Estimated economic benefit of increasing 25-hydroxyvitamin D concentrations of Canadians to or above 100 nmol/L

Mounting evidence from observational and clinical trials indicates that optimal vitamin D reduces the risk of many diseases. We used observational studies and recent data on 25- hydroxyvitamin D [25(OH) D] concentrations of Canadians from Cycle 3 of the Canadian Health Measures Survey to estimate the reduction in disease incidence, mortality rates, and the total economic burden (direct plus indirect) of disease if 25(OH) D concentrations of all Canadians were raised to or above 100 nmol/L. Recently, the mean 25(OH) D concentration of Canadians varied depending on age and season (51- 69 nmol/L), with an overall mean of 61 nmol/L. The diseases affected by 25(OH) D concentration included cancer, cardiovascular disease, dementia, diabetes mellitus, multiple sclerosis, respiratory infections, and musculoskeletal disorders. We used 25(OH) D concentration- health outcome relations for breast cancer and cardiovascular disease and results of clinical trials with vitamin D for respiratory infections and musculoskeletal disorders to estimate the reductions in disease burden for increased 25(OH) D concentrations. If all Canadians attained 25(OH) D concentrations> 100 nmol/L, the calculated reduction in annual economic burden of disease was $ 12.5 +/- 6 billion on the basis of economic burdens for 2016 and a reduction in annual premature deaths by 23,000 (11,000-34,000) on the basis of rates for 2011. However, the effects on disease incidence, economic burden, and mortality rate would be phased in gradually over several years primarily because once a chronic disease is established, vitamin D affects its progression only modestly. Nevertheless, national policy changes are justified to improve vitamin D status of Canadians through promotion of safe sun exposure messages, vitamin D supplement use, and/or facilitation of food fortification.