expert opinion

Symposium Report: Vitamin D Update 2011

April 11, 2011

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“In April 2011, a symposium on the latest developments in the field of vitamin D research was held at the Charité Hospital in Berlin, Germany, with 22 international speakers and more than 300 physicians and other health professionals. It was prompted by the currently established vitamin D deficiencies in broad sections of the population, including children, and the enormous increase in the significance of vitamin D for health. The lecture topics extended from heart disease through diabetes and cancer to numerous nervous, infectious and autoimmune diseases – illnesses which according to the experts can be encouraged by vitamin D deficiency.

The event ended with a clear call by the experts for responsible behavior with regard to sunshine and skin, as well as a basic and sufficiently highly dosed medicinal supply of vitamin D for all those who do not achieve a sufficiently high level of vitamin D through a responsible exposure to sunlight. Moreover the general recommendation of all the experts was that people should have the vitamin D reserves in their blood checked so as to have a basis for decisions about their behavior.

In summary of the event the experts* formulated a six-point paper:

1. Vitamin D is a precursor of a steroid hormone (calcitriol) needed in almost all the body’s cells. It can be produced by people themselves in the skin with the aid of the sun’s UVB rays. It is indispensable for the correct functioning of numerous organs, not just for bone metabolism.

2. There is a worldwide vitamin D deficiency, principally instigated by changes in lifestyle as a result of technological progress. In addition, people spend insufficient time in the sun because of a fear of skin cancer. Beyond the 40th parallel (thus also in middle/northern Europe, including Germany, as well as in the New England states of the USA and in Canada) people receive an insufficient supply of vitamin D, especially in the winter months, since because of the low angle of the sunlight not enough UVB rays to create vitamin D in the skin can penetrate the atmosphere in those places during this period.

3. A wealth of scientific studies in the last 20 years indicates that a vitamin D deficiency probably encourages almost all chronic illnesses, among them diabetes, cancer, high blood pressure and cardiovascular diseases, nervous diseases, autoimmune diseases, infectious diseases and allergies. The undersigned therefore urgently call for an intensification of research work on vitamin D in the broadest possible range of scientific disciplines.

4. The current arrangements for providing the population with vitamin D are insufficient to cover its deficiency. It is therefore necessary to revise the recommendations on exposure to natural and artificial sunlight; thus from spring to autumn, where possible at midday when the sun is highest, a large area of skin (while protecting frequently exposed areas) should deliberately be exposed on more than three days a week for a maximum of 20 minutes (taking account of skin type). On further exposure the skin should be protected with clothing or sun cream. Sunburn should be avoided at all costs.

5. Furthermore, the currently binding recommendation for an intake of 200 IU of vitamin D per day as compensation for lack of exposure to the sun is completely insufficient. A dosage of 1,000-2,000 IU per day (or 7,000-14,000 IU per week depending on age and body weight) is desirable especially during the winter months. This should achieve a level of at least 20 ng/ml in the blood. American scientists even recommend a target range of 40-60 ng/ml, which in a large-scale study required up to 10,000 IU per day. The American Institute of Medicine (IOM) gives 4,000 IU as the upper limit for a safe long-term daily dose. For children a daily dose of 50 IU per kilogram of body weight should be aimed at. Nursing mothers need 6,000 IU per day.

6. The scientists call on the specialist companies and the public sphere to translate these findings into the appropriate recommendations.”

Berlin, Germany, April 2011

* Bodo Lehmann (Klinik und Poliklinik für Dermatologie, Dresden, Germany), William B. Grant (Sunlight, Nutrition, and Health Research Center, San Francisco, USA), Robert Bals (Universitätsklinikum des Saar-landes, Homburg/Saar, Germany), Armin Zittermann (Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany), Harald Dobnig (Medizinische Universität Graz, Austria), Rolfdieter Krause (Nierenzentrum Berlin-Moabit, Berlin, Germany), Dirk Lemke (Median Klinik Berlin-Kladow, Germany), Bruce W. Hollis (Medical University of South Carolina, Department of Pediatrics, Charleston, USA), Carole A Baggerly (Grassroots Health Organization, Encinitas, USA), Nicolai Worm (Deutsche Hochschule für Prävention und Gesundheits-management, Saarbrücken), Jürgen Lademann (Klinik für Dermatologie, Venerologie und Allergologie, Charité-Universitätsmedizin, Berlin, Germany), Alexander Wunsch (Medical Light Consulting, Heidelberg, Germany), Stefan Pilz (Medizinische Universität Graz, Austria), Jörg Reichrath (Universitätsklinikum des Saarlandes, Homburg/Saar, Germany), M.F. Holick (University Medical Center, Boston, USA), Reinhold Vieth (University of Toronto, Canada), Uwe Gröber (Akademie für Mikronährstoffmedizin, Essen, Germany), Jörg Mahlstedt (Berufsverband Deutscher Nuklearmediziner, Essen, Germany), Raimund von Helden (Institut.VitaminDelta.de, Lennestadt, Germany), Hermann Teutemacher (Aeroprax, Herzzentrum, Wuppertal, Germany), Rainer Klapdor (Internist, Hamburg, Germany), Jörg Spitz (Institut für medizinische Information und Prävention, Schlangenbad, Germany)