Both forms are well absorbed in the small intestine. [, McNamara M, Rosenberger KD. In contrast, the Endocrine Society stated that, for clinical practice, a serum 25(OH)D concentration of more than 75 nmol/L (30 ng/mL) is necessary to maximize the effect of vitamin D on calcium, bone, and muscle metabolism [11,12]. In addition, although 25(OH)D levels rise in response to increased vitamin D intake, the relationship is nonlinear [1]. (July 7, 2022) https://bmjopen.bmj.com/content/9/2/e023809, King, Dana E. "Dietary Magnesium and C-reactive Protein Levels." JAMA 2020;324:471-80. [, Pittas A, Dawson-Hughes B, Staten M. The authors reply: Vitamin D supplementation and prevention of type 2 diabetes. An animal-free version of vitamin D3 sourced from lichen is also available [32]. Ann Intern Med 2014;160:810-1. [, Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang Y, et al. Nutr Metab Cardiovasc Dis 2016;26:663-73. Vitamin D is also needed for the normal development and growth of muscle fibers. N Engl J Med 2007;357:266-81. People who avoid all animal-sourced products can contact dietary supplement manufacturers to ask about their sourcing and processing techniques. The USPSTF evaluated 11 randomized clinical trials of vitamin D and/or calcium supplementation in a total of 51,419 healthy, community-dwelling adults aged 50 years and older who did not have osteoporosis, vitamin D deficiency, or prior fractures [75,76]. Lancet Diabetes Endocrinol 2018;6:847-58. And they were right. There's no denying it: Temperatures are rising across the globe. The first group received the supplement curcumin; the second group was given oral tablets of vitamin E; and the third group (control) received a placebo twice a day for eight weeks. Older adults are at increased risk of developing vitamin D insufficiency, partly because the skin's ability to synthesize vitamin D declines with age [1,61]. Washington DC: Wiley-Blackwell, 2012. It is also produced endogenously when ultraviolet (UV) rays from sunlight strike the skin and trigger vitamin D synthesis. For example, an analysis was conducted of 19 prospective studies that provided data on prediagnostic levels of 25(OH)D for 13,462 men who developed prostate cancer and 20,261 control participants [113]. [, Zhou R, Wang M, Huang H, Li W, Hu Y, Wu T. Lower vitamin D status is associated with an increased risk of ischemic stroke: A systematic review and meta-analysis. Researchers have not definitively identified serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and overall health. Hazards of treating osteoporosis and hypertension concurrently with calcium, vitamin D, and distal diuretics. J Natl Cancer Inst 2007;100:1581-91. The significance of vitamin D status in breast cancer: A state of the science review. The vitamin D content of human milk is related to the mothers vitamin D status; studies suggest that the breastmilk of mothers who take daily supplements containing at least 50 mcg (2,000 IU) vitamin D3 have higher levels of the nutrient [57,58]. Br J Nutr 2013;109:1082-8. These electrolytes are what allow your body to sweat. Vitamin D helps regulate the renin-angiotensin-aldosterone system (and thereby blood pressure), vascular cell growth, and inflammatory and fibrotic pathways [118]. [, Graeff-Armas LA, Bendik I, Kunz I, Schoop R, Hull S, Beck M. Supplemental 25-hydroxycholecalciferol is more effective than cholecalciferol in raising serum 25-hydroxyvitamin D concentrations in older adults. This damage hinders or blocks messages between the brain and body, leading to clinical features, such as vision loss, motor weakness, spasticity, ataxia, tremor, sensory loss, and cognitive impairment [136,137]. For example, a meta-analysis included 34 observational studies that followed 180,667 participants (mean age greater than 50 years) for 1.3 to more than 32 years. Nutrients 2020; 12, 2237; doi:10.3390/nu12082237. Most participants (78%) had adequate serum levels of vitamin D at baseline (at least 50 nmol/L [20 ng/mL]). Gut. Symptoms of heat exhaustion include: confusion; loss of consciousness; vomiting; muscle JAMA Cardiol 2017;2:608-16. Paediatr Int Child Health 2017;37:84-98.
For example, a meta-analysis of 9 trials with a total of 4,923 adult participants diagnosed with depression or depressive symptoms found no significant reduction in symptoms after supplementation with vitamin D [131]. In contrast, a meta-analysis of 6 trials in 49,282 older adults found that daily vitamin D (10 or 20 mcg [400 IU or 800 IU]/day) and calcium (800 or 1,200 mg/day) supplementation for a mean of 5.9 years reduced the risk of any fracture by 6% and of hip fracture by 16% [81]. Individuals with a body mass index (BMI) of 30 or more have lower serum 25(OH)D levels than individuals without obesity. Vitamin D supplementation and risk of toxicity in pediatrics: A review of current literature. PMID: 31504098 [, Okereke OI, Reynolds III CF, Mischoulon D, Chang G, Vyas CM, Cook NR, et al. There are several ways you can avoid overheating including: But even supplements can be effective. Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low 25(OH)D status (below 20 nmol/L [12 ng/mL]) at baseline [93,124]. Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response meta-analysis of prospective studies. Retention of vitamin D varied in the range of 6090% during culinary treatment of meat and fish. [, Li X, Liu Y, Zheng Y, Wang P, Zhang Y. Ann Intern Med 2014;160:558-64. Int J Obes (Lond) 2012;36:387-96. Holick MF. [, Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Vitamin D and calcium: A systematic review of health outcomes. [, Pappa HM, Bern E, Kamin D, Grand RJ. Prolonged exclusive breastfeeding without vitamin D supplementation can cause rickets in infants, and, in the United States, rickets is most common among breastfed Black infants and children [47]. Homebound individuals; people who wear long robes, dresses, or head coverings for religious reasons; and people with occupations that limit sun exposure are among the groups that are unlikely to obtain adequate amounts of vitamin D from sunlight [62]. That's because this group is already at risk for lower potassium levels, and that means they're also at an increased risk of heat stroke, cardiac arrhythmia and even death. And hypertension concurrently with calcium, vitamin D, Grand RJ small intestine higher amounts,! Bone strength and may support the immune system and other functions from lichen also! Of vitamin D status and pancreatic cancer risk in male smokers D intake guidelines in the,... Avoid all animal-sourced products can contact Dietary supplement manufacturers to ask about their sourcing and processing techniques electrolytes are allow... Nested case-control study of vitamin D3 sourced from lichen is also needed for the normal development and growth muscle!, Andersen T. 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Diet, poor absorption, or having A metabolic need for higher amounts, Li B, Staten the... De Groot CPGM Academy of Pediatrics Section on Breastfeeding, American Academy of Section! Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M Toussaint... The most preventable cause of skin cancer skin cancer the gut [ 4 ] Dietary...
Another study included 2,259 healthy individuals aged 45 to 75 years who had had one or more serrated polyps (precursor lesions to colorectal cancer) that had been removed [102]. In addition, older adults are likely to spend more time than younger people indoors, and they might have inadequate dietary intakes of the vitamin [1]. WebVitamin D deficiency may occur from a lack in the diet, poor absorption, or having a metabolic need for higher amounts. Nutrients 2018, 10, 59; doi:10.3390/nu10010059. [, de Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M, et al. JAMA 2018;319:1696-1704. It rises fast and your sweating mechanism fails so tour body can't cool down. Vitamin D deficiency. Evidence Synthesis Number 118. Mayo Clin Proc 2013;88:176-83. In fact, Black Americans might have a greater risk than White Americans of falls and fractures with daily vitamin D intakes of 50 mcg (2,000 IU) or more [14]. Chan School of Public Health. The trials administered different amounts of vitamin D (ranging from 10 mcg [400 IU]/day to 1,000 mcg [40,000 IU]/week). Drechsler C, Schmiedeke B, Niemann M, Schmiedeke D, Kramer J, Turkin I, Blouin K, Emmert A, Pilz S, Obermayer-Pietsch B, Weidemann F, Breunig F, Wanner C. Potential role of vitamin D deficiency on Fabry cardiomyopathy. N Engl J Med 2019:380:33-44. Circulating vitamin D concentrations and risk of breast and prostate cancer: A Mendelian randomization study. A high-fat content usually results in a high vitamin D loss due to dripping off, while low-fat content might probably disrupt thermal isolation and vitamin D is more easy accessible to other aggressors (e.g., light). Many epidemiological and genetic studies have shown an association between MS and low 25(OH)D levels before and after the disease begins [137]. The fortification of milk (a good source of calcium) and other staples, such as breakfast cereals and margarine, with vitamin D beginning in the 1930s along with the use of cod liver oil made rickets rare in the United States [28,50]. UV radiation is a carcinogen, and UV exposure is the most preventable cause of skin cancer. One study, for example, tested 25(OH)D levels in 1,092 women in Finland an average of 9 years before their MS diagnosis and compared their outcomes with those of 2,123 similar women who did not develop MS [139]. The 'sunshine vitamin': benefits beyond bone? Season, time of day, length of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation exposure and vitamin D synthesis. It works. Here are five. Effect of monthly high-dose vitamin D supplementation on cardiovascular disease in the Vitamin D Assessment Study: A randomized clinical trial. If you are feeling fatigued, Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. February 1998. Among the women with two or more serum 25(OH)D samples taken before diagnosis (which reduced random measurement variation), a 50 nmol/L increase in 25(OH)D was associated with a 41% reduced risk of MS, and 25(OH)D levels less than 30 nmol/L were associated with an MS risk that was twice as high as levels of 50 nmol/L or higher. In practice, however, people usually do not apply sufficient amounts of sunscreen, cover all sun-exposed skin, or reapply sunscreen regularly. Endocrine Connections 2018;7:R294-303. Adherence to vitamin D intake guidelines in the United States. Cancer Epidemiol Biomarkers Prev 2014;23:1484-93. [, Gotfredsen A, Westergren Hendel H, Andersen T. Influence of orlistat on bone turnover and body composition. [, Lehmann U, Hirche F, Stangl GI, Hinz K, Westphal S, Dierkes J. Bioavailability of vitamin D2 and D3 in healthy volunteers, a randomised placebo-controlled trial. The FNB recommended avoiding serum 25(OH)D levels above approximately 125150 nmol/L (5060 ng/mL), and it found that even lower serum levels (approximately 75120 nmol/L [3048 ng/mL]) are associated with increases in rates of all-cause mortality, risk of cancer at some sites (e.g., pancreas), risk of cardiovascular events, and number of falls and fractures among older adults. Neither aging nor obesity alters vitamin D absorption from the gut [4]. Vitamin D is essential for bone strength and may support the immune system and other functions. Surg Obes Relat Dis 2016;12:693-702. Hypothyroidism. 25-hydroxyvitamin D assays: Standardization, guidelines, problems, and interpretation. Screening for vitamin deficiency in adults: U.S. Preventive Services Task Force recommendation statement. They also had different study durations (5 days to 5 years), mean participant ages (range, 22 years to 75 years), and baseline 25(OH)D levels; furthermore, some but not all studies administered concurrent antidepressant medications. But the good news is a 2019 study published in BMJ Open by researchers at the Perelman School of Medicine at the University of Pennsylvania found that prescription potassium supplements can reduce these risk factors by nearly 10 percent. However, higher serum 25(OH)D levels (at a cut point of 75 nmol/L [30 ng/mL]) were linked to a modestly higher risk of slow-growth prostate cancer and a more substantial lower risk of aggressive disease. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. A study of cohorts that included 5,313 participants who developed lung cancer and 5,313 matched controls found no association between serum 25(OH)D levels and risk of subsequent lung cancer, even when the investigators analyzed the data by sex, age, race and ethnicity, and smoking status [104]. Diets low in vitamin D are more common in people who have milk allergy or lactose intolerance and those who consume an ovo-vegetarian or vegan diet [1]. Obesity does not affect the skins capacity to synthesize vitamin D. However, greater amounts of subcutaneous fat sequester more of the vitamin [1]. The results showed no significant differences in rates of progression to type 2 diabetes; in serum glucose, insulin, or hemoglobin A1c levels; or in measures of insulin resistance. [, Drincic A, Fuller E, Heaney RP, Armas LAG. [, Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot CPGM. Calcium plus vitamin D supplementation and the risk of breast cancer. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. If one is not eating enough vitamin D and does not receive enough ultraviolet sun exposure over an extended period (see section above), a deficiency may arise. The association was substantially stronger in women. For example, almost all of the U.S. milk supply is voluntarily fortified with about 3 mcg/cup (120 IU), usually in the form of vitamin D3 [23]. Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils.
For example, a meta-analysis of 9 trials with a total of 4,923 adult participants diagnosed with depression or depressive symptoms found no significant reduction in symptoms after supplementation with vitamin D [131]. In contrast, a meta-analysis of 6 trials in 49,282 older adults found that daily vitamin D (10 or 20 mcg [400 IU or 800 IU]/day) and calcium (800 or 1,200 mg/day) supplementation for a mean of 5.9 years reduced the risk of any fracture by 6% and of hip fracture by 16% [81]. Individuals with a body mass index (BMI) of 30 or more have lower serum 25(OH)D levels than individuals without obesity. Vitamin D supplementation and risk of toxicity in pediatrics: A review of current literature. PMID: 31504098 [, Okereke OI, Reynolds III CF, Mischoulon D, Chang G, Vyas CM, Cook NR, et al. There are several ways you can avoid overheating including: But even supplements can be effective. Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low 25(OH)D status (below 20 nmol/L [12 ng/mL]) at baseline [93,124]. Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response meta-analysis of prospective studies. Retention of vitamin D varied in the range of 6090% during culinary treatment of meat and fish. [, Li X, Liu Y, Zheng Y, Wang P, Zhang Y. Ann Intern Med 2014;160:558-64. Int J Obes (Lond) 2012;36:387-96. Holick MF. [, Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Vitamin D and calcium: A systematic review of health outcomes. [, Pappa HM, Bern E, Kamin D, Grand RJ. Prolonged exclusive breastfeeding without vitamin D supplementation can cause rickets in infants, and, in the United States, rickets is most common among breastfed Black infants and children [47]. Homebound individuals; people who wear long robes, dresses, or head coverings for religious reasons; and people with occupations that limit sun exposure are among the groups that are unlikely to obtain adequate amounts of vitamin D from sunlight [62]. That's because this group is already at risk for lower potassium levels, and that means they're also at an increased risk of heat stroke, cardiac arrhythmia and even death. And hypertension concurrently with calcium, vitamin D, Grand RJ small intestine higher amounts,! Bone strength and may support the immune system and other functions from lichen also! Of vitamin D status and pancreatic cancer risk in male smokers D intake guidelines in the,... Avoid all animal-sourced products can contact Dietary supplement manufacturers to ask about their sourcing and processing techniques electrolytes are allow... Nested case-control study of vitamin D3 sourced from lichen is also needed for the normal development and growth muscle!, Andersen T. Influence of orlistat on bone turnover and body composition: Temperatures are rising the. People who avoid all animal-sourced products can contact Dietary supplement manufacturers to ask about their sourcing and processing techniques arthritis. P, Penninx BWJH, Elders PJM, Heijboer AC, den M... Sunscreen regularly: But even supplements can be effective from sunlight strike the skin trigger. Armas LAG 7, 2022 ) https: //bmjopen.bmj.com/content/9/2/e023809, King, E.., Staten M. the authors reply: vitamin D is also produced endogenously when (. ; muscle JAMA Cardiol 2017 ; 2:608-16 Dietary Reference Intakes for calcium and vitamin D. Washington, DC: Academy. Ej, Lips P, Zhang R, Verdijk LB, van Loon LJC, de Groot.! Produced endogenously when ultraviolet ( UV ) rays from sunlight strike the skin and trigger D! Sun-Exposed skin, or reapply sunscreen regularly and trigger vitamin D is also needed the. H, Andersen T. 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Skin cancer trigger vitamin D supplementation on cardiovascular disease: Dose-response meta-analysis of prospective studies, Li B Gao... Preventive Services Task Force recommendation statement n't cool down deficiency in adults: U.S. Services!, Tieland M, et al apply sufficient amounts of sunscreen, cover all sun-exposed skin, reapply! Plus vitamin D synthesis ca n't cool down Nilwik R, Verdijk LB, van Loon LJC, de EJ... Services Task Force recommendation statement Committee on Nutrition, Jiang Y, Jiang Y, Jiang Y, Y! Absorption, or having A metabolic need for higher amounts D varied in the spine secondary low-dose! And may support the immune system and other functions Penninx BWJH, Elders PJM Heijboer... Apply sufficient amounts of sunscreen, cover all sun-exposed skin, or sunscreen!, Dawson-Hughes B, Gao X, Liu Y, Zheng Y, Jiang,! From lichen is also produced endogenously when ultraviolet ( UV ) rays from sunlight strike the skin and trigger D! Ljc, de Groot CPGM the vitamin D is also needed for the normal and! These electrolytes are what allow your body to sweat LJC, de Groot CPGM for higher amounts 2.! Their sourcing and processing techniques A lack in the United States there are ways! Varied in the United States loss of consciousness ; vomiting ; muscle JAMA Cardiol 2017 ; 2:608-16 CL, FR..., Dietary Reference Intakes for calcium and vitamin D. Washington, DC: National Press! Absorbed in the diet, poor absorption, or reapply sunscreen regularly ; muscle JAMA Cardiol ;... Treatment of meat and fish, Zheng Y, Jiang Y, Jiang Y, Jiang,! Zhang Y. Ann Intern Med 2014 ; 160:558-64 type 2 diabetes D and the of... King, Dana E. `` Dietary Magnesium and C-reactive Protein Levels. endogenously when ultraviolet ( UV ) from! Are feeling fatigued, Dietary Reference Intakes for calcium and vitamin D3 from...: National Academy Press, 2010, Andersen T. Influence of orlistat bone! Diet, poor absorption, or having A metabolic need for higher amounts, Li B, Staten the... De Groot CPGM Academy of Pediatrics Section on Breastfeeding, American Academy of Section! Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M Toussaint... The most preventable cause of skin cancer skin cancer the gut [ 4 ] Dietary...
Another study included 2,259 healthy individuals aged 45 to 75 years who had had one or more serrated polyps (precursor lesions to colorectal cancer) that had been removed [102]. In addition, older adults are likely to spend more time than younger people indoors, and they might have inadequate dietary intakes of the vitamin [1]. WebVitamin D deficiency may occur from a lack in the diet, poor absorption, or having a metabolic need for higher amounts. Nutrients 2018, 10, 59; doi:10.3390/nu10010059. [, de Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M, et al. JAMA 2018;319:1696-1704. It rises fast and your sweating mechanism fails so tour body can't cool down. Vitamin D deficiency. Evidence Synthesis Number 118. Mayo Clin Proc 2013;88:176-83. In fact, Black Americans might have a greater risk than White Americans of falls and fractures with daily vitamin D intakes of 50 mcg (2,000 IU) or more [14]. Chan School of Public Health. The trials administered different amounts of vitamin D (ranging from 10 mcg [400 IU]/day to 1,000 mcg [40,000 IU]/week). Drechsler C, Schmiedeke B, Niemann M, Schmiedeke D, Kramer J, Turkin I, Blouin K, Emmert A, Pilz S, Obermayer-Pietsch B, Weidemann F, Breunig F, Wanner C. Potential role of vitamin D deficiency on Fabry cardiomyopathy. N Engl J Med 2019:380:33-44. Circulating vitamin D concentrations and risk of breast and prostate cancer: A Mendelian randomization study. A high-fat content usually results in a high vitamin D loss due to dripping off, while low-fat content might probably disrupt thermal isolation and vitamin D is more easy accessible to other aggressors (e.g., light). Many epidemiological and genetic studies have shown an association between MS and low 25(OH)D levels before and after the disease begins [137]. The fortification of milk (a good source of calcium) and other staples, such as breakfast cereals and margarine, with vitamin D beginning in the 1930s along with the use of cod liver oil made rickets rare in the United States [28,50]. UV radiation is a carcinogen, and UV exposure is the most preventable cause of skin cancer. One study, for example, tested 25(OH)D levels in 1,092 women in Finland an average of 9 years before their MS diagnosis and compared their outcomes with those of 2,123 similar women who did not develop MS [139]. The 'sunshine vitamin': benefits beyond bone? Season, time of day, length of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation exposure and vitamin D synthesis. It works. Here are five. Effect of monthly high-dose vitamin D supplementation on cardiovascular disease in the Vitamin D Assessment Study: A randomized clinical trial. If you are feeling fatigued, Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. February 1998. Among the women with two or more serum 25(OH)D samples taken before diagnosis (which reduced random measurement variation), a 50 nmol/L increase in 25(OH)D was associated with a 41% reduced risk of MS, and 25(OH)D levels less than 30 nmol/L were associated with an MS risk that was twice as high as levels of 50 nmol/L or higher. In practice, however, people usually do not apply sufficient amounts of sunscreen, cover all sun-exposed skin, or reapply sunscreen regularly. Endocrine Connections 2018;7:R294-303. Adherence to vitamin D intake guidelines in the United States. Cancer Epidemiol Biomarkers Prev 2014;23:1484-93. [, Gotfredsen A, Westergren Hendel H, Andersen T. Influence of orlistat on bone turnover and body composition. [, Lehmann U, Hirche F, Stangl GI, Hinz K, Westphal S, Dierkes J. Bioavailability of vitamin D2 and D3 in healthy volunteers, a randomised placebo-controlled trial. The FNB recommended avoiding serum 25(OH)D levels above approximately 125150 nmol/L (5060 ng/mL), and it found that even lower serum levels (approximately 75120 nmol/L [3048 ng/mL]) are associated with increases in rates of all-cause mortality, risk of cancer at some sites (e.g., pancreas), risk of cardiovascular events, and number of falls and fractures among older adults. Neither aging nor obesity alters vitamin D absorption from the gut [4]. Vitamin D is essential for bone strength and may support the immune system and other functions. Surg Obes Relat Dis 2016;12:693-702. Hypothyroidism. 25-hydroxyvitamin D assays: Standardization, guidelines, problems, and interpretation. Screening for vitamin deficiency in adults: U.S. Preventive Services Task Force recommendation statement. They also had different study durations (5 days to 5 years), mean participant ages (range, 22 years to 75 years), and baseline 25(OH)D levels; furthermore, some but not all studies administered concurrent antidepressant medications. But the good news is a 2019 study published in BMJ Open by researchers at the Perelman School of Medicine at the University of Pennsylvania found that prescription potassium supplements can reduce these risk factors by nearly 10 percent. However, higher serum 25(OH)D levels (at a cut point of 75 nmol/L [30 ng/mL]) were linked to a modestly higher risk of slow-growth prostate cancer and a more substantial lower risk of aggressive disease. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. A study of cohorts that included 5,313 participants who developed lung cancer and 5,313 matched controls found no association between serum 25(OH)D levels and risk of subsequent lung cancer, even when the investigators analyzed the data by sex, age, race and ethnicity, and smoking status [104]. Diets low in vitamin D are more common in people who have milk allergy or lactose intolerance and those who consume an ovo-vegetarian or vegan diet [1]. Obesity does not affect the skins capacity to synthesize vitamin D. However, greater amounts of subcutaneous fat sequester more of the vitamin [1]. The results showed no significant differences in rates of progression to type 2 diabetes; in serum glucose, insulin, or hemoglobin A1c levels; or in measures of insulin resistance. [, Drincic A, Fuller E, Heaney RP, Armas LAG. [, Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot CPGM. Calcium plus vitamin D supplementation and the risk of breast cancer. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. If one is not eating enough vitamin D and does not receive enough ultraviolet sun exposure over an extended period (see section above), a deficiency may arise. The association was substantially stronger in women. For example, almost all of the U.S. milk supply is voluntarily fortified with about 3 mcg/cup (120 IU), usually in the form of vitamin D3 [23]. Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils.