Most
favorable serum concentrations of 25(OH)D for bone and general health have not
been established; they are likely to vary at each stage of life, depending on
the physiological measures selected .Also, as stated earlier, while serum
25(OH)D functions as a bio marker of experience to vitamin D (from sun, food,
and nutritional supplements), the extent to which such level serve as a bio
marker of effect (i.e., health outcomes) is not clearly established
.Furthermore, while serum 25(OH)D levels increase in response to amplified
vitamin D intake, the relationship is non-linear for reason that are not
totally clear .The increase varies, for example, by baseline serum levels and
length of supplementation. Increasing serum 25(OH)D to >50 requires more
vitamin D than mounting levels from a baseline <50. There is a steeper rise
in serum 25(OH)D when the dose of vitamin D is <1,000 IU/day; a lower, more
trodden response is seen at higher daily doses. When the dose is ≥1,000 IU/day,
the climb in serum 25(OH)D is approximately 1 for each 40 IU of intake. In
studies with a dose ≤600 IU/day, the rise is serum 25(OH)D was approximately
2.3 for each 40 IU of vitamin D consumed .In 2011, The Endocrine Society issued
clinical practice guidelines for vitamin D, stating that the desirable serum
concentration of 25to maximize the outcome of this vitamin on calcium, prepare,
and muscle metabolism .It also reported that to consistently raise serum levels
of 25(OH)D above 75 at least 1,500-2,000 IU/day of supplemental vitamin D might
be required in adults, and at least 1,000 IU/day in kids and adolescents.
However, the FNB committee that established DRIs for vitamin D extensively
reviewed a long list of latent health relationships on which recommendations
for vitamin D intake might be based .These health associations included
resistance to chronic diseases (such as cancer and cardiovascular diseases),
physiological parameters (such as immune answer or levels of parathyroid
hormone), and functional measures (such as skeletal health and physical
performance and falls). With the exception of measures related to bone health,
the health relationships examined were either not supported by enough evidence
to establish cause and effect, or the conflicting nature of the available
evidence could not be used to relation health benefits to particular levels of
intake of vitamin D or serum measures of 25(OH)D with any level of confidence.
This overall finish was confirmed by a more recent report on vitamin D and
calcium from the Agency for Healthcare Research and Quality, which reviewed
data from nearly 250 new studies published between 2009 and 2013 .The report
concluded that it is still not potential to spell out a affiliation between
vitamin D and health outcomes other than bone health.
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