Kevin D Cashman1,2, Mairead E Kiely3, Rikke Andersen4, Ida M Grønborg4, Katja H Madsen4, Janna Nissen4, Inge Tetens4,5, Laura Tripkovic6, Susan A Lanham-New6, Laura Toxqui7, M Pilar Vaquero7, Ulrike Trautvetter8, Gerhard Jahreis8, Vikram V Mistry9, Bonny L Specker10, Jürgen Hower11, Anette Knoll12, Dennis Wagner13, Reinhold Vieth13,14, Inger Öhlund15, Pia Karlsland Åkeson16, Neil R Brett17, Hope A Weiler17, Christian Ritz5. 1. Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland. k.cashman@ucc.ie. 2. Department of Medicine, University College Cork, Cork, Ireland. k.cashman@ucc.ie. 3. Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland. 4. Research Group for Risk-Benefit, Division for Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark. 5. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Copenhagen, Denmark. 6. Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. 7. Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Madrid, Spain. 8. Institute of Nutrition, Friedrich Schiller University of Jena, Dornburger Str, 24, 07743, Jena, Germany. 9. Dairy Science Department, South Dakota State University, Brookings, 57007, USA. 10. Ethel Austin Martin Endowed Program in Human Nutrition, South Dakota State University, Brookings, 57007, USA. 11. Überörtliche Gemeinschaftspraxis für Kinder- und Jugendmedizin Standort Dümpten, Mellinghofer Straße 256, 45475, Mülheim an der Ruhr, Germany. 12. Freelance Statistician, Kreppe 2, 85276, Pfaffenhofen/Ilm, Germany. 13. Department of Nutritional Sciences, University of Toronto, Toronto, M563E2, Canada. 14. Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, M5G1X5, Canada. 15. Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. 16. Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden. 17. School of Human Nutrition, McGill University, Sainte Anne de Bellevue, QC, Canada.
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.
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 Ddeficiency (i.e., serum 25(OH)D < 30 nmol/L) in the general population.
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