Cashman Kevin D
Vitamin D Research Group, School of Food and Nutritional Sciences, University College Cork, Ireland; Department of Medicine, University College Cork, Ireland.
J Steroid Biochem Mol Biol. 2015 Apr;148:19-26. doi: 10.1016/j.jsbmb.2015.01.023. Epub 2015 Jan 28.
Vitamin D deficiency is evident in many parts of the globe, even in the sunnier regions, for a variety of reasons. Such deficiency contributes to risk of metabolic bone disease as well as potentially other non-skeletal chronic diseases in both early-life and later-life, and thus strategies for its prevention are of major public health importance. Dietary Reference Intervals (called Dietary Reference Intakes (DRI) and Dietary Reference Values (DRVs) in North America and Europe, respectively) for vitamin D have a key role in protecting against vitamin D deficiency in the population, and these have been re-evaluated in recent years on both sides of the Atlantic. The current DRI and DRVs for vitamin D and their basis will be overviewed in this review as well as some limitations that existed within the evidence-base and which contribute some degree of uncertainty to these new requirement estimates for vitamin D. The review will also compare current population intake estimates for children and adults in North America and Europe against the estimated average requirement (EAR) for vitamin D, as a benchmark of nutritional adequacy. While vitamin D supplementation has been suggested as a method of bridging the gap between current vitamin D intakes and new recommendations, the level of usage of vitamin D supplements in many countries as well as the vitamin D content of available supplements in these countries, appears to be low. The fortification of food with vitamin D has been suggested as a strategy for increasing intake with potentially the widest reach and impact in the population. The present review will highlight the need to re-evaluate current food fortification practices as well as consider new additional food-based approaches, such as biofortification of food with vitamin D, as a means of collectively tackling the low intakes of vitamin D within populations and the consequent high prevalence of low vitamin D status that are observed. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.
由于多种原因，维生素D缺乏在全球许多地区都很明显，即使在阳光更充足的地区也是如此。这种缺乏会导致代谢性骨病的风险增加，以及在生命早期和晚期可能引发其他非骨骼慢性疾病，因此预防维生素D缺乏的策略具有重大的公共卫生意义。维生素D的膳食参考摄入量（在北美和欧洲分别称为膳食参考摄入量（DRI）和膳食参考值（DRV））在预防人群维生素D缺乏方面起着关键作用，近年来大西洋两岸都对其进行了重新评估。本综述将概述当前维生素D的DRI和DRV及其依据，以及证据基础中存在的一些局限性，这些局限性在一定程度上导致了这些维生素D新需求估计的不确定性。该综述还将把北美和欧洲儿童及成人目前的人群摄入量估计值与维生素D的估计平均需求量（EAR）进行比较，以此作为营养充足性的基准。虽然有人建议补充维生素D作为缩小当前维生素D摄入量与新建议之间差距的一种方法，但许多国家维生素D补充剂的使用水平以及这些国家现有补充剂中的维生素D含量似乎都很低。有人建议对食品进行维生素D强化，以此作为一种增加摄入量的策略，这种策略在人群中可能具有最广泛的覆盖范围和影响。本综述将强调重新评估当前食品强化做法的必要性，并考虑新的额外基于食物的方法，例如用维生素D对食物进行生物强化，以此作为共同应对人群中维生素D摄入量低以及由此观察到的维生素D水平低患病率高的一种手段。本文是名为“第17届维生素D研讨会”的特刊的一部分。
