Review Article: Health benefit of increased serum 25(OH)D levels from oral intake and ultraviolet-B irradiance in the Nordic countries.
OBJECTIVE
A low serum 25-hydroxyvitamin D [25(OH)D] level is a risk factor for many diseases, including musculoskeletal diseases, many types of cancer, cardiovascular diseases, diabetes mellitus, infectious diseases, autoimmune diseases, and brain diseases. This report estimates the reduction in mortality rates for the five Nordic countries for an increase in population mean serum 25-hydroxyvitamin D level to 105 nmol/L.


METHODS
Serum vitamin D dose-incidence/prognosis relationships can be developed with significant levels of reliability for most vitamin D-sensitive diseases on the basis of ecological, cross-sectional, and observational studies, randomized controlled trials, and meta-analysis of such studies. These dose-response relations are used to estimate the population-wide benefit of raising mean serum 25(OH)D concentration to 105 nmol/L for the five Nordic countries.


RESULTS
From this study, the reductions in mortality rates possible by raising population mean serum 25(OH)D levels to 105 nmol/L are: Denmark, 17% (estimated range,11%-24%); Finland, 24% (17%-32%); Iceland, 24% (17%-32%); Norway, 18% (11%-26%); and Sweden, 18% (8%-25%).


CONCLUSIONS
Reaching these levels would require changes in health policies with respect to solar ultraviolet-B (UVB) irradiance, vitamin D fortification of food, availability of vitamin D and calcium supplements, and attitude toward use of UVB lamps. Adverse effects of oral vitamin D intake are limited, and those from UVB irradiance are minor compared with the benefits.
Grant
William B
WB
Sunlight, Nutrition, and Health Research Center, San Francisco, CA, USA. wbgrant@infionline.net
Juzeniene
Asta
A
Moan
Johan E
JE
D015652:25-Hydroxyvitamin D 2 / Q000097:blood* / Q000528:radiation effects; D000284:Administration, Oral; D003718:Denmark / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D005387:Finland / Q000453:epidemiology; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D009026:Mortality; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D013472:Sunlight; D013548:Sweden / Q000453:epidemiology; D014466:Ultraviolet Rays; D014807:Vitamin D / Q000008:administration & dosage*
D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2