![]() ![]() Some authors recommend a 25(OH)D serum concentration above ≥ 50 nmol/L (20 ng/mL) as being optimal for health. German authorities also consider a value below 50 nmol/L to be insufficient. ![]() Vitamin D deficiency has been previously defined as a 25(OH)D serum concentration < 50 nmol/L (<20 ng/mL) and vitamin D insufficiency as a 25(OH)D serum concentration of 51–74 nmol/L (21–29 ng/mL). ![]() īecause of the high prevalence of vitamin D deficiency worldwide and because of the substantial consequences for human health, it is of high importance to obtain reliable data concerning vitamin D status and vitamin D supply in individual populations. Two recent randomized controlled trials reported in the secondary analyses that cancer and progression to diabetes were reduced for those with BMI <25 and <30, respectively (for 20 IU per day vitamin D 3 intake, respectively (1 IU is equivalent to 0.025 µg)). ‘Worst-best case’ and ‘best-worst case’ scenario analyses demonstrated that vitamin D could be associated with a dramatic increase or decrease in mortality. As an example, in a systematic review that updated and reassessed the benefits and harms of vitamin D supplementation used in primary and secondary prophylaxis of mortality, vitamin D supplementation decreased mortality in all 56 trials analyzed together (5,920/47,472 (12.5%) vs. Notably, the causal relationship between vitamin D status and health has convincingly been demonstrated for many outcomes, including overall mortality. Beyond the well-known key role of vitamin D in calcium homeostasis and bone health, it has been shown that vitamin D deficiency is associated with a broad variety of independent diseases, including several types of cancer, cardio-vascular, autoimmune and infectious diseases. Because an increasing body of evidence has convincingly demonstrated that vitamin D deficiency is very common worldwide, it is the aim of this paper to (i) give an update of the vitamin D status in a population with a western diet, namely, the German population, and to (ii) develop strategies to optimize the vitamin D supply that consider both the advantages as well as the disadvantages/risks of different approaches, including increasing vitamin D status by dietary intake, by supplements, or by UVB-induced cutaneous synthesis of vitamin D.ĭuring the last decade, our scientific knowledge of the pleiotropic biological effects of vitamin D metabolites and their relevance to human health has expanded widely. ![]() However, only a few natural foods contain substantial amounts of vitamin D, and in most populations, the dietary source of vitamin D cannot fulfill the body´s requirements. In addition to UVB-induced vitamin D production in skin, in humans, there are two other possible sources of vitamin D: from diet and supplements. However, this causes a dilemma because solar or artificial UVR exposure is associated with skin cancer risk. In most populations, including the German population, UVB-induced cutaneous vitamin D production is the main source for fulfilling the human body’s requirements of vitamin D. In contrast, many of these new biological effects of vitamin D compounds, including regulation of the circadian clock and many metabolic functions, are mediated by other vitamin D metabolites, including 20-hydroxyvitamin D and 20,23-dihydroxyvitamin D, and involve their binding to the aryl hydrocarbon receptor (AhR) and retinoid-orphan receptor (ROR). Moreover, recent findings have demonstrated biological effects of the vitamin D endocrine system that are not mediated via activation of the classical nuclear vitamin D receptor (VDR) by binding with high affinity to its corresponding ligand, the biologically active vitamin D metabolite 1,25-dihydroxyvitamin D (1,25(OH) 2D). Beyond the well-known key role of vitamin D in calcium homeostasis and bone health, it has been shown that vitamin D deficiency is associated with a broad variety of independent diseases, including several types of cancer, and with increased overall mortality. During the last decade, our scientific knowledge of the pleiotropic biological effects of vitamin D metabolites and their relevance to human health has expanded widely. ![]()
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