Endogenous and exogenous vitamin D synthesis are associated to environmental, biological and social (economical and cultural) factors. Another approach is the resilience factor hypothesis, which describes serum vitamin D status as helpful in survival of fatal conditions and therefore inversely correlated to morbidity and mortality. Moreover the debate continues whether hypovitaminosis D is cause, result or by-product of poor health. Furthermore important randomized controlled trials (RCTs) give in many cases conflicting results due to certain limitations.
Most observational and epidemiological trials, as well as meta-analyses report the benefits of optimal serum 25-Hydroxyvitamin D () status. The scientific debate about VDD and its complications is far from resolved because of lack of scientific based proofs in certain areas. Vitamin D deficiency (VDD) is already recognized as a pandemic affecting over 1 billion people worldwide. (J Am Board Fam Med 2009 22:698 –706.) Background and Physiology Unfortunately, little evidence guides clinicians on when to screen for vitamin D deficiency or effective treatment options. New recommendations from the American Academy of Pediatrics address the need for supplementation in breastfed newborns and many questions are raised regarding the role of maternal supplementation during lactation. Although it is well known that the combination of vitamin D and calcium is necessary to maintain bone density as people age, vitamin D may also be an independent risk factor for falls among the elderly. Low vitamin D levels are associated with increased overall and cardiovascular mortality, cancer incidence and mortality, and autoimmune diseases such as multiple sclerosis.
In addition, recent epidemiologic studies have observed relationships between low vitamin D levels and multiple disease states. Vitamin D is a fat-soluble vitamin that plays an important role in bone metabolism and seems to have some anti-inflammatory and immune-modulating properties.
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