Contents - IARC

Vitamin D and Cancer
6.5.2 Newborns
Infants have a relatively high need of vitamin D because of their high rate of skeletal growth. At
birth, infants have acquired in uteri the vitamin D reserves that must carry them through the first
months of the life. It has been found that 64% of French neonates have serum vitamin D levels below
< 12 ng/mL which corresponds to a severe vitamin D deficiency (Zeghoud et al.,1997). Breast-fed
infants are particularly at risk because of the low concentrations of vitamin D in human milk (Specker
et al.,1985). Additionally, the situation worsens when there is a restriction in exposure to sunlight for
seasonal, latitudinal, cultural or social reasons. Infants born in the autumn months at extreme latitudes
are particularly at risk because they spend the first months of their life indoors and therefore have little
opportunity to endogenously synthesise vitamin D during this period. Accordingly, sporadic cases of
rickets are still being reported in many northern areas but almost always in infants fed with human milk
(Pettifor and Daniels, 1997; Brunvand and Nordshus, 1996; Binet and Kooh, 1996; Gessner et
al.,1997). Infant formula is supplemented with vitamin D at levels sufficient to prevent rickets.
6.5.3 Elderly people
Several studies have demonstrated an age-related decline in vitamin D metabolism (Holick,
1994), including the rate of skin synthesis, the rate of hydroxylation, and the response of target tissues
(e. g. bone) (see Chapter 7). Various supplementation schemes (often also including calcium) using
continuous daily oral taking of 10 to 20 µg of vitamin D, or intermittent intramuscular injection of depot
vitamin D2 (Burns and Paterson, 1985), or spending 30 minutes outdoor every day (Reid et al.,1986)
have all shown ability to increase serum 25-hydroxyvitamin D levels in elderly subjects.
6.6 Conclusions
This chapter has highlighted the existence of a wide heterogeneity in terms of recommendations
on levels of dietary vitamin D amongst countries, population groups and age-ranges. Differences in
national recommendations may result in confusion for policy makers, health professionals and
consumers.
There is growing awareness that vitamin D is required in sufficient amounts for adequate bone
health. To date recommendations for vitamin D intakes are done in order to secure optimal bone
health. No recommendations are in place from governments or health agencies for recommending
increases in body vitamin D status that could eventually contribute to prevent cancer or other chronic
diseases.
4 http://whqlibdoc.who.int/trs/WHO_TRS_916.pdf
5 http://whqlibdoc.who.int/publications/2004/9241546123.pdf
6 OPTIFORD related publications
Andersen R, Brot C, Ovesen L (2001) Towards a strategy for optimal vitamin D fortification (OPTIFORD). Nutr Metab
Cardiovasc Dis, 11: Suppl. to No. 4, pp 74-77.
Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Chabros E, Charzewska J, Flynn A, Jakobsen J, Kärkkäinen
M, Kiely M, Lambarg-Allardt C, Moreiras O, Natri AM, O’Brien M, Rogalska-Niedzwiedz M, Ovesen L (2005) Teenage girls
and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr, 59, 533-541.
Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Jakobsen J, Lamberg-Allardt C, Ovesen L (2007) Pakistani
immigrant children and adults in Denmark have severely low vitamin D status. Eur J Clin Nutr, 62, 625-634.
Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, JakobsenJ, Lamberg-Allardt C, Ovesen L (2008) Effect of
vitamin D supplementation on bone and vitamin D status among Pakistani immigrants in Denmark: a randomised doubleblinded
placebo-controlled intervention study. Br J Nutr, 100, 197-207.
Viljakainen HT et al.,(2006) A positive dose-response effect of vitamin D supplementation on site-specific bone mineral
augmentation in adolescent girls: a double-blinded randomised placebo-contraolled 1-year intervention. J Bone Miner Res,
21, 836-844
Viljakainen HT et al.,(2006) A seasonal variation of calcitropic hormones, bone turnover and bone mineral density in early and
mid-puberty girls – a cross-sectional study. Br J Nutr, 96, 124-130
Viljakainen HT et al.,(2006) How much vitamin D3 do the elderly need? J Am Coll Nutr, 25, 429-435.
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