Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy

Proc Nutr Soc. 2018 Aug;77(3):292-301. doi: 10.1017/S0029665117004104. Epub 2017 Dec 4.

Abstract

Vitamin D is a unique nutrient. First, it acts as a pro-hormone and secondly, the requirement for vitamin D can be met by both endogenous synthesis from sunlight and by dietary sources. This complicates the determination of dietary requirements for vitamin D, which along with the definition of optimal vitamin D status, have been highly controversial and much debated over recent years. Adolescents are a population group at high risk of low vitamin D status, which is concerning given the important role of vitamin D, and calcium, in promoting normal bone mineralisation and attainment of peak bone mass during this rapid growth phase. Dietary vitamin D recommendations are important from a public health perspective in helping to avoid deficiency and optimise vitamin D status for health. However limited experimental data from winter-based dose-response randomised trials in adolescents has hindered the development of evidence-based dietary requirements for vitamin D in this population group. This review will highlight how specifically designed randomised trials and the approach adopted for estimating such requirements can lead to improved recommendations. Such data indicate that vitamin D intakes of between 10 and about 30 µg/d may be required to avoid deficiency and ensure adequacy in adolescents, considerably greater than the current recommendations of 10-15 µg/d. Finally this review will consider the implications of this on public health policy, in terms of future refinements of vitamin D requirement recommendations and prioritisation of public health strategies to help prevent vitamin D deficiency.

Keywords: 1; 25(OH)D 25-hydroxyvitamin D; EAR estimated average requirement; EFSA European Food Safety Authority; IOM Institute of Medicine; NDNS National Diet and Nutrition Survey; ODIN Food-based solutions for optimal vitamin D nutrition through the life cycle; RCT randomised controlled trial; SACN Scientific Advisory Committee on Nutrition; UVB ultraviolet B; 25(OH)2D 1; 25-dihydroxyvitamin D; 25-hydroxyvitamin D; Adolescence; Dietary requirements; Vitamin D.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Bone Density
  • Diet*
  • Humans
  • Nutrition Policy*
  • Nutritional Requirements*
  • Nutritional Status
  • Public Health
  • Seasons
  • Sunlight
  • Vitamin D / administration & dosage*
  • Vitamin D / blood
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / prevention & control*
  • Vitamins / administration & dosage*
  • Vitamins / blood
  • Vitamins / therapeutic use

Substances

  • Vitamins
  • Vitamin D