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Vitamin D in 2020: Stop or Not Yet?

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (31 July 2020) | Viewed by 50380

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Prof. Dr. Marie Courbebaisse

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Service de Physiologie-Explorations Fonctionnelles Rénales, Georges Pompidou European Hospital, AP-HP, Université Paris Descartes, INSERM U1151, Paris, France
Interests: mineral metabolism; nephrolithiasis; glomerular filtration rate measurement
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Etienne Cavalier

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Department of Clinical Chemistry, University of Liège, B-4000 Liège, Belgium
Interests: vitamin D; parathormone; laboratory methods; bone; GFR measurement

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Dear Colleagues,

Many things have been said and written on the skeletal and nonskeletal effects of vitamin D, but the largest recent interventional studies are generally negative. How should we thus position ourselves in 2020? Should we say “stop” or “not yet”? Indeed, the aging of the population, but also new challenges and discoveries are still triggering interest in this old molecule.

In this Special Edition of Nutrients, we invite the finest experts to give their opinion on this important debate. We also encourage scientists to submit their latest research (original papers) and their reviews on nutritional request in the general population and in high-risk groups, such as among mobile societies, treatment strategies, optimal intakes and cut-offs, epidemiology, analytical updates and new devices for vitamin D measurement, bone and muscle health, kidney stones, cardiovascular diseases, diabetes mellitus, chronic kidney disease, infectious and auto-immune diseases, cancers, and pregnancy outcomes.

The scene is set, and the debate is open. Go to your keyboards!

Dr. Marie Courbebaisse
Prof. Dr. Etienne Cavalier
Guest Editors

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Keywords

Vitamin D
Rickets
Osteomalacia
Osteoporosis
Fall
Cardiovascular diseases
Diabetes mellitus
Cancers
Infectious diseases
Auto-immune diseases
Kidney stones
Chronic kidney disease
Pregnancy

Published Papers (11 papers)

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Editorial

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3 pages, 178 KiB

Open AccessEditorial

Vitamin D in 2020: An Old Pro-Hormone with Potential Effects beyond Mineral Metabolism

by Marie Courbebaisse and Etienne Cavalier

Nutrients 2020, 12(11), 3378; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12113378 - 03 Nov 2020

Cited by 8 | Viewed by 2551

Abstract

Vitamin D is not a vitamin but a pro-hormone. [...] Full article

(This article belongs to the Special Issue Vitamin D in 2020: Stop or Not Yet?)

Research

Jump to: Editorial

15 pages, 533 KiB

Open AccessArticle

Barriers towards Sun Exposure and Strategies to Overcome These Barriers in Female Indoor Workers with Insufficient Vitamin D: A Qualitative Approach

by Nurul Nadiah Shahudin, Mohd Jamil Sameeha, Arimi Fitri Mat Ludin, Zahara Abdul Manaf, Kok-Yong Chin and Nor Aini Jamil

Nutrients 2020, 12(10), 2994; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12102994 - 30 Sep 2020

Cited by 8 | Viewed by 8307

Abstract

The prevalence of vitamin D insufficiency is significant even in tropical countries such as Malaysia. Sun exposure is the primary source of vitamin D for most people due to limited intakes of food containing vitamin D and supplements. This study explored the perception of barriers towards sun exposure and strategies to overcome these barriers among vitamin D insufficient women workers in Kuala Lumpur, Malaysia. Twenty-five female indoor workers with serum 25-hydroxyvitamin D < 50 nmol/L participated in seven focus group discussions (FGDs). Barriers towards sun exposure were lack of accurate knowledge of vitamin D, health concern towards sun exposure, time constraints, desire to have fair and beautiful skin, sedentary lifestyle, indoor workplace, weather, lack of social support, living arrangement, safety concerns, and religious or cultural practices. The improvement strategies were classified into lifestyle changes and workplace opportunity for sun exposure. Public education on safe sun exposure to produce an optimal level of vitamin D is necessary. Future studies should evaluate the effectiveness of sunlight exposure program at workplace for the high-risk vitamin D deficiency group. Full article

(This article belongs to the Special Issue Vitamin D in 2020: Stop or Not Yet?)

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11 pages, 774 KiB

Open AccessArticle

Effect of Vitamin D Supplement on Vulvovaginal Atrophy of the Menopause

by Thawinee Kamronrithisorn, Jittima Manonai, Sakda Arj-Ong Vallibhakara, Areepan Sophonsritsuk and Orawin Vallibhakara

Nutrients 2020, 12(9), 2876; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092876 - 21 Sep 2020

Cited by 14 | Viewed by 7072

Abstract

The effects of oral vitamin D supplements on vaginal health in postmenopausal women with vulvovaginal atrophy (VVA) was evaluated. A double-blinded, randomized placebo-controlled trial was conducted for 12 weeks to investigate changes on vaginal maturation index (VMI), vaginal pH, and the visual analog scale (VAS) of VVA symptoms. The vitamin D group received oral ergocalciferol, at 40,000 IU per week, while the placebo group received an identical placebo capsule. Eighty postmenopausal women were enrolled. There were no significant differences in baseline characteristics between both groups. In an intention-to-treat analysis, VMI, vaginal pH, and VAS of VVA symptoms showed no significant differences between both groups at the six and 12 weeks. However, the mean difference of VMI in the vitamin D group between baseline and at six weeks showed significant improvement (5.5 + 16.27, p <0.05). Moreover, the mean vaginal pH and VAS of VVA patients in the vitamin D group were significantly improved at both six and 12 weeks compared to baseline. The oral vitamin D supplementation for 12 weeks potentially improves vaginal health outcomes in postmenopausal women with VVA symptoms, demonstrated by the improved mean VMI, vaginal pH, and VAS at six and 12 weeks between baseline, however, no significant differences were observed from the placebo treatment. Full article

(This article belongs to the Special Issue Vitamin D in 2020: Stop or Not Yet?)

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14 pages, 748 KiB

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The Association between 25-Hydroxyvitamin D Concentration and Disability Trajectories in Very Old Adults: The Newcastle 85+ Study

by Sarah Hakeem, Nuno Mendonca, Terry Aspray, Andrew Kingston, Carmen Ruiz-Martin, Carol Jagger, John C. Mathers, Rachel Duncan and Tom R. Hill

Nutrients 2020, 12(9), 2742; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092742 - 09 Sep 2020

Cited by 4 | Viewed by 2353

Abstract

Background: Low vitamin D status is common in very old adults which may have adverse consequences for muscle function, a major predictor of disability. Aims: To explore the association between 25-hydroxyvitamin D [25(OH)D] concentrations and disability trajectories in very old adults and to determine whether there is an ‘adequate’ 25(OH)D concentration which might protect against a faster disability trajectory. Methodology: A total of 775 participants from the Newcastle 85+ Study for who 25(OH)D concentration at baseline was available. Serum 25(OH)D concentrations of <25 nmol/L, 25–50 nmol/L and >50 nmol/L were used as cut-offs to define low, moderate and high vitamin D status, respectively. Disability was defined as difficulty in performing 17 activities of daily living, at baseline, after 18, 36 and 60 months. Results: A three-trajectory model was derived (low-to-mild, mild-to-moderate and moderate-to-severe). In partially adjusted models, participants with 25(OH)D concentrations <25 nmol/L were more likely to have moderate and severe disability trajectories, even after adjusting for sex, living in an institution, season, cognitive status, BMI and vitamin D supplement use. However, this association disappeared after further adjustment for physical activity. Conclusions: Vitamin D status does not appear to influence the trajectories of disability in very old adults. Full article

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20 pages, 765 KiB

Open AccessArticle

Disparities in Head and Neck Cancer: A Case for Chemoprevention with Vitamin D

by Mirela Ibrahimovic, Elizabeth Franzmann, Alison M. Mondul, Katherine M. Weh, Connor Howard, Jennifer J. Hu, W. Jarrard Goodwin and Laura A. Kresty

Nutrients 2020, 12(9), 2638; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092638 - 29 Aug 2020

Cited by 6 | Viewed by 3386

Abstract

Blacks experience disproportionate head and neck cancer (HNC) recurrence and mortality compared to Whites. Overall, vitamin D status is inversely associated to HNC pointing to a potential protective linkage. Although hypovitaminosis D in Blacks is well documented it has not been investigated in Black HNC patients. Thus, we conducted a prospective pilot study accessing vitamin D status in newly diagnosed HNC patients stratified by race and conducted in vitro studies to investigate mechanisms associated with potential cancer inhibitory effects of vitamin D. Outcome measures included circulating levels of vitamin D, related nutrients, and risk factor characterization as well as dietary and supplemental estimates. Vitamin D-based in vitro assays utilized proteome and microRNA (miR) profiling. Nineteen patients were enrolled, mean circulating vitamin D levels were significantly reduced in Black compared to White HNC patients, 27.3 and 20.0 ng/mL, respectively. Whites also supplemented vitamin D more frequently than Blacks who had non-significantly higher vitamin D from dietary sources. Vitamin D treatment of HNC cell lines revealed five significantly altered miRs regulating genes targeting multiple pathways in cancer based on enrichment analysis (i.e., negative regulation of cell proliferation, angiogenesis, chemokine, MAPK, and WNT signaling). Vitamin D further altered proteins involved in cancer progression, metastasis and survival supporting a potential role for vitamin D in targeted cancer prevention. Full article

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12 pages, 1863 KiB

Open AccessArticle

Effect of Vitamin D Treatment on Dynamics of Stones Formation in the Urinary Tract and Bone Density in Children with Idiopathic Hypercalciuria

by Joanna Milart, Aneta Lewicka, Katarzyna Jobs, Agata Wawrzyniak, Małgorzata Majder-Łopatka and Bolesław Kalicki

Nutrients 2020, 12(9), 2521; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092521 - 20 Aug 2020

Cited by 8 | Viewed by 3363

Abstract

Vitamin D supplementation in patients with urolithiasis and hypercalciuria is considered to be unsafe. We analyzed the impact of vitamin D supplementation on selected health status parameters in children with idiopathic hypercalciuria. The study included 36 children with urolithiasis resulting from excessive calcium excretion. The level of calcium and 25(OH)D (hydroxylated vitamin D - calcidiol) in serum, urinary calcium excretion and the presence of stones in urinary tract were assessed prospectively. Blood and urine samples were collected at the time when the patient was qualified for the study and every three months up to 24 month of vitamin D intake at a dose of 400 or 800 IU/day. At time zero and at 12, and 24 months of vitamin D supplementation, densitometry was performed. Supplementation with vitamin D caused a statistically significant increase in the concentration of 25(OH)D in serum. There were no significant changes in calcium concentration in serum, excretion of calcium in urine but also in bone density. There was no significant increase in the risk of formation or development of stones in the urinary tract. Supplementation with vitamin D (400–800 IU/day) in children with idiopathic hypercalciuria significantly increases 25(OH)D concentration, does not affect calciuria, but also does not improve bone density. Full article

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18 pages, 698 KiB

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Validation and Determination of 25(OH) Vitamin D and 3-Epi25(OH)D3 in Breastmilk and Maternal- and Infant Plasma during Breastfeeding

by Jennifer Gjerde, Marian Kjellevold, Lisbeth Dahl, Torill Berg, Annbjørg Bøkevoll and Maria Wik Markhus

Nutrients 2020, 12(8), 2271; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12082271 - 29 Jul 2020

Cited by 9 | Viewed by 3960

Abstract

Vitamin D deficiency in pregnant women and their offspring may result in unfavorable health outcomes for both mother and infant. A 25hydroxyvitamin D (25(OH)D) level of at least 75 nmol/L is recommended by the Endocrine Society. Validated, automated sample preparation and liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods were used to determine the vitamin D metabolites status in mother-infant pairs. Detection of 3-Epi25(OH)D3 prevented overestimation of 25(OH)D3 and misclassification of vitamin D status. Sixty-three percent of maternal 25(OH)D plasma levels were less than the recommended level of 25(OH)D at 3 months. Additionally, breastmilk levels of 25(OH)D decreased from 60.1 nmol/L to 50.0 nmol/L between six weeks and three months (p < 0.01). Furthermore, there was a positive correlation between mother and infant plasma levels (p < 0.01, r = 0.56) at 3 months. Accordingly, 31% of the infants were categorized as vitamin D deficient (25(OH)D < 50 nmol/L) compared to 25% if 3-Epi25(OH)D3 was not distinguished from 25(OH)D3. This study highlights the importance of accurate quantification of 25(OH)D. Monitoring vitamin D metabolites in infant, maternal plasma, and breastmilk may be needed to ensure adequate levels in both mother and infant in the first 6 months of infant life. Full article

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13 pages, 295 KiB

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Vitamin-D Receptor-Gene Polymorphisms Affect Quality of Life in Patients with Autoimmune Liver Diseases

by Agnieszka Kempinska-Podhorodecka, Monika Adamowicz, Mateusz Chmielarz, Maciej K. Janik, Piotr Milkiewicz and Malgorzata Milkiewicz

Nutrients 2020, 12(8), 2244; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12082244 - 27 Jul 2020

Cited by 11 | Viewed by 2470

Abstract

Vitamin D deficiency has been associated with depressive symptoms and reduced physical functioning. The aim of the study was to characterize the relationship between polymorphisms of the vitamin D receptor (VDR) gene and the quality of life in patients with autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Three polymorphisms of the VDR gene (TaqI-rs731236, BsmI-rs1544410, and ApaI-rs7975232) were analyzed in patients with AIH (n = 142) and PBC (n = 230) and in healthy individuals (n = 376). Patient quality of life was assessed by validated questionnaires such as Medical Outcomes Study Short-Form 36 (SF-36), State Trait Anxiety Inventory (STAI), Modified Fatigue-Impact Scale (MFIS), Patient-Health Questionnaire 9 (PHQ-9), and PBC-40. The TaqI C and ApaI A alleles are risk alleles in both AIH and PBC, and a significant dominance of the A allele in BsmI was observed in AIH patients. In terms of quality of life, the presence of the CC or CT TaqI genotype was associated with emotional reactions, including the fatigue and the cognitive skills of patients with PBC, whereas in the group of AIH patients, homozygotes CC of TaqI, AA of BsmI, and AA of ApaI had worse physical, social, emotional, and mental function. The genetic variations of VDR gene can influence individual susceptibility to develop chronic autoimmune liver diseases such as AIH and PBC and affect quality of life. Full article

(This article belongs to the Special Issue Vitamin D in 2020: Stop or Not Yet?)

15 pages, 1198 KiB

Open AccessArticle

Vitamin D Synthesis Following a Single Bout of Sun Exposure in Older and Younger Men and Women

by Jenna R. Chalcraft, Linda M. Cardinal, Perry J. Wechsler, Bruce W. Hollis, Kenneth G. Gerow, Brenda M. Alexander, Jill F. Keith and D. Enette Larson-Meyer

Nutrients 2020, 12(8), 2237; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12082237 - 27 Jul 2020

Cited by 38 | Viewed by 7334

Abstract

Older adults are frequently cited as an at-risk population for vitamin D deficiency that may in part be due to decreased cutaneous synthesis, a potentially important source of cholecalciferol (vitamin D₃). Previous studies found that cutaneous D₃ production declines with age; however, most studies have been conducted ex vivo or in the photobiology lab. The purpose of this study was to characterize the response of vitamin D metabolites following a 30-min bout of sun exposure (15-min each to the dorsal and ventral sides) at close to solar noon in younger and older adults. Methods: 30 healthy individuals with skin type II/III were recruited; a younger cohort, aged 20–37 (n = 18) and an older cohort (n = 12), age 51–69 years. Exposure was at outer limits of sensible sun exposure designed to enhance vitamin D synthesis without increasing risk of photo ageing and non-melanoma skin cancer. Serum D₃ concentration was measured at baseline, 24, 48 and 72 h post-exposure. Serum 25(OH)D was measured at baseline and 72 h post-exposure plus 168 h post-exposure in the older cohort. Results: D₃ increased in response to sun exposure (time effect; p = 0.002) with a trend for a difference in D₃ between cohorts (time*group; p = 0.09). By regression modeling of continuous data, age accounted for 20% of the variation in D₃ production. D₃ production decreased by 13% per decade. Despite changes in D₃, however, serum 25(OH)D did not change from baseline to 72 or 168 h post exposure (p > 0.10). Conclusions: Serum D₃ concentration increased significantly in response to outdoor sun exposure in younger and older adults. While ageing may dampen cutaneous synthesis, sunlight exposure is still a significant source of vitamin D₃. Full article

(This article belongs to the Special Issue Vitamin D in 2020: Stop or Not Yet?)

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17 pages, 692 KiB

Open AccessArticle

Nutrihealth Study: Seasonal Variation in Vitamin D Status Among the Slovenian Adult and Elderly Population

by Maša Hribar, Hristo Hristov, Matej Gregorič, Urška Blaznik, Katja Zaletel, Adrijana Oblak, Joško Osredkar, Anita Kušar, Katja Žmitek, Irena Rogelj and Igor Pravst

Nutrients 2020, 12(6), 1838; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12061838 - 19 Jun 2020

Cited by 28 | Viewed by 5052

Abstract

Several studies conducted around the world showed substantial vitamin D insufficiency and deficiency among different population groups. Sources of vitamin D in the human body include ultraviolet B (UVB)-light-induced biosynthesis and dietary intake, but people’s diets are often poor in vitamin D. Furthermore, in many regions, sun exposure and the intensity of UVB irradiation during wintertime are not sufficient for vitamin D biosynthesis. In Slovenia, epidemiological data about vitamin D status in the population were investigated through a national Nutrihealth study—an extension to the national dietary survey SI.Menu (2017/18). The study was conducted on a representative sample of 125 adult (18–64 years) and 155 elderly (65–74 years old) subjects, enrolled in the study in different seasons. Their vitamin D status was determined by measuring the serum 25-hydroxy-vitamin D (25(OH)D) concentration. Thresholds for vitamin D deficiency and insufficiency were 25(OH)D levels below 30 and 50 nmol/L, respectively. Altogether, 24.9% of the adults and 23.5% of the elderly were found to be vitamin D deficient, while an insufficient status was found in 58.2% and 62.9%, respectively. A particularly concerning situation was observed during extended wintertime (November–April); vitamin D deficiency was found in 40.8% and 34.6%, and insufficient serum 25(OH)D levels were observed in 81.6% and 78.8%, respectively. The results of the study showed high seasonal variation in serum 25(OH)D levels in both the adult and elderly population, with deficiency being especially pronounced during wintertime. The prevalence of this deficiency in Slovenia is among the highest in Europe and poses a possible public health risk that needs to be addressed with appropriate recommendations and/or policy interventions. Full article

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15 pages, 844 KiB

Open AccessArticle

Long-Term Effects of Vitamin D Supplementation in Obese Children During Integrated Weight–Loss Programme—A Double Blind Randomized Placebo–Controlled Trial

by Michał Brzeziński, Agnieszka Jankowska, Magdalena Słomińska-Frączek, Paulina Metelska, Piotr Wiśniewski, Piotr Socha and Agnieszka Szlagatys-Sidorkiewicz

Nutrients 2020, 12(4), 1093; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12041093 - 15 Apr 2020

Cited by 17 | Viewed by 3608

Abstract

Background: Vitamin D was studied in regards to its possible impact on body mass reduction and metabolic changes in adults and children with obesity yet there were no studies assessing the impact of vitamin D supplementation during a weight management program in children and adolescence. The aim of our study was to assess the influence of 26 weeks of vitamin D supplementation in overweight and obese children undergoing an integrated 12–months’ long weight loss program on body mass reduction, body composition and bone mineral density. Methods: A double–blind randomized placebo–controlled trial. Vitamin D deficient patients (<30 ng/ml level of vitamin D) aged 6–14, participating in multidisciplinary weight management program were randomly allocated to receiving vitamin D (1200 IU) or placebo for the first 26 weeks of the intervention. Results: Out of the 152 qualified patients, 109 (72%) completed a full cycle of four visits scheduled in the program. There were no difference in the level of BMI (body mass index) change – both raw BMI and BMI centiles. Although the reduction of BMI centiles was greater in the vitamin D vs. placebo group (−4.28 ± 8.43 vs. −2.53 ± 6.10) the difference was not statistically significant (p = 0.319). Similarly the reduction in fat mass—assessed both using bioimpedance and DEXa was achieved, yet the differences between the groups were not statistically significant. Conclusions: Our study ads substantial results to support the thesis on no effect of vitamin D supplementation on body weight reduction in children and adolescents with vitamin D insufficiency undergoing a weight management program. Full article

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