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Update in Vitamin D

University of California-Los Angeles (UCLA)-Orthopaedic Hospital Research Center and Department of Orthopaedic Surgery (J.S.A., M.H.); Department of Molecular, Cell, and Developmental Biology (J.S.A.); Department of Medicine (J.S.A., M.H.); and the Molecular Biology Institute (M.H.), UCLA, Los Angeles, California 90095-7358

Address all correspondence and requests for reprints to: John S. Adams, M.D., UCLA-Orthopaedic Hospital Research Center, 615 Charles Young Drive South, Room 410E, Los Angeles, California 90095-7358. E-mail: jsadams{at}mednet.ucla.edu.

The past decade, particularly the last 18 months, witnessed a vigorous increase in interest in vitamin D from both the lay and biomedical worlds. Much of the growing interest in vitamin D is powered by new data being extracted from the National Health and Nutrition Examination Survey (NHANES). The newest statistics demonstrate that more than 90% of the pigmented populace of the United States (Blacks, Hispanics, and Asians) now suffer from vitamin D insufficiency (25-hydroxyvitamin D <30 ng/ml), with nearly three fourths of the white population in this country also being vitamin D insufficient. This represents a near doubling of the prevalence of vitamin D insufficiency seen just 10 yr ago in the same population. This review attempts to provide some explanation for: 1) the rapid decline in vitamin D status in the United States; 2) the adverse impact of vitamin D insufficiency on skeletal, infectious/inflammatory, and metabolic health in humans; and 3) the therapeutic rationale and reliable means for vigorous supplementation of our diets with vitamin D.

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