The IOM further recommended that serum 25(OH)D levels of 20 ng/ml (= 50 nmol/l) would cover 97.5% of population, and levels > 50 ng/ml (= 125 nmol/l) could have potential adverse effects. Importantly, the recommendations were made based on an assumption of minimal or no sun exposure this was to provide a margin of safety because of the variability in skin synthesis of vitamin D according to season, latitude, skin pigmentation, genetic factors, and other variables, and also because of concerns about skin cancer with increasing exposure to solar radiation. These recommendations were made based on data on bone health only the IOM considered that the current non-bone health data to be inconsistent, inconclusive and insufficient to be used to make public health recommendations. On November 30, 2010, the IOM released new recommendations on vitamin D (Table 3). Examples of selected food sources of vitamin D are shown in Table 2. Because of the known side effects of exposure to ultraviolet (UV) radiation, including the development of skin cancer, careful sun protection should be practiced (Table 1).įortunately, people who choose to protect their skin from the sun can acquire a sufficient amount of vitamin D by mouth (from a combination of diet and vitamin supplements), thus providing an alternative route to maintaining a healthy vitamin D concentration that avoids the risk associated with sun exposure. However, UVB rays are also the major cause of sunburns and it is well established that exposure to sunlight or to tanning booths increases the risk of developing skin cancer. Ultraviolet B (UVB) is the portion of sunlight that stimulates human skin to produce vitamin D. Vitamin D3 is also commonly used in fortified foods. ![]() It is available as a single ingredient over-the-counter vitamin supplement, and is also commonly incorporated into calcium supplements and multivitamins. Vitamin D3 (cholecalciferol) is the natural form that is produced in the skin. ![]() There are three sources of vitamin D: synthesis by the skin following exposure to sunlight, certain foods (often through vitamin D fortification), and vitamin D supplements. ![]() While multiple reports have shown that low blood levels of vitamin D are associated with certain cancers, neurologic disease, diseases of heart and blood vessels and death from all causes, the Institute of Medicine (IOM) recently concluded that at this time, the evidence for non-bone health outcomes was inconsistent, and inclusive as to a cause-and-effect relationship. Vitamin D plays a crucial role in forming and maintaining strong, healthy bones. Position Statement on Vitamin D (Revised: February 2014
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