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  1. Agency for Healthcare Research and Quality (AHRQ) evidence report issued in 2007 (Cranney et al., 2007), hereafter referred to in this chapter as AHRQ-Ottawa without a reference citation; and

  2. AHRQ evidence report issued in 2009 (Chung et al., 2009), hereafter referred to in this chapter as AHRQ-Tufts without a reference citation;

  3. The Institute of Medicine (IOM) report Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (IOM, 1997);

  4. Literature searches conducted by the committee;

  5. Publicly available input from stakeholders either through written submissions to the committee or as presented during the information gathering workshop.

As outlined in Chapter 1, the ARHQ analyses are highly relevant to DRI development. Evidence-based systematic reviews have been identified as a useful tool for the purposes of dietary reference value development (Russell et al., 2009), and the work of this committee was enhanced by the availability of these two high-quality evidence reports from AHRQ. The approach used, questions asked, data search criteria, and the detailed results from the AHRQ-Ottawa and AHRQ-Tufts can be found in Appendixes C and D.

In sum, the focus of AHRQ-Ottawa was on the:

  • Association of specific circulating 25-hydroxyvitamin D (25OHD) concentrations with bone health outcomes in children, women of reproductive age, postmenopausal women, and elderly men;

  • Effect of vitamin D dietary intake (fortified foods and/or supplements) and sun exposure on serum 25OHD levels;

  • Effect of vitamin D on bone mineral density (BMD) and fracture or fall risk; and

  • Identification of potential harms associated with vitamin D exposures above current reference intakes.

The AHRQ-Tufts evidence report analyzed data related to calcium and vitamin D with respect to a broader spectrum of health outcomes. AHRQ-Tufts also served to update and expand AHRQ-Ottawa. Specifically, AHRQ-Tufts focused on the:

  • Relationship between vitamin D and growth, cardiovascular disease (CVD), body weight, cancer, immunological outcomes, bone health, all-cause mortality, hypertension/blood pressure, and BMD and bone mineral content (BMC); and

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