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June 3, 2011

Pro und Kontra zum I.O.M.-REPORT über Vitamin D (Institute of Medicine)

Responses to the Institute of Medicine's report on vitamin D and calcium along with selected papers that seemed to help steer the IOM's decision

Prepared by William B. Grant, Ph.D.,

IOM (Institute of Medicine). 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press.

A summary of the IOM report

  1. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011 Jan;96(1):53-8. 
  2. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 dietary reference intakes for calcium and vitamin d: what dietetics practitioners need to know. J Am Diet Assoc. 2011 Apr;111(4):524-7.

Supporting documents

  1. Chung, M., Balk, E. M., Brendel, M., Ip, S., Lau, J., Lee, J., et al. (2009). Vitamin D and calcium: a systematic review of health outcomes. Evid Rep Technol Assess (Full Rep)(183), 1-420. (Prepared by Tufts Evidence-based Practice Center under Contract No. 290-2007-10055-I). AHRQ Publication No. 09-E015, Rockville, MD: Agency for Healthcare Research and Quality. August 2009. (
  2. Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, Proksch N, Pastor F, Netter C, Streichert T, Püschel K, Amling M. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res. 2010 Feb;25(2):305-12.

39 kritische Antworten auf den IOM-REPORT über Vitamin D:

Critical responses...
to the IOM report and those reporting higher vitamin D requirements than in the report (39 journal publications)

  1. Bischoff-Ferrari, H, Willett W. Comment on the IOM Vitamin D and Calcium Recommendations. For Adult Bone Health, Too Low on Vitamin D—and Too Generous on Calcium. The Nutrition Source. Harvard University, 2011.
  2. Bosomworth NJ. Mitigating epidemic vitamin D deficiency: The agony of evidence. Can Fam Physician. 2011 Jan;57(1):16-20. 
  3. Boucher BJ. The 2010 recommendations of the American Institute of Medicine for daily intakes of vitamin. Public Health Nutrition. 2011 Apr;14(4):740.
  4. Cannell J. Era or error?, Public Health Nutrition. 2011 Apr;14(4):743.
  5. Cannell J. The FNB has failed millions. Guest Editorial. Townsend Letter. 2011 Feb/Mar 2011;(331,332):103.
  6. de Boer IH, Kestenbaum B, Siscovick DS. Vitamin D insufficiency. N Engl J Med. 2011 Apr 7;364(14):1379-80; author reply 1380.
  7. Ebeling PR. Routine screening for vitamin D deficiency in early pregnancy: past its due date? Med J Aust. 2011 Apr 4;194(7):332-3.
  8. García de Tena J, Abejón L, Horcajo P. Vitamin D insufficiency. N Engl J Med. 2011 Apr 7;364(14):1378; author reply 1380. 
  9. Garland CF, French CB, Baggerly LL, Heaney RP. Vitamin D Supplement Doses and Serum 25-hydroxyvitamin D in the Range Associated with Cancer Prevention. Anticancer Res 2011;31: 617-22.
  10. Gillie O. Editorial: Blinded by science, pragmatism forgotten. Public Health Nutrition. 2011 Apr;14(4):566-7.
  11. Ginde A. Vitamin D intake: what advice should be given to women of childbearing age? Expert Rev. Obstet. Gynecol. 2011;6(2):115–118.
  12. Giovannucci E. Vitamin D, how much is enough and how much is too much? Public Health Nutrition. 2011 Apr;14(4):740-1.
  13. Gorham ED, Garland CF. Vitamin D and the limits of randomized controlled trials. Public Health Nutrition. 2011 Apr;14(4):741-3.
  14. Grant WB. Additional strong evidence that optimal serum 25(OH)D levels are at least 75 nmol/l. Int J Epi (accepted Mar. 21)
  15. Grant WB. Differences in sunshine duration and vitamin D production may explain much of the English north-south divide in mortality rates. BMJ. Rapid Responses. 21 Feb. 2011.
  16. Grant WB. Effect of interval between serum draw and follow-up period on relative risk of cancer incidence with respect to 25-hydroxyvitamin D level; implications for meta-analyses and setting vitamin D guidelines. Dermato-Endocrinology. In press
  17. Grant WB. Is the Institute of Medicine Report on calcium and vitamin D good science? Biol Res Nurs. 2011 Apr;13(2):117-9.
  18. Grant WB. The Institute of Medicine did not find the vitamin D-cancer link because it ignored ultraviolet-B dose studies. Public Health Nutrition. 2011 Apr;14(4):745-6.
  19. Grant WB. Weighing the Evidence linking UVB irradiance, vitamin D, and cancer risk. Mayo Clin Proc. 2011 Apr;86(4):362-3. 
  20. Grant WB. Additional strong evidence that optimal serum 25(OH)D levels are at least 75 nmol/l. Int J Epi 2011 Apr. 18 epub; doi: 10.1093/ije/dyr068
  21. Haddow JE, Neveux LM, Palomaki GE, Lambert-Messerlian G, Canick JA, Grenache DG, Lu J. The Relationship between PTH and 25-Hydroxy Vitamin D Early in Pregnancy. Clin Endocrinol (Oxf). 2011 Apr 4. doi: 10.1111/j.1365-2265.2011.04066.x. [Epub ahead of print]
  22. Heaney RP, Grant WB, Holick MF, Amling M. The IOM Report on Vitamin D Misleads. J Clin Endocrinol Metab. eLetter. (4 March 2011)
  23. Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res. 2011;26(3):455-7. 
  24. Heaney RP. Finding the appropriate referent for vitamin D. Public Health Nutrition. 2011 Apr;14(4):749-50.
  25. Holick MF. The D-batable institute of medicine report: a D-lightful perspective. Endocr Pract. 2011 Jan-Feb;17(1):143-9.
  26. Holick MF. The IOM D-lemma. Public Health Nutrition. 2011 May;14(5):939-41.
  27. Hollis BW, Wagner CL. The vitamin D requirement during human lactation: the facts and IOM's 'utter' failure. Public Health Nutrition. 2011 Apr;14(4):748-9.
  28. Hypponen E, Boucher B. Dietary reference intakes for vitamin D. BMJ Rapid Response. 13 Jan. 2011
  29. Katz DL. The Public Health Implications of the 2010 Dietary Guidelines; An Expert Interview With David L. Katz, MD, MPH by Janet Kim, MPH. Feb. 15, 2011.
  30. Mark S, Lambert M, Delvin EE, O'Loughlin J, Tremblay A, Gray-Donald K. Higher vitamin D intake is needed to achieve serum 25(OH)D levels greater than 50 nmol/l in Québec youth at high risk of obesity. Eur J Clin Nutr. 2011 Mar 2. [Epub ahead of print]
  31. Norman AW, Henry HL. Vitamin D nutritional policy is at a crossroads. Poster presented at American Society of Nutrition conference "Controversies in Clinical Nutrition" San Francisco. February 2011.
  32. Norman AW. Vitamin D nutritional policy is at a crossroads. Public Health Nutrition. 2011 Apr;14(4):744-5.
  33. Roth DE. Vitamin D supplementation during pregnancy: safety considerations in the design and interpretation of clinical trials. J Perinatol. 2011 Jan 20. [Epub ahead of print]
  34. Schwalfenberg GK, Whiting SJ. A Canadian response to the 2010 Institute of Medicine vitamin D and calcium guidelines. Public Health Nutrition. 2011 Apr;14(4):746-8.
  35. Taylor CE, Camargo CA Jr. Impact of micronutrients on respiratory infections. Nutr Rev. 2011 May;69(5):259-69. 
  36. Vieth R. Vitamin D nutrient to treat TB begs the prevention question. Lancet. 2011 Jan 15;377(9761):189-90. 
  37. Weiss ST, Litonjua AA. Vitamin D insufficiency. N Engl J Med. 2011 Apr 7;364(14):1379; author reply 1380.
  38. Welsh P, Peters MJ, Sattar N. Vitamin D insufficiency. N Engl J Med. 2011 Apr 7;364(14):1378-9; author reply 1380. 
  39. Yngve A, Tseng M, Haapala I, McNeill C, Hodge A. Vitamin D. The big D-bate. Public Health Nutrition. 2011 Apr;14(4):565.

Web postings critical of the IOM report

  1. Grant WB. Vitamin D deficiency is a serious health concern. March 31, 2011. 
  3. Linus Pauling Institute
  4. Society of Integrative Oncology, quoting Kathy Crew, Gregory A. Plotnikoff and Michael Holick
  5. Spreen A. Vitamin D conspiracy leads straight to Big Pharma.  02/19/2011

Neutral or not assessed

  1. Anand S, Kaysen GA, Chertow GM, Johansen KL, Grimes B, Dalrymple LS, Kurella Tamura M Vitamin D deficiency, self-reported physical activity and health-related quality of life: the Comprehensive Dialysis Study.  Nephrol Dial Transplant. 2011 Mar 23. [Epub ahead of print]
  2. Binkley N, Lewiecki EM.  Vitamin D and Common Sense. J Clinical Densitometry. 2011 Apr;14(2):95-9.
  3. de Gruijl FR. Sufficient vitamin D from casual sun exposure? Photochem Photobiol. 2011 May;87(3):598-601. 
  4. Gilaberte Y, Aguilera J, Carrascosa JM, Figueroa FL, Romaní de Gabriel J, Nagore E. Vitamin D: evidence and controversies. Actas Dermosifiliogr. 2011 May 25. [Epub ahead of print] English, Spanish. 
  5. Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos CT. "Vitamin D Status: United States, 2001-2006". CDC/NCHS Data Brief. Number 59, March 2011.
  6. Monk RD, Bushinsky DA. Making Sense of the Latest Advice on Vitamin D Therapy. J Am Soc Nephrol. 2011 May 26. [Epub ahead of print]
  7. Nicholas J. Vitamin D and Cancer: Uncertainty Persists; Research Continues. J Natl Cancer Inst. 2011 May 23. [Epub ahead of print] 
  8. Rogers C. Postgastrectomy nutrition. Nutr Clin Pract. 2011 Apr;26(2):126-36.
  9. Smith SM, Zwart SR, Ploutz-Snyder RJ, Locke JP. Response to Vitamin D Intake: From the Antarctic to the Institute of Medicine J. Nutr. 2011 141: 5 985-986.
  10. Wehr E, Trummer O, Giuliani A, Gruber HJ, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol. 2011 May;164(5):741-9.

D Is for Debate. UC Berkeley Wellness Letter, March, 2011

Accepting without comment

  1. Arem H, Weinstein S, Horst R, Virtamo J, Yu K, Albanes D, Abnet CC. Serum 25-hydroxyvitamin D and risk of oropharynx and larynx cancers in Finnish men. Cancer Epidemiol Biomarkers Prev. 2011 Apr 28. [Epub ahead of print]
  2. Council on Environmental Health, Section on Dermatology, Balk SJ. Ultraviolet radiation: a hazard to children and adolescents. Pediatrics. 2011 Mar;127(3):588-97
  3. Donatti TL; Koch VHKa; Takayama L , Pereira, RMR. Effects of glucocorticoids on growth and bone mineralization. J. Pediatr. (Rio J.) [online]. 2011, vol.87, n.1, pp. 4-12. ISSN 0021-7557.
  4. Whiting SJ, Langlois KA, Vatanparast H, Greene-Finestone LS. The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: an examination in children and adults with and without supplement use. Am J Clin Nutr. 2011 May 25. [Epub ahead of print]

Defending the IOM report

  1. [No authors listed] Calcium and vitamin D. New guidelines warn against supplement overuse. Mayo Clin Womens Healthsource. 2011 May;15(5):1-2. 
  2. [No authors listed] Mayo Clinic office visit. Vitamin D deficiency. Mayo Clin Womens Healthsource. 2011 May;15(5):6.
  3. Abrams SA. Dietary Guidelines for Calcium and Vitamin D: A New Era. Pediatrics. 2011 Feb 21. [Epub ahead of print] 
  4. British Association of Dermatologists, Cancer Research UK, Diabetes UK, the Multiple Sclerosis Society, the National Heart Forum, the National Osteoporosis Society and the Primary Care Dermatology Society.  Cancer Research UK, December 17 2010
  5. Davis CD, Milner JA. Nutrigenomics, Vitamin D and cancer prevention. J Nutrigenet Nutrigenomics. 2011 Mar 23;4(1):1-11. [Epub ahead of print]
  6. Editors, J. American Assoc. of Physician's Assistants. Limited evidence of benefits of vitamin D supplementation. • february 2011 • 24(2) • JAAPA E3
  7. Elmets CA. New Institute of Medicine Recommendations on Vitamin D. Journal Watch Dermatology December 17, 2010
  8. Hahne D. Vitamin D: Wenig harte Fakten zur Prävention chronischer Krankheiten. Dtsch Arztebl 2011; 108(9): A-452 / B-364 / C-364 MEDIZINREPORT
  9. Hansen KE. High-Dose Vitamin D: Helpful or Harmful? Curr Rheumatol Rep. 2011 Mar 3. [Epub ahead of print]
  10. Khosla S. What do we tell our patients about calcium and vitamin D supplementation? J Clin Endocrinol Metab. 2011 Jan;96(1):69-71. No abstract available. 
  11. Manson JE, Mayne ST, Clinton SK. Vitamin D and prevention of cancer—ready for prime time? N Engl J Med. 2011;364:1385-1387.
  12. Mathieu C, Van der Schueren BJ. Vitamin D deficiency is not good for you. Diabetes Care. 2011 May;34:1245-6.
  13. Nahleh Z, Bhatti NS, Meenakshi Mal M. How to reduce your cancer risk: mechanisms and myths. Internat J General Med. 2011:4 277–287
  14. National Health Service, UK
  15. Reid IR, Avenell A. Evidence-based policy on dietary calcium and vitamin D. J Bone Miner Res. 2011;26(3):452-4.
  16. Rosen CJ. Vitamin D insufficiency. N Engl J Med. 2011;364:248-54.
  17. Ross AC. The 2011 report on dietary reference intakes for calcium and vitamin D. Public Health Nutr. 2011 May;14(5):938-939.
  18. Slomski A. IOM endorses vitamin D, calcium only for bone health, dispels deficiency claims. JAMA. 2011 Feb 2;305(5):453-4, 456. 
  19. Stolzenberg-Solomon R, Weinsterein SJ, Helzlsouer K. Three Authors Reply. Am J Epidemiol (2011) 173(4): 476-477.
  20. Tanne JH. Most Americans and Canadians get enough calcium and vitamin D, report says. BMJ 341:doi:10.1136/bmj.c6998 (Published 3 December 2010)
  21. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc. 2011;86(1):50-60.

Published prior or independent to the IOM report and responses thereto but bearing on the issues

  1. Abrams SA. What Are the Risks and Benefits to Increasing Dietary Bone Minerals and Vitamin D Intake in Infants and Small Children? Annu Rev Nutr. 2010 Aug 18. [Epub ahead of print]
  2. Aloia J, Bojadzievski T, Yusupov E, Shahzad G, Pollack S, Mikhail M, Yeh J. The relative influence of calcium intake and vitamin D status on serum parathyroid hormone and bone turnover biomarkers in a double-blind, placebo-controlled parallel group, longitudinal factorial design. J Clin Endocrinol Metab. 2010 Jul;95(7):3216-24. 
  3. Cannell JJ, Hollis BW, Zasloff M, Heaney RP. Diagnosis and treatment of vitamin D deficiency. Expert Opin Pharmacother. 2008 Jan;9(1):107-18.
  4. Grant WB, Cross HS, Garland CF, Gorham ED, Moan J, Peterlik M, Porojnicu AC, Reichrath J, Zittermann A. Estimated benefit of increased vitamin D status in reducing the economic burden of disease in Western Europe. Prog Biophys Mol Biol. 2009 Feb-Apr;99(2-3):104-13.
  5. Grant WB, Juzeniene A, Moan JE. Health benefit of increased serum 25(OH)D levels from oral intake and ultraviolet-B irradiance in the Nordic countries. Scand J Public Health. 2011 39:70-8.
  6. Grant WB, Schuitemaker G. Health benefits of higher serum 25-hydroxyvitamin D levels in The Netherlands. J Steroid Biochem Molec Biol. 2010;121(1-2): 456–8.
  7. Grant WB. In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B irradiance. Dermato-Endocrinology, 2009;1(4):207-14. 
  8. Grant WB. In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B irradiance. Dermato-Endocrinology, 2009;1(4):207-14.
  9. Grant WB. The UVB-vitamin D-cancer hypothesis is very strong. J Am Dietetic Assoc. 2011 Mar;111(3):365-6. Toner CD, Davis CD, Milner JA. Authors' response. J Am Diet Assoc. 2011 Mar;111(3):366. 
  10. Helzlsouer KJ. For the VDPP Steering Committee. Overview of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epi, 2010 172: 4-9.
  11. Lanham-New SA, Buttriss JL, Miles LM, Ashwell M, Berry JL, Boucher BJ, Cashman KD, Cooper C, Darling AL, Francis RM, Fraser WD, de Groot CP, Hyppönen E, Kiely M, Lamberg-Allardt C, Macdonald HM, Martineau AR, Masud T, Mavroeidi A, Nowson C, Prentice A, Stone EM, Reddy S, Vieth R, Williams CM. Proceedings of the Rank Forum on Vitamin D. Br J Nutr. 2011 Jan;105(1):144-56
  12. Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, et al. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: Recommendations for clinical practice. Autoimmun Rev. 2010 Sep;9(11):709-15.
  13. Toner CD, Davis CD, Milner JA. The vitamin D and cancer conundrum: Aiming at a moving target. J Am Diet Assoc. 2010 Oct;110(10):1492-1500.


Kritik, IOM, Institute of Medicine, USA, Pro und Contra

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