Vol 64, No 4 (2013)
Review paper
Published online: 2013-09-04

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Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe — recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency

Paweł Płudowski, Elżbieta Karczmarewicz, Milan Bayer, Graham Carter, Danuta Chlebna-Sokół, Justyna Czech-Kowalska, Romuald Dębski, Tamas Decsi, Anna Dobrzańska, Edward Franek, Piotr Głuszko, William B. Grant, Michael F. Holick, Liudmila Yankovskaya, Jerzy Konstantynowicz, Janusz B. Książyk, Krystyna Księżopolska-Orłowska, Andrzej Lewiński, Mieczysław Litwin, Szimonetta Lohner, Roman S. Lorenc, Jacek Łukaszkiewicz, Ewa Marcinowska-Suchowierska, Andrzej Milewicz, Waldemar Misiorowski, Michał Nowicki, Vladyslav Povoroznyuk, Piotr Rozentryt, Ema Rudenka, Yehuda Shoenfeld, Piotr Socha, Bogdan Solnica, Mieczysław Szalecki, Marek Tałałaj, Szabolcs Varbiro, Michał A. Żmijewski
DOI: 10.5603/EP.2013.0012
Endokrynol Pol 2013;64(4):319-327.

Abstract

Introduction: Adequate Vitamin D intake and its concentration in serum are important for bone health and calcium–phosphate metabolismas well as for optimal function of many organs and tissues. Documented trends in lifestyle, nutritional habits and physical activityappear to be associated with moderate or severe Vitamin D deficits resulting in health problems. Most epidemiological studies suggest thatVitamin D deficiency is prevalent among Central European populations. Concern about this problem led to the organising of a conferencefocused on overcoming Vitamin D deficiency.

Methods: After reviewing the epidemiological evidence and relevant literature, a Polish multidisciplinary group formulated theses onrecommendations for Vitamin D screening and supplementation in the general population. These theses were subsequently sent to ScientificCommittee members of the ‘Vitamin D — minimum, maximum, optimum’ conference for evaluation based on a ten-point scale.With 550 international attendees, the meeting ‘Vitamin D — minimum, maximum, optimum’ was held on October 19–20, 2012 in Warsaw(Poland). Most recent scientific evidence of both skeletal and non-skeletal effects of Vitamin D as well as the results of panellists’ votingwere reviewed and discussed during eight plenary sessions and two workshops.

Results: Based on many polemical discussions, including post-conference networking, the key opinion leaders established ranges ofserum 25-hydroxyVitamin D concentration indicating Vitamin D deficiency [< 20 ng/mL (< 50 nmol/L)], suboptimal status [20–30 ng/mL(50–75 nmol/L)], and target concentration for optimal Vitamin D effects [30–50 ng/mL (75–125 nmol/L)]. General practical guidelines regardingsupplementation and updated recommendations for prophylactic Vitamin D intakes in Central European neonates, infants, childrenand adolescents as well as in adults (including recommendations for pregnant and breastfeeding women and the elderly) were developed.

Conclusions: Improving the Vitamin D status of children, adolescents, adults and the elderly must be included in the priorities of physicians,healthcare professionals and healthcare regulating bodies. The present paper offers elaborated consensus on supplementationguidance and population strategies for Vitamin D in Central Europe.