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. 2016 Jul 1;11(7):e0157262.
doi: 10.1371/journal.pone.0157262. eCollection 2016.

The Current Recommended Vitamin D Intake Guideline for Diet and Supplements During Pregnancy Is Not Adequate to Achieve Vitamin D Sufficiency for Most Pregnant Women

Fariba Aghajafari  1 , Catherine J Field  2 , Bonnie J Kaplan  1 , Doreen M Rabi  1 , Jack A Maggiore  3 , Maeve O'Beirne  1 , David A Hanley  1 , Misha Eliasziw  4 , Deborah Dewey  1 , Amy Weinberg  2 , Sue J Ross  5 ; APrON Study Team
Affiliations

The Current Recommended Vitamin D Intake Guideline for Diet and Supplements During Pregnancy Is Not Adequate to Achieve Vitamin D Sufficiency for Most Pregnant Women

Fariba Aghajafari et al. PLoS One. .

Abstract

Background: The aims of this study were to determine if pregnant women consumed the recommended vitamin D through diet alone or through diet and supplements, and if they achieved the current reference range vitamin D status when their reported dietary intake met the current recommendations.

Methods: Data and banked blood samples collected in second trimester from a subset of 537 women in the APrON (Alberta Pregnant Outcomes and Nutrition) study cohort were examined. Frozen collected plasma were assayed using LC-MS/MS (liquid chromatography-tandem mass spectrometry) to determine 25(OH)D2, 25(OH)D3, 3-epi-25(OH)D3 concentrations. Dietary data were obtained from questionnaires including a Supplement Intake Questionnaire and a 24-hour recall of the previous day's diet.

Results: Participants were 87% Caucasian; mean (SD) age of 31.3 (4.3); BMI 25.8 (4.7); 58% were primiparous; 90% had education beyond high school; 80% had a family income higher than CAN $70,000/year. 25(OH)D2, 25(OH)D3, and 3-epi-25(OH)D3) were identified in all of the 537 plasma samples;3-epi-25(OH)D3 contributed 5% of the total vitamin D. The median (IQR) total 25(OH)D (D2+D3) was 92.7 (30.4) nmol/L and 20% of women had 25(OH)D concentration < 75 nmol/L. The median (IQR) reported vitamin D intake from diet and supplements was 600 (472) IU/day. There was a significant relationship between maternal reported dietary vitamin D intake (diet and supplement) and 25(OH)D and 3-epi-25(OH)D3 concentrations in an adjusted linear regression model.

Conclusions: We demonstrated the current RDA (600 IU/ day) may not be adequate to achieve vitamin D status >75 nmol/L in some pregnant women who are residing in higher latitudes (Calgary, 51°N) in Alberta, Canada and the current vitamin D recommendations for Canadian pregnant women need to be re-evaluated.

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Conflict of interest statement

Competing Interests: All intellectual property related to the laboratory-developed analytical method used in this publication is the property of Doctor’s Data, Inc. Dr. Jack Maggiore is an employee of Doctor’s Data, Inc. He has no ownership in the company and makes no such claims as to the patentability of the method. Dr. Maggiore has no conflicts of interest or commercial affiliation with any company, diagnostic or otherwise. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Scatter plot of plasma 3-epi-25(OH)D3 and 25(OH)D3 in pregnant women during second trimester of pregnancy in a longitudinal cohort of pregnant women and their infants in Alberta, Canada (n = 537).
Pearson correlation coefficient showed a significant correlation between 25(OH)D3 and 3-epi-25(OH)D3 (r = 0.69, P<0.001).
Fig 2
Fig 2. Absolute concentrations of (A) plasma 25(OH)D, and (B) plasma 3-epi-25(OH)D3 versus maternal vitamin D intake (IU/day) in a longitudinal cohort of pregnant women and their infants in Alberta, Canada.
Black horizontal lines in each box represent medians; edges of each box represent 25th and 75th percentiles; the lines extending from each box represent 1.5 times the interquartile range; outliers are shown as stars.
See this image and copyright information in PMC

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