Endocrine Abstracts

Vitamin D deficiency has a high worldwide prevalence. This is of concern for public health because a poor vitamin D status can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D may also prevent extraskeletal diseases such as respiratory tract infections and reduce premature deaths. Several nutritional guidelines have been revised within the last few years leading to and increase of the recommended dietary reference intakes for vitamin D. Based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, the recommended target levels for 25(OH)D usually range from ≥ 25 to 50 nmol/l (10–20 ng/ml), corresponding to a daily vitamin D intake of 400–800 international units (10–20 μg). General populations clearly fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations <30 and <50 nmol/l are present in 13.0% and 40.4% of the general population, respectively. This definitely requires action from public health authorities. Approaches to increase vitamin D status include promotion of a healthier lifestyle, vitamin D supplementation or vitamin D food fortification. The current knowledge on vitamin D safety provides a solid basis to introduce vitamin D food fortification in order to improve public health with this very safe and cost-effective approach. On the other hand, we also have to deal with vitamin D diagnostics and treatment in patient care that is challenging due to inconsistent recommendations and several knowledge gaps regarding clinical effects of vitamin D supplementation.