title: Clinical Review: The 2011 report on dietary reference intake for vitamin D: where do we go from here?
abstract: BACKGROUND
  The Institute of Medicine (IOM) report on dietary reference intakes (DRI) for vitamin D is reviewed, along with its implications.
  
  
  METHODS
  Evidence-based reviews were completed; the IOM committee conducted its own literature search, an open public workshop, and two open sessions, and maintained a public web site for stakeholder input. The consensus report of the 14 scientists on the committee was reviewed by a panel of experts.
  
  
  RESULTS
  Only bone health could be used as an indicator for DRI development. Evidence for extraskeletal outcomes was inadequate, inconsistent, or insufficient to develop DRI. The recommended dietary allowance was found to be 600 IU/d for ages 1-70 yr, corresponding on average to a serum 25-hydroxyvitamin D (25OHD) level of at least 50 nmol/liter (20 ng/ml), and 800 IU/d for those older than 70 yr. Comparison with current levels of 25OHD in the National Health and Nutrition Examination Survey population survey revealed that the vitamin D intake in the United States and Canada is adequate. An upper limit was set at 4000 IU/d for adults, corresponding to an average serum 25OHD level of 125 nmol/liter (50 ng/ml).
  
  
  CONCLUSIONS
  Previous reports of an epidemic of vitamin D deficiency in North America were based on an overestimation of adequacy. Population screening with serum 25OHD is therefore not warranted. Current laboratory reference ranges for serum 25OHD are overestimated and should be revised. Practice guidelines to treat disease should not be applied to the healthy American population where use of the DRI is appropriate.
authors.affiliation: Winthrop University Hospital, Mineola, New York 11501, USA. jaloia@winthrop.org
authors.forename: John F
authors.initials: JF
authors.lastname: Aloia
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000378:metabolism; D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D001842:Bone and Bones / Q000502:physiology; D002136:Calcium, Dietary / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D004032:Diet; D004034:Diet Surveys; D019587:Dietary Supplements; D006304:Health Status; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology; D009656:North America; D018673:Nutrition Policy; D011634:Public Health; D012016:Reference Values; D013472:Sunlight; D014481:United States; D014807:Vitamin D / Q000008:administration & dosage* / Q000009:adverse effects / Q000502:physiology / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2