comment on Vitamin D insufficiency

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CommentaryCommentaireVitamin D insufficiency: no recommended dietaryallowance exists for this nutrient Reinhold Vieth, Donald Fraserß See related article page 1517ickets, a defect in bone growth during infancy and designed to ensure anything. They are simply based on thechildhood, was first characterized in 1650. Al- old, default strategy for setting a nutritional guideline,R though cod-liver oil was used as a folk remedy in which is to recommend an amount of nutrient similar tonorthern Europe starting in the late 1700s, it was not until what healthy people are eating. This approach underlies1922 that the medical community realized that something the circular logic behind a familiar refrain about nutrition:1,2in it prevented and cured rickets. As recently as 4 decades “If you eat a good diet, you won’t need supplements.” Byago, physicians assumed that vitamin D nutrition was ade- this logic, the answer to the question, “How much nutrientquate if people exhibited no clinical or radiographic signs do you need?” is, “Whatever healthy people happen to be3,4 of rickets. Osteomalacia, the adult counterpart of rickets, eating.” The essential point, lost in the confusing terminol-was rarely seen, and it was assumed that adults require no ogy of modern nutrient recommendations, is that a recom-4more, and usually less, vitamin D than infants do. It was mended daily allowance (RDA) does not yet exist for vita-also assumed that the D generated in the skin, vita- min ...

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Vitamin D insufficiency: no recommended dietary

ßSee related article page 1517

CMAJ  JUNE 11, 2002; 166 (12)

1541

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– concen raons o. ne ner m, wee eve that a daily supplement of 25 µg (1000 IU) of vitamin D3is advisable for all adults.

Dr. Vieth is Associate Professor, Department of Laboratory Medicine and Patho-biology, University of Toronto, and Director of the Bone and Mineral Laboratory, Department of Pathology and Laboratory Medicine, Mount Sinai Hospital,

Toronto, Ont. Dr. Fraser is Professor Emeritus, Departments of Paediatrics and Physiology, University of Toronto, and Honourary Physician, the Hospital for Sick Children, Toronto, Ont. He was a member of the Committee on Nutrition, American Academy of Pediatrics, the reports of which formed the basis of earlier

Contributors:was the primary author of this commentary. DonaldReinhold Vieth -

Correspondence to:Dr. Reinhold Vieth, Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Ave., Toronto ONM5G 1X5; fax 416 5868628; rvieth@mtsinai.on.ca

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