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The second committee meeting was held August 4-5, 2009 in Washington, DC and included an Information-Gathering Workshop on August 4, 2009. The agenda for this workshop is below, along with the PowerPoint presentations that were used by the speakers during the workshop. Please note, online presentations from this meeting are subject to copyright protection. Permission from the speaker is required prior to any copying, reproducing, or rebroadcasting any portion of the speaker's presentations. Additional copyright and legal policies of The National Academies can be read in the National Academies Legal Statement.

Geographic variation in breast cancer mortality in the United States: a hypothesis involving exposure to solar radiation. Garland FC, Garland CF, Gorham ED, Young JF. Prev Med. 1990 Nov;19(6):614-22. PMID: 2263572 doi:10.1016/0091-7435(90)90058-R Vitamin D from sunlight exposure may be associated with low risk for fatal breast cancer, and differences in ultraviolet light reaching the United States population may account for the striking regional differences in breast cancer mortality. The ecological nature of this study is emphasized, and the possibility that an indirect association with dietary and socioeconomic factors could explain these findings is discussed.

Vitamin D levels in healthy men in eastern Saudi Arabia. Sadat-Ali M, AlElq A, Al-Turki H, Al-Mulhim F, Al-Ali A. Ann Saudi Med. 2009 Sep-Oct;29(5):378-82. PMID: 19700896

Differences in vitamin D status between countries in young adults and the elderly. McKenna MJ. Am J Med. 1992 Jul;93(1):69-77. PMID: 1385673 PURPOSE: To compare vitamin D status between countries in young adults and in the elderly. MATERIALS AND METHODS: Reports on vitamin D status (as assessed by serum 25-hydroxyvitamin D) from 1971 to 1990 were reviewed. Studies were grouped according to geographic regions: North America (including Canada and the United States); Scandinavia (including Denmark, Finland, Norway, and Sweden); and Central and Western Europe (including Belgium, France, Germany, Ireland, The Netherlands, Switzerland, and the United Kingdom). RESULTS: Vitamin D status varies with the season in young adults and in the elderly, and is lower during the winter in Europe than in both North America and Scandinavia. Oral vitamin D intake is lower in Europe than in both North America and Scandinavia. Hypovitaminosis D and related abnormalities in bone chemistry are most common in elderly residents in Europe but are reported in all elderly populations. CONCLUSIONS: The vitamin D status in young adults and the elderly varies widely with the country of residence. Adequate exposure to summer sunlight is the essential means to ample supply, but oral intake augmented by both fortification and supplementation is necessary to maintain baseline stores. All countries should adopt a fortification policy. It seems likely that the elderly would benefit additionally from a daily supplement of 10 micrograms of vitamin D.

An estimated 50% to 60% of older people have suboptimal vitamin D levels, which is a problem that could affect more than bone health. Recent cross-sectional studies have also shown an association between low vitamin D levels and cardiovascular disease, hypertension, and metabolic syndrome. In a long-term prospective study from Germany, researchers assessed whether 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were associated with all-cause and cardiovascular mortality among more than 3000 consecutive patients (mean age, 62) referred for coronary angiography.

Ecological Studies Of Ultraviolet B, Vitamin D And Cancer Since 2000. Grant WB, Mohr SB. Ann Epidemiol. 2009 Mar 6. [Epub ahead of print] PMID: 19269856 doi:10.1016/j.annepidem.2008.12.014

Vitamin D, found in fish and produced by sun exposure, can help stave off the mental decline that can affect people in old age, a study has suggested. UK and US researchers looked at 2,000 people aged 65 and over.

"So why is Dr Vieth so frustrated? You might think he'd have cause for celebration. But for him and other vitamin D researchers around the world, the good news comes with a bitter aftertaste. They believe they can prove vitamin D could help millions live longer and be healthier and yet they have not been able to convince their own governments. In the US and Canada, official vitamin D policy is set by the Institute of Medicine. And in the opinion of Vieth, the current recommendations - 200 International Units per day for people under 50, 400 for people aged 51-70, and 600 for those 71 and older - are outrageously low. Bruce Hollis, professor of paediatrics at the Medical University of South Carolina, calls 400 IU a day "a joke". That's because the best research suggests that to achieve the higher vitamin D blood levels associated with disease prevention, most adults in the US would need to take 1,000-2,000 IU a day: five to 10 times more than the current official recommendation for adult In 1999, Reinhold Vieth (pictured right) published a review of vitamin D research in response to the IOM conclusions. In it, he argued that there was no evidence that amounts lower than 20,000 IU a day could be toxic. "Throughout my preparation of this review, I was amazed at the lack of evidence supporting statements about the toxicity of moderate doses of vitamin D," Vieth wrote. Studies have since shown 10,000 IU a day of vitamin D to be safe. While any substance will become toxic in excess, vitamin D researchers today accept that the current vitamin D recommendations could be more than quadrupled with no fear of toxicity.!

The role of Vitamin D3 metabolism in prostate cancer. Lou YR, Qiao S, Talonpoika R, Syvälä H, Tuohimaa P. J Steroid Biochem Mol Biol. 2004 Nov;92(4):317-25. Epub 2004 Dec 19. Review. PMID: 15663995 doi:10.1016/j.jsbmb.2004.10.007 In summary, the local metabolism of hormonal Vitamin D seems to play an important role in the development and progression of prostate cancer.

Serum 25-hydroxyvitamin D and the risk of ovarian cancer. Toriola AT, Surcel HM, Agborsangaya C, Grankvist K, Tuohimaa P, Toniolo P, Lukanova A, Pukkala E, Lehtinen M. Eur J Cancer. 2009 Aug 25. [Epub ahead of print] PMID: 19713101 doi:10.1016/j.ejca.2009.08.002 Conclusion Overall, we did not observe a significant association between serum 25-OHD concentrations and the risk of ovarian cancer. However, we found evidence suggestive of an increased risk among women with low to insufficient serum 25-OHD concentrations.

"People with coeliac disease may be more susceptible to osteoporosis because their own immune system attacks their bone tissue, a study suggests. Osteoporosis is a known risk of coeliac disease and has been explained by a failure to absorb calcium or vitamin D. "

Twice single doses of 100,000 IU of vitamin D in winter is adequate and safe for prevention of vitamin D deficiency in healthy children from Ushuaia, Tierra Del Fuego, Argentina. Tau C, Ciriani V, Scaiola E, Acuña M. J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):651-4. Epub 2007 Jan 25. PMID: 17257830 doi:10.1016/j.jsbmb.2006.12.027 These results disclosed that to prevent vitamin D deficiency for children at zones of risk at the south of our country, double supplementation of 100,000 IU of vitamin D during autumn and winter, would be adequate and safe.

Effectiveness and safety of vitamin D in relation to bone health. Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D, Fang M, Yazdi F, Garritty C, Sampson M, Barrowman N, Tsertsvadze A, Mamaladze V. Evid Rep Technol Assess (Full Rep). 2007 Aug;(158):1-235. Review. PMID: 18088161

"D-vitamiinin saantisuositus moninkertaistettava Kansainvälinen paine D-vitamiinin saantisuosituksen korottamiseksi kasvaa. Suomessa viranomaissuositus aikuisille on 7,5 mikrogrammaa. Kalifornian yliopiston 18-henkinen tiedemiesryhmä vaatii suosituksen nostamista 2000 kansainväliseen yksikköön eli 50 mikrogrammaan. Suiomessa Pekka Puska haraa vastaan. Tohtori Anthony W. Norman ja hänen tiedemiesryhmänsä kutsuvat maailman muita tutkijoita toimiin ("call to action") aikuisten ihmisten D-vitamiinin saantisuosituksen nostamiseksi 50 mikrogrammaan päivässä. Normanin laatima pääkirjoitus D-vitamiinista julkaistiin joulukuun American Journal of Nutritionissa (linkki lopussa). "Päättäjien on syytä perehtyä tieteellisiin tutkimuksiin, jotka puoltavat suosituksen nostamista", sanoo tiedemiesryhmä. Se suosittelee elintarvikkeiden rikastamista D-vitamiinilla ja D-vitamiinin käyttöä ravintolisänä. Yhdysvalloissa viranomaissuositus on alle 50-vuotiaille aikuisille 5 µg, 51-70 -vuotiaille 10 µg ja yli 70-vuotiaille 15 µg. Suomessa suositus on 7,5 µg alle 60-vuotiaille ja 10 µg sitä vanhemmille. "Amerikkalaiset tiedemiehet allekirjoittivat lausunnon, jonka mukaan aikuisen [amerikkalaisen] ihmisen D3-vitamiinin tarve on 2000 kansainvälistä yksikköä [eli 50 mikrogrammaa] vuorokaudessa", sanoo Norman. "Suositeltu annos on täysin turvallinen", hän korostaa ja viittaa Yhdysvaltain tiedeakatemian (National Academy of Sciences) lausuntoon."