Index*
A
Abscesses, 171
Acceptable Macronutrient Distribution Range (AMDR), 3
Achlorhydria, 37
Acronyms and abbreviations, 523–526
Adequate Intake (AI), 3, 8, 20, 21–22, 489–490.
See also Calcium, AIs;
Vitamin D, AIs
Adipokines, 491
Adipose tissue, 83, 84, 87–88, 106, 490, 491, 518
Adiposity, 11, 84, 105–106, 143, 152, 156, 490–491.
See also Obese or overweight persons;
Weight loss or dieting
Adolescents, 14 through 18 years.
See also Puberty
bone health, 53–54, 195, 202–208, 218, 226, 280
calcium
DRIs, 7, 349, 351, 352, 354–355, 393–394, 464, 1104, 1108, 1114
estimated intake, 465, 466, 467, 480
retention, 268
DRI development, 24, 385–387, 393–394, 445
EARs, 7, 9, 349, 351, 354–355, 385, 387, 393, 394, 464, 469, 1104–1105
growth spurts, 8, 24, 39, 53, 354, 421
lactation, 7, 57, 257, 282, 283, 349, 361, 362, 363, 393, 394, 424, 446, 464, 469
multiple sclerosis and serum 25OHD, 173
pregnancy, 56, 57, 250, 257, 278, 361, 362, 393, 394, 424, 446, 469
RDAs, 7, 9, 349, 351, 354–355, 385, 387, 393, 394, 464, 469, 1106-1110
ULs, 7, 9, 419, 420, 421, 441, 445, 464, 469, 1112–1115
vitamin D, 9, 95, 385–387, 393–394, 441, 445, 469, 470–473, 475, 1106, 1112
vitamins, 1104–1105, 1112–1115
water, total, 1110
Adults, 19 through 30 years
bone health, 218, 242, 270, 382–383, 384
calcium, 7, 39, 54, 269, 349, 355, 421–424, 464, 465, 466, 467, 1104, 1108, 1114
DRI development, 24, 355–356, 387–389, 393–394, 421–422, 423–424, 443–445
EARs, 7, 9, 349, 355, 387–388, 389, 393, 394, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
RDAs, 7, 9, 349, 355, 387–388, 389, 393, 394, 464, 469, 1106–1110
ULs, 7, 9, 421, 423, 443, 445, 464, 469, 1112–1115
vitamin D, 9, 95, 387–389, 393–394, 443–445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Adults, 31 through 50 years
bone health, 218–219, 242, 382–383, 384
calcium, 7, 39, 54–55, 349, 355–356, 421–424, 464, 465, 466, 467, 1104, 1108, 1114
DRI development, 24–25, 355–356, 387–389, 393–394, 421–424, 443–445
EARs, 7, 9, 349, 355, 387–388, 389, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
RDAs, 7, 9, 349, 355, 387–388, 389, 464, 469, 1106–1110
ULs, 7, 9, 421, 423, 443, 445, 464, 469, 1112–1115
vitamin D, 9, 95–96, 387–389, 393–394, 443–445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Adults, 51 through 70 years
bone health, 219, 226–234, 235, 382–383, 384
calcium, 7, 349, 356–359, 421–423, 463–464, 465, 466, 467, 480–481, 1104, 1108, 1114
dementia, 183
DRI development, 24–25, 355–356, 389, 421–423, 443–445
EARs, 7, 9, 167, 349, 356, 357, 359, 387–388, 389, 392, 393, 394, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
RDAs, 7, 9, 349, 356, 357, 359, 387–388, 389, 393, 394, 464, 469, 1106–1110
ULs, 7, 9, 421, 423, 443, 445, 464, 469, 1112–1115
vitamin D, 9, 389, 392–394, 443–445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Adults, 70+ years.
See also Elderly population
bone health, 219, 226–234, 235, 360, 382–383, 384, 439
calcium, 7, 349, 356, 359–361, 421–423, 464–465, 466, 467, 1104, 1108, 1114
cognitive function, 183, 185–186
DRI development, 359–361, 389–392, 443–445
EARs, 7, 9, 349, 356, 360–361, 389, 392, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
RDAs, 7, 9, 349, 356, 361, 389–390, 392, 464, 469, 1106–1110
ULs, 7, 9, 421, 423, 443, 445, 464, 469, 1112–1115
vitamin D, 9, 389–392, 439, 443–445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Adverse effects
calcium, 22, 42, 404, 405–424, 481, 488, 500–501
chronic, vs. acute toxicity, 404
due to nutrient deficiency. See Calcium, deficiency;
Phosphorus, deficiency;
Vitamin D, deficiency
ethical issues, 404, 425, 488, 518
indicators. See Indicators of adverse outcomes for excess intake
in risk assessment approach to DRI development, 27, 403, 515
African Americans
breast-fed infants and vitamin D, 385, 494–495
calcitriol levels, 260–261, 296
cardiovascular mortality, 438
cognitive function, 186
diabetes, 153
limited data for DRI development, 347
multiple sclerosis, 174
puberty, 24
serum 25OHD levels
atherosclerotic plaque, 438, 444
bone health, 106, 208, 260–261, 295, 298, 439, 493
effects of skin pigmentation, 374, 493, 494–495
vitamin D dose–response, 431
systemic lupus erythematosus, 177
See also Gambians;
Nigerians
Agency for Healthcare Research and Quality (AHRQ)
Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews, 127, 128
overview of AHRQ-Ottawa and AHRQ-Tufts reports, 5, 30–31, 97–98, 100, 126–127
Albumin. See Serum albumin
Alcohol consumption, 64, 140, 143, 230, 434
All-laboratory trimmed mean (ALTM), 109
Alopecia, 94
Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (ATBC), 147, 415, 436
Altitude, 105
Amenorrhea, 502
American Academy of Dermatology, 495
American Academy of Pediatrics, 95, 258
American Dietetic Association, 497
American Institute for Cancer Research, 415
Amsterdam Growth and Health Longitudinal Study, 274
Anemia, 176
Angiotensin II, 190
Ankylosis, 174
Anti-angiogenic action, 92, 146
Antibody-based assays, 107, 108, 109, 365
Anti-inflammatory action, 92, 146, 184, 517
Antimicrobial activity, 177, 178, 179, 181
Antirachitic, 80
Arsenic, 1114
Arthralgia, 176
Arthritis, 176.
See also Osteoarthritis;
Rheumatoid arthritis
Asian ancestry or Asians, 179, 199, 231, 252, 254, 268, 347, 439.
See also Chinese ancestry or Chinese;
East Asian ancestry;
South Asian ancestry or South Asians
Assay shift and drift, 107–111, 365–366, 460–461
Asthma, 4, 129, 168–170, 181, 182
Atherosclerosis, 147, 438, 444
Atmospheric conditions, 104, 105, 492
Autoimmune disease, 4, 5, 78, 91, 170–177, 181–182, 189, 192.
See also Crohn’s disease;
Diabetes (type 1);
Inflammatory bowel disease;
Multiple sclerosis;
Osteoarthritis;
Rheumatoid arthritis;
Systemic lupus erythematosus
B
Background intake. See Benchmark intake
Balance (calcium). See Calcium balance
Balance (physical), 166
Beck Depression Inventory (BDI), 187
Benchmark intake (BI), 17, 418, 440, 519
Bioavailability, 29, 37, 39, 62–63, 498, 503, 516, 521
Biomarkers
for colon carcinogenesis, 144
of exposure, 25
serum 25OHD as biomarker of vitamin D effect, 13–14, 96–97, 263–264, 291, 293, 439, 484, 517, 520
serum 25OHD as biomarker of vitamin D exposure, 8, 12–13, 96, 99, 293, 363, 381–382, 384, 480, 483
use of term, 25
Blood pressure, 152, 154, 190.
See also Hypertension
Blood volume, extracellular, 407
Body mass. See Lean body mass or lean mass
Body mass index, 48, 88, 141, 155, 211, 212, 228, 231, 434, 435, 490
Bone.
See also Bone health;
Skeleton
accretion, 46–47, 53, 54, 55, 95, 267–272, 292–294, 351
calcium content at maturity, 54
disorders. See Bone, fracture;
Bone loss;
Osteomalacia;
Osteoporosis;
Rickets
effects of menopause, 47–48, 52
formation or mineralization, 44–45, 242, 253, 276–277, 296
fracture
African Americans, 294, 296, 493
BMD, 50, 51, 273, 285–292, 298, 357–358
bone loss as risk factor, 48, 60, 359–360
calcium supplementation, 285–290, 358, 360, 390–392
as indicator of adverse outcomes for excess intake, 6, 405
as indicator of nutrient adequacy, 4, 9, 129
from military training, 234n.3, 242, 275
with osteomalacia, 49, 50, 276–277
during pregnancy, 278
and serum 25OHD, 195, 215, 226–234, 276, 366–367, 390
vegans diet and risk for, 497
vitamin D supplementation, 161, 234–235, 236–242, 275, 277, 290–292, 358, 390–392, 438–439
maintenance, 283–284, 292–294, 387–388
organic matrix (osteoid), 43, 49–50, 62, 94, 275–276
remodeling, 45–46, 52, 54, 59, 62, 272, 409
resorption during lactation, 45n.3, 57, 96, 256, 259, 281–282, 362
serum 25OHD levels and. See Serum 25-hydroxyvitamin D, bone health
types, 45
Bone health, as indicator of nutrient adequacy.
See also under specific life-stage groups
African Americans, 208, 294–298
bone maintenance, 283–284, 292–294, 387–388
integration of evidence, 262–277, 292–294, 370–371
menopausal status, 209–218, 226, 234–242, 360–361
Bone loss.
See also Osteoporosis
age-related, 52, 54, 55, 95–96, 193, 284, 285, 356, 361
calcium intake and, 35, 40, 274, 285–292, 356
effects of caffeine intake, 64
effects of menopause, 47–48, 52, 54–55, 58, 360–361
effects of soft drink intake, 64
integration of evidence, 262–277, 292–294, 370–371
serum 25OHD and, 195
spaceflight, 46
Bone mass
calcium intake and, 35, 47, 53, 54, 273–274, 417
measures associated with calcium, 57–62.
See also Bone mineral content;
Bone mineral density;
Calcium balance
peak, 47, 54, 250, 270, 282, 296
physical activity and, 46, 54, 273, 287, 490–491
protein intake and, 63
reduction. See Bone loss;
Osteoporosis
Bone mineral apparent density (BMAD), 206
Bone mineral content (BMC)
calcium intake and supplementation, 47, 60–62, 219–226, 270–271
definition, 60
effects of adiposity, 491
as indicator of nutrient adequacy, 4, 129
postmenopausal women and elderly men, 214, 216
pregnancy and lactation, 249, 254, 255, 259, 278, 279–280, 283
serum 25OHD and, 195, 196–205, 218, 219, 393–394
vitamin D intake and supplementation, 271, 279–280
Bone mineral density (BMD)
bone fracture and, 50, 51, 273, 285–292, 298, 357–358
calcium intake and supplementation, 60–62, 175, 219–226, 270–271, 273–274, 284–290, 392–393
effects of adolescent pregnancy, 56, 362
effects of lactation, 57, 256, 257, 259, 282, 283
effects of menopause, 47–48, 52
effects of oral contraceptive use, 501–503
effects of pregnancy, 7, 8, 249, 250, 254, 255, 256, 278, 279–280, 361, 362
as indicator of nutrient adequacy, 4, 129
serum 25OHD and, 195, 196–207, 209, 210–216, 218–219, 226–234, 275, 283, 368–369, 386–387
use of term, 60
vitamin D intake and supplementation, 95, 175, 271, 274–275, 279–280, 290–292, 386–387, 392–393
Boron, 1114
Bowel obstruction, 171.
See also Inflammatory bowel disease
Brain tissue, 184
Breast cancer, 139–142, 435–436
Breastfeeding. See Human milk;
Infants, breast-fed;
Lactation
British Paediatric Association, 431, 432, 441
C
Caffeine, 64
Calcidiol. See 25-Hydroxyvitamin D
Calcifediol. See 25-Hydroxyvitamin D
Calcification of soft tissue (calcinosis), 6, 44, 61, 88, 405, 406, 409–410, 422, 425, 426
Calcitriol (1,25-dihydroxyvitamin D).
See also Serum calcitriol
cardiovascular disease, 78, 150–151
extra-renal production, 90, 177, 189, 518–519
falls and physical performance, 157
fetal, 252
formation in the kidney, 77, 84, 90, 481
functions
bone formation, 44
calcium absorption, 35, 38, 39, 89, 253, 260, 264, 267
calcium excretion, 42
calcium regulation, 40–41, 89–90, 157, 253
cytokine production, 189
glucose transport in the brain, 184
phosphorus regulation, 64, 77, 89
vascular reactivity enhanced by, 148
half-life, 97
interactions with prescription drugs, 504
multiple sclerosis treatment, 173, 174
not used as a measure of vitamin D nutriture, 97
in pleural fluid, 177
during preeclampsia, 189
during pregnancy, 56, 96, 174, 250–251, 252, 254
rheumatoid arthritis treatment, 175
rickets and osteomalacia, 49, 94
systemic lupus erythematosus treatment, 176
tuberculosis, 178
use of term, 78
vitamin D intoxication, 427
Calcium.
See also Calcium balance;
Serum calcium
absorption.
See also Calcium, bioavailability
African Americans, 260–261, 296
children, 352
from the gut, and increased risk for nephrolithiasis, 411, 500
impaired with rickets, 94
as indicator of nutrient adequacy, 4, 129
infants, 52, 253, 350, 503, 505
methods of measurement, 264–265
during pregnancy or lactation, 242, 249, 250, 253, 256–257, 259, 277, 279, 281–282, 292, 361, 424
relationship with vitamin D, 35, 40–41, 143, 279
role of calcitriol, 35, 38, 39, 89, 253, 260, 264, 267
and serum 25OHD, 213, 257, 259, 264–267, 271, 277, 284, 292, 366, 368, 388–389
accretion, 53–54, 269, 350, 351–353, 354, 503.
See also Bone, accretion
adverse effects with. See Adverse effects, calcium;
Calcium, ULs
AIs, 7, 8, 58n.4, 345, 346, 348–351.
See also Calcium balance, studies;
Calcium retention
autism, 183
bioavailability, 37, 39, 62–63, 498, 503
See also Supplements, calcium, and bone health
cancer, 5, 135, 137, 139, 140, 141, 143, 144–145, 147, 414–416
cardiovascular disease, 148, 149
cognitive function, 186
deficiency, 35, 40, 48–50, 243–248, 254, 271, 386
depression, 188
DRIs
adolescents, 7, 351, 352, 354–355, 1104, 1108, 1114
adults, 7, 355–361, 1104, 1108, 1114
background of current report, 346
children, 7, 351, 352, 353–355, 1104, 1108, 1114
infants, 7, 348–351, 1104, 1108, 1114
in IOM 1997 report, 16, 58–60, 61, 346, 350, 351, 404
lactation, 7, 361, 362, 1104, 1108, 1114
pregnancy, 7, 361–362, 1104, 1108, 1114
summary tables, 7–8, 349, 464, 1104, 1108, 1114
EARs.
See also Calcium, AIs
and accretion/retention, 58n.4, 268, 272, 292
adolescents, 7, 351, 354, 356, 357, 359, 1104
adults, 7, 355, 356, 357, 359, 360–361, 1104
children, 7, 351, 353, 354, 1104
lactation, 7, 9, 349, 361, 362, 464, 1104
pregnancy, 7, 9, 349, 361, 362, 464, 1104
summary tables, 7, 349, 464, 1104
elemental, 37
excretion
children, 352
infants, 8
during lactation, 256, 257, 282
postmenopausal women, 55
reduction with diuretics, 407
relationship with calcium intake, 42, 256, 257, 413–414
relationship with hypercalciuria, 406–407
food sources of, 36, 62–63, 413, 466, 497, 498
homeostatic regulation, 35, 40–41, 49, 56, 84, 89–90, 153, 157, 253
in human milk, 39, 52–53, 56, 57, 256, 257
intake. See Calcium intake
interactions with other nutrients. See Calcium interactions
ionized, 35, 43, 56, 250, 257, 424
during lactation, 7, 8, 45n.3, 56–57, 256–257, 362
metabolism, 35, 38–42, 43, 56.
See also Calcium balance
mobilization or transport, 153, 177–178, 249, 254, 356, 361
physiological role, 35, 42–52, 157, 184
during pregnancy, 7, 189, 190, 242, 249–250, 361–362
RDAs, 7, 272, 292, 351, 353, 354, 355, 356, 357, 359, 361, 1108
retention. See Calcium retention
rheumatoid arthritis, 175
supplements. See Supplements, calcium
ULs, 7, 8, 418–420, 421–424, 464, 488, 500–501, 1114–1115
umbilical cord level, 251, 254
units of measurement, 31
Calcium-alkali syndrome, 407–409, 418, 422, 423
Calcium balance.
See also Calcium, homeostatic regulation
adolescents, 58
adults, 355
bone remodeling and, 45–46, 272
definition, 57
as indicator of nutrient adequacy, 4, 129
infants, 58
outcomes, 58
during pregnancy or lactation, 249, 277–278, 282, 362
regulated by calcitriol. See Calcitriol, functions, calcium regulation
studies, 57–60, 58n.4, 350, 351, 352
Calcium carbonate, 37, 63, 407, 408, 417.
See also Supplements, calcium
Calcium citrate, 37, 43, 63, 417.
See also Supplements, calcium
“Calcium economy,” 294–298, 517
Calcium glucoheptonate, 37n.2
Calcium gluconate, 37n.2
Calcium hydroxyapatite, 35, 37n.2, 43, 44–45
Calcium intake.
See also Supplements, calcium
absorption of lipids and, 148
assessment
estimates from national surveys, 10, 458–460
from food sources only, 465, 466
water, 36
assumption of adequacy for vitamin D DRI, 347–348
bone health and
BMC/BMD, 47, 60–62, 175, 195, 219–226, 270–274, 285–290, 392–393
bone accretion, 47, 53–54, 292
bone mineralization, 276
dose–response relationship, 360
skeletal recovery after weaning, 57, 256–257, 258, 282, 283, 285
cancer, 144–145, 146, 147, 414–416
cardiovascular disease, 148
See also Indicators of adverse outcomes for excess intake
excretion of calcium and, 42, 414
falls and physical performance, 157
inadequate. See Calcium, deficiency
for neutral calcium balance, 58, 273, 285
plateau intake, 58
preeclampsia and pregnancy-induced
relationship with calcium absorption, 38–39, 56
relationship with calcium retention, 269
rheumatoid arthritis, 175
systemic lupus erythematosus, 176
Calcium interactions
foods and food components, 62–64
magnesium, 37
prescription drugs, 422
vitamin D, 5, 6, 35, 60, 136, 358, 360, 369, 388, 484, 517
Calcium lactate, 37n.2
Calcium retention
calcium intake and, 58–60, 269, 270
effects of dietary protein, 63
integration of evidence, 292
plateau intake, 58
regression modeling, 58
Canada
calcium intake assessment, 37, 465–468
changes in diet of indigenous Canadian populations, 11, 498–500
compared with the U.S., 474, 476–477
national intake surveys, 10–11, 110–111, 457–458, 461–462, 521
Recommended Nutrient Intakes, 15
use of DRIs, 15
vitamin D
deficiency, 13–14, 486–488, 494
in formula, 81
intake assessment and serum 25OHD levels, 10–11, 110–111, 474–477, 478
in milk, 79
supplementation, 81
Canadian Community Health Survey (CCHS), 461, 467, 474, 475
Canadian Food Inspection Agency (CFIA), 79
Canadian Health Measures Survey (CHMS), 462, 474, 476, 478, 499
Canadian Institute for Health Information, 461
Canadian Multicentre Osteoporosis Study, 270
Canadian Nutrient File (CNF), 462
Cancer/neoplasms.
See also specific histological sites
calcitriol and, 77, 91–92, 139
as indicator of adverse outcomes for excess intake, 6, 405
as indicator of nutrient adequacy, 4, 5, 129, 134–139
vitamin D and, 91–92, 135–139, 486
Cancer Prevention Study II Nutrition Cohort, 142, 414, 436
Carbohydrate, 83, 1104, 1110, 1111
Carcinogenesis, 91–92, 135, 143, 144
Cardiovascular diseases
calcium and, 148, 149, 150, 407, 410, 481
as indicator of adverse outcomes for excess intake, 6, 405
as indicator of nutrient adequacy, 4, 5, 129
serum 25OHD and, 148–149, 150–152, 437–438
vitamin D and, 88, 148, 149, 425, 426, 437–438
Carotenoids, 1113
Cartilage, 44, 48, 94, 174, 175
Caucasian ancestry
puberty, 24
serum 25OHD levels, 101, 103, 104, 155, 173, 174, 203, 205–206, 211–213, 215, 216
Celiac disease, 254
Cell differentiation, 77, 91, 140, 143, 146, 157, 176
Cell proliferation, 77, 90, 140, 146, 157
Centers for Disease Control and Prevention (CDC), 420, 460, 477
Cerebrovascular disease, 147
Cesarean section, 192
Children, ages 1 through 3 years
bone health, 218, 382–383, 384, 386
calcium, 7, 61, 268, 349, 351, 352, 353, 413–414, 420, 463, 464, 465, 466, 467, 1104, 1108, 1114
DRI development, 23, 385–387, 445
EARs, 7, 9, 349, 351, 353, 385, 387, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
growth rate, 23
RDAs, 7, 9, 349, 351, 353, 385, 387, 464, 469, 1106–1110
ULs, 7, 9, 420, 441, 445, 464, 469, 1112–1115
vitamin D, 9, 95, 169, 385–387, 441, 445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Children, ages 4 through 8 years
bone health, 195, 202–208, 218, 382–383, 384, 386
calcium, 7, 47, 53, 61, 265, 268, 349, 351, 353–354, 385, 387, 464, 465, 466, 467, 1104, 1108, 1114
DRI development, 24, 385–387, 445
EARs, 7, 9, 349, 351, 385, 387, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
RDAs, 7, 9, 349, 351, 354, 385, 387, 464, 469, 1106–1110
ULs, 7, 9, 420, 421, 441, 445, 464, 469, 1112–1115
vitamin D, 9, 95, 169, 385–387, 441, 445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Children, ages 9 through 13 years
bone health, 53–54, 195, 202–208, 218, 226, 280
calcium, 39, 53–54, 265, 354–355, 386, 417, 465, 466, 467, 1104, 1108, 1114
DRI development, 24, 354–355, 385–387, 445
EARs, 7, 9, 349, 351, 464, 469
elements, 1108–1109, 1114–1115
RDAs, 7, 9, 349, 351, 464, 469, 1106–1110
ULs, 7, 9, 419, 420, 421, 441, 445, 464, 469, 1112–1115
vitamin D, 9, 385–387, 441, 445, 469, 470–473, 475, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Chills, 180
Chinese ancestry or Chinese, 188, 216, 228, 268
Cholecalciferol. See Vitamin D3
Cholestasis, 505
Cholesterol, 83, 84, 148, 434, 435, 1111
Chronic disease and DRI development, 2, 5, 16, 28, 486, 489.
See also specific diseases
CLUE, 436
Cognitive function, 4, 129, 183–186, 188
Colorectal cancer/colon polyps, 135, 142–144
Communication deficits, 182
Competitive protein-binding assays (CPBAs), 107, 108, 109
Constipation, 6, 37, 405, 417, 422
Contraceptives, oral, 11, 501–503
Convulsions, 94
Cord, blood chemistry, 192, 251, 252, 254, 281
Coronary artery disease, 147
Corpuscular indexes, 417
Cramping, 171
Creatinine, 176, 406, 408, 409, 428–429, 434
Crohn’s disease, 4, 129, 171–173
Cross-cultural differences. See Race/ethnicity
Cubilin-megalin receptor system, 88
D
Dairy products
autism, 183
cancer risk, 142, 146, 414–415
constipation from, 417
diabetes, 155
lactose intolerance or cow’s milk allergy, 496–498, 501
protective compound against kidney
stones, 500
vitamin D–fortified, 79–80, 431–432, 497
Data
assignment of “race” in study design, 295
associations vs. causal or predictive relationships, 263–264, 480, 485, 517
challenges
graded doses, 12, 484, 515, 519
isolation of effects of single nutrient, 5, 6, 11, 12, 35, 346, 485
limited or incomplete. See Research needs;
Uncertainties
pre-existing disease conditions, 406, 42
standardization, 109, 516, 521
statistical analysis/synthesis methodology, 158–159, 519
extrapolation
from animal studies, 96
from EAR and UL values, 27
from observed data to general population, 404
from one life stage to another, 23, 24, 346, 355, 393
inconsistency in measured outcomes, 181
postmortem, 275, 350, 367, 388
quality, and hierarchy of study design, 127, 128, 130, 131–132, 133
uncertainties in analysis, 158–159
uncertainties in collection, 11–12, 167
weighted, 519
7-Dehydrocholesterol, 75, 81, 95, 100, 101, 104, 496
Deoxyribonucleic acid (DNA), 105, 143
Dermatitis, 168
Diabetes (type 1), 4, 5, 170–171, 189, 192, 255
Diabetes (type 2), 4, 5, 129, 151, 152–156
DiaSorin, 110–111, 111n.12, 476, 476n.17–18
Dietary intake.
See also Supplements;
specific nutrients
assessment. See Intake assessment, dietary
effects on asthma, 168
fat, 83, 148, 168, 498, 1110, 1111
of indigenous Canadian populations, 11, 498–500
of peoples in the far north, 492
research needs, 521
total intake, 457, 459, 474, 483
tuberculosis, 179
use of term, 457
vegetarian or vegan, 11, 63, 179, 496–498
Dietary Reference Intakes (DRIs)
AI and, 345
calcium. See Calcium, DRIs
See also Adequate Intake;
Estimated Average Requirements;
Recommended Dietary Allowance;
Tolerable Upper Intake Levels
development
and chronic disease, 2, 5, 16, 28, 486, 489
and public health. See Public health
considerations, in DRI
development
rationale and assumptions, 16–17, 347–348, 351, 369, 370, 385.
See also Sun exposure, DRI development, assumption of minimal
risk assessment in, 17, 18, 26–29, 30, 32, 345, 403, 481–482, 488–490, 514–516
elements, 1108–1109, 1114–1115
extrapolation. See Data, extrapolation
IOM committee. See Institute of Medicine, committee
measures. See Indicators of adverse outcomes for excess intake;
Indicators of nutrient adequacy
overview, 7, 12, 18–19, 23–25, 457, 458, 479–481
total water, 1110
vitamin D. See Vitamin D, DRIs
vitamins, 1106–1107, 1112–1113
Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (IOM, 1997)
calcium, 16, 58–60, 61, 346, 350, 351, 404, 416, 420–421
vitamin D, 9, 16, 97, 346, 404, 425, 487
Dieting. See Weight loss or dieting
Dietitians of Canada, 497
1,25-Dihydroxyvitamin D. See Calcitriol
24,25-Dihydroxyvitamin D, 78, 86, 109, 504
Dose–response relationships
intake–response assessment, 17, 28–29, 31, 403, 418–424, 440–446, 515–516, 519–520
public health approach vs. medical approach, 482, 521
research needs, 12, 159, 346, 359, 360, 482, 519–520
serum 25OHD
and cardiovascular disease, 148, 149, 437–438
and vitamin D, 98, 364–365, 381, 431, 439
vitamin D
and bone health, 159–160, 161, 167, 291, 363, 364, 365–383, 390
and colorectal cancer, 145
and serum 25OHD levels, 98, 364–365, 381, 431, 439
and type 1 diabetes, 171
Duel-energy X-ray absorptiometry (DXA), 56, 57, 61–62, 199–201, 205–206, 210–216, 229, 231, 233
Dyslipidemias, 152
E
Eating disorders, 406, 407, 425
Elderly population.
See also Adults, 70+ years
bone health and serum 25OHD, 209–218, 226–234, 496
diabetes, 154
indoor environment or institution, 11, 37, 241, 496
Elements, 1108–1109, 1114–1115
Encephalomyelitis, 173
Endocrine system, 35, 40–41, 84, 89, 153, 156
Endpoints, 25, 158, 263, 489, 505
Energy metabolism, 24
Epidemiological studies, 63, 131, 132, 135, 145, 176–177, 185, 278, 361
Epidémiologie de l’Ostéoporose (EPIDOS), 185
Ercalcitriol, 78
Ergocalciferol. See Vitamin D2
Estimated Average Requirements (EARs).
See also specific nutrients
calcium. See Calcium, EARs
coefficient of variation, 21
cut-point method, 462, 480, 486–487
development, 2, 8–9, 20–21, 26
of females. See Females, EARs
during lactation. See Lactation, EARs
of males. See Males, EARs
during pregnancy. See Pregnancy, EARS
RDA and, 2, 3, 20, 21, 23, 369
selection of indicators of nutrient adequacy, 27–28, 31, 125–127, 129, 130–134, 298–299
serum 25OHD level and, 294
throughout the life cycle. See under specific life stages
uses, 3
vitamin D. See Vitamin D, EARs
Estradiol, 42, 55, 213, 256, 501
Estrogen, 24, 48, 54–55, 62, 96, 285, 287, 490, 501–503
Ethical considerations, 404, 425, 488, 504, 518
Ethinyl estradiol. See Contraceptives, oral
Ethnic background. See Race/ethnicity
Etiology, 5, 134, 187, 406, 426–427, 486
European ancestry, 101, 374, 375
European Prospective Investigation into Cancer and Nutrition (EPIC), 145
Exercise. See Physical activity
F
Falls and physical performance.
See also Physical activity
definition and assessment challenges, 158
as indicator of adverse outcomes for excess intake, 6, 161, 405
as indicator of nutrient adequacy, 4, 5, 129, 156–167
serum 25OHD, 157, 158–160, 162–165, 166, 167, 226, 439
Fat, dietary, 83, 148, 168, 498, 1110, 1111
Females.
See also Gender differences;
Women
EARs, 7, 9, 349, 363, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
macronutrients, 1110
RDAs, 7, 9, 349, 363, 464, 469, 1106–1110
ULs, 7, 9, 419, 441, 464, 469, 1112–1115
vitamin D intake assessment, 470–473, 475
vitamins, 1106–1107, 1112–1113
water, total, 1110
Fetus
asthma, 168
See also Pregnancy, bone health, BMC/BMD
brain development, 184
calcium needs, 55–56, 242, 249, 281, 361, 393–394
and non-skeletal reproductive outcomes, 192
preeclampsia, 189
PTH, 252
skeleton development, 55–56, 57, 193, 242, 249, 393–394
vitamin D, 96, 169, 182, 252–256, 279–280, 393–394
Fever, 180
Fibroblast-like growth factor-23 (FGF23), 77, 84, 85, 90, 515, 518
Finnish peoples, 169, 191, 203, 206, 225, 232, 372, 374, 376, 383, 437, 492
First Nation peoples, 11, 245, 462, 498–500
Food and Drug Regulation, 79
Food and Nutrient Database for Dietary Studies 3.0 (USDA), 459
Food composition databases, 36, 80, 458, 459
Food sources.
See also Fortified foods of calcium, 36, 62–63, 413, 466, 497, 498
calcium intake estimates from, 465, 466
vitamin D intake estimates from, 470, 474, 475, 476
Forest plot, 209, 217, 234, 238–240
Formula, infant, 52, 80–81, 95, 431, 503, 505
Fortified foods, 1, 15, 22, 36, 62, 79–80, 431–432, 466, 497, 498.
See also Formula, infant
Fracture. See Bone, fracture
Framingham Offspring Study, 148, 149, 437
Framingham Osteoporosis Study, 63
Fructose, 415
G
Gambians, 53, 249, 256, 257, 259, 278
Gas chromatography, 109
Gastroenteritis, 180
Gender differences, 95, 101, 139, 354, 437.
See also Men;
Women
Genetics
assignment of “race” in study design, 295
calcitriol gene expression, 146
calcium content of human milk, 53
genetic variation and serum 25OHD as biomarker, 517
systemic lupus erythematosus, 176
vitamin D, 140.
See also Vdr gene;
Vdr-null mice
GLA protein, 44
Glomerular filtration rate (GFR), 55, 411, 412, 426, 428–429, 435
Glucocorticoids, 62
Glucose, 153–154, 155, 156, 170, 184, 505
Growth factors, 43, 44, 91, 143, 146, 184.
See also Fibroblast-like growth factor-23;
Vascular endothelial growth factor
Growth hormone, 53
Growth rate, 6, 23, 405, 420, 431, 495
H
Handgrip strength, 166
Hazard characterization, 26, 27, 28–29, 345, 403, 514, 515–516, 519–520, 522
Hazard identification, 26, 27–28, 30, 125, 403, 514, 515, 516–519, 522
Hazard ratio, 137, 227, 286, 358, 412, 433
Health Canada, 94–95, 461, 476
Health Professionals Follow-up Study (HPFS), 138, 147, 148, 151, 415, 436
Heart failure, 147, 150–151, 166
See also Growth rate
Hematocrit, 417
Hippocampal cells, 184
Hispanics, 104, 174, 347, 374, 493, 494, 495
Hormone replacement therapy (HRT), 210, 213, 286, 358, 393, 501–503
Human milk.
See also Infants, breast-fed;
Lactation
calcium content, 8, 39, 52–53, 56, 57, 256, 257, 259, 281–282, 349, 351, 394, 503
intake volume per day, 53, 349, 351
as optimal source of nutrients, 348–349
phosphorus in, 503
vitamin D content, 80, 94, 96, 257, 494
volume produced, 282
Hydroxyapatite. See Calcium hydroxyapatite
1α-Hydroxycholecalciferol, 157
1α-Hydroxylase
in the brain, 184
calcitriol formation and, 35, 56, 77, 84, 97
expressed in extra-renal tissues, 77
expressed in the colon and rectum, 143
expressed in the kidney, 35, 42, 56, 251, 252
expressed in the placenta, 189, 251, 252
with granulomatous diseases, 431
impaired with vitamin D–dependent rickets type 1, 94
with inflammatory disease, 177–178
molecular cloning, 177
suppression by FGF23, 85
vitamin D2 and, 93
1α-Hydroxylase-null mice, 253, 260
25-Hydroxyvitamin D (25OHD).
See also Serum 25-hydroxyvitamin D
assays for, 107–111, 476, 484, 516, 521
discovery, 107
formation in the liver, 77, 85
in human milk, 80, 94, 257–258
lifetime, 86
relationship with calcium absorption, 95, 347
use of term, 78
vitamin D intoxication, 89, 427–430
Hypercalcemia
calcification associated with, 406, 409–410
as indicator of adverse outcome for excess intake, 6, 405, 406, 425, 440, 443, 501
in IOM 1997 report, 404
renal insufficiency with, 407–409, 410
toxic condition, 140, 174, 406–407
Hypercalciuria
increased risk for nephrolithiasis with, 411, 501
as indicator of adverse outcome for excess intake, 6, 405
in IOM 1997 report, 404
during pregnancy, 56, 250, 277, 278–279, 424, 501
with sarcoidosis, 91
Hyperglycemia, 155
Hyperparathyroidism, 48, 49, 55, 95–96, 111, 296, 409
Hyperphosphatemia, 407, 409n.1
Hypertension, 4, 5, 129, 147, 151, 189–191, 435.
See also Cardiovascular diseases
Hypervitaminosis D, 88, 93, 109, 425, 440, 481, 518
Hypocalcemia, 48, 49, 94, 184, 251, 253, 254, 256
Hypocalciuria, 189
Hypophosphatemia, 48, 253, 407
I
IARC studies, 141, 143–144, 145
Immune function, 78, 91, 167–168, 170, 176, 177, 180
Immune responses, 4, 5, 129, 167–182
Immunoglobulins, 91, 169–170, 176, 497
Indian ancestry or Indians (East Indian), 207, 245, 493–494
Indians (North American). See American Indians;
First Nation peoples
Indicator, use of term, 25
Indicators of adverse outcomes for excess intake, 28, 403, 405–418, 422, 424–440
Indicators of frailty, 434
Indicators of nutrient adequacy.
See also specific indicators, nutrients, and life stages
data quality, hierarchy of study design, 127, 128, 130, 131–132, 133
process, 25–26, 27–28, 130, 132–134, 135
review and selection, 27–28, 31, 125–127, 129, 130–134, 298–299, 515, 516–519
Indoor environments and institutionalized persons, 37, 241, 496
Infants, 0 to 12 months.
See also Formula, infant;
Human milk
ages 0 to 6 months, 7, 23, 39, 109, 192, 218, 251–252, 268, 348, 349, 350, 383, 385, 386, 418, 419–420, 440, 441, 442, 464, 469, 1106–1110, 1112–1115
ages 6 to 12 months, 7, 23, 348, 349, 350–351, 383, 385, 386, 418, 420, 441, 442, 464, 469, 1104–1110, 1112–1115
birthweight or length, 192–193, 251–252, 254, 255, 283
bone health, 195, 196–201, 251–252, 257–258, 283, 386, 394
breast-fed, 39, 52, 94, 201, 348–349, 350, 493, 494–495
calcium
absorption, 39, 52, 253, 350, 503, 505
accretion, 268
balance, 58
bone deposition, 52
intake, 52–53, 249, 281–282, 349
RDAs, 1108
total body, 268
elements, 1108–1109, 1114–1115
growth rate, retarded, 6, 405, 431, 495
indicators of adverse outcome for excess intake, 6, 405, 431, 495
macronutrients, 1110
ULs, 418, 419, 420, 464, 1112–1115
vitamin D, 94–95, 96, 258, 383, 385, 431–432, 440–442, 494–495, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Infectious diseases, 4, 5, 78, 177–181, 182.
See also Influenza;
Tuberculosis;
Upper respiratory infections;
Vaginosis
See also Anti-inflammatory action;
Asthma;
utoimmune disease;
Crohn’s disease;
Inflammatory bowel disease
Inflammatory bowel disease (IBD), 4, 37, 171–173
Institute of Medicine (IOM)
committee
approach for intake assessment, 462–463
conclusions about vitamin D
deficiency, 13–14, 293, 480, 486–488
data review for DRI development, 3, 5–6, 16–17, 29–32, 135
members’ expertise, 16
process, 2
risk assessment approach for DRI development, 17, 18, 26–29, 30, 32, 125, 345, 403, 479, 488–490, 514–516
summary of uncertainties and research needs, 483–486, 513–522
1997 report. See Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride
overview of DRI development, 1, 15–16
workshops, 2, 97, 127, 404–405, 482
Institutionalized people, 37, 241, 496
Insulin, 152, 153, 154–155, 156, 170
Intake. See Calcium intake, assessment;
Dietary intake;
Intake assessment, dietary;
Vitamin D intake, assessment
Intake assessment
calcium. See Calcium intake, assessment
dietary, 10–11, 110–111, 457–463, 516, 521
in risk assessment approach, 27, 29, 514
vitamin D. See Vitamin D intake, assessment
Intake–response assessment, 17, 28–29, 31, 403, 418–424, 440–446, 515–516, 519–520
Interactions. See Calcium interactions;
Nutrient–nutrient interactions;
Vitamin D interactions
International Unit (IU), 78
Iowa Women’s Health Study, 175
Iron, 6, 37, 80n.3, 405, 416–417, 418, 1105, 1108, 1114
J
Jadad Score, 127, 128, 196–198, 203–204, 210–211, 236
K
Kidney function. See Renal function
Kidney stones. See Nephrolithiasis
L
Labor, obstructed, 192
Lactation.
See also Human milk;
Infants, breast-fed
adolescents, 7, 57, 257, 282, 283, 349, 361, 362, 363, 393, 394, 424, 464, 469
calcium, 7, 8, 45n.3, 56–57, 256–257, 281–282, 292, 349, 361, 362, 464, 1104, 1108
EARs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
macronutrients, 1110
RDAs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 1106–1110
serum 25OHD and, 218–219, 283, 394
twins, 257
ULs, 7, 9, 419, 424, 441, 446, 464, 469, 1112–1115
vitamin D, 9, 96, 257–260, 282–283, 363, 393, 394, 441, 469, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Lactose, 39, 80n.3, 260, 498, 505.
See also Lactose intolerance
Lactose intolerance, 347, 496–498, 501
Lean body mass or lean mass, 166, 202, 204, 490, 491
Leukopenia, 176
Life stage.
See also Adolescents;
Adults;
Children;
Infants
calcium, 7–8, 52–57, 345, 349, 464
extrapolation of data from one to another, 23, 24, 346, 355, 393
interpolation of data, 423
vitamin D, 9, 94–96, 345, 363, 441, 469
Liquid chromatography (LC), 107, 108–109, 110, 365, 430
Literature review, 17, 28, 31, 126, 127, 130, 141, 252
Liver, 77, 83, 84, 85, 86–87, 105, 106, 492, 498
Longitudinal Aging Study Amsterdam, 166, 434
Lowest observed adverse effect level (LOAEL), 418, 421, 422, 423
Lowest observed effect level (LOEL), 29
Lupus. See Systemic lupus erythematosus
Lymphadenopathy, 176
M
Macrophage, 44, 90, 91, 175, 177
Magnesium, 16, 37, 168, 1105, 1108, 1115
Magnetic resonance imaging (MRI), 185
Males.
See also Gender differences;
Men
EARs, 7, 9, 349, 363, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
macronutrients, 1110
RDAs, 7, 9, 349, 363, 464, 469, 1106–1110
serum 25OHD levels, 476
ULs, 7, 9, 419, 441, 464, 469, 1112–1115
vitamin D intake assessment, 470–473, 475
vitamins, 1106–1107, 1112–1113
water, total, 1110
Malnutrition, 254
Maori peoples, 155
Mass spectrometry, 107, 108–109, 110
Melanin. See Skin pigmentation
Men.
See also Gender differences;
Males
bone health
bone loss, 356
fractures, 234–242, 356, 359–360, 391, 392
and serum 25OHD, 209–218, 226–234
vitamin D and calcium supplementation, 157, 162, 234–242, 393
cognitive function, 185
mean age of puberty, 24
nephrolithiasis incidence rate, 411
serum 25OHD level and cardiovascular risk, 437
Menarche, 139.
See also Puberty
Menopausal status
bone health, 8, 47–48, 52, 54–55, 209–218, 226, 234–242, 360–361, 392
calcium absorption, 40
Metabolic syndrome, 4, 5, 129, 152–156.
See also Obese or overweight persons
Methodological considerations.
See also Data;
Indicators of nutrient adequacy
assay for serum 25OHD, 107–111, 476, 484, 516, 521
assay shift and drift, 107–111, 365–366, 460–461
assignment of “race,” 295
calcium balance studies, 57–58
complications in the course of a study, 130
cut-point method, 13, 14, 144, 462, 480, 486–488, 522
flaws, biases, and confounding effects in study design, 130
IOM committee data review, 17
IOM committee intake assessment, 462–463, 477
standardization, 109, 516, 521
use of new, 489n.1
Michaelis-Menten constants, 87
Microsome, 87
Middle Eastern ancestry or Middle Easterners, 204, 246, 259, 493–494, 495
Milk. See Dairy products;
Formula, infant;
Human milk
Milk-alkali syndrome (MAS), 407.
See also Calcium-alkali syndrome
Mini-Mental State Examination for Koreans (MMSE-K), 186
Models, statistical
calcium retention, 58, 59–60, 268, 353
calcium supplement intake, 460
cognitive function, 185
dietary intake, 460
effect of latitude on vitamin D synthesis, 104, 380–383
effects of seasonal sun exposure, 496
intake–response assessment, 28
mixed effect model, 380
Monte Carlo approach, 460
public health approach vs. medical
serum 25OHD and BMC/BMD, 212, 214
serum 25OHD and vitamin D intake, 380, 463
Molybdenum, 37, 1105, 1109, 1115
Moroccans, 244
Mortality, 6, 156, 179, 405, 425, 432–435, 438, 444
Multiple sclerosis (MS), 4, 129, 173–174, 181
Muscles, 43, 49, 50, 84, 156–157, 180, 184, 202
Myelin, 173
Myocardial infarction, 147, 148, 149, 151, 437
N
National Cancer Institute (NCI), 459, 460
National Center for Health Statistics (NCHS), 110
National Council on Skin Cancer Prevention, 495–496
National Health and Nutrition Examination Survey (NHANES)
calcium intake and BMD, 273
First (NHANES I), 458
post-2000 data, 150, 437, 458–459, 465, 466, 470, 471, 472, 473, 493
Second (NHANES II), 63, 110–111, 458
serum 25OHD levels, 169, 365, 404, 405, 460–461
Third (NHANES III), 56, 57, 110–111, 138, 148–149, 166, 185–186, 257, 274, 433, 434, 435, 438, 458
National Institute of Standards and Technology (NIST), 110
National Institutes of Health (NIH), 424, 459, 497, 513, 521
National Osteoporosis Foundation, 357
Native Americans. See American Indians;
First Nation peoples
Natriuresis, 407
Nephrocalcinosis, 406, 409, 412
Nephrolithiasis (kidney stones)
association with nephrocalcinosis, 409
as indicator of adverse outcome for excess intake, 6, 405, 422, 423, 500–501
risk with excess calcium, 286, 410–414, 422, 481
risk with excess vitamin D, 286, 426
Nerve transmission, 35, 43, 89, 173
Neuroblastoma cells, 184
Neurological manifestations, 176
Neuropsychological functioning, 4, 5, 182–188.
See also Autism;
Cognitive function;
Depression
New York University Women’s Health Study, 436
Nickel, 1115
No observed adverse effect level (NOAEL), 418.
See also Calcium, ULs;
Vitamin D, ULs
No observed effect level (NOEL), 28
Northern Finland Birth Cohort of 1966, 191
Norwegians, 154, 187, 244, 437
Numbness, in the limbs, 173
Nurses’ Health Study (NHS), 141, 142, 155, 177, 412–413, 436
Nutrient–nutrient interactions, 5, 6, 7, 11, 12, 35, 37, 346, 405, 416–417, 485
O
Obese or overweight persons.
See also Adipose tissue;
Adiposity;
Metabolic syndrome
bariatric surgery, 88, 106, 518
calcium absorption, 39
challenges with bone mass measurement, 62
definition, 490
metabolic syndrome, 152
vitamin D storage, 88, 105–106, 156, 490, 518
Organ transplant recipients, 158
Osteoarthritis, 216
Osteoblast, 44, 45, 46, 49, 50, 256, 491
Osteocalcin, 44
Osteoclast, 44, 45, 46, 89, 256, 491
Osteoid. See Bone, organic matrix
Osteomalacia
cannot be corrected by increased calcitriol, 49
as indicator of nutrient adequacy, 4, 129
during pregnancy, 253
serum 25OHD and, 8, 195, 275, 284, 292, 293, 367, 368, 470–471n.16, 494
Osteophyte, 61
Osteoporosis
with adolescent pregnancy, 250
African Americans, 294–295, 296, 493
FDA primary outcome, 167
inclusion in bone health measures, 489
low calcium intake and vitamin D levels, 49
with osteomalacia, 50
serum PTH as risk factor, 260
serum 25OHD and, 231
Osteoporotic Fractures in Men Study (MrOS), 185, 356, 367
Oxalic acid (oxalate), 62, 411, 413, 498, 500
P
Pacific Islanders, 155
Pakistani ancestry or Pakistanis, 202, 209, 218, 244, 275, 493–494
Pancreatic cancer, 425, 436–437, 486
Pancreatic endocrine function, 153, 156
Pancreatic insufficiency, 254
Paralysis, 173
Parathyroid gland (PTG), 35, 40, 41
Parathyroid hormone (PTH)
as biomarker for bone resorption, 55, 111
bone health and
African Americans, 296
children and adolescents, 205
infants, 198
postmenopausal women and elderly men, 210, 214–215, 227
calcium and, 35, 38, 40–41, 42, 49, 56, 62, 89, 407
fetal, 252
as indicator of nutrient adequacy, 4, 129, 260–262
multiple sclerosis, 174
osteomalacia, 50
Parathyroid hormone-related protein (PTHrP), 256, 257
Parkinson’s disease, 158
Periosteal expansion, 44, 46, 53
Peripheral artery disease or peripheral vascular disease, 147, 150, 152, 437
Phosphate, 44, 49, 64, 77, 84, 89–90, 407, 409, 426, 500
Phosphorus
absorption, 64
BMD and, 62
bone formation, 44
EARs, 1105
in human milk, 503
in milk with cream, 407
RDAs, 1109
regulation by calcitriol, 64, 77, 89
serum, 40, 41, 50, 77, 90, 407, 426
ULs, 1115
Physical activity.
See also Falls and physical performance
bone fracture and, 286
bone mass and, 46, 54, 273, 287, 490–491
diabetes, 155
serum 25OHD and, 105
vitamin D synthesis in the skin, 105
Phytic acid, 62
Pigmentation. See Skin pigmentation
Placenta, 52, 55, 90, 189, 251, 252
Pneumonia, 180
Polynesians, 155
Population segments and conditions of interest, 11, 17, 29, 31, 490–505
Preeclampsia and pregnancy-induced hypertension, 4, 5, 189–191, 250
Pregnancy.
See also Lactation
adolescents, 56, 57, 250, 257, 278, 361, 362, 393, 394, 424, 469
bone health
BMC/BMD, 249, 250, 254, 255, 256, 278, 279–280, 361, 362
fracture, 278
serum 25OHD and, 192–193, 205, 218–219, 251, 255, 279–280, 281
calcium, 7, 8, 39, 55–56, 96, 242, 249–250, 277–278, 279, 292, 349, 361–362, 424, 464, 1104, 1108
DRI development, 24, 361–362, 393–394
EARs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 1104–1105
elements, 1108–1109, 1114–1115
hypercalciuria during, 424, 501
macronutrients, 1110
multiple sclerosis remission, 174
non-skeletal reproductive outcomes, 192–193
preeclampsia and pregnancy-induced hypertension, 4, 5, 189–191, 250
RDAs, 7, 9, 349, 361, 362, 363, 393, 394, 464, 469, 1106–1110
ULs, 7, 9, 419, 424, 441, 446, 464, 469, 1112–1115
vitamin D, 9, 96, 169, 182, 192, 193, 250–260, 279–281, 363, 393–394, 441, 469, 1106, 1112
vitamins, 1106–1107, 1112–1113
water, total, 1110
Prescription drugs, interactions with, 11, 87, 422, 504, 505
Profile of Mood States (POMS), 188
Prohormone, vitamin D as, 75, 84, 481, 484
Proinflammatory state, 152
Project VIVA, 169
Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), 141, 436
Prostate cancer, 6, 145–147, 405, 414–416, 422, 437
Prothrombotic state, 152
Proton-pump inhibitors, 37, 407
Provitamin D. See 7-Dehydrocholesterol
Puberty, 8, 24, 39, 47, 262, 354.
See also Adolescents
Public health considerations cancer, 134
cardiovascular disease, 147
in DRI development
calcium, 359, 360, 421, 423, 477
overview, 29, 293, 298, 404, 479, 482, 488–489, 522
vitamin D, 370, 388, 420, 440, 442, 445, 483, 485, 488, 494
R
Race/ethnicity
assignment of “race” in study design, 295
breast-fed infants and vitamin D, 385, 494–495
cardiovascular mortality, 438
clothing and sun exposure, 105, 494
fractures, 439
limited data for DRI development, 347
onset of breast development, 24
relationship between serum 25OHD and PTH, 260–261
serum 25OHD levels, 101, 103, 104, 106, 174, 260–261, 374, 431, 438, 439, 444, 493
Radioimmunoassay (RIA), 110–111, 198
Randomised Evaluation of Calcium and/Or vitamin D (RECORD), 154
Recommended Dietary Allowances (RDAs)
applicable population, 21
background, 15
calcium. See Calcium, RDAs
EAR and, 2, 3, 20, 21, 23, 369
macronutrients, 1110
throughout the life cycle. See under specific life stages
uses, 15
vitamin D. See Vitamin D, RDAs
water, total, 1110
Recommended Nutrient Intakes (RNIs), 15
Rectal mucosa cancer, 135
Renal function
calcitriol formation and, 77, 84, 90, 481
renal insufficiency
cardiovascular disease, 426
chronic kidney disease–mineral disorder, 55
hypercalcemia, 42, 406, 407–409, 410, 425
percent of N. Amer. population with, 406
renal dialysis patients, 91
vitamin D intoxication, 88, 426
Reproductive outcomes, non-skeletal, 4, 192–193.
See also Preeclampsia and pregnancy-induced hypertension
Research needs
adverse effects of vitamin D, 424–425
background diet to calculate total level of intake, 346
calcium intake and BMD, 273
clinical trials, 5, 12, 22, 135, 404, 486
dose–response relationships, 12, 159, 346, 359, 360, 482, 484, 489, 519–520.
See also Sun exposure, DRI development
ethnic/racial considerations, 347, 516–517
indicator review and selection, 515, 516–519
intake assessment, 22, 516, 520–521
intake response–assessment, 519–520
isolation of effects of single nutrient, 5, 6, 11, 12, 35, 346, 485
long-term data, 12, 425, 485, 518
serum 25OHD, 12, 139, 181, 517, 518, 519, 520, 521
sun exposure, 12, 484, 516, 520
vitamin D as a hormone, 12
Rhinitis, 169
Rickets
hereditary vitamin D–resistant (VDDR II), 49, 94, 252, 254, 260, 276
as indicator of nutrient adequacy, 4, 129
neonatal or vitamin D–deficiency, 75, 252, 254, 256, 280–281
premature infants, 503
prevention with vitamin D–fortified foods, 79
serum 25OHD, 49, 235, 237, 243–248, 271, 293, 366, 368, 386, 470–471n.16, 494
vitamin D–dependent (VDDR I), 49, 94, 252, 254, 260, 276
Risk, use of term, 26
Risk analysis, basic assumptions, 18–19, 347–348
Risk assessment
definition, 18
in DRI development, 17, 18, 26–29, 30, 32, 345, 403, 479, 488–490, 514–516
four steps, 27
overview, 3
population segments and conditions of interest, 11, 490–505
role of dietary intake assessment, 457
Risk characterization, 11, 17, 26, 27, 29, 479
Risk communication, 18
Risk management, 18
S
Scarring and scar tissue, 171, 173
Schizophrenia, 182
Scleroderma, 409
Seasonal affective disorder, 186, 187
Sensitive populations. See Special concerns
Serum albumin, 215, 229, 249–250, 257, 434, 435
Serum calcitriol, 38, 78, 150–151, 177, 191
Serum calcium
colorectal cancer, 143
decline with rickets, 49
diabetes, 153
effects of excess vitamin D, 405, 426, 428–429, 430–431
hypercalcemia, 38, 406, 408, 426
as indicator of adverse outcomes for excess intake, 6, 405
during pregnancy, 56, 249–250, 253
regulation, 35, 40–41, 77, 89–90, 426
Serum 25-hydroxyvitamin D (25OHD)
assays for, 107–111, 476, 484, 516, 521
autism, 183
as biomarker
of vitamin D effect, 13–14, 96–97, 263–264, 291, 293, 439, 484, 517, 520
of vitamin D exposure, 8, 12–13, 96, 99, 293, 363, 381–382, 384, 480, 483, 486–488, 520
bone health and
African Americans, 106, 208, 260–261, 295, 298, 439, 493
BMD, 195, 196–207, 209–218, 275, 368, 386–387
bone loss, fractures, osteomalacia, 195, 275
calcium absorption, 213, 257, 259, 264–267, 271, 277, 284, 292, 366, 368, 388–389
children and adolescents, 195, 202–208, 382–383, 384
distribution in healthy populations, 294
DRI development
analysis and outcomes, 263–264, 380–383
conclusions, 366–370, 381–382, 486–488
integration of evidence, 292–294, 370–379
interpretation of data in the literature, 365–366
non-linear relationship with vitamin D intake, 12, 99, 379–383, 384, 484
fractures, 195, 231, 235, 236–237, 291–292, 366–367, 390, 438–439
osteomalacia, 195, 275, 284, 292, 293, 367, 368, 470–471n.10, 494
postmenopausal women and elderly men, 209–218, 226–234
pregnancy and lactation, 192–193, 205, 218–219, 251, 255, 257–259, 279–280, 281, 283, 393–394
rickets, 49, 235, 237, 243–248, 271, 293, 366, 368, 386, 470n.10, 494
cancer, 5, 138, 139, 140–141, 143–145, 146, 436–437
cardiovascular disease and hypertension, 148–149, 150–152
desired level for population median, 8, 470–471n.16
falls and physical performance, 157, 158–160, 162–165, 166, 167
half-life, 263
infants, 195, 196–201, 257–258, 281, 283, 504–505
inflammatory bowel disease and Crohn’s disease, 172–173
insulin sensitivity, 154
intake assessment process
levels for U.S. and Canada, 10–11, 13, 476
methodological considerations, 463, 476
in national surveys, 460–461, 462, 474, 477–478
review of national survey data, 31, 477–478, 480
vs. plasma 25OHD, 461n.10
interactions with prescription drugs, 504
mortality, all-cause, 425, 432–435, 444
neonatal, 109, 258, 280–281, 283
population baseline, 99
preeclampsia and pregnancy-induced hypertension, 189, 190, 191
public health considerations, 521
race/ethnicity considerations, 101, 103, 104, 106, 174
relationship with BMD, 95
relationship with body fat, 88, 105–106
relationship with PTH, 111, 260–262
research needs, 517, 518, 519, 520, 521
rheumatoid arthritis, 175
systemic lupus erythematosus, 177
tuberculosis, 178, 179, 180, 494
uncertainties associated with, 12, 13, 97, 381–382
vaginosis, 192
vitamin D and
effects of sun exposure. See Sun exposure, relationship between 25OHD and vitamin D
effects of supplementation, 98, 106, 179, 180, 243–248, 251–252, 266, 379, 381–382, 426–430, 431
intake, 10–11, 97–100, 110–111, 364, 370–383, 386–387, 468–477
intake assessment data, 468–477, 484
Serum 25-hydroxyvitamin D2 (25OHD2), 107, 108
Serum 25-hydroxyvitamin D3 (25OHD3), 107, 108
Serum parathyroid hormone, 111, 174, 260–262
Serum phosphorus, 40, 41, 50, 77, 90, 407, 426
Serum vitamin D3, 104
Shanghai Women’s and Men’s Health Studies, 436
Silicon, 1115
Skeleton.
See also Bone;
Bone health
bone types, 45
gestational development, 55–56, 57, 193, 242, 249, 281, 393–394
timeframe for turnover, 45
Skin cancer, 6, 12, 136, 363, 370, 481, 491, 496
Skin eruptions, 176
Skin pigmentation, 101–104, 174, 370, 481, 493–495
Smoking, 147, 415, 434, 435, 436
Sodium, 62, 63–64, 168, 1109, 1115
South Asian ancestry or South Asians, 101, 103, 154, 493–494
Special concerns
limited or incomplete data. See Data, challenges;
Uncertainties
population segments and conditions of interest, 11, 17, 29, 31, 490–505
Stakeholders, 2, 3, 19, 29, 126, 127, 479, 513, 521
Staphylococcus, 178
STATA regression analysis software, 159
Statistics Canada, 461, 467, 475, 476, 477
Stem cells, 43
Stroke, 147, 149, 150, 152, 158, 160, 185
Study of Osteoporotic Fractures, 213, 296
Sugars, 1111.
See also Fructose;
Glucose
Sun exposure
altitude, 105
atmospheric conditions, 104, 105, 492
cardiovascular diseases, 148
Crohn’s disease, 172
DRI development
assumption of minimal, 8, 98, 364, 370–371, 378–379, 389, 481, 482–483
research needs, 12, 484, 516, 520
latitude considerations, 11, 98–99, 100, 101, 104–105, 136, 170, 174, 202, 371–383, 477–478, 491–492
during pregnancy, 254
prostate cancer, 147
radiation. See Ultraviolet A radiation;
Ultraviolet B radiation
reduced vitamin D synthesis
indoor environment, 11, 37, 496
skin pigmentation, 11, 100–104, 174, 370, 481, 493–495, 520
sunscreen, 11, 105, 370, 495–496, 516, 520
relationship between serum 25OHD and vitamin D, 98–105, 172, 187, 364, 370–383, 430, 468, 471–473, 477–478.
See also Sun exposure, reduced vitamin D synthesis;
Sun exposure, skin cancer;
Vitamin D, synthesis in the skin
seasonal affective disorder, 187
seasonal considerations, 100–101, 102, 104, 174, 200, 371, 378–383, 471–473, 478, 484, 492
skin cancer, 6, 12, 136, 363, 370, 481, 491, 496, 520
Sun protection factor (SPF), 495
Sunscreen, 11, 105, 370, 495–496, 516, 520
Supplements
calcium
adverse effects with, 22, 42, 404, 405–424, 481, 500–501.
See also Calcium, ULs
bioavailability, 63
and bone health, 209, 210–211, 217, 218, 219–226, 234–242, 243, 246, 274, 285–290, 358, 360, 391, 417
cancer, 137, 139, 141, 142, 144–145, 147, 414–416
cardiovascular disease, 149–150
falls and physical performance, 158, 162–165
during lactation, 256
percent of population which takes, 37
preeclampsia and pregnancy-induced hypertension, 190, 191, 250
role in intake assessment, 460, 463–464, 466
and serum 25OHD levels, 243, 266
with vegan diet, 498
dosage issues, 1
phosphate, 414
self-reported use, 36, 37, 460
vitamin D
adverse effects with, 6, 10, 404, 405, 412, 427, 486.
See also Vitamin D, ULs
and bone health, 196–208, 209–226, 234–235, 236–242, 243–248, 285–286, 290–292, 358, 390–392
cardiovascular disease, 148, 149
effects on serum 25OHD level, 87–89, 98, 106, 179, 180, 243–248, 251–252, 266, 379, 381–382, 426–430, 431, 468, 471
falls and physical performance, 157–165, 167, 438
and infant birthweight or length, 192, 193, 251–252, 283
influenza and upper respiratory
infections, 180
during lactation, 258
preeclampsia, 190
during pregnancy, 9, 96, 169, 182, 190, 192, 193, 251–252
rheumatoid arthritis, 175
with vegan diet, 498
Surrogates, 8, 25, 144, 145, 264
Synovial fibroblasts, 175
Synovitis of the joints, 174
Systemic lupus erythematosus (SLE), 4, 129, 176–177
T
Threshold effect, 141, 515, 516
Thrombogenicity, 148
Thyroid gland, 40
Toddlers. See Children, ages 1 through 3 years
Tolerable Upper Intake Levels (ULs), 3, 5–6, 8, 10, 12, 22, 403–405, 1112–1115.
See also Calcium, ULs;
Vitamin D, ULs
Total intake. See Dietary intake, total intake
Transient receptor potential cation channel, vanilloid family member 5 (TRPV5), 42
Transient receptor potential cation channel, vanilloid family member 6 (TRPV6), 38, 253
Tuberculosis (TB), 4, 5, 91, 177–180, 430, 494
Tufts Medical Center Evidence-based Practice Center, 513
Tympanosotomy tube placement, 181
U
Ulcers, 407
Ultraviolet A radiation (UVA), 105
Ultraviolet B radiation (UVB), 105, 179, 254, 430, 491–492, 494.
See also Sun exposure
Uncertainties.
See also Data;
Research needs
calcium-vitamin D interactions and independent effects, 5, 6, 60, 358, 360, 369, 388, 405, 484
in the context of risk assessment, 3, 18, 19, 29
in data collection, 11–12, 167
dose–response relationships, 12, 159, 346, 355, 359, 360, 482, 484, 489, 515, 519.
See also Sun exposure, DRI development
due to pre-existing disease conditions, 406, 422
meta-regression analysis methods, 158–159
methods for serum 25OHD assay, 107–111, 476, 484.
See also Methodological considerations, assay shift and drift
need for long-term data, 12, 425, 485, 518
non-linear relationship between serum 25OHD and vitamin D intake, 12, 99, 379–383, 384, 484
Uncertainty factor (UF), 29, 404–405, 420, 421, 422, 442
United States
calcium intake assessment, 37, 463–465, 466
compared with Canada, 474, 476–477
national intake surveys, 10–11, 110, 457, 458–461, 521
vitamin D deficiency, 13–14, 480, 486–488
vitamin D intake assessment and serum 25OHD levels, 10–11, 110, 468–473
Units of measurement, 31–32, 78, 487
Upper Levels of Intake (ULs). See Tolerable
Upper Intake Levels
Upper respiratory infections, 4, 5, 129, 169, 180–181
U.S. Department of Agriculture (USDA), 36, 38, 79, 458, 459, 462
U.S. Food and Drug Administration (FDA), 80, 167
V
Vaginosis, 192
Vanadium, 1115
Vascular endothelial growth factor (VEGF), 92
Vdr gene, 140, 168, 170, 172, 173, 178, 182, 184
Vdr-null mice, 91, 143, 148, 171, 173, 184, 251, 253, 259–260, 279
Vegetarian or vegan diet, 11, 63, 179, 496–498
Vision loss, 173
Vitamin A, 180, 1104, 1106, 1112
Vitamin D.
See also Calcitriol;
25-Hydroxyvitamin D;
Serum 25-hydroxyvitamin D
adverse effects. See Adverse effects, vitamin D;
Vitamin D, ULs
anti-bacterial activity, 178, 181
associations vs. causal or predictive relationships, 263–264, 480, 485, 517
as biomarker of total intake, 12–13
cancer
colorectal, 143
cardiovascular disease, 148, 149, 152
cognitive function, 183–86, 188
deficiency
and bone metabolism, 35.
See also Osteomalacia;
Rickets
and cognitive function, 184, 185
colon cancer, 143
conclusions, 13–14, 293, 480, 486–488
defined by cut-point value, 480
indoor environments and institutionalized older persons, 241, 496
inflammatory bowel disease, 172
influenza and upper respiratory infections, 180
multiple sclerosis, 173
normal calcitriol levels, 97
pregnancy or lactation, 218, 251, 253–256, 259–260, 279–280
and serum 25OHD all-cause mortality, 432–435
and skin pigmentation, 481, 493–495
systemic lupus erythematosus, 176
type 1 diabetes, 171
diabetes and, 153–155, 170, 171
DRI development
analysis and outcomes, 380–383
integration of evidence, 292–294, 370–379
interpretation of data in the literature, 292–294, 365–366, 370–379
in IOM 1997 report, 9, 16, 97, 346, 404, 425, 487
DRIs
background of current report, 16, 346
in IOM 1997 report, 9, 16, 97, 346, 404, 425, 487
lactation, 9, 363, 393, 394, 441, 446, 469, 1104
pregnancy, 9, 363, 393, 394, 441, 446, 469, 1104
EARs
adolescents, 9, 363, 385, 387, 469, 1104
adults, 9, 363, 389, 392, 393, 394, 469, 1104
children, 9, 363, 385, 387, 469, 1104
lactation, 9, 363, 393, 394, 469, 1104
and outcome of physical performance, 167
pregnancy, 9, 363, 393, 394, 469, 1104
summary tables, 9, 363, 469, 1104
elderly population and, 87, 219, 234–235, 496
functions and physiological actions, 77–78, 89–94, 143, 153, 156, 176, 177, 180, 184, 251
hormonal action and regulation, 6, 12, 515
infants, 9, 363, 383, 385, 469, 504
influenza and upper respiratory infections, 180
intake. See Vitamin D intake
intoxication, 6, 10, 88–89, 93, 405, 425, 426–430, 443, 518
irritable bowel syndrome, 172
during lactation, 9, 96, 257–260, 282–283, 393, 394
lifetime, 86
metabolism, 35, 83–89, 92–93, 189
neuroprotective effects, 183–184
non-linear relationship with serum 25OHD levels, 12, 99, 379–383, 384, 484
during pregnancy, 191, 250–256, 279–281, 393–394
as a prohormone, 75, 84, 481, 484
RDAs
adolescents, 9, 363, 385, 387, 469, 1106
adults, 9, 363, 389–390, 392, 393, 394, 469, 1106
children, 9, 363, 385, 387, 469, 1106
infants, 1106
lactation, 9, 363, 393, 394, 469, 1106
pregnancy, 9, 363, 393, 394, 469, 1106
summary tables, 9, 363, 469, 1106
reference value development, 293–294, 480
rheumatoid arthritis, 175
serum 25OHD and. See Serum
aaaa25-hydroxyvitamin D, vitamin D and
storage, 84, 87–88, 105–106, 156, 173, 370, 490, 492, 498, 518
submariners, 83
sun exposure and. See Sun exposure
supplementation. See Supplements, vitamin D
synthesis in the skin, 6, 11, 81–83, 95, 100–105, 481, 493–495, 520
synthetic analogues, 78, 81n.5
systemic lupus erythematosus, 176–177
threshold effect, 141, 515, 516
ULs
adults, 441, 443–445, 469, 1112
lactation, 441, 446, 469, 1112
pregnancy, 441, 446, 469, 1112
summary tables, 9, 441, 469, 1112
use of term, 78
Vitamin D binding protein (DBP), 77, 84, 86, 88, 107, 251, 427
Vitamin D External Quality Assurance Scheme (DEQAS), 109–110, 365
Vitamin D intake
adverse effects. See Adverse effects, vitamin D;
Vitamin D, ULs
assessment
Canadian surveys, 461–462, 499
estimates from national surveys, 10–11, 459–460
food sources only, 470, 474, 475, 476
assumption of adequacy for calcium DRI, 347
BMC/BMD and, 95, 175, 271, 274–275, 279–280, 386–387, 392–393
cardiovascular disease, 148, 149, 152
Crohn’s disease, 172
diabetes, 155
excess, 88–89, 424–449, 481, 486, 517–518.
See also Adverse effects, vitamin D;
Indicators of adverse outcomes for excess intake
falls and physical performance, 157–165, 167, 438
See also Bone, fracture, vitamin D supplementation
indigenous Canadian populations, 498–499
intoxication, 6, 10, 88–89, 93, 405, 425, 426–430, 443, 518
during pregnancy, 169, 182, 279–281
rheumatoid arthritis, 175
serum 25OHD. See Serum 25-hydroxyvitamin D, vitamin D and;
Sun exposure, relationship between serum 25OHD and vitamin D
from supplements. See Supplements, vitamin D
through the life stages, 8–10, 94–96
Vitamin D interactions
calcium, 5, 6, 35, 60, 136, 358, 360, 369, 388, 405, 484, 517
prescription drugs, 11, 87, 504, 505
Vitamin D receptor (VDR)
in the brain, 184
expressed in cells with rheumatoid lesions, 175
expressed in the duodenum, 38
expressed in the fetus, 252–253
expressed in the prostate, 146, 147
infants lacking, 254
lactation and, 91
muscle tissue, 157
regulation of expression by calcitriol, 38, 90, 91
rickets due to genetic absence of (VDDR II), 49, 94, 252, 254, 260, 276
use of term, 140n.1
Vitamin D response element (VDRE), 77, 140
Vitamin D2
equivalence issues with vitamin D3, 92–93, 97, 519
fortified foods, 80
overview, 78
serum level as biomarker of total intake, 107, 108
supplementation, 81
Vitamin D3
deprivation, and autism, 182
equivalence issues with vitamin D2, 92–93, 97, 519
fortified foods, 80
overview, 78
serum level, not used to estimate synthesis in the skin, 104
serum level as biomarker of total intake, 107, 108
storage, 105
synthesis in the skin. See Vitamin D, synthesis in the skin
Vitamin E, 180, 1104, 1106, 1112
Vitamins, 1106–1107, 1114–1115
W
Weight, 140, 153, 192–193, 254, 406, 420, 425.
See also Growth rate
Weight loss or dieting, 39, 106, 172, 518
West Indians, 245
White-matter hyperintensity volume, 185
Women.
See also Females;
Gender differences;
Lactation;
Menopausal status;
Pregnancy
bone health
fractures, 234–242, 257, 285–286, 357–358, 391, 392, 438, 439
and serum 25OHD, 209–218, 226–234, 235
vitamin D and calcium supplementation, 226, 234–242
calcium, 40, 58, 162, 226, 234–242, 356, 357–359, 360–361, 477, 480–481
cognitive function, 185
depression, 188
falls, 157, 161, 162, 166, 438
glucose tolerance, 154
mean age of puberty, 24
rheumatoid arthritis, 175
serum 25OHD level and cardiovascular risk, 437
systemic lupus erythematosus, 177
Women’s Health Initiative (WHI), 138, 141, 185, 220, 234, 285, 298, 358, 393, 411–412, 413, 422
World Cancer Research Fund, 415
X
X-ray. See Duel-energy X-ray absorptiometry
Y
Young adults. See Adults, 19 through 30 years
Z