优化维生素D补充剂量,以降低普通人群血清25-羟基维生素D浓度过低或过高的风险。

Optimal Vitamin D Supplementation Doses that Minimize the Risk for Both Low and High Serum 25-Hydroxyvitamin D Concentrations in the General Population.

作者信息

Veugelers Paul J, Pham Truong-Minh, Ekwaru John Paul

机构信息

School of Public Health, University of Alberta, 350 University Terrace, Edmonton, AB T6G 2T4, Canada.

出版信息

Nutrients. 2015 Dec 4;7(12):10189-208. doi: 10.3390/nu7125527.

Abstract

The Recommended Dietary Allowance (RDA) is the nutrient intake considered to be sufficient to meet the requirements of 97.5% of the population. Recent reports revealed a statistical error in the calculation of the RDA for vitamin D opening the question of what the recommendation should be. We took a dual approach to answer this question: (1) we aggregated 108 published estimates on vitamin D supplementation and vitamin D status; and (2) we analyzed 13,987 observations of program participants. The aggregation of published data revealed that 2909 IU of vitamin D per day is needed to achieve serum 25-hydroxyvitamin D (25(OH)D) concentrations of 50 nmol/L or more in 97.5% of healthy individuals. For normal weight, overweight and obese program participants this was 3094, 4450 and 7248 IU respectively. These supplementation doses would also result in 2.5% of normal weight, overweight and obese participants having 25(OH)D concentrations above 210, 200 and 214 nmol/L respectively. As these concentrations are high, an approach that minimizes the risk for both low and high concentrations seems desirable. With this approach we estimated, for example, that doses of 1885, 2802 and 6235 IU per day are required for normal weight, overweight and obese individuals respectively to achieve natural 25(OH)D concentrations (defined as 58 to 171 nmol/L). In conclusion, the large extent of variability in 25(OH)D concentrations makes a RDA for vitamin D neither desirable nor feasible. We therefore propose recommendations be articulated in the form of an optimal intake that minimizes the risk for both low and high serum 25(OH)D concentrations. This contribution includes body weight specific recommendations for optimal intakes for various combinations of lower and upper 25(OH)D concentration targets.

摘要

推荐膳食摄入量(RDA)是指被认为足以满足97.5%人群需求的营养素摄入量。近期报告显示,维生素D的RDA计算存在统计误差,这引发了关于该推荐量应该是多少的问题。我们采用了双重方法来回答这个问题:(1)汇总了108篇已发表的关于维生素D补充和维生素D状态的估计数据;(2)分析了13987名项目参与者的观察结果。已发表数据的汇总显示,97.5%的健康个体要使血清25-羟基维生素D(25(OH)D)浓度达到50 nmol/L或更高,每天需要2909国际单位的维生素D。对于体重正常、超重和肥胖的项目参与者,这一数值分别为3094、4450和7248国际单位。这些补充剂量还会导致2.5%的体重正常、超重和肥胖参与者的25(OH)D浓度分别高于210、200和214 nmol/L。由于这些浓度较高,一种能将低浓度和高浓度风险降至最低的方法似乎是可取的。通过这种方法我们估计,例如,体重正常、超重和肥胖个体每天分别需要1885、2802和6235国际单位的剂量才能达到自然的25(OH)D浓度(定义为58至171 nmol/L)。总之,25(OH)D浓度的巨大变异性使得制定维生素D的RDA既不可取也不可行。因此,我们建议以最佳摄入量的形式来阐明相关建议,以将血清25(OH)D浓度过低和过高的风险降至最低。本研究给出了针对不同25(OH)D浓度目标下限和上限组合的最佳摄入量的体重特异性建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e64/4690079/c85d2baf9425/nutrients-07-05527-g001.jpg

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