A Critical Appraisal of Strategies to Optimize Vitamin D Status in Germany, a Population with a Western Diet

• Published in: Nutrients Vol. 11; no. 11; p. 2682
• Main Authors: Saternus, Roman, Vogt, Thomas, Reichrath, Jörg
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06.11.2019; MDPI
• Subjects: Adolescent; Adult; Aged; Agronomy; Biological activity; Biological effects; Biotechnology; Calciferol; Cancer; Child; Child, Preschool; Confidence intervals; Diabetes mellitus; Diet, Western; dietary intake of vitamin d; Dietary Supplements; Endocrine system; Female; germany; Germany - epidemiology; Humans; Infant; Male; Metabolites; Middle Aged; Mortality; Mushrooms; Nutrient deficiency; Nutrient enrichment; Nutritional Status - physiology; Skin; Sunlight; Ultraviolet radiation; uvb-induced cutaneous vitamin d production; Vitamin D; Vitamin D - administration & dosage; Vitamin D - blood; Vitamin D - metabolism; Vitamin D - therapeutic use; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - therapy; Vitamin D receptors; vitamin d status; Vitamin D3; Vitamin deficiency; Young Adult; Germany; UVB-induced cutaneous vitamin D production; Dietary Intake of vitamin D; Germany; vitamin D status
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11112682

During the last decade, our scientific knowledge of the pleiotropic biological effects of vitamin D metabolites and their relevance to human health has expanded widely. Beyond the well-known key role of vitamin D in calcium homeostasis and bone health, it has been shown that vitamin D deficiency is associated with a broad variety of independent diseases, including several types of cancer, and with increased overall mortality. Moreover, recent findings have demonstrated biological effects of the vitamin D endocrine system that are not mediated via activation of the classical nuclear vitamin D receptor (VDR) by binding with high affinity to its corresponding ligand, the biologically active vitamin D metabolite 1,25-dihydroxyvitamin D (1,25(OH) D). In contrast, many of these new biological effects of vitamin D compounds, including regulation of the circadian clock and many metabolic functions, are mediated by other vitamin D metabolites, including 20-hydroxyvitamin D and 20,23-dihydroxyvitamin D, and involve their binding to the aryl hydrocarbon receptor (AhR) and retinoid-orphan receptor (ROR). In most populations, including the German population, UVB-induced cutaneous vitamin D production is the main source for fulfilling the human body's requirements of vitamin D. However, this causes a dilemma because solar or artificial UVR exposure is associated with skin cancer risk. In addition to UVB-induced vitamin D production in skin, in humans, there are two other possible sources of vitamin D: from diet and supplements. However, only a few natural foods contain substantial amounts of vitamin D, and in most populations, the dietary source of vitamin D cannot fulfill the body´s requirements. Because an increasing body of evidence has convincingly demonstrated that vitamin D deficiency is very common worldwide, it is the aim of this paper to (i) give an update of the vitamin D status in a population with a western diet, namely, the German population, and to (ii) develop strategies to optimize the vitamin D supply that consider both the advantages as well as the disadvantages/risks of different approaches, including increasing vitamin D status by dietary intake, by supplements, or by UVB-induced cutaneous synthesis of vitamin D.