Vitamin D

Vitamin D is an essential fat-soluble vitamin that is primarily responsible for maintaining normal serum concentrations of calcium and phosphate by increasing their absorption in the small intestine. This ensures proper bone mineralization and remodeling. Over the past decade, there has been growing interest and research regarding the role of vitamin D in non-skeletal health. This interest has been prompted by the finding of vitamin D receptors on a wide range of cell types in the human body and data from observational studies demonstrating associations between low vitamin D levels and increased risk for various adverse health outcomes outside of bone health. Because most of the vitamin D in the human body is typically synthesized endogenously by way of dermal exposure to ultraviolet light, living in far northern or southern latitudes is a known risk factor for vitamin D deficiency. As such, Alaska health care providers should be knowledgeable about vitamin D to educate their patients on the risk factors for deficiency and help them make informed decisions regarding vitamin D intake and supplementation.

Current studies indicate that special supplementation and/or screening recommendations may be warranted for certain Alaska populations due to the presence of risk factors such as limited sunlight exposure during the winter months, darker skin pigmentation, and changing dietary intake patterns. The Alaska Division of Public Health published an Epidemiology Bulletin in 2017 to provide a brief overview of vitamin D for Alaska health care providers. The document included a review of the sources of vitamin D, the roles of vitamin D in the body, the current screening and supplementation recommendations available from selected professional and governmental bodies, and the available Alaska-specific vitamin D research findings. Additional resources are available below to learn more about vitamin D, vitamin D deficiency in Alaska, and selected screening and supplementation recommendations. As new information becomes available this page will be updated.

Alaska Research

• Alaska Epidemiology Bulletin. "Update on Prevention of Rickets in Alaska Children." No 21, November 30, 2021.
  
• Alaska Epidemiology Bulletin. "Vitamin D Supplementation and Screening for the Prevention of Rickets and Osteomalacia in Alaska: Recommendations from the Alaska Vitamin D Workgroup." No 20, September 12, 2018.
• Alaska Epidemiology Bulletin. “A Brief Overview on Vitamin D for Alaska Health Care Providers." No 19, August 17, 2017.
• Alaska Epidemiology Bulletin. “Vitamin D Deficiency in Prenatal Alaska Native Women.” No 27, November 1, 2016.
• Alaska Epidemiology Bulletin. Alaska Epidemiology Bulletin. “Vitamin D Deficiency and Rickets among Alaska Native Children.” No 6, May 20, 2014.
• Singleton R, Lescher R, Gessner BD, Benson M, Bulkow L, Rosenfeld J, et al. Singleton R, Lescher R, Gessner BD, Benson M, Bulkow L, Rosenfeld J, et al. Rickets and vitamin D deficiency in Alaska Native children. J Pediatr Endocrinol Metab. 2015;28(0):815–23.
• O’Brien DM, Thummel KE, Bulkow LR, Wang Z, Corbin B, Klejka J, et al. Declines in traditional marine food intake and vitamin D levels from the 1960s to present in young Alaska Native women. Public Health Nutr. 2016;1–8.

Overview of Vitamin D

• Wacker M, Holick MF. Wacker M, Holick MF. Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5:111–n8.
• Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr. 2008;88(suppl):500S–6S.

Intake, Supplementation, and Screening Recommendations

• Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): The National Academies Press; 2010.
• Perrine CG, Sharma AJ, Jefferds MED, Serdula MK, Scanlon KS. Perrine CG, Sharma AJ, Jefferds MED, Serdula MK, Scanlon KS. Adherence to vitamin D recommendations among US infants. Am Acad Pediatr. 2010;125(4):627–32.
• American College of Obstetricians and Gynecologists. Vitamin D: screening and supplementation during pregnancy. Committee Opinion No. 495.
• American Geriatrics recommendations abstracted from the American Geriatrics Society Consensus Statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc. 2014;62(1):147-52. 40.
  
• National Osteoporosis Foundation. National Osteoporosis Foundation. Calcium/Vitamin D.
• U.S. Preventive Services Task Force. Recommendations for Primary Care Practice.  Published Recommendations. Final Summary. Vitamin D Deficiency: Screening. Release Date: November 2014.
  
• U.S. Preventive Services Task Force. Recommendations for Primary Care Practice.  Published Recommendations. Final Summary. Vitamin D and Calcium to Prevent Fractures: Preventive Medication. Release Date: February 2013.
  

Other Nutritional Recommendations

• United States Department of Agriculture Food and Nutrition Service Special Supplemental Nutrition Program for Women Infants, and Children.  Infant Nutrition and Feeding: A Guide for Use in the WIC and CSF Programs. 2009.  Reference Handbook.
• U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015.
• Institute of Medicine. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington (DC): The National Academies Press; 2006.

Meta-analyses

• Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014;348:1–19.
• Chowdhury R, Kunutsor S, Vitezova A, OliverWilliams C, Chowdhury S, Kiefte-de-Jong JC, et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ. 2014;348.
• Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014;2(1):76–89.