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. 2021 Mar;60(2):939-959.
doi: 10.1007/s00394-020-02298-x. Epub 2020 Jun 15.

Individual participant data (IPD)-level meta-analysis of randomised controlled trials with vitamin D-fortified foods to estimate Dietary Reference Values for vitamin D

Kevin D Cashman  1   2 , Mairead E Kiely  3 , Rikke Andersen  4 , Ida M Grønborg  4 , Katja H Madsen  4 , Janna Nissen  4 , Inge Tetens  4   5 , Laura Tripkovic  6 , Susan A Lanham-New  6 , Laura Toxqui  7 , M Pilar Vaquero  7 , Ulrike Trautvetter  8 , Gerhard Jahreis  8 , Vikram V Mistry  9 , Bonny L Specker  10 , Jürgen Hower  11 , Anette Knoll  12 , Dennis Wagner  13 , Reinhold Vieth  13   14 , Inger Öhlund  15 , Pia Karlsland Åkeson  16 , Neil R Brett  17 , Hope A Weiler  17 , Christian Ritz  5
Affiliations

Individual participant data (IPD)-level meta-analysis of randomised controlled trials with vitamin D-fortified foods to estimate Dietary Reference Values for vitamin D

Kevin D Cashman et al. Eur J Nutr. 2021 Mar.

Abstract

Context and purpose: Individual participant data-level meta-regression (IPD) analysis is superior to meta-regression based on aggregate data in determining Dietary Reference Values (DRV) for vitamin D. Using data from randomized controlled trials (RCTs) with vitamin D3-fortified foods, we undertook an IPD analysis of the response of winter serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among children and adults and derived DRV for vitamin D.

Methods: IPD analysis using data from 1429 participants (ages 2-89 years) in 11 RCTs with vitamin D-fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D DRV estimates across a range of serum 25(OH)D thresholds using unadjusted and adjusted models.

Results: Our IPD-derived estimates of vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25 and ≥ 30 nmol/L are 6 and 12 µg/day, respectively (unadjusted model). The intake estimates to maintain 90%, 95% and 97.5% of concentrations ≥ 50 nmol/L are 33.4, 57.5 and 92.3 µg/day, respectively (unadjusted) and 17.0, 28.1 and 43.6 µg/day, respectively (adjusted for mean values for baseline serum 25(OH)D, age and BMI).

Conclusions: IPD-derived vitamin D intakes required to maintain 90%, 95% and 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L are much higher than those derived from standard meta-regression based on aggregate data, due to the inability of the latter to capture between person-variability. Our IPD provides further evidence that using food-based approaches to achieve an intake of 12 µg/day could prevent vitamin D deficiency (i.e., serum 25(OH)D < 30 nmol/L) in the general population.

Keywords: Dietary reference values; Individual participant data-level meta-regression analyses; Recommended dietary allowance; Vitamin D recommendations; Vitamin D-fortified foods.

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References

    1. Cashman KD, Kiely M (2011) Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. Br J Nutr 106:1617–1627 - PubMed
    1. Cashman KD, Dowling KG, Škrabáková Z, Gonzalez-Gross M, Valtueña J, De Henauw S, Moreno L, Damsgaard CT, Michaelsen KF, Mølgaard C et al (2016) Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr 103:1033–1044 - PubMed - PMC
    1. Pilz S, März W, Cashman KD, Kiely ME, Whiting SJ, Holick MF, Grant WB, Pludowski P, Hiligsmann M, Trummer C et al (2018) Rationale and plan for vitamin D food fortification: a review and guidance paper. Front Endocrinol (Lausanne) 9:373
    1. Institute of Medicine (2011) Dietary reference intakes for calcium and vitamin D. The National Academies Press, Washington, DC
    1. Brooks SPJ, Greene-Finestone L, Whiting S, Fioletov VE, Laffey P, Petronella N (2017) An analysis of factors associated with 25-Hydroxyvitamin D levels in white and non-white Canadians. J AOAC Int 100:1345–1354 - PubMed

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