Dietary Reference Intakes For Vitamin Research Articles

Vitamin C and its therapeutic potential in the management of COVID19.

COVID19 has emerged as one of the worst pandemics in the history of mankind. Several vaccines have been approved by different government agencies worldwide, but data on their efficacy and safety are limited, and distribution remains a massive challenge. As per WHO, personal immunity is vital for protection against COVID19. Earlier, Vitamin C-mediated pathways have been shown to play critical role in boosting immunity attributed to its antioxidant properties. Recently, the involvement of such pathways in protection against COVID19 has been suggested. The controlled doses of Vitamin C administered through intravenous (IV) injections are being studied for determining its role in the prognosis of COVID19. In this article, we have discussed the potential role of Vitamin C in the management in COVID19 patients and presented recent clinical trials data. Additionally, we have elaborated the possibility of administering Vitamin C through inhalers in order to achieve local high concentration and the challenges of such approach.

Vitamin D intake and bone mineral density in Korean adults: analysis of the 2009-2011 Korea National Health and Nutrition Examination Survey.

The prevalence of vitamin D deficiency in Koreans is quite high; however, until recently, Korean National Health and Nutrition Survey (KNHANES) had not analyzed the vitamin D intake among Koreans. Additionally, the Korean Dietary Reference Intake for vitamin D was established based on insufficient evidence. Therefore, we investigated vitamin D intake and its relationship with bone mineral density (BMD) in Korean adults using the combined data from the 2009-2011 KNHANES. This study was conducted in 11,949 healthy adults. Vitamin D intake was assessed using a 24-h recall method, and the BMD was measured using dual-energy X-ray absorptiometry. The prevalence of vitamin D deficiency (< 20 ng/mL) was 64% in men and 77% in women. In women aged ≥ 50 yrs and men aged < 50 yrs, there was a significant positive correlation between vitamin D intake and serum 25-hydroxyvitamin D level after sun exposure adjustment. The BMD of postmenopausal women aged ≥ 50 yrs with a vitamin D intake of 5 µg/day or more was significantly higher than that of women with intake less than 5 µg/day. After adjusting for age, energy, and calcium intake, the vitamin D intake of the osteoporotic group was significantly lower than that of the osteopenia group in women. Since the relationship between vitamin D intake and BMD was observed in women aged ≥ 50 yrs, further research is needed to clarify these findings using cohort or randomized controlled trials.

Vitamin K intake and health, consideration from the epidemiological studies.

The most fundamental function of vitamin K is to activate the blood coagulation factors in the liver. Despite the recent recognition of its extra-hepatic actions, the current Dietary Reference Intakes for vitamin K is based on the amount necessary for maintaining the normal blood coagulation in many countries. To define the Dietary Reference Intake for vitamin K, appropriate biomarkers well-reflecting the vitamin K status are essential. Unfortunately, however, no markers are currently available with properties enabling us to properly define the vitamin K status; i.g., no interference by other factors and the presence of widely approved cut-off values. Thus, Adequate Intake is determined, which is an index based on the representative dietary intake data from healthy individuals. Recently, epidemiological studies have been reported regarding the relationship between vitamin K and noncommunicable diseases including osteoporotic fracture. Furthermore, studies focusing on the relationship between vitamin K intake and metabolic syndrome, physical function, depression, cognition, and all-cause mortality have become available, although limited in number. This review summarizes the recent findings in favor of the novel functions of vitamin K. More epidemiological studies are needed to define the appropriate vitamin K intake value based on the prevention of various disorders.

The prevalence and risk of missing outcome data in prenatal vitamin D supplemented gestational diabetes mellitus patients: a systematic review and meta-analysis protocol

The prevalence and risk of missing outcome data in prenatal vitamin D supplemented gestational diabetes mellitus patients: a systematic review and meta-analysis protocol

Vitamin K Intake in Chronic Stroke: Implications for Dietary Recommendations.

Previous research has identified a possible association between vitamin K intake and cardiometabolic disease. This could mean that the assessment of vitamin K intake is a meaningful tool when monitoring individuals with preexisting cardiovascular disease. Sixty chronic stroke survivors (men and women, body mass index (BMI) 30.36 ± 6.61 kg/m2, age 61.7 ± 7.2 years) completed food records which were analyzed for energy, macronutrient, micronutrient, and food group servings. Participants were divided into two groups: below vitamin K recommendation (BEL, n = 49) and met vitamin K recommendation (MET, n = 11). Energy and macronutrient intake did not differ between groups (all p > 0.127). Vegetable intake was higher in the MET group (p = 0.0001). Vitamin K intake was higher in the MET group (p = 0.0001). Calcium (p = 0.003), vitamin A (p = 0.007), and vitamin E (p = 0.005) intakes were higher in the MET group. There were no differences in sodium, potassium, vitamin D, vitamin C, and iron intakes between groups (all p > 0.212). In this sample of chronic stroke survivors, 82% reported consuming below the Dietary Reference Intake (DRI) for vitamin K. Given that the majority of this study population did not reach the DRI for vitamin K, it is advisable to promote the adequate intake of food rich in vitamin K. Further work is needed to determine the significance of low vitamin K intake in this population.

S2757 Vitamin K Deficiency in the Setting of Long-Term Blenderized Tube Feeds in a Teenager

INTRODUCTION: Severe, symptomatic presentation of nutritional deficiencies are uncommon in the current era. Vitamin K deficiency is classically seen in newborns and can present as early as 24 hours after birth and as late as up to 6 months. However, in pediatric patients with chronic comorbidities, vitamin K deficiency can also occur later in life with risk factors such as enteral feeding and recent antibiotic use. We describe a case of acquired vitamin K deficiency in a teenager on long term enteral nutrition. CASE DESCRIPTION/METHODS: A 17-year-old male with spinal muscular atrophy type 1, ventilator, and gastrostomy tube dependence, was admitted for coagulopathy noted during routine follow up after a diarrheal illness. He was treated with a short course of metronidazole for suspected small intestinal bacterial overgrowth as stool pathogens were negative. Physical examination revealed oozing from an anal fissure, tracheostomy, and gastrostomy sites. Laboratory studies revealed a prothrombin time (PT) of 114 s (normal: 9.4-12.5 s), partial thromboplastin time (PTT) 99.2 s (normal: 25.1-36.5 s) and international normalized ratio (INR) of 9.5 (normal: 1.1 or below). Fibrinogen and D-dimer were normal, ruling out disseminated intravascular coagulation. Factors V were normal at 94%, VIII more than 150%, VII low at 3%, and IX low at 11%. Mixing studies revealed deficiencies of the intrinsic and extrinsic pathways, and this, coupled with low factors VII and IX confirmed vitamin K deficiency. He received parenteral vitamin K which resolved his coagulopathy - PT 13.2 seconds, PTT 37.1 seconds, and INR of 1.2. His blenderized tube feeding regimen consisted of a base of Vivonex® Pediatric® mixed with baby foods and juice. This formulation did not meet the Dietary Reference Intake for vitamin K (44.2mcg/dL, recommended is 60-75mcg/dL), protein, phosphorus, calcium, zinc, folate, and essential fatty acids. He was discharged home on supplemental vitamin K, a multivitamin, protein supplement and, safflower oil. DISCUSSION: Our case highlights an important, yet frequently unrecognized differential of coagulopathy: vitamin K deficiency. This could be asymptomatic until the patient develops a bleeding diathesis. Clinicians should be aware that for pediatric patients on long-term blenderized tube feeds, it is essential to monitor micro and macronutrients on a regular basis.

Selenium supplementation can relieve the clinical complications of COVID-19 and other similar viral infections

Selenium supplementation can relieve the clinical complications of COVID-19 and other similar viral infections

Our Current Dietary Reference Intakes for Vitamin A-Now 20 Years Old.

ABSTRACTThe DRI values for vitamin A were last reviewed and defined in 2001. At the time, there was very sparse data that could be used to set the DRI values for pregnancy, lactation, and infancy. In the subsequent 20 y since the last formal review, a number of findings relevant to the adequacy indicator of visual dark adaptation in pregnancy, the usual vitamin A content of breast milk across lactation stages, and vitamin A metabolism in women and children have been published. Furthermore, identification of genetic variables affecting the bioconversion of provitamin A carotenoids to vitamin A have provided an improved explanation for interindividual variability in responses to provitamin A carotenoids. The purpose of this collection of articles, introduced herein, is to review and apply recent findings about vitamin A status, address current gaps in knowledge, and suggest avenues for future research needed to refine the DRI values for pregnancy, lactation, and early life.

Sharpening the global focus on ethnicity and race in the time of COVID-19

Sharpening the global focus on ethnicity and race in the time of COVID-19

Melanin has a Small Inhibitory Effect on Cutaneous Vitamin D Synthesis: A Comparison of Extreme Phenotypes

Epidemiology suggests that melanin inhibits cutaneous vitamin D3 synthesis by UVR. Laboratory investigations assessing the impact of melanin on vitamin D production have produced contradictory results. We determined the effect of melanin on vitamin D3 photosynthesis in healthy young volunteers (n= 102) of Fitzpatrick skin types II-VI (white to black). Participants, irrespective of skin type, were exposed to the same suberythemal UVR dose, to 85% body surface area, using solar simulated UVR or narrowband UVB (311 nm). This was repeated five times with intervals of 3-4 days between UVR exposures. Blood was taken before, during, and after the irradiation and assessed for serum 25-hydroxyvitamin D3 (25[OH]D3) as a marker of vitamin D3 status. Linear UVR dose-dependent increases in 25(OH)D3 were highly significant (P ≤ 7.7 x 10-11). The ratios of regression slopes of the different skin type groups were compared, and only skin type II was significantly steeper than the other groups. Comparisons between extreme skin types II and VI showed melanin inhibition factors of approximately 1.3-1.4, depending on the UVR source. We conclude that the inhibitory effect of melanin on vitamin D3 synthesis is small, compared with erythema, but that this difference may be sufficient to explain the epidemiological data.

Dietary and Physical Activity Behaviors in Women with Polycystic Ovary Syndrome per the New International Evidence-Based Guideline.

Lifestyle modifications are recommended as first-line therapy in polycystic ovary syndrome (PCOS). However, usual dietary and physical activity (PA) behaviors of women with PCOS remain uncertain, likely owing to controversy in diagnostic criteria. Our objective was to contrast the usual dietary and PA behaviors of women with PCOS (n = 80) diagnosed by the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS to that of controls (n = 44). Study outcomes were dietary intake, diet quality (Healthy Eating Index-2015), and PA (questionnaire, waist-worn accelerometers). Women with PCOS met the acceptable macronutrient distribution ranges for carbohydrate, fat, and protein, but did not meet the recommended dietary reference intakes for vitamin D (mean (95% confidence interval); 6 (5–7) μg/d), vitamin B9 (275 (252–298) μg/d), total fiber (24 (22–26) g/d), or sodium (4.0 (3.6–4.4) g/d). Women with PCOS also met the US recommendations for PA. No differences were detected in dietary intake, diet quality, or PA levels between groups (p ≥ 0.11). In conclusion, women with and without PCOS have comparable dietary and PA behaviors. A lack of unique targets for dietary or PA interventions supports the position of the new guideline to foster healthy lifestyle recommendations for the management of PCOS.

Erratum.

Risk AnalysisVolume 38, Issue 12 p. 2738-2739 ErratumFree Access Erratum This article corrects the following: Partitioning of Dietary Metal Intake—A Metal Dietary Exposure Screening Tool Nga L. Tran*, Leila M. Barraj, Carolyn Scrafford, Xiaoyu Bi, Terry Troxell, Volume 35Issue 5Risk Analysis pages: 872-881 First Published online: December 24, 2014 First published: 07 December 2018 https://doi.org/10.1111/risa.13237AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat In Tran et al. (2015), the following errors were published on pages 875 and 881. On page 876, in Table I should have appeared as follows: Table I. Existing exposure limits, background exposure and default screening level limits in the MDEST Metals Exposure Limits Background Exposures Default Screening Level Exposure Limits (MDEST Portion) Inorganic Arsenic TDI: 0.3 μg/kg bw/day(15) – 0.015 μg/kg bw/day (Assumed 5% of TDI) Cadmium PTDI: 0.83 μg/kg bw/day(16) Diet: 0.36 μg/kg bw/day (90th percentile for US 2+ yrs(11)) Drinking water: 0.17 μg/kg bw/day (calculated based on drinking water limit) 0.3 μg/kg bw/day Chromium III 250 μg/day(17, 18) Diet: 15-54 μg/day(19) Drinking water: 7.2 μg/day(20) 188.8 μg/day Chromium VI RfD: 0.9 μg/kg bw/day(21) Drinking water: 1.7 μg/kg bw/day(18) 0.045 μg/kg bw/day (Assumed 5% of exposure limits) Lead PTTI: Children 0-6 yrs: 6 μg/day Children 7+ yrs: 15 μg/day Pregnant Lactating Females: 25 μg/day Adults: 75 μg/day(22) Diet and drinking water: Children 0-6 yrs: 3 μg/day Children 7+ yrs: 7.5 μg/day Pregnant Lactating Females: 12.5 μg/day Adults: 25 μg/day (based on 50% of PTTI for vulnerable population; 2/3 of PTDI for adults) Children 0-6 yrs: 3 μg/day Children 7+ yrs: 7.5 μg/day Pregnant Lactating Females: 12.5 μg/day Adults: 25 μg/day Mercury (Total) PTDI 4 μg/kg bw/week or 0.57 μg/kg bw/day(23) Diet: 0.14 μg/kg bw/day (90th percentile for US 2+ y(11)). Drinking water: 0.067 μg/kg bw/day, calculated based on FDA's maximum allowable level in bottle water of 0.002 mg/L and assuming 2 liters per day and 60 kg bw (FDA, 2007) 0.36 μg/kg bw/day PTDI: Provisional Tolerable Daily Intake, μg: Microgram, bw: Bodyweight, kg: Kilogram, PTTI: Provisional total tolerable intake, RfD: reference dose, TDI: Tolerable Daily Intake, yrs: Years, TDS: total diet study. On page 881: References 15-23 were omitted and should have been included as listed below. 15. Code of Federal Regulations. Title 21, part 165 - beverages, subpart b – requirements for specific standardized beverages, sec. 165.110 bottled water. US Government Printing Office; 2013. Available at: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm. Accessed December 2, 2013. 16. Joint FAO/WHO Expert Committee on Food Additives (JECFA). Evaluation of certain food additives and contaminants, 73rd meeting of the joint fao/who expert committee on food additives. Geneva: World Health Organization Joint FAO/WHO Expert Committee on Food Additives; 2010. 17. European Food Safety Authority (EFSA). Scientific opinion on the safety of trivalent chromium as a nutrient added for nutritional purposes to foodstuffs for particular nutritional uses and foods intended for the general population (including food supplements). EFSA Journal, 2010; 8(12):1882. 18. World Health Organization (WHO). Trace elements in human nutrition and health. Geneva: World Health Organization; 1996. 19. Institute of Medicine (IOM). Dietary reference intakes for vitamin a, vitamin k, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, DC: The National Academies Press; 2001. 20. US Department of Health and Human Services (US HHS), Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological profile for chromium – draft for public comment. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Services; 2008. 21. Agency for Toxic Substances and Disease Registry (ATSDR). 2008. Toxicological profile for chromium – Draft for public comment. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Services. Available at: http://www.atsdr.cdc.gov/ToxProfiles/tp5.pdf; accessed April 2012. 22. Carrington C, Bolger P. An assessment of the hazards of lead in food. Regul Toxicol Pharmacol, 1992; 16(3):265-72. 23. Joint FAO/WHO Expert Committee on Food Additives (JECFA). Safety evaluation of certain contaminants in foodWorld Health Organization, Food and Agriculture Organization of the United Nations; 2011. We apologize for these errors. Reference Tran, N. L., Barraj, L. M., Scrafford, C., Bi, X., & Troxell, T. (2015). Partitioning of dietary metal intake—a metal dietary exposure screening tool. Risk Analysis, 35, 872– 881. Retrieved from https://doi.org/10.1111/risa.12322 Volume38, Issue12Special Issue: Communicating About ZikaDecember 2018Pages 2738-2739 ReferencesRelatedInformation

Perspective: Should Vitamin E Recommendations for Older Adults Be Increased?

Current vitamin E requirements are uniformly applied across the population for those >14 y of age. However, aging is associated with alterations in cellular and physiologic functions, which are affected by vitamin E. Therefore, it is questionable whether vitamin E requirements can be uniformly applied to all adult age categories. With aging, there is dysregulation of the immune system in which there are decreased cell-mediated and pathogen defense responses coupled with an overactive, prolonged inflammatory state. Both animal and human studies in the aged suggest that intake above currently recommended levels of vitamin E may improve immune and inflammatory responses and be associated with a reduced risk of infectious disease. We review the evidence that was considered in establishing the current requirements for vitamin E and highlight data that should be considered in determining the vitamin E requirements in older adults, particularly focusing on the evidence suggesting a benefit of increased vitamin E intake on immune function and inflammatory processes and resistance to infection. The main objective of this Perspective is to initiate the discussion of whether the current Dietary Reference Intake for vitamin E should be increased for the older population. We make this suggestion on the basis of mechanistic studies showing biological plausibility, correction of a major cellular dysfunction in older adults, and strong evidence from several animal and a few human studies indicating a reduction in risk and morbidity from infections.

Rationale and Plan for Vitamin D Food Fortification: A Review and Guidance Paper.

Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from ≥25 to ≥50 nmol/L (≥10–≥20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 μg (400–800 international units). Most populations fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations <30 nmol/L (12 ng/mL) and <50 nmol/L (20 ng/mL) are present in 13.0 and 40.4% of the general population, respectively. This substantial gap between officially recommended dietary reference intakes for vitamin D and the high prevalence of vitamin D deficiency in the general population requires action from health authorities. Promotion of a healthier lifestyle with more outdoor activities and optimal nutrition are definitely warranted but will not erase vitamin D deficiency and must, in the case of sunlight exposure, be well balanced with regard to potential adverse effects such as skin cancer. Intake of vitamin D supplements is limited by relatively poor adherence (in particular in individuals with low-socioeconomic status) and potential for overdosing. Systematic vitamin D food fortification is, however, an effective approach to improve vitamin D status in the general population, and this has already been introduced by countries such as the US, Canada, India, and Finland. Recent advances in our knowledge on the safety of vitamin D treatment, the dose-response relationship of vitamin D intake and 25(OH)D levels, as well as data on the effectiveness of vitamin D fortification in countries such as Finland provide a solid basis to introduce and modify vitamin D food fortification in order to improve public health with this likewise cost-effective approach.

Adequacy of Parent-Packed Lunches and Preschooler's Consumption Compared to Dietary Reference Intake Recommendations

abstractBackground: U.S. preschool children consume inadequate amounts of key nutrients. Understanding the contents of lunches packed by parents and consumed by their children can help identify areas of opportunity for the development of healthy food preferences.Objective: To evaluate the nutrient adequacy of lunches packed by parents and consumed by children attending early care and education (ECE) centers.Methods: Baseline data from 607 parent–child dyads in the “Lunch Is in the Bag” cluster-randomized controlled trial in Central Texas were examined. Foods packed by parents and consumed by children in sack lunches were observed at 30 ECE centers on 2 nonconsecutive days. Mean levels of energy, macronutrients, vitamins, and minerals were estimated with covariate-adjusted multilevel regression models that accounted for center-level clustering and repeated within-child measures.Results: Energy (kilocalories) was 602.48 for packed lunches compared to 374.40 for consumed lunches. In packed lunches, percentage of energy as macronutrients for protein (14.8%), carbohydrate (55.9%), and total fat (31.2%) were within the acceptable macronutrient distribution range (AMDR) for the children's ages. Sugar (28.9% of energy) was above the AMDR recommendation. Only a quarter of parents packed 33% or more of the child's dietary reference intake (DRI) for dietary fiber. Over half the parents packed 33% or more of the DRI for vitamin A and calcium, and less than one in 8 packed 33% of the DRI for potassium. Children consistently consumed between 60 and 80% of the nutrients that were packed.Conclusions: Preschool children rely on parents to present them with healthy food choices, but lunches packed by parents for their preschool children do not consistently provide adequate nutrients. These data and the relationships between the dietary quality of packed and consumed lunches can be useful information to guide nutrition behavior change through targeted interventions.

Decreased Nutrient Intake Is Associated With Premature Cervical Remodeling

ObjectiveTo examine the direct relationship between nutrient intake and cervical remodeling. DesignLongitudinal descriptive design. SettingMaternal–fetal medicine clinic in a Midwestern urban city. ParticipantsForty-seven pregnant African American women. MethodsParticipants completed the Block brief food frequency questionnaire at 19 to 24 weeks and 27 to 29 weeks gestation and had quantitative ultrasonic attenuation estimates at 19 to 21 weeks, 23 to 25 weeks, 27 to 29 weeks, 31 to 33 weeks, and 35 to 37 weeks gestation. ResultsTrajectory mixture models identified two subpopulations within our sample: those at risk (n = 36) and at less risk (n = 11) for premature cervical remodeling. More participants in the less-risk group consumed the dietary reference intake for calcium, vitamin A, folate, vitamin E, zinc, and vitamin D than in the at-risk group. The percentage of participants in the less-risk group who consumed the recommended dietary reference intake for vitamin E was twice the percentage of women in the at-risk group (82% and 44%, respectively; p = .004). Mean intake of calcium was almost 1.3 times more (p = .05) and for zinc was 1.5 times more (p = .04) in the less-risk group than in the at-risk group. ConclusionPractitioners can inform women that certain nutrients, particularly zinc, calcium, and vitamin E, could be important to the health of the cervix and inhibit premature cervical remodeling, which in turn may help prevent preterm birth.

69-Year-Old Woman With Confusion and Fatigue

Resident in Internal Medicine, Mayo School of Graduate Medical Education, Rochester, MN (H.M.K.); Advisor to resident and Consultant in Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN (A.E.K.). A 69-year-old woman presented to her primary care physicianwith a 4-day history of fatigue and dizziness. She was 45 minutes late for her appointment because she had trouble driving to the office. She reported no motor or sensory deficits but had difficulty with coordination. Review of systems was positive for dysuria and urinary frequency. She did not have fever, chills, weight or appetite changes, respiratory, cardiac, or gastrointestinal symptoms, or recent head trauma. The patient’s medical history was remarkable for hypertension, hyperlipidemia, type 2 diabetes mellitus, osteoporosis, and gastroesophageal reflux disease. Medications included metoprolol tartrate, lisinopril with hydrochlorothiazide, lovastatin, cholecalciferol, and as-needed calcium carbonate. She had smoked half a pack of cigarettes per day for 40 years but had quit smoking 6 years previously. She didnot use alcohol or illicit drugs. On examination, the patient was afebrile with a blood pressure of 104/67 mm Hg, heart rate of 76 beats/min, respiratory rate of 17 breaths/min, oxygen saturation of 94% while breathing room air, and body mass index (calculated as weight in kilograms divided by height inmeters squared) of 39 kg/m. Shewas alert and oriented to person, place, and time. Her speech was dysarthric, and she had difficulty following simple commands. Her coordination was impaired with symmetric dysmetria on finger-to-nose testing, heel-kneeshin testing, and rapid alternating movements. Cranial nerves II through XII were intact. Results of motor and sensory examinations were within normal limits. Reflexes were symmetric. Lymph node, thyroid, cardiac, respiratory, gastrointestinal, musculoskeletal, and skin examinations identified no abnormalities.

Outcome of a public consultation on the Draft Scientific Opinion of the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) on Dietary Reference Values for iron

EFSA Supporting PublicationsVolume 12, Issue 10 876E Technical reportOpen Access Outcome of a public consultation on the Draft Scientific Opinion of the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) on Dietary Reference Values for iron European Food Safety Authority (EFSA), European Food Safety Authority (EFSA)Search for more papers by this author European Food Safety Authority (EFSA), European Food Safety Authority (EFSA)Search for more papers by this author First published: 21 October 2015 https://doi.org/10.2903/sp.efsa.2015.EN-876 Published date: 21 October 2015 Question number: EFSA-Q-2015-00260 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References Bannon DI, Abounader R, Lees PS and Bressler JP, 2003. Effect of DMT1 knockdown on iron, cadmium, and lead uptake in Caco-2 cells. American Journal of Physiology. Cell Physiology, 284, C44– 50. D-A-CH (Deutsche Gesellschaft für Ernährung – Österreichische Gesellschaft für Ernährung – Schweizerische Gesellschaft für Ernährungsforschung – Schweizerische Vereinigung für Ernährung), 2013. Referenzwerte für die Nährstoffzufuhr. Umschau Braus Verlag, Frankfurt/Main, Germany, 292 pp. Dainty JR, Berry R, Lynch SR, Harvey LJ and Fairweather-Tait SJ, 2014. Estimation of dietary iron bioavailability from food iron intake and iron status. PLoS ONE, 9, e111824. EFSA (European Food Safety Authority), 2004. Scientific opinion of the Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) on a request from the Commission related to the Tolerable Upper Intake Level of iron. The EFSA Journal 2004, 125, 1– 34. 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Dietary reference intakes for vitamin D based on the revised 2010 dietary guidelines are not being met by children in Alberta, Canada

Canadian children have been shown to be not meeting the revised (2010) dietary recommended intake (DRI) for vitamin D through diet alone. However, no study has evaluated whether diet and supplementation together are supporting Canadian children in meeting the DRIs for vitamin D intake. This study assessed the adequacy of vitamin D intake through diet and supplements among Albertan children and the determinants of meeting dietary guidelines. 2686 grade 5 students aged 10 to 11 years in Alberta, Canada were surveyed. We hypothesized that less than 50% of children would meet the DRI. Vitamin D intake from diet and supplements was assessed using a food frequency questionnaire. The adequacy of vitamin D intake was estimated using the Estimated Average Requirement (EAR) of 400 IU (International Units) and Recommended Dietary Allowance (RDA) of 600 IU. Random effect multiple logistic regression was used to identify correlates of meeting DRIs. Forty five percent of children met the EAR and 22% met the RDA for vitamin D. When vitamin D intake from diet alone was considered, only 16% and 2% met the EAR and RDA, respectively. Parental education, household income and physical activity were positively correlated with meeting DRIs, and students attending metropolitan area schools were more likely to meet the EAR than students attending rural area schools (OR = 1.28; P = .043). The majority of children did not meet the DRI for vitamin D. Health promotion strategies aiming to improve the vitamin D status of Albertan children are necessary given the importance of vitamin D for children’s health and development.

Bone and Nutrition. Vitamin D intake and bone

Vitamin D insufficiency is one of the risk factors of osteoporosis. To know the vitamin D intake for the prevention of bone loss and fracture, it is necessary to evaluate the appropriate serum 25-hydroxyvitamin D (25-D) concentration for bone health, and the vitamin D intake to maintain its concentration. Although vitamin D intake 15 and 20 μg/d have been set as RDA (Recommended Dietary Allowance) in USA/Canada DRIs (Dietary reference intakes), 5.5 μg/d has been set as AI (adequate intake) in Japanese DRIs (2015). While reference values in Japan and USA/Canada were quite different, both DRIs are common in that it aim to maintain the serum 25-D concentration to more than 50 nmol/L. In the present review, vitamin D intakes and bone health, vitamin D status in Japanese people, DRIs for vitamin D and improvement of vitamin D insufficiency are reviewed.