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Dietary Reference Intakes for Calcium and Vitamin D (2011)
Food and Nutrition Board (FNB)

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. "Appendix C: Methods and Results from the AHRQ-Ottawa Evidence-Based Report on Effectiveness and Safety of Vitamin D in Relation to Bone Health." Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press, 2011.

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DRI Dietary Reference Intakes Calcium Vitamin D

Chapter 2. Methods

Key Questions Addressed in This Report

The University of Ottawa EPC’s evidence report on Vitamin D is based on a systematic review of the scientific literature. A technical expert panel was recruited to help refine key questions and provide expertise to the review team during the review process. The finalized questions were:

  1. Are specific circulating concentrations of 25(OH)D associated with the following health outcomes in:

    1. Children: rickets, bone mineral density (BMD) or bone mineral content (BMC), fractures, parathyroid hormone (PTH)?

    2. Women of reproductive age (includes pregnant and lactating women): BMD, calcaneal ultrasound, fractures, calcium absorption, PTH?

    3. Elderly men and postmenopausal women: BMD, fractures, falls?

  1. Does dietary intake (fortified foods and/or vitamin D supplementation) or sun exposure affect circulating concentrations of 25(OH)D?

    1. Does this vary with different age groups, ethnicity, use of sunscreen, geography and/or body mass index (BMI)?

    2. What are the effects of fortified foods on circulating 25(OH)D concentrations?

    3. What is the effect of sun exposure and vitamin D supplementation on levels of serum 25(OH)D?

  1. What is the evidence regarding the effect of supplemental doses of vitamin D on bone mineral density, fractures and fall risk in:

    1. Women of reproductive age and postmenopausal women?

    2. Elderly men?

    3. Is there variation with baseline levels of 25(OH)D?

  1. Is there a level of sunlight exposure (time of year, latitude, BMI, amount of skin exposed) that is sufficient to maintain adequate vitamin D levels, but does not increase the risk of melanoma or non-melanoma skin cancer?

  2. Does intake of vitamin D above current reference intakes lead to toxicities (e.g., hypercalcemia, hypercalciuria, calcification of soft tissue or major organs, kidney stones)?

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Front Matter (R1-R16)
Summary (1-14)
1 Introduction (15-34)
2 Overview of Calcium (35-74)
3 Overview of Vitamin D (75-124)
4 Review of Potential Indicators of Adequacy and Selection of Indicators: Calcium and Vitamin D (125-344)
5 Dietary Reference Intakes for Adequacy: Calcium and Vitamin D (345-402)
6 Tolerable Upper Intake Levels: Calcium and Vitamin D (403-456)
7 Dietary Intake Assessment (457-478)
8 Implications and Special Concerns (479-512)
9 Information Gaps and Research Needs (513-522)
Appendix A: Acronyms, Abbreviations, and Glossary (523-536)
Appendix B: Issues and Interests Identified by Study Sponsors (537-538)
Appendix C: Methods and Results from the AHRQ-Ottawa Evidence-Based Report on Effectiveness and Safety of Vitamin D in Relation to Bone Health (539-724)
Appendix D: Methods and Results from the AHRQ-Tufts Evidence-Based Report on Vitamin D and Calcium (725-1012)
Appendix E: Literature Search Strategy (1013-1018)
Appendix F: Evidence Maps (1019-1024)
Appendix G: Cases Studies of Vitamin D Toxicity (1025-1034)
Appendix H: Estimated Intakes of Calcium and Vitamin D from National Surveys (1035-1044)
Appendix I: Proportion of the Population Above and Below 40 nmol/L Serum 25-Hydroxyvitamin D Concentrations and Cumulative Distribution of Serum 25-Hydroxyvitamin D Concentrations: United States and Canada (1045-1058)
Appendix J: Workshop Agenda and Open Session Agendas (1059-1064)
Appendix K: Biographical Sketches of Committee Members (1065-1074)
Index (1075-1102)
Summary Tables: Dietary Reference Intakes (1103-1116)