Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Vitamin D and Cancer<br />
6.5.2 Newborns<br />
Infants have a relatively high need of vitamin D because of their high rate of skeletal growth. At<br />
birth, infants have acquired in uteri the vitamin D reserves that must carry them through the first<br />
months of the life. It has been found that 64% of French neonates have serum vitamin D levels below<br />
< 12 ng/mL which corresponds to a severe vitamin D deficiency (Zeghoud et al.,1997). Breast-fed<br />
infants are particularly at risk because of the low concentrations of vitamin D in human milk (Specker<br />
et al.,1985). Additionally, the situation worsens when there is a restriction in exposure to sunlight for<br />
seasonal, latitudinal, cultural or social reasons. Infants born in the autumn months at extreme latitudes<br />
are particularly at risk because they spend the first months of their life indoors and therefore have little<br />
opportunity to endogenously synthesise vitamin D during this period. Accordingly, sporadic cases of<br />
rickets are still being reported in many northern areas but almost always in infants fed with human milk<br />
(Pettifor and Daniels, 1997; Brunvand and Nordshus, 1996; Binet and Kooh, 1996; Gessner et<br />
al.,1997). Infant formula is supplemented with vitamin D at levels sufficient to prevent rickets.<br />
6.5.3 Elderly people<br />
Several studies have demonstrated an age-related decline in vitamin D metabolism (Holick,<br />
1994), including the rate of skin synthesis, the rate of hydroxylation, and the response of target tissues<br />
(e. g. bone) (see Chapter 7). Various supplementation schemes (often also including calcium) using<br />
continuous daily oral taking of 10 to 20 µg of vitamin D, or intermittent intramuscular injection of depot<br />
vitamin D2 (Burns and Paterson, 1985), or spending 30 minutes outdoor every day (Reid et al.,1986)<br />
have all shown ability to increase serum 25-hydroxyvitamin D levels in elderly subjects.<br />
6.6 Conclusions<br />
This chapter has highlighted the existence of a wide heterogeneity in terms of recommendations<br />
on levels of dietary vitamin D amongst countries, population groups and age-ranges. Differences in<br />
national recommendations may result in confusion for policy makers, health professionals and<br />
consumers.<br />
There is growing awareness that vitamin D is required in sufficient amounts for adequate bone<br />
health. To date recommendations for vitamin D intakes are done in order to secure optimal bone<br />
health. No recommendations are in place from governments or health agencies for recommending<br />
increases in body vitamin D status that could eventually contribute to prevent cancer or other chronic<br />
diseases.<br />
4 http://whqlibdoc.who.int/trs/WHO_TRS_916.pdf<br />
5 http://whqlibdoc.who.int/publications/2004/9241546123.pdf<br />
6 OPTIFORD related publications<br />
Andersen R, Brot C, Ovesen L (2001) Towards a strategy for optimal vitamin D fortification (OPTIFORD). Nutr Metab<br />
Cardiovasc Dis, 11: Suppl. to No. 4, pp 74-77.<br />
Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Chabros E, Charzewska J, Flynn A, Jakobsen J, Kärkkäinen<br />
M, Kiely M, Lambarg-Allardt C, Moreiras O, Natri AM, O’Brien M, Rogalska-Niedzwiedz M, Ovesen L (2005) Teenage girls<br />
and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr, 59, 533-541.<br />
Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Jakobsen J, Lamberg-Allardt C, Ovesen L (2007) Pakistani<br />
immigrant children and adults in Denmark have severely low vitamin D status. Eur J Clin Nutr, 62, 625-634.<br />
Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, JakobsenJ, Lamberg-Allardt C, Ovesen L (2008) Effect of<br />
vitamin D supplementation on bone and vitamin D status among Pakistani immigrants in Denmark: a randomised doubleblinded<br />
placebo-controlled intervention study. Br J Nutr, 100, 197-207.<br />
Viljakainen HT et al.,(2006) A positive dose-response effect of vitamin D supplementation on site-specific bone mineral<br />
augmentation in adolescent girls: a double-blinded randomised placebo-contraolled 1-year intervention. J Bone Miner Res,<br />
21, 836-844<br />
Viljakainen HT et al.,(2006) A seasonal variation of calcitropic hormones, bone turnover and bone mineral density in early and<br />
mid-puberty girls – a cross-sectional study. Br J Nutr, 96, 124-130<br />
Viljakainen HT et al.,(2006) How much vitamin D3 do the elderly need? J Am Coll Nutr, 25, 429-435.<br />
31