title: How much vitamin D do we need for skeletal health?
abstract: BACKGROUND
  Vitamin D is critical for musculoskeletal health and has been implicated in the risk of extraskeletal diseases, including cancer, cardiovascular diseases, and autoimmune diseases, as well as overall mortality. Although numerous studies deal and have dealt with vitamin D deficiency and its consequences, experts cannot agree on the right 25-hydroxyvitamin D levels. This survey aims to shed light on the ongoing vitamin D controversy from different angles.
  
  
  OBJECTIVE
  We discuss the minimum threshold for the 25-hydroxyvitamin D level to guarantee optimal health, why vitamin is D critical to musculoskeletal and extraskeletal functions, and new evidence for the success of prevention measures such as food fortification.
  
  
  METHODS
  We searched PubMed, Google Scholar, and reference lists of articles using several keywords. The most recent search was in February 2011.
  
  
  RESULTS
  While the use of parathyroid hormone as a surrogate measure did not lead to a consensus concerning the required 25-hydroxyvitamin D serum level, the combined analysis of bone mineralization and vitamin D status has established minimum levels of more than 75 nmol/L (30 ng/mL) to guarantee at least skeletal health. An effective measure to approach this status is food fortification, which has been demonstrated by countries such as Canada, the United States, and Finland.
  
  
  CONCLUSIONS
  Given the health economic implications of failure to maintain a balanced vitamin D status, action is recommended to integrate current scientific knowledge on vitamin D into physicians' treatment of patients and governmental policies on food fortification.
authors: Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors: Christoph
authors: C
authors: von Domarus
authors: Jonathan
authors: J
authors: Brown
authors: Florian
authors: F
authors: Barvencik
authors: Michael
authors: M
authors: Amling
authors: Pia
authors: P
authors: Pogoda
mesh_terms: D001842:Bone and Bones / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications / Q000517:prevention & control
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D