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home:food:vitamind:vitamin_d_supplementation_policy [09.01.2019] – [Increase in supplementation by consumers] sallieqhome:food:vitamind:vitamin_d_supplementation_policy [09.14.2022] (current) – external edit 127.0.0.1
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 The fortification of milk with vitamin D was also adopted in Europe; however, the process was not closely monitored, and in Great Britain it caused an outbreak of vitamin D intoxication, or hypercalcemia, the clinical manifestations of which are loss of appetite, lethargy, excessive thirst and polyuria, nausea and vomiting, constipation, and muscle weakness, and renal failure if the hypercalcemic state is unrecognized and prolonged. This outbreak led to the banning of the vitamin D fortification of milk in most of Europe. The fortification of milk with vitamin D was also adopted in Europe; however, the process was not closely monitored, and in Great Britain it caused an outbreak of vitamin D intoxication, or hypercalcemia, the clinical manifestations of which are loss of appetite, lethargy, excessive thirst and polyuria, nausea and vomiting, constipation, and muscle weakness, and renal failure if the hypercalcemic state is unrecognized and prolonged. This outbreak led to the banning of the vitamin D fortification of milk in most of Europe.
  
- //**Kumaravel Rajakumar**,// et al (({{pubmed>long:17761571}}))+ //**Kumaravel Rajakumar**,// et al (({{pmid>long:17761571}}))
 </blockquote> </blockquote>
  
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 commercial sale. commercial sale.
  
-//**Victor Lindén, M.D.**// (({{pubmed>long:4425790}}))+//**Victor Lindén, M.D.**// (({{pmid>long:4425790}}))
 </blockquote> </blockquote>
  
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 ==== Recent rates of supplementation ==== ==== Recent rates of supplementation ====
  
-A September 2010 report published by //Nutrition Business Journal// points out that in the previous two years, 'vitamin' D supplement sales to consumers have increased by more than 100% per year – a four-fold increase.(({{pubmed>long:21337617}})) +A September 2010 report published by //Nutrition Business Journal// points out that in the previous two years, 'vitamin' D supplement sales to consumers have increased by more than 100% per year – a four-fold increase.(({{pmid>long:21337617}})) 
  
-A number of researchers and public health advocates have proposed adding high doses of 'vitamin' D to other substances such as breads.(({{pubmed>long:21332187}}))+A number of researchers and public health advocates have proposed adding high doses of 'vitamin' D to other substances such as breads.(({{pmid>long:21332187}}))
 ===== No biological basis for supplementation in healthy people ===== ===== No biological basis for supplementation in healthy people =====
  
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 If the optimal serum 25(OH)D level for skeletal health is 30 ng/mL or greater, then vitamin D insufficiency is widespread, affecting about 75% of adults based on a recent survey of more than 20,000 Americans. However, after a comprehensive analysis of existing research studies, the Institute of Medicine recently concluded that nearly all individuals are vitamin D replete when their 25(OH)D levels are 20 ng/mL or greater. Furthermore, two recent publications challenge the belief that 25(OH)D levels greater than 30 ng/mL are optimal for bone health. In a randomized, placebo-controlled trial, high-dose, once- yearly vitamin D therapy increased the incidence of fractures and falls. The second study reported that high- dose vitamin D did not reduce levels of parathyroid hormone or bone resorption among adults with 25(OH)D levels less than 32 ng/mL at baseline. It is time to question whether serum 25(OH)D levels of 30 ng/mL or greater are necessary for all individuals. If the optimal serum 25(OH)D level for skeletal health is 30 ng/mL or greater, then vitamin D insufficiency is widespread, affecting about 75% of adults based on a recent survey of more than 20,000 Americans. However, after a comprehensive analysis of existing research studies, the Institute of Medicine recently concluded that nearly all individuals are vitamin D replete when their 25(OH)D levels are 20 ng/mL or greater. Furthermore, two recent publications challenge the belief that 25(OH)D levels greater than 30 ng/mL are optimal for bone health. In a randomized, placebo-controlled trial, high-dose, once- yearly vitamin D therapy increased the incidence of fractures and falls. The second study reported that high- dose vitamin D did not reduce levels of parathyroid hormone or bone resorption among adults with 25(OH)D levels less than 32 ng/mL at baseline. It is time to question whether serum 25(OH)D levels of 30 ng/mL or greater are necessary for all individuals.
  
-//**K.E. Hansen,** High-Dose Vitamin D: Helpful or Harmful?// (({{pubmed>long:21369796}}))+//**K.E. Hansen,** High-Dose Vitamin D: Helpful or Harmful?// (({{pmid>long:21369796}}))
 </blockquote> </blockquote>
 ===== Food supplementation policy, by country ===== ===== Food supplementation policy, by country =====
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 ====United States==== ====United States====
  
-Fluid milk and breakfast cereals are the predominant vehicles for 'vitamin' D in the United States.(({{pubmed>long:15585792}})) +Fluid milk and breakfast cereals are the predominant vehicles for 'vitamin' D in the United States.(({{pmid>long:15585792}})) 
  
-The U.S. Food and Drug Administration does not require the addition of vitamin D to milk, but it does regulate the inexpensive additive. The FDA has jurisdiction because in sufficient amounts 'vitamin' D can be poisonous(({{pubmed>long:7733425}})) (to say nothing of the secosteroid's long-term effect on chronic disease).+The U.S. Food and Drug Administration does not require the addition of vitamin D to milk, but it does regulate the inexpensive additive. The FDA has jurisdiction because in sufficient amounts 'vitamin' D can be poisonous(({{pmid>long:7733425}})) (to say nothing of the secosteroid's long-term effect on chronic disease).
  
 A number of dairy manufacturers have opted not to fortify their product lines with 'vitamin' D, or to supplement only with vitamin A. One can verify this information with the National Dairy Council. A number of dairy manufacturers have opted not to fortify their product lines with 'vitamin' D, or to supplement only with vitamin A. One can verify this information with the National Dairy Council.
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 ==== Canada ==== ==== Canada ====
  
-Canada fortifies fluid milk and margarine.(({{pubmed>long:15585792}})) +Canada fortifies fluid milk and margarine.(({{pmid>long:15585792}})) 
  
  
 ==== Europe ==== ==== Europe ====
  
-In Europe, fortification with 'vitamin' D varies. In some countries, the level of fortification can be quite low, at least in comparison to other developed countries. However, it is common practice, especially in Scandinavian countries to give children cod liver oil.  One Finnish study of children born in 1966 found that between 74 and 88% of their mothers reported giving them cod liver oil.(({{pubmed>long:15699498}}))+In Europe, fortification with 'vitamin' D varies. In some countries, the level of fortification can be quite low, at least in comparison to other developed countries. However, it is common practice, especially in Scandinavian countries to give children cod liver oil.  One Finnish study of children born in 1966 found that between 74 and 88% of their mothers reported giving them cod liver oil.(({{pmid>long:15699498}}))
  
  
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 ==== Australia and New Zealand==== ==== Australia and New Zealand====
  
-In Australia, margarine and some milk and milk products are currently fortified with 'vitamin' D. In New Zealand fortification of margarine is not mandatory, but since 1996 voluntary fortification of margarine, fats and dairy food items has been permitted.(({{pubmed>long:12149085}}))+In Australia, margarine and some milk and milk products are currently fortified with 'vitamin' D. In New Zealand fortification of margarine is not mandatory, but since 1996 voluntary fortification of margarine, fats and dairy food items has been permitted.(({{pmid>long:12149085}}))
  
  
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 {{tag>supplementation_policy FDA Food_and_drink foods letter vitamin_D}} {{tag>supplementation_policy FDA Food_and_drink foods letter vitamin_D}}
  
 +<nodisp>
 ===== Notes and comments ===== ===== Notes and comments =====
  
-broke [[http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2011/02/01/prweb5016334.DTL#ixzz1J9HSqLXl|survey by ConsumerLab.com]]+broke [[https://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2011/02/01/prweb5016334.DTL#ixzz1J9HSqLXl|survey by ConsumerLab.com]]
  
  
   * Legacy content   * Legacy content
  
-===== References =====+===== References =====</nodisp> 
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