Individual participant data (IPD)-level meta-analysis of randomised controlled trials to estimate the vitamin D dietary requirements in dark-skinned individuals resident at high latitude

Kevin Cashman, Mairead E Kiely, Rikke Andersen, Ida M Grønborg, Inge Tetens , Laura Tripkovic, Susan A Lanham-New, Christel Lamberg-Allardt, Folasade Adebayo, J Christopher Gallagher, Lynette M Smith, Jennifer M Sacheck , Qiushi Huang, Kimmie Ng, Chen Yuan, Edward L Giovannucci , Kumaravel Rajakumar, Charity G Patterson , Inger Öhlund, Torbjörn LindPia Karlsland Åkeson, Christian Ritz

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Context and purpose
There is an urgent need to develop vitamin D dietary recommendations for dark-skinned populations resident at high latitude. Using data from randomised controlled trials (RCTs) with vitamin D3-supplements/fortified foods, we undertook an individual participant data-level meta-regression (IPD) analysis of the response of wintertime serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among dark-skinned children and adults residing at ≥ 40° N and derived dietary requirement values for vitamin D.

Methods
IPD analysis using data from 677 dark-skinned participants (of Black or South Asian descent; ages 5–86 years) in 10 RCTs with vitamin D supplements/fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D intake estimates across a range of 25(OH)D thresholds.

Results
To maintain serum 25(OH)D concentrations ≥ 25 and 30 nmol/L in 97.5% of individuals, 23.9 and 27.3 µg/day of vitamin D, respectively, were required among South Asian and 24.1 and 33.2 µg/day, respectively, among Black participants. Overall, our age-stratified intake estimates did not exceed age-specific Tolerable Upper Intake Levels for vitamin D. The vitamin D intake required by dark-skinned individuals to maintain 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L was 66.8 µg/day. This intake predicted that the upper 2.5% of individuals could potentially achieve serum 25(OH)D concentrations ≥ 158 nmol/L, which has been linked to potential adverse effects in older adults in supplementation studies.

Conclusions
Our IPD-derived vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25, 30 and 50 nmol/L are substantially higher than the equivalent estimates for White individuals. These requirement estimates are also higher than those currently recommended internationally by several agencies, which are based predominantly on data from Whites and derived from standard meta-regression based on aggregate data. Much more work is needed in dark-skinned populations both in the dose–response relationship and risk characterisation for health outcomes.
Original languageEnglish
JournalEuropean Journal of Nutrition
Volume61
Pages (from-to)1015-1034
Number of pages20
ISSN1436-6215
DOIs
Publication statusPublished - Mar 2022
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 25-HYDROXYVITAMIN D LEVELS
  • AFRICAN
  • CHILDREN
  • D DEFICIENCY
  • D METABOLITES
  • D SUPPLEMENTATION
  • DOSE-RESPONSE
  • Dark-skinned
  • Dietary reference values
  • Individual participant data-level meta-regression analyses
  • PREVENTION
  • Recommended dietary allowance
  • STANDARDIZATION
  • Vitamin D recommendations
  • WHITE
  • 3143 Nutrition

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