July 2009 - Vol 4 Issue 7
The Great D Debate
Vitamin D requirements and sources
by Michelle Gibeault Traub, R.D.
One of the greatest debates in medicine right now is just how much vitamin D we should be getting every day. New findings are continually released showing that the benefits of vitamin D extend to nearly every cell in the body. Yet, these findings are so new that the government is concerned about officially changing their vitamin D recommendations. Should we sit by and wait until a decision is made, or should we start getting more vitamin D right now?
How much vitamin D?
In 1997 the Institute of Medicine’s Food and Nutrition Board set Dietary Reference Intakes (DRI) for vitamin D that varied from 200 IU to 600 IU based on age (See chart below). Included in these references was a recommended upper limit for vitamin D intake set at 1000 IU per day for children and 2000 IU for adults. At the time they believed that exceeding these limits could result in toxicity symptoms such as nausea, vomiting, and weakness. However, many physicians are now advocating that an intake of 1000 IU of vitamin D per day should be the minimum intake, not the maximum! Those physicians note that toxicity symptoms are extremely rare. In fact, in a May press release from the American Association of Clinical Endocrinologists (AACE), Dr. Neil Binkley noted that, “One would need daily doses of 40,000 IU or higher before seeing negative side effects.” Other studies have shown that up to 10,000 IU per day is considered safe. The biggest concern in setting any nutritional recommendations is the long term impact of getting too much which is why the Institute of Medicine is cautious about changing their recommendations. Regardless, several other respected health agencies have made updates to their recommendations as you can see in the following chart:
VITAMIN D RECOMMENDATIONS
Age |
Per Dietary Reference Intakes (DRI) from the IOM |
Per National Osteoporosis Foundation (NOF) |
Per American Academy of Pediatrics (AAP) |
Infants |
|
|
400 IU (in supplement form if baby is breastfed) |
8-19 |
200 IU |
400-800 IU |
|
19-50 |
200 IU |
400-800 IU |
|
51-70 |
400 IU |
800 – 1,000 IU |
|
>71 |
600 IU |
800 – 1,000 IU |
|
NOTE: The IOM (Institute of Medicine) is currently discussing increasing the DRIs for vitamin D. The NOF and AAP have already increased recommendations based on recent clinical findings.
Getting enough vitamin D
Since getting too much vitamin D is rarely the issue, the more important point to stress is just how to get the vitamin D that you need on a daily basis. Although getting enough vitamin D from foods can be a challenge, with careful planning you can meet some of your needs. The chart below can help:
Vitamin D Foods
Food |
IU per serving |
Cod liver oil, 1 tablespoon |
1,360 |
Salmon, cooked, 3.5 ounces |
360 |
Mackerel, cooked, 3.5 ounces |
345 |
Tuna fish, canned in oil, 3 ounces |
200 |
Sardines, canned in oil, drained, 1.75 ounces |
250 |
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup |
98 |
Margarine, fortified, 1 tablespoon |
60 |
Ready-to-eat cereal, fortified.75-1 cup (read labels as brands vary) |
40 |
Egg, 1 whole (vitamin D is found in yolk) |
20 |
Liver, beef, cooked, 3.5 ounces |
15 |
Cheese, Swiss, 1 ounce |
12 |
Vitamin D supplements
If loading up on fatty fish and fortified dairy products is not for you, vitamin D supplements are an easy option. If you take a calcium supplement with vitamin D, like Adora Calcium, you are meeting some of your vitamin D needs. Many multivitamins are also now including increased amounts of the vital nutrient. Vitamin D supplements are also available in a variety of strengths. They are very inexpensive and if you aren’t meeting vitamin D needs through safe sun exposure or food, supplements may be necessary.
When deciding to take a nutritional supplement always consult with a registered dietitian, naturopath, or physician skilled in nutritional science to be sure you are making the healthiest choice based on your own medical needs.
A note from the makers of Adora Calcium – “While we were concerned about increasing vitamin D levels in our product without having updated recommendations from the IOM, we are working on increasing the vitamin D content of Adora Calcium so that it contains more of the vitamin D3 that our consumers have requested.”
References
- National Institutes of Health Office of Dietary Supplements. Dietary Supplement Fact Sheet: Vitamin D. retrieved 6/1/09 LINK
- American Association of Clinical Endocrinologists. Experts Say Recommended Daily Dosage for Vitamin D is ‘Grossly Inadequate’. media.aace.com. May 18, 2009. Retrieved 6/26/09 LINK
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