Vitamin D: A steroid vitamin which promotes the intestinal absorption and metabolism of calcium and phosphorus. Under normal conditions of sunlight exposure, no dietary supplementation is necessary because sunlight promotes adequate vitamin D synthesis in the skin. Deficiency can lead to bone deformity (rickets) in children and bone weakness (osteomalacia) in adults.
Vitamin D comes from the diet (eggs, fish, and dairy products) and is produced in the skin. Skin production of the active form of vitamin D depends on exposure to sunlight. Active people living in sunny regions produce most of the vitamin D they need from their skin. In less sunny climes the skin production of vitamin D is markedly diminished in the winter months, especially among the elderly and the housebound. In that population, vitamin D supplements become important.
Vitamin D deficiency among the elderly is quite common in the US. In a study of hospitalized patients in a general medical ward, vitamin D deficiency was detected in 57% of the patients. An estimated 50% of elderly women consume far less vitamin D in their diet than recommended.
The Food and Nutrition Board of the Institute of Medicine has recommended the following as an adequate vitamin D intake: 200 IU daily for people 19-50 years old; 400 International Units (IU) daily for those 51-70 years old; and 600 IU daily for those 71 years and older. An average multivitamin tablet contains 400 IU of vitamin D. Therefore, taking a multivitamin a day should help provide the recommended amount of vitamin D. The new recommended daily allowance (RDA), as set in 2010, is based on age, as follows: for those 1-70 years of age, 600 IU daily; for those 71 years and older, 800 IU daily; and for pregnant and lactating women, 600 IU daily. The IOM further recommended that serum 25(OH)D levels of 20ng/mL (= 50 nmol/L) is adequate, and levels > 50ng/mL (= 125 nmol/L) could have potential adverse effects
As to children, the National Academy of Sciences and American Academy of Pediatrics have recommended that all infants, including those who are exclusively breastfed, have a minimum intake of 200 International Units (IU) of vitamin D per day beginning during the first 2 months of life. In addition, it is recommended that an intake of 200 IU of vitamin D per day be continued throughout childhood and adolescence, because adequate sunlight exposure is not easily determined for a given individual.
