A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health
Vitamin D<sub>3</sub> has many important health benefits. Unfortunately, these benefits are not widely known among health care personnel and the general public. As a result, most of the world’s population has serum 25-hydroxyvitamin D (25(OH)D) concentrations far below optimal values. Th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/3/639 |
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| author | William B. Grant Fatme Al Anouti Barbara J. Boucher Erdinç Dursun Duygu Gezen-Ak Edward B. Jude Tatiana Karonova Pawel Pludowski |
| author_facet | William B. Grant Fatme Al Anouti Barbara J. Boucher Erdinç Dursun Duygu Gezen-Ak Edward B. Jude Tatiana Karonova Pawel Pludowski |
| author_sort | William B. Grant |
| collection | DOAJ |
| description | Vitamin D<sub>3</sub> has many important health benefits. Unfortunately, these benefits are not widely known among health care personnel and the general public. As a result, most of the world’s population has serum 25-hydroxyvitamin D (25(OH)D) concentrations far below optimal values. This narrative review examines the evidence for the major causes of death including cardiovascular disease, hypertension, cancer, type 2 diabetes mellitus, and COVID-19 with regard to sub-optimal 25(OH)D concentrations. Evidence for the beneficial effects comes from a variety of approaches including ecological and observational studies, studies of mechanisms, and Mendelian randomization studies. Although randomized controlled trials (RCTs) are generally considered the strongest form of evidence for pharmaceutical drugs, the study designs and the conduct of RCTs performed for vitamin D have mostly been flawed for the following reasons: they have been based on vitamin D dose rather than on baseline and achieved 25(OH)D concentrations; they have involved participants with 25(OH)D concentrations above the population mean; they have given low vitamin D doses; and they have permitted other sources of vitamin D. Thus, the strongest evidence generally comes from the other types of studies. The general finding is that optimal 25(OH)D concentrations to support health and wellbeing are above 30 ng/mL (75 nmol/L) for cardiovascular disease and all-cause mortality rate, whereas the thresholds for several other outcomes appear to range up to 40 or 50 ng/mL. The most efficient way to achieve these concentrations is through vitamin D supplementation. Although additional studies are warranted, raising serum 25(OH)D concentrations to optimal concentrations will result in a significant reduction in preventable illness and death. |
| first_indexed | 2024-03-09T23:20:39Z |
| format | Article |
| id | doaj.art-8d19b7f514ef4fe4b4f579cfe88eb2ba |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T23:20:39Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-8d19b7f514ef4fe4b4f579cfe88eb2ba2023-11-23T17:27:07ZengMDPI AGNutrients2072-66432022-02-0114363910.3390/nu14030639A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal HealthWilliam B. Grant0Fatme Al Anouti1Barbara J. Boucher2Erdinç Dursun3Duygu Gezen-Ak4Edward B. Jude5Tatiana Karonova6Pawel Pludowski7Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USADepartment of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab EmiratesThe Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London E12AT, UKDepartment of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul 34098, TurkeyDepartment of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul 34098, TurkeyTameside and Glossop Integrated Care NHS Foundation Trust, Fountain Street, Ashton-under-Lyne OL6 9RW, UKClinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint-Petersburg, RussiaDepartment of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, 04730 Warsaw, PolandVitamin D<sub>3</sub> has many important health benefits. Unfortunately, these benefits are not widely known among health care personnel and the general public. As a result, most of the world’s population has serum 25-hydroxyvitamin D (25(OH)D) concentrations far below optimal values. This narrative review examines the evidence for the major causes of death including cardiovascular disease, hypertension, cancer, type 2 diabetes mellitus, and COVID-19 with regard to sub-optimal 25(OH)D concentrations. Evidence for the beneficial effects comes from a variety of approaches including ecological and observational studies, studies of mechanisms, and Mendelian randomization studies. Although randomized controlled trials (RCTs) are generally considered the strongest form of evidence for pharmaceutical drugs, the study designs and the conduct of RCTs performed for vitamin D have mostly been flawed for the following reasons: they have been based on vitamin D dose rather than on baseline and achieved 25(OH)D concentrations; they have involved participants with 25(OH)D concentrations above the population mean; they have given low vitamin D doses; and they have permitted other sources of vitamin D. Thus, the strongest evidence generally comes from the other types of studies. The general finding is that optimal 25(OH)D concentrations to support health and wellbeing are above 30 ng/mL (75 nmol/L) for cardiovascular disease and all-cause mortality rate, whereas the thresholds for several other outcomes appear to range up to 40 or 50 ng/mL. The most efficient way to achieve these concentrations is through vitamin D supplementation. Although additional studies are warranted, raising serum 25(OH)D concentrations to optimal concentrations will result in a significant reduction in preventable illness and death.https://www.mdpi.com/2072-6643/14/3/639Alzheimer’s diseasecancercardiovascular diseaseCOVID-19diabeteshypertension |
| spellingShingle | William B. Grant Fatme Al Anouti Barbara J. Boucher Erdinç Dursun Duygu Gezen-Ak Edward B. Jude Tatiana Karonova Pawel Pludowski A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health Nutrients Alzheimer’s disease cancer cardiovascular disease COVID-19 diabetes hypertension |
| title | A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health |
| title_full | A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health |
| title_fullStr | A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health |
| title_full_unstemmed | A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health |
| title_short | A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health |
| title_sort | narrative review of the evidence for variations in serum 25 hydroxyvitamin d concentration thresholds for optimal health |
| topic | Alzheimer’s disease cancer cardiovascular disease COVID-19 diabetes hypertension |
| url | https://www.mdpi.com/2072-6643/14/3/639 |
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