Individual participant data (IPD)-level meta-analysis of randomised controlled trials to estimate the vitamin D dietary requirements in dark-skinned individuals resident at high latitude
(2022) In European Journal of Nutrition 61(2). p.1015-1034- Abstract
Context and purpose: There is an urgent need to develop vitamin D dietary recommendations for dark-skinned populations resident at high latitude. Using data from randomised controlled trials (RCTs) with vitamin D3-supplements/fortified foods, we undertook an individual participant data-level meta-regression (IPD) analysis of the response of wintertime serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among dark-skinned children and adults residing at ≥ 40° N and derived dietary requirement values for vitamin D. Methods: IPD analysis using data from 677 dark-skinned participants (of Black or South Asian descent; ages 5–86 years) in 10 RCTs with vitamin D supplements/fortified foods identified via a systematic review... (More)
Context and purpose: There is an urgent need to develop vitamin D dietary recommendations for dark-skinned populations resident at high latitude. Using data from randomised controlled trials (RCTs) with vitamin D3-supplements/fortified foods, we undertook an individual participant data-level meta-regression (IPD) analysis of the response of wintertime serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among dark-skinned children and adults residing at ≥ 40° N and derived dietary requirement values for vitamin D. Methods: IPD analysis using data from 677 dark-skinned participants (of Black or South Asian descent; ages 5–86 years) in 10 RCTs with vitamin D supplements/fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D intake estimates across a range of 25(OH)D thresholds. Results: To maintain serum 25(OH)D concentrations ≥ 25 and 30 nmol/L in 97.5% of individuals, 23.9 and 27.3 µg/day of vitamin D, respectively, were required among South Asian and 24.1 and 33.2 µg/day, respectively, among Black participants. Overall, our age-stratified intake estimates did not exceed age-specific Tolerable Upper Intake Levels for vitamin D. The vitamin D intake required by dark-skinned individuals to maintain 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L was 66.8 µg/day. This intake predicted that the upper 2.5% of individuals could potentially achieve serum 25(OH)D concentrations ≥ 158 nmol/L, which has been linked to potential adverse effects in older adults in supplementation studies. Conclusions: Our IPD-derived vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25, 30 and 50 nmol/L are substantially higher than the equivalent estimates for White individuals. These requirement estimates are also higher than those currently recommended internationally by several agencies, which are based predominantly on data from Whites and derived from standard meta-regression based on aggregate data. Much more work is needed in dark-skinned populations both in the dose–response relationship and risk characterisation for health outcomes. Trail registration: PROSPERO International Prospective Register of SystematicReviews (Registration Number: CRD42018097260)
(Less)
- author
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Dark-skinned, Dietary reference values, Individual participant data-level meta-regression analyses, Recommended dietary allowance, Vitamin D recommendations
- in
- European Journal of Nutrition
- volume
- 61
- issue
- 2
- pages
- 1015 - 1034
- publisher
- Springer
- external identifiers
-
- pmid:34705075
- scopus:85117929906
- ISSN
- 1436-6207
- DOI
- 10.1007/s00394-021-02699-6
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
- id
- 0019cba6-d08c-4aca-b761-53408490d1f1
- date added to LUP
- 2021-11-24 08:25:27
- date last changed
- 2024-04-20 16:21:37
@article{0019cba6-d08c-4aca-b761-53408490d1f1,
abstract = {{<p>Context and purpose: There is an urgent need to develop vitamin D dietary recommendations for dark-skinned populations resident at high latitude. Using data from randomised controlled trials (RCTs) with vitamin D<sub>3</sub>-supplements/fortified foods, we undertook an individual participant data-level meta-regression (IPD) analysis of the response of wintertime serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among dark-skinned children and adults residing at ≥ 40° N and derived dietary requirement values for vitamin D. Methods: IPD analysis using data from 677 dark-skinned participants (of Black or South Asian descent; ages 5–86 years) in 10 RCTs with vitamin D supplements/fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D intake estimates across a range of 25(OH)D thresholds. Results: To maintain serum 25(OH)D concentrations ≥ 25 and 30 nmol/L in 97.5% of individuals, 23.9 and 27.3 µg/day of vitamin D, respectively, were required among South Asian and 24.1 and 33.2 µg/day, respectively, among Black participants. Overall, our age-stratified intake estimates did not exceed age-specific Tolerable Upper Intake Levels for vitamin D. The vitamin D intake required by dark-skinned individuals to maintain 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L was 66.8 µg/day. This intake predicted that the upper 2.5% of individuals could potentially achieve serum 25(OH)D concentrations ≥ 158 nmol/L, which has been linked to potential adverse effects in older adults in supplementation studies. Conclusions: Our IPD-derived vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25, 30 and 50 nmol/L are substantially higher than the equivalent estimates for White individuals. These requirement estimates are also higher than those currently recommended internationally by several agencies, which are based predominantly on data from Whites and derived from standard meta-regression based on aggregate data. Much more work is needed in dark-skinned populations both in the dose–response relationship and risk characterisation for health outcomes. Trail registration: PROSPERO International Prospective Register of SystematicReviews (Registration Number: CRD42018097260)</p>}},
author = {{Cashman, Kevin D. and Kiely, Mairead E. and Andersen, Rikke and Grønborg, Ida M. and Tetens, Inge and Tripkovic, Laura and Lanham-New, Susan A. and Lamberg-Allardt, Christel and Adebayo, Folasade A. and Gallagher, J. Christopher and Smith, Lynette M. and Sacheck, Jennifer M. and Huang, Qiushi and Ng, Kimmie and Yuan, Chen and Giovannucci, Edward L. and Rajakumar, Kumaravel and Patterson, Charity G. and Öhlund, Inger and Lind, Torbjörn and Åkeson, Pia Karlsland and Ritz, Christian}},
issn = {{1436-6207}},
keywords = {{Dark-skinned; Dietary reference values; Individual participant data-level meta-regression analyses; Recommended dietary allowance; Vitamin D recommendations}},
language = {{eng}},
number = {{2}},
pages = {{1015--1034}},
publisher = {{Springer}},
series = {{European Journal of Nutrition}},
title = {{Individual participant data (IPD)-level meta-analysis of randomised controlled trials to estimate the vitamin D dietary requirements in dark-skinned individuals resident at high latitude}},
url = {{http://dx.doi.org/10.1007/s00394-021-02699-6}},
doi = {{10.1007/s00394-021-02699-6}},
volume = {{61}},
year = {{2022}},
}