Skip to main content Accessibility help
×
Home
Hostname: page-component-768ffcd9cc-727vs Total loading time: 0.758 Render date: 2022-12-03T19:44:09.871Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Vitamin D in preventive medicine: are we ignoring the evidence?

Published online by Cambridge University Press:  09 March 2007

Armin Zittermann*
Affiliation:
Department of Nutrition Science, University of Bonn, Endenicher Allee 11-13, 53115 Bonn, Germany
*
Corresponding Author: Associate professor Armin Zittermann, fax +49 228 733217, email a.zittermann@uni-bonn.de
Rights & Permissions[Opens in a new window]

Abstract

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Vitamin D is metabolised by a hepatic 25-hydroxylase into 25-hydroxyvitamin D (25(OH)D) and by a renal 1α-hydroxylase into the vitamin D hormone calcitriol. Calcitriol receptors are present in more than thirty different tissues. Apart from the kidney, several tissues also possess the enzyme 1α-hydroxylase, which is able to use circulating 25(OH)D as a substrate. Serum levels of 25(OH)D are the best indicator to assess vitamin D deficiency, insufficiency, hypovitaminosis, adequacy, and toxicity. European children and young adults often have circulating 25(OH)D levels in the insufficiency range during wintertime. Elderly subjects have mean 25(OH)D levels in the insufficiency range throughout the year. In institutionalized subjects 25(OH)D levels are often in the deficiency range. There is now general agreement that a low vitamin D status is involved in the pathogenesis of osteoporosis. Moreover, vitamin D insufficiency can lead to a disturbed muscle function. Epidemiological data also indicate a low vitamin D status in tuberculosis, rheumatoid arthritis, multiple sclerosis, inflammatory bowel diseases, hypertension, and specific types of cancer. Some intervention trials have demonstrated that supplementation with vitamin D or its metabolites is able: (i) to reduce blood pressure in hypertensive patients; (ii) to improve blood glucose levels in diabetics; (iii) to improve symptoms of rheumatoid arthritis and multiple sclerosis. The oral dose necessary to achieve adequate serum 25(OH)D levels is probably much higher than the current recommendations of 5–15 μg/d.

Type
Review article
Copyright
Copyright © The Nutrition Society 2003

References

Adams, JS, Clemens, TL, Parrish, JA & Holick, MF (1982) Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects. New England Journal of Medicine 306 722725.CrossRefGoogle ScholarPubMed
Aguado, P, del Campo, MT, Garces, MV, Gonzalez-Casuas, ML, Bernad, M, Gijon-Banos, J, Martin Mola, E, Torrijos, A & Martinez, ME (2000) Low vitamin D levels in outpatient postmenopausal women from a rheumatology clinic in Madrid, Spain: their relationship with bone mineral density. Osteoporosis International 11 739744.CrossRefGoogle ScholarPubMed
Alagol, F, Shihadeh, Y, Boztepe, H, Tanakol, R, Yarman, S, Azizlerli, H & Sandalci, O (2000) Sunlight exposure and vitamin D deficiency in Turkish women. Journal of Endocrinological Investigation 23 173177.CrossRefGoogle ScholarPubMed
Allegra, V, Luisetto, G, Mengozzi, L, Martimbianco, L & Vasile, A (1994) Glucose-induced insulin secretion in uremia: role of 1α,25(OH)2-Vitamin D3. Nephron 68 4147.CrossRefGoogle Scholar
Andjelkovic, Z, Vojinnovic, J, Pejnovic, N, Popovic, M, Dujicv, A, Mitrovic, D, Pavlica, L & Stefanovic, D (1999) Disease modifying and immunmodulatory effects of high dose 1α(OH) D3 in rheumatoid arthritis patients. Clinical and Experimental Rheumatology 17 453456.Google Scholar
Andersen, R, Brot, C & Ovesen, L (2001) Towards a strategy for optimal vitamin D fortification (OPTIFORD). Nutrition Metabolism and Cardiovascular Disease 11, Suppl. 4, 7477.Google Scholar
Axelsson, I, Gebre-Medhin, M, Hernell, O, Jakobsson, I, Michaelsen, KF & Samuelson, G (1999) The AD-drops can be replaced by D-drops [in Swedish]. Lakartidningen 96 22002204.Google ScholarPubMed
Barger-Lux, MJ, Heaney, RP, Lanspa, SJ, Healy, JC & DeLuca, HF (1995) An investigation of sources of variation in calcium absorption efficiency. Journal of Clinical and Endocrinological Metabolism 80 406411.Google ScholarPubMed
Basha, B, Rao, DS, Han, ZH & Parfitt, AM (2000) Osteomalacia due to vitamin D depletion: a neglected consequence of intestinal malabsorption. American Journal of Medicine 108 296300.CrossRefGoogle ScholarPubMed
Baynes, KCR, Boucher, BJ, Feskens, EJM & Kromhout, D (1997) Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia 40 344347.CrossRefGoogle ScholarPubMed
Bell, NH, Epstein, S, Greene, A, Shary, J, Oexmann, MJ & Shaw, S (1985) Evidence for alteration of the vitamin D-endocrine system in obese subjects. Journal of Clinical Investigation 76 370373.CrossRefGoogle ScholarPubMed
Bhalla, AK, Amento, EP, Clemens, TL, Holick, MF & Krane, SM (1983) Specific high-affinity receptors for 1,25-dihydroxyvitamin D3 in human peripheral blood mononuclear cells: presence in monocytes and induction in T lymphocytes following activation. Journal of Clinical Endocrinology and Metabolism 57 13081310.CrossRefGoogle Scholar
Birge, SJ & Haddad, JG (1975) 25-Hydroxycholecalciferol stimulation of muscle metabolism. Journal of Clinical Investigation 56 11001107.CrossRefGoogle ScholarPubMed
Bischoff, H, Stähelin, HB, Vogt, P, Friderich, P, Vontheim, R, Tyndall, A & Theiler, R (1999 a) Immobility as a major cause of bone remodeling in residents of a long-stay geriatric ward. Calcified Tissue International 64 485489.CrossRefGoogle ScholarPubMed
Bischoff, HA, Stahelin, HB, Dick, W, Akos, R, Theiler, R, Pfeiffer, M, Begerow, B & Lew, RA (2001) Fall prevention by vitamin D and calcium supplementation: A randomized controlled trial. Journal of Bone and Mineral Research 16, Suppl. 1, S163 Abstr.Google Scholar
Bischoff, HA, Stahelin, HB, Urscheler, N, Ehrsam, R, Vonthein, R, Perrig-Chiello, P, Tyndall, A & Theiler, R (1999 b) Muscle strength in the elderly: its relation to vitamin D metabolites. Archives of Physical and Medical Rehabilitation 80 5458.CrossRefGoogle ScholarPubMed
Blank, S, Scanlon, KS, Sinks, TH, Lett, S & Falk, H (1995) An outbreak of hypervitaminosis D associated with the overfortification of milk from a home-delivery dairy. American Journal of Public Health 85 656659.CrossRefGoogle ScholarPubMed
Boltz-Nitulescu, G, Willheim, M, Spittler, A, Leutmezer, F, Tempfer, C & Winkler, S (1995) Modulation of IgA, IgE, and IgG Fc receptor expression on human mononuclear phagocytes by 1 alpha,25-dihydroxyvitamin D3 and cytokines. Journal of Leukocyte Biology 58 256262.CrossRefGoogle ScholarPubMed
Bostick, RM, Potter, JD, Sellers, TA, McKenzie, DR, Kushi, LH & Folsom, AR (1993) Relation of calcium, vitamin D, and dairy food intake to incidence of colon cancer among older women. The Iowa Women's Health Study. American Journal of Epidemiology 137 13021317.CrossRefGoogle ScholarPubMed
Boucher, BJ (1998) Inadequate vitamin D status: does it contribute to the disorders comprising syndrome ‘X]? British Journal of Nutrition 79 315327.CrossRefGoogle ScholarPubMed
Boucher, BJ, Mannan, N, Noonan, K, Hales, CN & Evans, SJ (1995) Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia 38 12391245.CrossRefGoogle ScholarPubMed
Bouillon, R, Carmeliet, G, Daci, E, Segaert, S & Verstuyf, A (1998) Vitamin D Metabolism and Action. Osteoporosis International 8 S13S19.CrossRefGoogle ScholarPubMed
Bouillon, R, Xiang, DZ, Convents, R & Van Baelen, H (1992) Polyunsaturated fatty acids decrease the apparent affinity of vitamin D metabolites for human vitamin D-binding protein. Journal of Steroid Biochemistry and Molecular Biology 42 855861.CrossRefGoogle ScholarPubMed
Bouillon, RA, Auwerx, JH, Lissens, WD & Pelemans, WK (1987) Vitamin D status in the elderly: seasonal substrate deficiency causes 1,25-dihydroxycholecalciferol deficiency. American Journal of Clinical Nutrition 45 755763.CrossRefGoogle Scholar
Brohult, J & Jonson, B (1973) Effects of large doses of calciferol on patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology 2 173176.CrossRefGoogle ScholarPubMed
Brot, C, Vestergaard, P, Kolthoff, N, Gram, J, Hermann, AP & Sörensen, OH (2001) Vitamin D status and its adequacy in healthy Danish perimenopausal women: relationships to dietary intake, sun exposure and serum parathyroid hormone. British Journal of Nutrition 86, Suppl. 1, S97S103.CrossRefGoogle ScholarPubMed
Cantorna, MT, Hayes, CE & DeLuca, HF (1996) 1,25-Dihydroxyvitamin D3 reversibly blocks the progression of relapsing encephalomyelitis, a model of multiple sclerosis. Proceedings of the National Academy of Sciences 93 78618764.CrossRefGoogle ScholarPubMed
Cantorna, MT, Humpal-Winter, J & DeLuca, HF (1999) Dietary calcium is a major factor in 1,25-dihydroxycholecalciferol suppression of experimental autoimmune encephalomyelitis in mice. Journal of Nutrition 129 19661971.CrossRefGoogle ScholarPubMed
Cantorna, MT, Mahon, BD, Bemiss, CJ, Gordon, SA, Cruz, JD & Cosman, F (2001) Altered cytokine profile in patients with multiple sclerosis following vitamin D supplementation. Annals of Nutrition and Metabolism 45, Suppl., 290 AbstrGoogle Scholar
Cantorna, MT, Munsick, C, Bemiss, C & Mahon, BD (2000) 1,25-Dihydroxycholecalciferol prevents and ameliorates symptoms of experimental murine inflammatory bowel disease. Journal of Nutrition 130 26482652.CrossRefGoogle ScholarPubMed
Carroll, KK, Jacobson, EA, Eckel, LA & Newark, HL (1991) Calcium and carcinogenesis of the mammary gland. American Journal of Clinical Nutrition 54 206S208S.CrossRefGoogle ScholarPubMed
Chan, TY, Poon, P, Pang, J, Swaminathan, R, Chan, CH, Nisar, M, Williams, CS & Davies, PD (1994) A study of calcium and vitamin D metabolism in Chinese patients with pulmonary tuberculosis. Journal of Tropical Medicine and Hygiene 97 2630.Google ScholarPubMed
Chan, TYK (2000) Vitamin D deficiency and susceptibility to tuberculosis. Calcified Tissue International 66 476478.CrossRefGoogle ScholarPubMed
Chang, TJ, Lei, HH, Yeh, JI, Chiu, KC, Lee, KC, Chen, MC, Tai, TY & Chuang, LM (2000) Vitamin D receptor gene polymorphisms influence susceptibility to type 1 diabetes mellitus in the Taiwanese population. Clinical Endocrinology 52 575580.CrossRefGoogle ScholarPubMed
Chapuy, MC, Arlot, ME, Duboeuf, F, Brun, J, Crouzet, B, Arnaud, S, Delmas, PD & Meunier, PJ (1992) Vitamin D3 and calcium to prevent hip fractures in elderly women. New England Journal of Medicine 327 16371642.CrossRefGoogle ScholarPubMed
Chesney, RW (1989) Vitamin D: Can an upper limit be defined? Journal of Nutrition 119 18251828.CrossRefGoogle ScholarPubMed
Cohen, MS, Mesler, DE, Snipes, RG & Gray, TK (1986) 1,25-dihydroxyvitamin D3 activates secretion of hydrogen peroxide by human monocytes. Journal of Immunology 136 10491053.Google ScholarPubMed
Curry, OB, Bastein, JF, Francis, MJO & Smith, R (1983) Calcium uptake by sarcoplasmatic reticulum of muscle from vitamin D deficient rabbits. Nature 249 8384.CrossRefGoogle Scholar
D'Ambrosio, D, Cippitelli, M, Cocciolo, MG, Mazzeo, D, Di Lucia, P, Lang, R, Sinigaglia, F & Panina-Bordignon, P (1998) Inhibition of IL-12 production by 1,25-dihydroxyvitamin D3. Involvement of NF-kappa B downregulation in transcriptional repression of the p40 gene. Journal of Clinical Investigation 101 252262.CrossRefGoogle ScholarPubMed
Davies, PD (1985) A possible link between vitamin D deficiency and impaired host defence to Mycobacterium tuberculosis. Tubercle 66 301306.CrossRefGoogle ScholarPubMed
Davies, PD, Brown, RC & Woodhead, JS (1985) Serum concentrations of vitamin D metabolites in untreated tuberculosis. Thorax 40 187190.CrossRefGoogle ScholarPubMed
Davies, PDO, Church, HA, Bovornkitti, S, Chatumilind, A & Byrachandra, S (1988) Altered vitamin D homeostasis in tuberculosis. Internal Medicine (Thailand) 4 4547.Google Scholar
Davies, PS, Bates, CJ, Cole, TJ, Prentice, A & Clarke, PC (1999) Vitamin D: seasonal and regional differences in preschool children in Great Britain. European Journal of Clinical Nutrition 53 195198.CrossRefGoogle ScholarPubMed
Dawson-Hughes, B, Dallal, GE, Krall, EA, Harris, S, Sokoll, LJ & Falconer, G (1991) Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Annals of Internal Medicine 115 505512.CrossRefGoogle ScholarPubMed
Dawson-Hughes, B, Harris, SS, Krall, EA & Dallal, GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. New England Journal of Medicine 337 670676.CrossRefGoogle ScholarPubMed
Dawson-Hughes, B, Harris, SS, Krall, EA, Dallal, GE, Falconer, G & Green, CL (1995) Rates of bone loss in postmenopausal women randomly assigned to one of two dosages of vitamin D. American Journal of Clinical Nutrition 61 11401145.CrossRefGoogle ScholarPubMed
DeLuca, HF & Cantorna, MT (2001) Vitamin D: its role and uses in immunology. FASEB Journal 15 25792585.CrossRefGoogle ScholarPubMed
Department of Health (1998) Committee of Medical Aspects of Food Policy: Nutrition and Bone Health – With Particular Reference to Calcium and Vitamin D. report no. 49. London: HM Stationery Office.Google Scholar
Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung & Schweizerische Vereinigung für Ernährung (2000) Referenzwerte für die Nährstoffzufuhr. Frankfurt/M, Germany: Umschau Verlag.Google Scholar
Diamond, T, Smerdely, P, Kormas, N, Sekel, R, Vu, T & Day, P (1998) Hip fracture in elderly men: the importance of subclinical vitamin D deficiency and Hypogonadism. Medical Journal of Australia 169 138141.Google ScholarPubMed
Dichgans, F & Diener, HC (1987) Neurologie. In Lehrbuch der Inneren Medizin, pp. 10651067 [Groos, R, Schölmerich, P and Gerok, W, editors]. Stuttgart, Germany: Schattauer.Google Scholar
Docio, S, Riancho, JA, Perez, A, Olmos, JM, Amado, JA & Gonzalez-Macias, J (1998) Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies? Journal of Bone and Mineral Research 13 544548.CrossRefGoogle ScholarPubMed
Dottori, L, D'Ottavio, D & Brundisini, B (1982) Calcifediol and calcitonin in the therapy of rheumatoid arthritis. A short-term controlled study [in Italian]. Minerva Medicine 73 30333040.Google Scholar
Douglas, AS, Rawles, JM, Alexander, E & Allan, TM (1991) Winter pressure on hospital medical beds. British Medical Journal 303 508509.CrossRefGoogle ScholarPubMed
Dustan, HP (1990) Obesity and hypertension in blacks. Cardiovascular Drugs and Therapy 4, Suppl. 2, 395402.CrossRefGoogle ScholarPubMed
Eastwood, JB, de Wardener, HE, Gray, RW & Lemann, JL (1979) Normal plasma-1,25-(OH)2-vitamin-D concentrations in nutritional osteomalacia. Lancet i 13771378.CrossRefGoogle Scholar
Fardellone, P, Sebert, JL, Garabedian, M, Bellony, R, Maamer, M, Agbomson, F & Brazier, M (1995) Prevalence and biological consequences of vitamin D deficiency in elderly institutionalized subjects. Review Du Rhumatisme, English edition 62 576581.Google ScholarPubMed
Feldman, D, Skowronski, RJ & Peehl, DM (1995) Vitamin D and prostate cancer. Advances in Experimental and Medical Biology 375 5363.CrossRefGoogle ScholarPubMed
Feskens, EJ & Kromhout, D (1993) Epidemiologic studies on Eskimos and fish intake. Annals of the New York Academy of Sciences 683 915.CrossRefGoogle ScholarPubMed
Garland, CF, Garland, FC & Gorham, ED (1991) Can colon cancer incidence and death rates be reduced with calcium and vitamin D? American Journal of Clinical Nutrition 54 193S201S.CrossRefGoogle ScholarPubMed
Glerup, H, Mikkelsen, K, Poulsen, L, Hass, E, Overbeck, S, Thomsen, J, Charles, P & Eriksen, EF (2000) Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. Journal of Internal Medicine 247 260268.CrossRefGoogle Scholar
Goldberg, P, Fleming, MC & Picard, EH (1986) Multiple sclerosis decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D. Medical Hypotheses 21 193200.CrossRefGoogle ScholarPubMed
Graafmans, WC, Ooms, ME, Hofstee, HM, Bezemer, PD, Bouter, LM & Lips, P (1996) Falls in the elderly: a prospective study of risk factors and risk profiles. American Journal of Epidemiology 143 11291136.CrossRefGoogle ScholarPubMed
Grady, D, Halloran, B, Cummings, S, Leveille, S, Wells, L, Black, D & Byl, N (1991) 1,25-Dihydroxyvitamin D3 and muscle strength in the elderly: a randomized controlled trial. Journal of Clinical Endocrinology and Metabolism 73 11111117.CrossRefGoogle ScholarPubMed
Guillemant, J, Le, HT, Maria, A, Allemandou, A, Peres, G & Guillemant, S (2001) Wintertime vitamin D deficiency in male adolescents: effect on parathyroid function and response to vitamin D3 supplements. Osteoporosis International 12 875879.CrossRefGoogle ScholarPubMed
Guyton, KZ, Kensler, TW & Posner, GH (2001) Cancer chemoprevention using natural vitamin D and synthetic analogs. Annual Review of Pharmacology and Toxicology 41 421–42.CrossRefGoogle ScholarPubMed
Harris, SS & Dawson-Hughes, B (1998) Seasonal changes in plasma 25-hydroxyvitamin D concentrations of young American black and white women. American Journal of Clinical Nutrition 67 12321236.CrossRefGoogle ScholarPubMed
Hartman, JJ (2000) Vitamin D deficiency rickets in children: prevalence and need for community education. Orthopaedic Nursing 19 6367.CrossRefGoogle ScholarPubMed
Hayes, CE, Cantorna, MT & DeLuca, HF (1997) Vitamin D and multiple sclerosis. Proceedings of the Society of Experimental Biology and Medicine 216 2127.CrossRefGoogle ScholarPubMed
Health Council of the Netherlands (2000) Dietary Reference Values: Calcium, Vitamin D, Thiamin, Riboflavin, Niacin, Pantothenic Acid and Biotin, Publication No. 2000/12. The Hague, The Netherlands: Health Council of the Netherlands.Google Scholar
Heaney, RP (2000) Vitamin D: How much do we need, and how much is too much? Osteoporosis International 11 553555.CrossRefGoogle ScholarPubMed
Hegarty, V, Woodhouse, P & Khaw, KT (1994) Seasonal variation in 25-hydroxyvitamin D and parathyroid hormone concentrations in healthy elderly people. Age and Ageing 23 478482.CrossRefGoogle ScholarPubMed
Hein, G & Oelzner, P (2000) Vitamin D metabolites in rheumatoid arthritis: findings – hypotheses – consequences [in German]. Zeitschrift für Rheumatologie 59, Suppl. 1, 2832.CrossRefGoogle Scholar
Hellebostad, M, Markestad, T & Seeger Halvorsen, K (1985) Vitamin D deficiency rickets and vitamin B12 deficiency in vegetarian children. Acta Paediatrica Scandinavica 74 191195.CrossRefGoogle ScholarPubMed
Heseker, H, Adolf, T, Eberhardt, W, Hartmann, S, Herwig, A, Kübler, W, Matiaske, B, Moch, KJ, Nitsche, A, Schneider, R & Zipp, A (1994) Lebensmittel- und Nährstoffaufnahme Erwachsener in der Bundesrepublik Deutschland, 2nd Ed. [Kübler, W, Anders, H, Heeschen, W and Kohlmeier, M, editors], Niederkleen. Germany: Wissenschaftlicher Fachverlag Dr. Fleck.Google Scholar
Hesse, V & Jahreis, G (1990) Vitamin D-induced tissue calcinosis and arteriosclerosis changes. II Current knowledge and conclusions for preventive vitamin D administration in infancy and early childhood [in German]. Pädiatrie und ihre Grenzgebiete 29 213219.Google Scholar
Holick, MF (1994) McCollum Award Lecture, Vitamin D: New horizons for the 21st century. American Journal of Clinical Nutrition 60 619630.CrossRefGoogle ScholarPubMed
Holick, MF (2002) Vitamin D: The underappreciated D-lightful hormone that is important for skeletal and cellular health. Current Opinion in Endocrinology and Diabetes 9 8798.CrossRefGoogle Scholar
Holick, MF, Matsuoka, LY & Wortsman, J (1989) Age, vitamin D and solar ultraviolet. Lancet ii 11041105.CrossRefGoogle Scholar
Holmes, RP & Kummerow, FA (1983) The relationship of adequate and excessive intake of vitamin D to health and disease. Journal of the American College of Nutrition 2 173199.CrossRefGoogle ScholarPubMed
Hotamisligil, CS & Spiegelman, BM (1994) Tumor necrosis factor α: a key component of the obesity-diabetes link. Diabetes 43 12711278.CrossRefGoogle ScholarPubMed
Huber, SA, Sakkinen, P, Conze, D, Hardin, N & Tracy, R (1999) Interleukin-6 exacerbates early atherosclerosis in mice. Arteriosclerosis Thrombosis and Vascular Biology 19 23642367.CrossRefGoogle ScholarPubMed
Hunter, D, Major, P, Arden, N, Swaminathan, R, Andrew, T, MacGregor, AJ, Keen, R, Snieder, H & Spector, TD (2000) A randomized controlled trial of vitamin D supplementation on preventing postmenopausal bone loss and modifying bone metabolism using identical twin pairs. Journal of Bone and Mineral Research 15 276283.CrossRefGoogle ScholarPubMed
Hyppönen, E, Laara, E, Reunanen, A, Jarvelin, MR & Virtanen, SM (2001) Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358 15001503.CrossRefGoogle ScholarPubMed
Jacobus, CH, Holick, MF, Shao, Q, Chen, TC, Holm, IA, Kolodny, JM, Fuleihan, GE & Seely, EW (1992) Hypervitaminosis D associated with drinking milk. New England Journal of Medicine 30 11731177.CrossRefGoogle Scholar
Jahnsen, J, Falch, JA, Mowinckel, P & Aadland, E (2002) Vitamin D status, parathyroid hormone and bone mineral density in patients with inflammatory bowel disease. Scandinavian Journal of Gastroenterology 37 192199.CrossRefGoogle ScholarPubMed
John, EM, Schwartz, GG, Dreon, DM & Koo, J (1999) Vitamin D and breast cancer risk: the NHANES I Epidemiologic follow-up study, 1971–1975 to 1992. National Health and Nutrition Examination Survey. Cancer Epidemiology Biomarkers and Prevention 8 399406.Google ScholarPubMed
Kärkkainen, MU, Wiersma, JW & Lamberg-Allardt, CJ (1997) Postprandial parathyroid hormone response to four calcium-rich foodstuffs. American Journal of Clinical Nutrition 65 17261730.CrossRefGoogle ScholarPubMed
Kocian, J (1992) Diabetic osteopathy. Favorable effect of treatment of osteomalacia with vitamin D and calcium on high blood glucose levels [in Czech]. Vnitrni Lekarstri 38 352356.Google Scholar
Koutka, P, Chen, TC & Holick, MF (2001) Vitamin D intoxication associated with an over-the-counter supplement. New England Journal of Medicine 345 6667.CrossRefGoogle Scholar
Krause, R, Böhring, M, Hopfenmhller, W, Holick, MF & Sharma, AM (1998) Ultraviolet B and blood pressure. Lancet 352 709710.CrossRefGoogle ScholarPubMed
Kröger, H, Penttila, IM & Alhava, EM (1993) Low serum vitamin D metabolites in women with rheumatoid arthritis. Scandinavian Journal of Rheumatology 22 172177.CrossRefGoogle ScholarPubMed
Kumar, S, Davies, M, Zakaria, Y, Mawer, EB, Gordon, C, Olukoga, AO & Boulton, AJ (1994) Improvement in glucose tolerance and beta-cell function in a patient with vitamin D deficiency during treatment with vitamin D. Postgraduate Medicine Journal 70 440443.CrossRefGoogle Scholar
Lamb, EJ, Wong, T, Smith, DJ, Simpson, DE, Coakley, AJ, Moniz, C & Muller, AF (2002) Metabolic bone disease is present at diagnosis in patients with inflammatory bowel disease. Alimentary Pharmacology and Therapy 16 18951902.CrossRefGoogle ScholarPubMed
Lamberg-Allardt, CJE, Outila, TA, Kärkkäinen, MUM, Rita, HJ & Valsta, LM (2001) Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe? Journal of Bone and Mineral Research 16 20662073.CrossRefGoogle ScholarPubMed
Lawson, DE, Cole, TJ, Salem, SI, Galal, OM, el-Meligy, R, Abdel-Azim, S, Paul, AA & el-Husseini, S (1987) Aetiology of rickets in Egyptian children. Human Nutrition Clinical Nutrition 41 199208.Google Scholar
Lawson, M, Thomas, M & Hardiman, A (1999) Dietary and lifestyle factors affecting plasma vitamin D levels in Asian children living in England. European Journal of Clinical Nutrition 53 268272.CrossRefGoogle ScholarPubMed
LeBoff, MS, Kohlmeier, L, Hurwitz, S, Franklin, J, Wright, J & Glowacki, J (1999) Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 281 15051511.CrossRefGoogle ScholarPubMed
Lehtonen-Veromaa, M, Mottonen, T, Irjala, K, Karkkainen, M, Lamberg-Allardt, C, Hakola, P & Viikari, J (1999) Vitamin D intake is low and hypovitaminosis D common in healthy 9- to 15-year-old Finnish girls. European Journal of Clinical Nutrition 53 746751.CrossRefGoogle ScholarPubMed
Lehtonen-Veromaa, M, Mottonen, T, Nuotio, I, Irjala, K & Viikari, J (2002) The effect of conventional vitamin D(2) supplementation on serum 25(OH)D concentration is weak among peripubertal Finnish girls: a 3-y prospective study. European Journal of Clinical Nutrition 56 431437.CrossRefGoogle ScholarPubMed
Lemire, JM, Adams, JS, Kermani-Arab, V, Bakke, AC, Sakai, R & Jordan, SC (1985) 1,25-Dihydroxyvitamin D3 suppresses human T helper/inducer lymphocyte activity in vitro. Journal of Immunology 134 30323035.Google Scholar
Lemire, JM, Archer, DC, Beck, L & Spiegelberg, HL (1995) Immunosuppressive actions of 1,25-dihydroxyvitamin D3: preferential inhibition of Th1 functions. Journal of Nutrition 125, Suppl. 6, 1704S1708S.Google ScholarPubMed
Lilienfeld-Toal, HV, Messerschmidt, W, Sturm, B & Ochs, H (1978) 25-hydroxy-vitamin D levels in a patient with hypervitaminosis D. Klinische Wochenschrift 56 715717.CrossRefGoogle Scholar
Lind, L, Lithell, H, Skarfors, E, Wide, L & Ljunghall, S (1988) Reduction of blood pressure by treatment with alphacalcidol. A double-blind, placebo-controlled study in subjects with impaired glucose tolerance. Acta Medica Scandinavica 223 211217.CrossRefGoogle ScholarPubMed
Lind, L, Wengle, B & Ljunghall, S (1987) Blood pressure is lowered by vitamin D (alphacalcidol) during long-term treatment of patients with intermittent hypercalcaemia. A double-blind, placebo-controlled study. Acta Medica Scandinavica 222 423427.CrossRefGoogle ScholarPubMed
Lind, L, Wengle, B, Wide, L & Ljunghall, S (1989) Reduction of blood pressure during long-term treatment with active vitamin D (Alphacalcidiol) is dependent on plasma rennin activity and calcium status. A double-blind, placebo-controlled study. American Journal of Hypertension 2 2025.CrossRefGoogle Scholar
Linhares, ER, Jones, DA, Round, JM & Edwards, RHT (1984) Effect of nutrition on vitamin D status: studies on healthy and poorly nourished children. American Journal of Clinical Nutrition 39 625630.CrossRefGoogle Scholar
Lips, P, Graafmans, WC, Ooms, ME, Bezemer, PD & Bouter, LM (1996) Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Annals of Internal Medicine 15 400406.CrossRefGoogle Scholar
Ljunghall, S, Lind, L, Lithell, H, Skarfors, E, Selenus, I, Sörensen, OH & Wide, L (1987) Treatment with one-alpha-hydroxycholecalciferol in middle-aged men with impaired glucose tolerance – A prospective randomized double-blind study. Acta Medica Scandinavica 222 361367.CrossRefGoogle ScholarPubMed
McAlindon, TE, Felson, DT, Zhang, Y, Hannan, MT, Aliabadi, P, Weissman, B, Rush, D & Wilson, PWF (1996) Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham study. Annals of Internal Medicine 125 353359.CrossRefGoogle ScholarPubMed
McCarron, DA, Morris, CD & Bukoski, R (1987) The calcium paradox of essential hypertension. American Journal of Medicine 82 2733.CrossRefGoogle ScholarPubMed
MacGregor, GA & Cappuccio, FP (1993) The kidney and essential hypertension: a link to osteoporosis? Journal of Hypertension 11 781785.CrossRefGoogle ScholarPubMed
McKeigue, PM, Pierpoint, T, Ferrie, JE & Marmot, MG (1992) Relationship of glucose intolerance and hyperinsulinaemia to body fat pattern in south Asians and Europeans. Diabetologia 35 785791.Google ScholarPubMed
McKenna, M (1992) Differences in vitamin D status between countries in young adults and elderly. American Journal of Medicine 93 6977.CrossRefGoogle ScholarPubMed
McKenna, MJ & Freaney, R (1998) Secondary hyperparathyroidisms in the elderly: means to defining hypovitaminosis D. Osteoporosis International 8 S3S6.CrossRefGoogle ScholarPubMed
Malabanan, A, Veronikis, IE & Holick, MF (1998) Redefining vitamin D insufficiency. Lancet 351 805806.CrossRefGoogle ScholarPubMed
Markestad, T, Hesse, V, Siebenhuner, M, Jahreis, G, Aksnes, L, Plenert, W & Aarskog, D (1987) Intermittent high-dose vitamin D prophylaxis during infancy: effect on vitamin D metabolites, calcium, and phosphorus. American Journal of Clinical Nutrition 46 652658.CrossRefGoogle ScholarPubMed
Mendall, MA, Patel, P, Asante, M, Ballam, L, Morris, J, Strachan, DP, Camm, AJ & Northfield, TC (1997) Relation of serum cytokine concentrations to cardiovascular risk factors and coronary heart disease. Heart 78 273277.CrossRefGoogle ScholarPubMed
Muhe, L, Lulseged, S, Mason, KE & Simoes, EAF (1997) Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet 349 18011804.CrossRefGoogle ScholarPubMed
Müller, K, Diamant, M & Bendtzen, K (1991 a) Inhibition of production and function of interleukin-6 by 1,25-dihydroxyvitamin D3. Immunology Letters 28 115120.CrossRefGoogle ScholarPubMed
Müller, K, Haahr, PM, Diamant, M, Rieneck, K, Kharazmi, A & Bendtzen, K (1992) 1,25-dihydroxyvitamin D3 inhibits cytokine production by human blood monocytes at the post-transcriptional level. Cytokine 4 506512.CrossRefGoogle ScholarPubMed
Müller, K, Heilmann, C, Poulsen, LK, Barington, T & Bendtzen, K (1991 b) The role of monocytes and T cells in 1,25-dihydroxyvitamin D3 mediated inhibition of B cell function in vitro. Immunopharmacology 21 121128.CrossRefGoogle Scholar
National Nutrition Council (1999) Finnish Nutrition Recommendations, pp. 24. Helsinki, Finland: Ministry of Agriculture and Forestry.Google Scholar
Need, AG, Horowitz, M, Morris, HA & Nordin, BEC (2000) Vitamin D status: effects on parathyroid hormone and 1,25-dihydroxyvitamin D in postmenopausal women. American Journal of Clinical Nutrition 71 15771581.CrossRefGoogle ScholarPubMed
Nemere, I & Farach-Carson, MC (1998) Membrane receptors for steroid hormones: A case for specific cell surface binding sites for vitamin D metabolites and estrogens. Biochemical and Biophysical Research Communications 248 442449.CrossRefGoogle ScholarPubMed
Nemere, I, Zhou, LX & Norman, AW (1993) Nontranscriptional effects of steroid hormones. Receptor 3 277291.Google ScholarPubMed
Nieves, J, Cosman, F, Herbert, J, Shen, V & Lindsay, R (1994) High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis. Neurology 44 16871692.CrossRefGoogle ScholarPubMed
Nordin, BE, Baker, MR, Horsman, A & Peacock, M (1985) A prospective trial of the effect of vitamin D supplementation on metacarpal bone loss in elderly women. American Journal of Clinical Nutrition 42 470474.CrossRefGoogle ScholarPubMed
Norman, AW (1998) Receptors for 1α25(OH)2D3: Past, present, and future. Journal of Bone and Mineral Research 13 13601369.CrossRefGoogle Scholar
Oelzner, P, Müller, A, Deschner, F, Höller, M, Abendroth, K, Hein, G & Stein, G (1998) Relationship between disease activity and serum levels of vitamin D metabolites and PTH in rheumatoid arthritis. Calcified Tissue International 62 193198.CrossRefGoogle ScholarPubMed
Ooms, ME, Roos, JC, Bezemer, PD, van der Vijgh, WJ, Bouter, LM & Lips, P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. Journal of Clinical Endocrinology and Metabolism 80 10521058.Google ScholarPubMed
Ortlepp, JR, Lauscher, J, Hoffmann, R, Hanrath, P & Joost, HG (2001) The vitamin D receptor gene variant is associated with the prevalence of type 2 diabetes mellitus and coronary artery disease. Diabetic Medicine 18 842845.CrossRefGoogle ScholarPubMed
Outila, TA, Kärkkäinen, MUM & Lamberg-Allardt, CJE (2001) Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. American Journal of Clinical Nutrition 74 206210.CrossRefGoogle ScholarPubMed
Pan, WH, Wang, CY, Li, LA, Kao, LS & Yeh, SH (1993) No significant effect of calcium and vitamin D supplementation on blood pressure and calcium metabolism in elderly Chinese. Chinese Journal of Physiology 36 8594.Google ScholarPubMed
Patel, R, Collins, D, Bullock, S, Swaminathan, R, Blake, GM & Fogelman, I (2001) The effect of season and vitamin D supplementation on bone mineral density in healthy women: a double-masked crossover study. Osteoporosis International 12 319325.CrossRefGoogle Scholar
Peacock, M (1995) Nutritional aspects of hip fractures. Challenges of Modern Medicine 7 213222.Google Scholar
Peacock, M, Liu, G, Carey, M, McClintock, R, Ambrosius, W, Hui, S & Johnston, CC (2000) Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. Journal Clinical Endocrinology and Metabolism 85 30113019.Google ScholarPubMed
Pfeifer, M, Begerow, B, Minne, HW, Abrams, C, Nachtigall, D & Hansen, C (2000) Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. Journal of Bone and Mineral Research 15 11131138.CrossRefGoogle ScholarPubMed
Pfeiffer, M, Begerow, B, Minne, HW, Nachtigall, D & Hansen, C (2001) Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. Journal of Clinical Endocrinology and Metabolism 86 16331667.Google Scholar
Pleasure, D, Wyszynski, B, Summer, A, Schotland, D, Feldmann, B, Nugent, N, Hitz, K & Goodman, X (1979) Skeletal muscle calcium metabolism and contraction force in vitamin D deficient chicks. Journal of Clinical Investigation 64 11571167.CrossRefGoogle ScholarPubMed
Podolsky, DK (1991) Inflammatory bowel disease. New England Journal of Medicine 325 9281016.CrossRefGoogle ScholarPubMed
Poiton, JJ, Francis, MJ & Smith, R (1979) Effect of vitamin D deficiency on sarcoplasmic reticulum function and troponin C concentration of rabbit skeletal muscle. Clinical Science 57 257263.CrossRefGoogle Scholar
Provvedini, DM, Deftos, LJ & Manolagas, SC (1986) 1,25-dihydroxyvitamin D3 promotes in vitro morphologic and enzymatic changes in normal human monocytes consistent with their differentiation into macrophages. Bone 7 2328.CrossRefGoogle ScholarPubMed
Provvedini, DM & Manolagas, SC (1989) 1α,25-dihydroxyvitamin D3 receptor distribution and effects in subpopulations of normal human T lymphocytes. Journal of Clinical Endocrinology and Metabolism 68 774779.CrossRefGoogle Scholar
Pryke, AM, Duggan, C, White, CP, Posen, S & Mason, RS (1990) Tumor necrosis factor-alpha induces vitamin D-1-hydroxylase activity in normal human alveolar macrophages. Journal of Cell Physiology 142 652656.CrossRefGoogle ScholarPubMed
Rehman, PKM (1994) Sub-clinical rickets and recurrent infection. Journal of Tropical Pediatrics 40, 58.Google ScholarPubMed
Rigby, WFC (1988) The immunobiology of vitamin D. Immunology Today 9 5458.Google ScholarPubMed
Rigby, WF, Waugh, M & Graziano, RF (1990) Regulation of human monocyte HLA-DR and CD4 antigen expression, and antigen presentation by 1,25-dihydroxyvitamin D3. Blood 76 189197.Google ScholarPubMed
Rimaniol, JM, Authier, FJ & Chariot, P (1994) Muscle weakness in intensive care patients’ initial manifestation of vitamin D deficiency. Intensive Care Medicine 20 591592.CrossRefGoogle Scholar
Ritz, E, Boland, R & Kreusser, W (1980) Effects of vitamin D and parathyroid hormone on muscle: potential role in uremic myopathy. American Journal of Clinical Nutrition 33 15221529.CrossRefGoogle ScholarPubMed
Rudnicki, PM & Molsted-Pedersen, L (1997) Effect of 1,25-dihydroxycholecalciferol on glucose metabolism in gestational diabetes mellitus. Diabetologia 40 4044.CrossRefGoogle ScholarPubMed
Scharla, SH (1998) Prevalence of subclinical vitamin D deficiency in different European countries. Osteoporosis International 8 S7S12.CrossRefGoogle ScholarPubMed
Scharla, SH, Scheidt-Nave, C, Leidig, G, Woitge, H, Wüster, C, Seibel, MJ & Ziegler, R (1996) Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: A population-based study. Experimental and Clinical Endocrinology and Diabetes 104 289292.CrossRefGoogle ScholarPubMed
Schwartz, GG (1992) Multiple sclerosis and prostate cancer: what do their similar geographies suggest? Neuroepidemiology 11 244254.CrossRefGoogle ScholarPubMed
Scragg, R (1981) Seasonality of cardiovascular disease mortality and the possible protective effect of ultra-violet radiation. International Journal of Epidemiology 10 337341.CrossRefGoogle ScholarPubMed
Scragg, R, Holdaway, I, Jackson, R & Lim, T (1992) Plasma 25-hydroxyvitamin D3 and its relation to physical activity and other heart disease risk factors in the general population. Annals of Epidemiology 2 697703.CrossRefGoogle ScholarPubMed
Scragg, R, Jackson, R, Holdaway, IM, Lim, T & Beaglehole, R (1990) Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. International Journal of Epidemiology 19 559563.CrossRefGoogle ScholarPubMed
Scragg, R, Khaw, KT & Murphy, S (1995) Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. European Journal of Clinical Nutrition 49 640646.Google ScholarPubMed
Selles, J, Bellido, T & Boland, R (1994) Modulation of calcium uptake in cultured cardiac muscle cells by 1,25-dihydroxyvitamin D3. Journal of Molecular and Cell Cardiology 26 15931599.CrossRefGoogle ScholarPubMed
Sonnenberg, A, McCarty, DJ & Jacobsen, SJ (1991) Geographic variation of inflammatory bowel disease within the United States. Gastroenterology 100 143149.CrossRefGoogle ScholarPubMed
Souci, SW, Fachmann, W & Kraut, H (1994) Die Zusammensetzung der Lebensmittel. Nährwerttabellen. Stuttgart, Germany: Wissenschaftliche Verlagsgesellschaft mbH.Google Scholar
Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board and Institute of Medicine (1997) Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride, pp. 250287. Washington, DC: National Academy of Sciences.Google Scholar
Statistisches Bundesamt (1998) Gesundheitsbericht für Deutschland. Diabetes Mellitus, pp. 237242. Stuttgart, Germany: Metzler und Poeschel.Google Scholar
Stene, LC, Ulriksen, J, Magnus, P & Joner, G (2000) Use of cod liver oil during pregnancy associated with lower risk of type I diabetes in the offspring. Diabetologia 43 10931098.CrossRefGoogle ScholarPubMed
Strazzullo, P (1991) The renal leak in primary hypertension: pathophysiological aspects and clinical implications. Nutrition Metabolism and Cardiovascular Disease 1 98103.Google Scholar
Stroder, J & Arensmeyer, E (1965) Der Actomyosingehalt der Skelettmuskulatur bei experimenteller Rachitis (The actinomysin content of the skeletal muscle in experimental rickets). Klinische Wochenschrift 43 12011202.Google Scholar
Trang, H, Cole, DE, Rubin, LA, Pierratos, A, Siu, S & Vieth, R (1998) Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2. American Journal of Clinical Nutrition 68 854858.CrossRefGoogle ScholarPubMed
Tuohimaa, P, Lyakhovich, A, Aksenov, N, Pennanen, P, Syvala, H, Lou, YR, Ahonen, M, Hasan, T, Pasanen, P, Blauer, M, Manninen, T, Miettinen, S, Vilja, P & Ylikomi, T (2001) Vitamin D and prostate cancer. Journal of Steroid Biochemistry and Molecular Biology 76 125134.CrossRefGoogle ScholarPubMed
Türk, S, Yeksan, M, Tamer, N, Gürbilek, M, Erdogan, Y & Erkul, I (1992) Effect of 1,25(OH)2 D3 treatment on glucose intolerance in uremia. Nephrology Dialysis Transplantation 7 12071212.CrossRefGoogle Scholar
van der Wielen, RPJ, Lowik, MRH, van den Berg, H, de Groot, LC, Haller, J, Moreiras, O & Van Staveren, WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346 207210.CrossRefGoogle Scholar
van Lente, (2000) Markers of inflammation as predictors in cardiovascular disease. Clinica Chimica Acta 293 3152.CrossRefGoogle ScholarPubMed
Vieth, R (1999) Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. American Journal of Clinical Nutrition 69 842856.CrossRefGoogle ScholarPubMed
Vieth, R, Chan, PC & MacFarlane, GD (2001 a) Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. American Journal of Clinical Nutrition 73 288294.CrossRefGoogle ScholarPubMed
Vieth, R, Cole, DE, Hawker, GA, Trang, HM & Rubin, LA (2001 b) Wintertime vitamin D insufficiency is common in young Canadian women, and their vitamin D intake does not prevent it. European Journal of Clinical Nutrition 55 10911097.CrossRefGoogle ScholarPubMed
Vik, T, Try, K & Stromme, JH (1980) The vitamin D status of man at 70° north. Scandinavian Journal of Clinical and Laboratory Investigation 40 227232.CrossRefGoogle ScholarPubMed
Whybro, A, Jagger, H, Barker, M & Eastell, R (1998) Phosphate supplementation in young men: lack of effect on calcium homeostasis and bone turnover. European Journal of Clinical Nutrition 52 2933.CrossRefGoogle ScholarPubMed
Wilkinson, RJ, Llewelyn, M, Toossi, Z, Patel, P, Pasvol, G, Lalvani, A, Wright, D, Latif, M & Davidson, RN (2000) Influence of vitamin D deficiency and vitamin D receptor polymorphisms on tuberculosis among Gujarati Asians in west London: a case-control study. Lancet 355 618621.CrossRefGoogle ScholarPubMed
Woo, J, Chan, HS, Hazlett, CB, Ho, SC, Chan, R, Sham, A & Davies, PD (1996) Tuberculosis among elderly Chinese in residential homes: tuberculin reactivity and estimated prevalence. Gerontology 42 155162.CrossRefGoogle ScholarPubMed
Wortsman, J, Matsuoka, LY, Chen, TC, Lu, Z & Holick, MF (2000) Decreased bioavailability of vitamin D in obesity. American Journal of Clinical Nutrition 72 690693.CrossRefGoogle ScholarPubMed
Yamauchi, Y, Tsunematsu, T, Konda, S, Hoshino, T, Itokawa, Y & Hoshizaki, H (1989) A double blind trial of alfacalcidol on patients with rheumatoid arthritis (RA) [in Japanese]. Ryumachi 29 1124.Google Scholar
Ziambaras, K & Dagogo-Jack, S (1997) Reversible muscle weakness in patients with vitamin D deficiency. Western Journal of Medicine 167 435439.Google ScholarPubMed
Zittermann, A (1987) Vitamin D Status von Patienten mit hereditären Aminosäurestoffwechselstörungen und von Patienten mit Phenylketonurie (Vitamin D status in patients with hereditary disturbances in amino acid metabolism and in patients with phenylketonuria). PhD thesis, BonnGoogle Scholar
Zittermann, A, Sabatschus, O, Jantzen, S, Platen, P, Danz, A, Dimitriou, T, Scheld, K, Klein, K & Stehle, P (2000) Exercise-trained young men have higher calcium absorption rates and plasma calcitriol levels in comparison to age-matched sedentary controls. Calcified Tissue International 67 215219.CrossRefGoogle Scholar
Zittermann, A, Scheld, K & Stehle, P (1998) Seasonal variations in vitamin D status and calcium absorption do not influence bone turnover in young women. European Journal of Clinical Nutrition 52 501506.CrossRefGoogle Scholar
Zittermann, A, Schulze Schleithoff, S, Tenderich, G, Berthold, HK, Körfer, R & Stehle, P (2003) Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure. Journal of the American College of Cardiology 43 105112.CrossRefGoogle Scholar
You have Access
567
Cited by