin D supplementation on areal BMD [4] and would be compatible with compensatory adaptation of bone to mechanical strain that is a prominent mechanism in the skeleton [5][6][7]. Furthermore, in the randomized, double-blind, placebo-controlled ViDA trial, monthly high-dose vitamin D supplementation of 100 000 IU colecalciferol for 3-4 years did not change the risk of fractures, and the result was independent of baseline S-25OHD levels including even less than 25 nmol L À1 and over 75 nmol L À1 [8]. The same interpretation can be applied to observational studies showing the association between use of proton pump inhibitors and an increased risk of hip fracture [9,10].As discussed by the authors [1], the effect of vitamin D supplementation on areal BMD appears to be indirect. On the basis of suggestion by the Scientific Advisory Committee on Nutrition (SACN) in adults aged 50 years or older that vitamin D supplementation improves muscle strength/function and increases areal BMD, especially at the femoral neck rather than total hip and notably not at the lumbar spine [11], we suggested that an increase in areal BMD by vitamin D supplementation can result indirectly fro...

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Should healthy people take a vitamin D supplement in winter months?

Cited by 11 publications

References 10 publications

Impact of serum 25‐OH vitamin D level on lower urinary tract symptoms in men: a step towards reducing overactive bladder

Impact of serum 25‐OH vitamin D level on lower urinary tract symptoms in men: a step towards reducing overactive bladder

Is There a Difference in Serum Vitamin D Levels and Bone Mineral Density According to Body Mass Index in Young Adult Women?

Vitamin D and bone health: interpreting observational studies

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