Nutrition: new guidelines on vitamin D-ficiency--clear or confusing?

摘要

The increasing diversity of patient groups and rising prevalence of vitamin D deficiency highlight a pressing need for consensus-based guidance in terms of the evaluation, treatment and prevention of this condition. Following the Institute of Medicine's population-based recommendations, the Endocrine Society attempts to provide clear guidelines for clinicians but runs the risk of adding to the confusion.A recent Endocrine Society guideline on vitamin D deficiency contains two strong recommendations: that candidates at risk of vitamin D deficiency should be screened by measuring circulating concentrations of 25-hydroxyvitamin D, and that individuals should be identified as vitamin-D-deficient at a cut-off level of 50 nmol/1. A further 14 weak recommendations or suggestions range from dietary intakes for those considered to be at risk of vitamin D deficiency to suggestions for the treatment and prevention of deficiency in various population subgroups, as well as specific patient groups. Moreover, prescription of vitamin D supplements is recommended for the prevention of falls, but not for the prevention of death, cardiovascular disease or to improve quality of life