Skip to main content
Top
Published in: European Journal of Nutrition 2/2014

01-03-2014 | Review

Vitamin D supplementation, body weight and human serum 25-hydroxyvitamin D response: a systematic review

Authors: Armin Zittermann, Jana B. Ernst, Jan F. Gummert, Jochen Börgermann

Published in: European Journal of Nutrition | Issue 2/2014

Login to get access

Abstract

Purpose

There is considerable variation in incremental circulating 25-hydroxyvitamin D (25OHD) levels on vitamin D supplements, even when similar age groups and identical vitamin D doses are compared. We therefore aimed to investigate the importance of body weight for the dose–response relation in circulating 25OHD.

Methods

We performed a systematic review of randomized placebo-controlled vitamin D supplementation trials in all age groups ≥10 years to clarify the influence of body weight and other parameters on incremental circulating 25OHD levels (difference between baseline and in-study values) in vitamin D-deficient and non-deficient individuals.

Results

We included 144 cohorts from 94 independent studies, published from 1990 to November 2012, in our systematic review. There was a logarithmic association between vitamin D dose per kg body weight per day and increment in circulating 25OHD. In multivariable regression analysis, vitamin D dose per kg body weight per day could explain 34.5 % of variation in circulating 25OHD. Additional significant predictors were type of supplement (vitamin D2 or vitamin D3), age, concomitant intake of calcium supplements and baseline 25OHD, explaining 9.8, 3.7, 2.4 and 1.9 %, respectively, of the variation in circulating 25OHD.

Conclusions

This systematic review demonstrates that body weight is an important predictor of variation in circulating 25OHD in cohorts on vitamin D supplements. Our model provides an estimate of the daily vitamin D dose that is necessary for achieving adequate circulating 25OHD levels in vitamin D-insufficient or vitamin D-deficient individuals/cohorts with different body weights and ages.
Appendix
Available only for authorised users
Literature
1.
go back to reference Zittermann A, Gummert JF (2010) Nonclassical vitamin D actions. Nutrients 2:408–425CrossRef Zittermann A, Gummert JF (2010) Nonclassical vitamin D actions. Nutrients 2:408–425CrossRef
2.
go back to reference Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos CT (2011) Vitamin D status: United States, 2001–2006. NCHS Data Brief 59:1–8 Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos CT (2011) Vitamin D status: United States, 2001–2006. NCHS Data Brief 59:1–8
3.
go back to reference Hintzpeter B, Scheidt-Nave C, Müller MJ, Schenk L, Mensink GB (2008) Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J Nutr 138:1482–1490 Hintzpeter B, Scheidt-Nave C, Müller MJ, Schenk L, Mensink GB (2008) Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J Nutr 138:1482–1490
4.
go back to reference Hintzpeter B, Mensink GB, Thierfelder W, Müller MJ, Scheidt-Nave C (2008) Vitamin D status and health correlates among German adults. Eur J Clin Nutr 62:1079–1089CrossRef Hintzpeter B, Mensink GB, Thierfelder W, Müller MJ, Scheidt-Nave C (2008) Vitamin D status and health correlates among German adults. Eur J Clin Nutr 62:1079–1089CrossRef
5.
go back to reference Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, Fuleihan GEH, Josse RG, Lips P, Morales-Torres J, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820CrossRef Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, Fuleihan GEH, Josse RG, Lips P, Morales-Torres J, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820CrossRef
6.
go back to reference Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58CrossRef Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58CrossRef
7.
go back to reference DGE (German Nutrition Society), Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung (2012) D-A-CH-Referenzwerte für die Nährstoffzufuhr, 1. Auflage, 4., korrigierter Nachdruck 2012, Neuer Umschau Buchverlag, Neustadt an der Weinstraße DGE (German Nutrition Society), Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung (2012) D-A-CH-Referenzwerte für die Nährstoffzufuhr, 1. Auflage, 4., korrigierter Nachdruck 2012, Neuer Umschau Buchverlag, Neustadt an der Weinstraße
8.
go back to reference Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes B (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367:40–49CrossRef Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes B (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367:40–49CrossRef
9.
go back to reference Rizzoli R, Boonen S, Brandi ML, Bruyère O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29:305–313CrossRef Rizzoli R, Boonen S, Brandi ML, Bruyère O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29:305–313CrossRef
10.
11.
go back to reference Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C (2011) Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev 7:CD007470 Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C (2011) Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev 7:CD007470
13.
go back to reference Mastaglia SR, Mautalen CA, Parisi MS, Oliveri B (2006) Vitamin D2 dose required to rapidly increase 25OHD levels in osteoporotic women. Eur J Clin Nutr 60:681–687CrossRef Mastaglia SR, Mautalen CA, Parisi MS, Oliveri B (2006) Vitamin D2 dose required to rapidly increase 25OHD levels in osteoporotic women. Eur J Clin Nutr 60:681–687CrossRef
14.
go back to reference Gallagher JC, Sai A, Templin T, Smith L (2012) Dose response to Vitamin D supplementation in postmenopausal women: a randomized trial. Ann Intern Med 156:425–437CrossRef Gallagher JC, Sai A, Templin T, Smith L (2012) Dose response to Vitamin D supplementation in postmenopausal women: a randomized trial. Ann Intern Med 156:425–437CrossRef
15.
go back to reference Michaëlsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, Sundström J, Berglund L, Arnlöv J, Hellman P, Blomhoff R, Wolk A, Garmo H, Holmberg L, Melhus H (2010) Plasma vitamin D and mortality in older men: a community-based prospective cohort study. Am J Clin Nutr 92:841–848CrossRef Michaëlsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, Sundström J, Berglund L, Arnlöv J, Hellman P, Blomhoff R, Wolk A, Garmo H, Holmberg L, Melhus H (2010) Plasma vitamin D and mortality in older men: a community-based prospective cohort study. Am J Clin Nutr 92:841–848CrossRef
16.
go back to reference Durup D, Jørgensen HL, Christensen J, Schwarz P, Heegaard AM, Lind B (2012) A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study. J Clin Endocrinol Metab 97:2644–2652CrossRef Durup D, Jørgensen HL, Christensen J, Schwarz P, Heegaard AM, Lind B (2012) A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study. J Clin Endocrinol Metab 97:2644–2652CrossRef
17.
go back to reference Zittermann A, Kuhn J, Dreier J, Knabbe C, Gummert JF, Börgermann J (2013) Vitamin D status and the risk of major adverse cardiac and cerebrovascular events in cardiac surgery. Eur Heart J 34:1358–1364CrossRef Zittermann A, Kuhn J, Dreier J, Knabbe C, Gummert JF, Börgermann J (2013) Vitamin D status and the risk of major adverse cardiac and cerebrovascular events in cardiac surgery. Eur Heart J 34:1358–1364CrossRef
18.
go back to reference Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822CrossRef Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822CrossRef
19.
go back to reference Rossini M, Adami S, Viapiana O, Fracassi E, Idolazzi L, Povino MR, Gatti D (2012) Dose-dependent short-term effects of single high doses of oral vitamin D(3) on bone turnover markers. Calcif Tissue Int 91:365–369CrossRef Rossini M, Adami S, Viapiana O, Fracassi E, Idolazzi L, Povino MR, Gatti D (2012) Dose-dependent short-term effects of single high doses of oral vitamin D(3) on bone turnover markers. Calcif Tissue Int 91:365–369CrossRef
20.
go back to reference Souberbielle JC, Body JJ, Lappe J, Plebani M, Shoenfeld Y, Wang TJ, Bianchi ML, Bischoff-Ferrari H, Cavalier E, Ebeling P, Fardellone P, Gandini S, Gruson D, Guerin A, Heickendorff L, Hollis B, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practise. Autoimmun Rev 9:709–715CrossRef Souberbielle JC, Body JJ, Lappe J, Plebani M, Shoenfeld Y, Wang TJ, Bianchi ML, Bischoff-Ferrari H, Cavalier E, Ebeling P, Fardellone P, Gandini S, Gruson D, Guerin A, Heickendorff L, Hollis B, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practise. Autoimmun Rev 9:709–715CrossRef
21.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRef
22.
go back to reference Autier P, Gandini S, Mullie P (2012) A systematic review: influence of vitamin D supplementation on serum 25-hydroxyvitamin D concentration. J Clin Endocrinol Metab 97:2606–2613CrossRef Autier P, Gandini S, Mullie P (2012) A systematic review: influence of vitamin D supplementation on serum 25-hydroxyvitamin D concentration. J Clin Endocrinol Metab 97:2606–2613CrossRef
23.
go back to reference Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77:204–210 Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77:204–210
24.
go back to reference van Groningen L, Opdenoordt S, van Sorge A, Telting D, Giesen A, de Boer H (2010) Cholecalciferol loading dose guideline for vitamin D-deficient adults. Eur J Endocrinol 162:805–811CrossRef van Groningen L, Opdenoordt S, van Sorge A, Telting D, Giesen A, de Boer H (2010) Cholecalciferol loading dose guideline for vitamin D-deficient adults. Eur J Endocrinol 162:805–811CrossRef
25.
go back to reference Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF, For the 8 QUOROM group (1999) Improving the quality of reporting of meta-analysis of randomized controlled trials: the QUOROM statement. Lancet 354:1896–1900CrossRef Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF, For the 8 QUOROM group (1999) Improving the quality of reporting of meta-analysis of randomized controlled trials: the QUOROM statement. Lancet 354:1896–1900CrossRef
26.
go back to reference Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13CrossRef Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13CrossRef
27.
go back to reference Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239CrossRef Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239CrossRef
28.
go back to reference Stephensen CB, Zerofsky M, Burnett DJ, Lin Y, Hammock BD, Hall LM, McHugh T (2012) Ergocalciferol from mushrooms or supplements consumed with a standard meal increases 25-hydroxyergocalciferol but decreases 25-hydroxycholecalciferol in the serum of healthy adults. J Nutr 142:1246–1252CrossRef Stephensen CB, Zerofsky M, Burnett DJ, Lin Y, Hammock BD, Hall LM, McHugh T (2012) Ergocalciferol from mushrooms or supplements consumed with a standard meal increases 25-hydroxyergocalciferol but decreases 25-hydroxycholecalciferol in the serum of healthy adults. J Nutr 142:1246–1252CrossRef
29.
go back to reference Zwart SR, Mehta SK, Ploutz-Snyder R, Bourbeau Y, Locke JP, Pierson DL, Smith SM (2011) Response to vitamin D supplementation during Antarctic winter is related to BMI, and supplementation can mitigate Epstein–Barr Virus Reactivation. J Nutr 141:692–697CrossRef Zwart SR, Mehta SK, Ploutz-Snyder R, Bourbeau Y, Locke JP, Pierson DL, Smith SM (2011) Response to vitamin D supplementation during Antarctic winter is related to BMI, and supplementation can mitigate Epstein–Barr Virus Reactivation. J Nutr 141:692–697CrossRef
30.
go back to reference Gallagher JC, Yalamanchili V, Smith LM (2013) The effect of vitamin D supplementation on serum 25OHD in thin and obese women. J Steroid Biochem Mol Biol 136:195–200CrossRef Gallagher JC, Yalamanchili V, Smith LM (2013) The effect of vitamin D supplementation on serum 25OHD in thin and obese women. J Steroid Biochem Mol Biol 136:195–200CrossRef
31.
go back to reference Mazess RB, Peppler WW, Gibbons M (1984) Total body composition by dual-photon (153Gd) absorptiometry. Am J Clin Nutr 40:834–839 Mazess RB, Peppler WW, Gibbons M (1984) Total body composition by dual-photon (153Gd) absorptiometry. Am J Clin Nutr 40:834–839
32.
go back to reference Ducher G, Bass SL, Naughton GA, Eser P, Telford RD, Daly RM (2009) Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs: implications for bone strength at the distal forearm. Am J Clin Nutr 90:1104–1111CrossRef Ducher G, Bass SL, Naughton GA, Eser P, Telford RD, Daly RM (2009) Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs: implications for bone strength at the distal forearm. Am J Clin Nutr 90:1104–1111CrossRef
33.
go back to reference Lund B, Clausen N, Lund B, Andersen E, Sørensen OH (1980) Age-dependent variations in serum 1,25-dihydroxyvitamin D in childhood. Acta Endocrinol (Copenh) 94:426–429 Lund B, Clausen N, Lund B, Andersen E, Sørensen OH (1980) Age-dependent variations in serum 1,25-dihydroxyvitamin D in childhood. Acta Endocrinol (Copenh) 94:426–429
34.
go back to reference Chesney RW, Rosen JF, Hamstra AJ, Smith C, Mahaffey K, DeLuca HF (1981) Absence of seasonal variation in serum concentrations of 1,25-dihydroxyvitamin D despite a rise in 25-hydroxyvitamin D in summer. J Clin Endocrinol Metab 53:139–142CrossRef Chesney RW, Rosen JF, Hamstra AJ, Smith C, Mahaffey K, DeLuca HF (1981) Absence of seasonal variation in serum concentrations of 1,25-dihydroxyvitamin D despite a rise in 25-hydroxyvitamin D in summer. J Clin Endocrinol Metab 53:139–142CrossRef
35.
go back to reference Börgermann J, Lazouski K, Kuhn J, Dreier J, Schmidt M, Gilis-Januszewski T, Knabbe C, Gummert JF, Zittermann A (2012) 1,25-Dihydroxyvitamin D fluctuations in cardiac surgery are related to age and clinical outcome. Crit Care Med 40:2073–2081CrossRef Börgermann J, Lazouski K, Kuhn J, Dreier J, Schmidt M, Gilis-Januszewski T, Knabbe C, Gummert JF, Zittermann A (2012) 1,25-Dihydroxyvitamin D fluctuations in cardiac surgery are related to age and clinical outcome. Crit Care Med 40:2073–2081CrossRef
36.
go back to reference Vieth R, Fraser D, Kooh SW (1987) Low dietary calcium reduces 25-hydroxycholecalciferol in plasma of rats. J Nutr 117:914–918 Vieth R, Fraser D, Kooh SW (1987) Low dietary calcium reduces 25-hydroxycholecalciferol in plasma of rats. J Nutr 117:914–918
Metadata
Title
Vitamin D supplementation, body weight and human serum 25-hydroxyvitamin D response: a systematic review
Authors
Armin Zittermann
Jana B. Ernst
Jan F. Gummert
Jochen Börgermann
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 2/2014
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-013-0634-3

Other articles of this Issue 2/2014

European Journal of Nutrition 2/2014 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.