Urinary calcium response to high dose vitamin D3 with calcium supplementation in patients with multiple sclerosis

ObjectiveTo characterize the effect of vitamin D₃ intake on urinary calcium:creatinine ratios across predefined ranges of serum 25(OH)D.DesignPatients with multiple sclerosis (n = 25) received escalating doses of vitamin D₃ (4000–40,000 IU/d) with calcium (1200 mg/d).ResultsUrinary calcium:creatinine was driven by increased 25(OH)D when concentrations were < 75 nmol/L (r = 0.424, p = 0.009) and > 200 nmol/L (r = 0.281, p = 0.01), but no relationship existed when 25(OH)D concentrations were 76–200 nmol/L.ConclusionsA “safe”, physiological range of 25(OH)D concentrations is 75–200 nmol/L.     

Osteoporosis: recommendations for resistance exercise and supplementation with calcium and vitamin D to promote bone health

Hormone replacement therapy, once the gold standard for treatment of osteoporosis, is no longer a clinical option. Effective alternatives are available using resistance exercise and supplementation with calcium and vitamin D to ameliorate bone loss and promote new bone formation. This article summarizes current evidence and provides recommendations for community health nurses to develop effective plans for prevention and treatment of osteoporosis.     

The influence of maternal vitamin D supplementation on infant vitamin D status: A systematic review and meta-analyses

BackgroundInconsistencies exist with regard to effect of maternal vitamin D supplementation on infant vitamin D status. The inconsistencies could be attributed to numerous factors, such as duration of intervention and dosage, among others. In this work, we conducted a systematic review and meta-analysis to determine the influence of maternal vitamin D supplementation on infant vitamin D status.MethodsA comprehensive systematic search was performed in Scopus, EMBASE, Web of Science, and PubMed/MEDLINE, by investigators, from database inception until November 2019, without using any restrictions. Weighted mean difference (WMD) with the 95 % CI was used for assessing the effects of maternal vitamin D supplementation on 25(OH) D levels in infants.ResultsOverall results from 14 studies revealed a non-significant effect of maternal vitamin D administration on the level of 25(OH) D in breastfeeding infants (WMD: -0.464 ng/mL, 95 % CI: -6.68 to 5.75, p = 0.884, I² = 98 %). Subgroup analyses demonstrated that vitamin D supplementation dosage ≥2000 IU/day (WMD: 9 ng/mL, 95 % CI: 8.19, 9.82, I² = 99 %) and intervention duration ≥20 weeks (WMD: 16.20 ng/mL, 95 % CI: 14.89, 17.50, I² = 99 %) significantly increased 25(OH) D.ConclusionsThe main results indicate a non-significant increase in infant vitamin D following maternal vitamin D supplementation. Additionally, vitamin D supplementation dosage ≥2000 IU/day and intervention duration ≥20 weeks significantly increased infant 25(OH) D.     

Plasma glucose and insulin response to macronutrients in nondiabetic and NIDDM subjects

Information on the metabolic response in people with non-insulin-dependent diabetes mellitus (NIDDM) to ingested individual macronutrients is limited. Available information is reviewed herein. The major absorbed products of carbohydrate-containing foods are glucose, fructose, and galactose. The quantitative effect of these on the plasma glucose and insulin response is different for each. In addition, available data indicate that the glucose and particularly the insulin response is different from that in nondiabetic people. The quantitative effect of dietary proteins and fats on the circulating glucose and insulin concentrations in nondiabetic and NIDDM subjects also has been reviewed. Neither has a significant effect on the glucose concentration. Protein stimulates insulin secretion, and this is relatively more prominent in people with NIDDM. A strong synergistic interaction with glucose on insulin secretion is present, but this is absent in nondiabetic people. Ingested fat does not independently stimulate insulin secretion. However, when ingested with carbohydrate, it may have a considerable effect on the plasma glucose and/or insulin response to that carbohydrate, and the responses are different in nondiabetic and NIDDM subjects. This is probably not due to altered carbohydrate absorption. Intestinal hormones undoubtedly are playing a large role in the insulin secretory response in all of these studies, but this remains to be completely elucidated. Overall, the data indicate that the metabolic response to various foods determined in people with NIDDM may be different than that in nondiabetic people. In our opinion, much more information is required before dietary recommendations for NIDDM subjects can be made based on solid scientific data.