期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 106, 期 9, 页码 E3644-E3654出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgab296
关键词
vitamin D; elderly; RDA; desirable level; IOM; guidelines
资金
- American University of Beirut
- Lebanese Council for National Scientific Research
- Mayo Clinic, Rochester, Minnesota, USA
- Fogarty International Center and Office of Dietary Supplements of the National Institutes of Health [D43 TW009118]
- St Joseph University
This study found that the nutritional status of vitamin D in elderly individuals is influenced by dosage, with high dose vitamin D-3 supplements helping to increase 25(OH)D levels. The recommended dietary allowance of 600 IU/day by the Institute of Medicine does not bring 97.5% of ambulatory elderly individuals above the desirable threshold of 20 ng/mL. Therefore, country-specific RDAs should take into account the observed variability and predictors of achieved 25(OH)D levels.
Context Guidelines for the dosage of vitamin D supplementation vary widely globally. Objective To investigate the impact of 2 vitamin D doses, bracketed between the IOM recommended dietary allowance (RDA) and the upper tolerable limit, on vitamin D nutritional status in elderly individuals. Methods This post hoc analysis of data collected from a 12-month, double-blind, randomized control trial included 221 ambulatory participants (>= 65 years) with a mean BMI of 30.2 kg/m(2) and a mean baseline serum 25-hydroxyvitamin D [25(OH)D] level of 20.4 +/- 7.4 ng/mL, who were recruited from 3 outpatient centers in Lebanon. All participants received 1000 mg of elemental calcium daily from calcium citrate plus the daily equivalent of either 600 IU or 3750 IU of vitamin D-3. Results Mean 25(OH)D level at 12 months was 26.0 ng/mL with low dose and 36.0 ng/mL with high dose vitamin D-3. The proportion of participants reaching a value >= 20 ng/mL was 86% in the low dose, and 99% in the high dose arms, with no gender differences. The increment of 25(OH)D per 100 IU/day was 1 ng/mL with the low dose, and 0.41 ng/mL with the high dose. Serum 25(OH)D levels at 1 year were highly variable in both treatment arms. Baseline 25(OH)D level and vitamin D dose-but not age, BMI, gender, or season-were significant predictors of serum 25(OH)D level post-intervention. Conclusion The IOM Recommended Dietary Allowance (RDA) of 600 IU/day does not bring 97.5% of ambulatory elderly individuals above the desirable threshold of 20 ng/mL. Country-specific RDAs are best derived taking into account the observed variability and predictors of achieved 25(OH)D levels.
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