Table of Contents Author Guidelines Submit a Manuscript
Disease Markers
Volume 2015 (2015), Article ID 864370, 10 pages
http://dx.doi.org/10.1155/2015/864370
Review Article

Optimal Vitamin D Supplementation Levels for Cardiovascular Disease Protection

School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, Centre for Translational Inflammation Research (CTIR), University of Birmingham Laboratories, Queen Elizabeth Hospital Birmingham, Birmingham B15 2TH, UK

Received 14 June 2015; Accepted 9 August 2015

Academic Editor: Silvia Persichilli

Copyright © 2015 Sebastian T. Lugg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. A. S. Dusso, A. J. Brown, and E. Slatopolsky, “Vitamin D,” American Journal of Physiology—Renal Physiology, vol. 289, no. 1, pp. F8–F28, 2005. View at Publisher · View at Google Scholar · View at Scopus
  2. H. M. MacDonald, A. Mavroeidi, W. D. Fraser et al., “Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern?” Osteoporosis International, vol. 22, no. 9, pp. 2461–2472, 2011. View at Publisher · View at Google Scholar · View at Scopus
  3. M. F. Holick, “Vitamin D status: measurement, interpretation, and clinical application,” Annals of Epidemiology, vol. 19, no. 2, pp. 73–78, 2009. View at Publisher · View at Google Scholar · View at Scopus
  4. J. Merke, P. Milde, S. Lewicka et al., “Identification and regulation of 1,25-dihydroxyvitamin D3 receptor activity and biosynthesis of 1,25-dihydroxyvitamin D3. Studies in cultured bovine aortic endothelial cells and human dermal capillaries,” The Journal of Clinical Investigation, vol. 83, no. 6, pp. 1903–1915, 1989. View at Publisher · View at Google Scholar · View at Scopus
  5. D. Somjen, Y. Weisman, F. Kohen et al., “25-Hydroxyvitamin D3-1alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds,” Circulation, vol. 111, no. 13, pp. 1666–1671, 2005. View at Publisher · View at Google Scholar · View at Scopus
  6. D. X. Tishkoff, K. A. Nibbelink, K. H. Holmberg, L. Dandu, and R. U. Simpson, “Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility,” Endocrinology, vol. 149, no. 2, pp. 558–564, 2008. View at Publisher · View at Google Scholar · View at Scopus
  7. F. Silvagno, E. De Vivo, A. Attanasio, V. Gallo, G. Mazzucco, and G. Pescarmona, “Mitochondrial localization of vitamin D receptor in human platelets and differentiated megakaryocytes,” PLoS ONE, vol. 5, no. 1, Article ID e8670, 2010. View at Publisher · View at Google Scholar · View at Scopus
  8. X. Guillot, L. Semerano, N. Saidenberg-Kermanac'h, G. Falgarone, and M.-C. Boissier, “Vitamin D and inflammation,” Joint Bone Spine, vol. 77, no. 6, pp. 552–557, 2010. View at Publisher · View at Google Scholar · View at Scopus
  9. N. J. McKenna, R. B. Lanz, and B. W. O'Malley, “Nuclear receptor coregulators: cellular and molecular biology,” Endocrine Reviews, vol. 20, no. 3, pp. 321–344, 1999. View at Google Scholar · View at Scopus
  10. A. Hossein-nezhad, A. Spira, and M. F. Holick, “Influence of vitamin D status and vitamin D3 supplementation on genome wide expression of white blood cells: a randomized double-blind clinical trial,” PLoS ONE, vol. 8, no. 3, Article ID e58725, 2013. View at Publisher · View at Google Scholar · View at Scopus
  11. R. Bouillon, G. Carmeliet, L. Verlinden et al., “Vitamin D and human health: lessons from vitamin D receptor null mice,” Endocrine Reviews, vol. 29, no. 6, pp. 726–776, 2008. View at Publisher · View at Google Scholar · View at Scopus
  12. A. Tomaschitz, E. Ritz, B. Pieske et al., “Aldosterone and parathyroid hormone interactions as mediators of metabolic and cardiovascular disease,” Metabolism: Clinical and Experimental, vol. 63, no. 1, pp. 20–31, 2014. View at Publisher · View at Google Scholar · View at Scopus
  13. A. C. Looker and M. E. Mussolino, “Serum 25-hydroxyvitamin D and hip fracture risk in older U.S. white adults,” Journal of Bone and Mineral Research, vol. 23, no. 1, pp. 143–150, 2008. View at Publisher · View at Google Scholar · View at Scopus
  14. F. R. Pérez-López, “Vitamin D and its implications for musculoskeletal health in women: an update,” Maturitas, vol. 58, no. 2, pp. 117–137, 2007. View at Publisher · View at Google Scholar · View at Scopus
  15. E. Sohl, N. M. Van Schoor, R. T. de Jongh, M. Visser, D. J. H. Deeg, and P. Lips, “Vitamin d status is associated with functional limitations and functional decline in older individuals,” The Journal of Clinical Endocrinology & Metabolism, vol. 98, no. 9, pp. E1483–E1490, 2013. View at Publisher · View at Google Scholar · View at Scopus
  16. M. Wacker and M. F. Holiack, “Vitamin D-effects on skeletal and extraskeletal health and the need for supplementation,” Nutrients, vol. 5, no. 1, pp. 111–148, 2013. View at Publisher · View at Google Scholar · View at Scopus
  17. M. F. Holick, “Vitamin D deficiency,” The New England Journal of Medicine, vol. 357, no. 3, pp. 266–281, 2007. View at Publisher · View at Google Scholar · View at Scopus
  18. M. F. Holick, N. C. Binkley, H. A. Bischoff-Ferrari et al., “Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline,” The Journal of Clinical Endocrinology & Metabolism, vol. 96, no. 7, pp. 1911–1930, 2011. View at Publisher · View at Google Scholar
  19. Scientific Advisory Committee on Nutrition, Update on Vitamin D Position statement by the Scientific Advisory Committee on Nutrition, The Stationery Office, London, UK, 2007.
  20. A. Mithal, D. A. Wahl, J.-P. Bonjour et al., “Global vitamin D status and determinants of hypovitaminosis D,” Osteoporosis International, vol. 20, no. 11, pp. 1807–1820, 2009. View at Publisher · View at Google Scholar · View at Scopus
  21. S. G. Rostand, “Vitamin D deficiency in the pathogenesis of hypertension: still an unsettled question,” Current Hypertension Reports, vol. 16, no. 8, article 464, 2014. View at Publisher · View at Google Scholar · View at Scopus
  22. R. Scragg, M. Sowers, and C. Bell, “Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the third national health and nutrition examination survey,” American Journal of Hypertension, vol. 20, no. 7, pp. 713–719, 2007. View at Publisher · View at Google Scholar · View at Scopus
  23. I. H. De Boer, R. Katz, M. Conchol et al., “Serum 25-hydrocyvitamin D and change in estimated glomerular filtration rate,” Clinical Journal of the American Society of Nephrology, vol. 6, pp. 2141–2149, 2011. View at Google Scholar
  24. D. E. Godar, S. J. Pope, W. B. Grant, and M. F. Holick, “Solar UV doses of adult Americans and vitamin D3 production,” Dermato-Endocrinology, vol. 3, no. 4, pp. 243–250, 2011. View at Publisher · View at Google Scholar · View at Scopus
  25. S. G. Rostand, “Ultraviolet light may contribute to geographic and racial blood pressure differences,” Hypertension, vol. 30, no. 2, pp. 150–156, 1997. View at Publisher · View at Google Scholar · View at Scopus
  26. L. A. Beveridge, A. D. Struthers, F. Khan et al., “effect of vitamin D supplementation on blood pressure: a systematic review and meta-analysis incorporating individual patient data,” JAMA Internal Medicine, vol. 175, no. 5, pp. 745–754, 2015. View at Publisher · View at Google Scholar
  27. J. P. Forman, J. B. Scott, K. Ng et al., “Effect of vitamin d supplementation on blood pressure in blacks,” Hypertension, vol. 61, no. 4, pp. 779–785, 2013. View at Publisher · View at Google Scholar · View at Scopus
  28. Y. Dong, I. S. Stallmann-Jorgensen, N. K. Pollock et al., “A 16-week randomized clinical trial of 2000 international units daily vitamin D3 supplementation in black youth: 25-Hydroxyvitamin D, adiposity, and arterial stiffness,” Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 10, pp. 4584–4591, 2010. View at Publisher · View at Google Scholar · View at Scopus
  29. DO-HEALTH, “VitaminD3-Omega3-Home Exercise—Healthy Ageing and Longevity Trial,” 2015, http://www.do-health.eu.
  30. T. D. O'Connell, J. E. Berry, A. K. Jarvis, M. J. Somerman, and R. U. Simpson, “1,25-Dihydroxyvitamin D3 regulation of cardiac myocyte proliferation and hypertrophy,” The American Journal of Physiology, vol. 272, no. 4, part 2, pp. H1759–H1769, 1997. View at Google Scholar · View at Scopus
  31. R. U. Simpson, “Selective knockout of the vitamin D receptor in the heart results in cardiac hypertrophy: is the heart a drugable target for vitamin D receptor agonists?” Circulation, vol. 124, no. 17, pp. 1808–1810, 2011. View at Publisher · View at Google Scholar · View at Scopus
  32. J. Wu, M. Garami, T. Cheng, and D. G. Gardner, “1,25 (OH)2 vitamin D3 and retinoic acid antagonize endothelin-stimulated hypertrophy of neonatal rat cardiac myocytes,” The Journal of Clinical Investigation, vol. 97, no. 7, pp. 1577–1588, 1996. View at Publisher · View at Google Scholar · View at Scopus
  33. W. Xiang, J. Kong, S. Chen et al., “Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin-angiotensin systems,” American Journal of Physiology—Endocrinology and Metabolism, vol. 288, no. 1, pp. E125–E132, 2005. View at Publisher · View at Google Scholar · View at Scopus
  34. A. Zittermann, S. S. Schleithoff, G. Tenderich, H. K. Berthold, R. Körfer, and P. Stehle, “Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?” Journal of the American College of Cardiology, vol. 41, no. 1, pp. 105–112, 2003. View at Publisher · View at Google Scholar · View at Scopus
  35. A. J. van Ballegooijen, M. Visser, M. F. Cotch et al., “Serum vitamin D and parathyroid hormone in relation to cardiac structure and function: the ICELAND-MI substudy of AGES-Reykjavik,” The Journal of Clinical Endocrinology & Metabolism, vol. 98, no. 6, pp. 2544–2552, 2013. View at Publisher · View at Google Scholar · View at Scopus
  36. B. Kestenbaum, R. Katz, I. de Boer et al., “Vitamin D, parathyroid hormone, and cardiovascular events among older adults,” Journal of the American College of Cardiology, vol. 58, no. 14, pp. 1433–1441, 2011. View at Publisher · View at Google Scholar · View at Scopus
  37. F. N. Saleh, H. Schirmer, J. Sundsfjord, and R. Jorde, “Parathyroid hormone and left ventricular hypertrophy,” European Heart Journal, vol. 24, no. 22, pp. 2054–2060, 2003. View at Publisher · View at Google Scholar · View at Scopus
  38. S. A. Shedeed, “Vitamin D supplementation in infants with chronic congestive heart failure,” Pediatric Cardiology, vol. 33, no. 5, pp. 713–719, 2012. View at Publisher · View at Google Scholar
  39. S. S. Schleithoff, A. Zittermann, G. Tenderich, H. K. Berthold, P. Stehle, and R. Koerfer, “Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial,” American Journal of Clinical Nutrition, vol. 83, no. 4, pp. 754–759, 2006. View at Google Scholar · View at Scopus
  40. I. Gotsman, A. Shauer, D. R. Zwas et al., “Vitamin D deficiency is a predictor of reduced survival in patients with heart failure; vitamin D supplementation improves outcome,” European Journal of Heart Failure, vol. 14, no. 4, pp. 357–366, 2012. View at Publisher · View at Google Scholar · View at Scopus
  41. J. Thompson, R. Nitahpapand, P. Bhatti, and A. Kourliouros, “Vitamin D deficiency and atrial fibrillation,” International Journal of Cardiology, vol. 184, pp. 159–162, 2015. View at Publisher · View at Google Scholar
  42. L. Frost, S. P. Johnsen, L. Pedersen et al., “Seasonal variation in hospital discharge diagnosis of atrial fibrillation: a population-based study,” Epidemiology, vol. 13, no. 2, pp. 211–215, 2002. View at Publisher · View at Google Scholar · View at Scopus
  43. N. F. Murphy, S. Stewart, K. MacIntyre, S. Capewell, and J. J. V. McMurray, “Seasonal variation in morbidity and mortality related to atrial fibrillation,” International Journal of Cardiology, vol. 97, no. 2, pp. 283–288, 2004. View at Publisher · View at Google Scholar · View at Scopus
  44. M. Rienstra, S. Cheng, M. G. Larson et al., “Vitamin D status is not related to development of atrial fibrillation in the community,” American Heart Journal, vol. 162, no. 3, pp. 538–541, 2011. View at Publisher · View at Google Scholar · View at Scopus
  45. F. Qayyum, N. L. Landex, B. R. Agner, M. Rasmussen, C. Jøns, and U. Dixen, “Vitamin D deficiency is unrelated to type of atrial fibrillation and its complications,” Danish Medical Journal, vol. 59, no. 9, Article ID A4505, 2012. View at Google Scholar · View at Scopus
  46. M. Demir, U. Uyan, and M. Melek, “The effects of vitamin D deficiency on atrial fibrillation,” Clinical and Applied Thrombosis/Hemostasis, vol. 20, no. 1, pp. 98–103, 2014. View at Publisher · View at Google Scholar · View at Scopus
  47. W. R. Chen, Z. Y. Liu, Y. Shi et al., “Relation of low vitamin D to non valvular persistent atrial fibrillation in chinese patients,” Annals of Noninvasive Electrocardiology, vol. 19, no. 2, pp. 166–173, 2014. View at Publisher · View at Google Scholar · View at Scopus
  48. O. U. Ozcan, A. Gurlek, E. Gursoy, D. M. Gerede, and C. Erol, “Relation of vitamin D deficiency and new-onset atrial fibrillation among hypertensive patients,” Journal of the American Society of Hypertension, vol. 9, no. 4, pp. 307–312, 2015. View at Publisher · View at Google Scholar
  49. E. Kassi, C. Adamopoulos, E. K. Basdra, and A. G. Papavassiliou, “Role of vitamin D in atherosclerosis,” Circulation, vol. 128, no. 23, pp. 2517–2531, 2013. View at Publisher · View at Google Scholar · View at Scopus
  50. G. N. Thomas, B. Ó. Hartaigh, J. A. Bosch et al., “Vitamin D levels predict all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome: the Ludwigshafen risk and cardiovascular health (LURIC) study,” Diabetes Care, vol. 35, no. 5, pp. 1158–1164, 2012. View at Publisher · View at Google Scholar · View at Scopus
  51. T. J. Wang, M. J. Pencina, S. L. Booth et al., “Vitamin D deficiency and risk of cardiovascular disease,” Circulation, vol. 117, no. 4, pp. 503–511, 2008. View at Publisher · View at Google Scholar · View at Scopus
  52. F. Oz, A. Y. Cizgici, H. Oflaz et al., “Impact of vitamin D insufficiency on the epicardial coronary flow velocity and endothelial function,” Coronary Artery Disease, vol. 24, no. 5, pp. 392–397, 2013. View at Publisher · View at Google Scholar · View at Scopus
  53. J. Y. Liew, S. R. Sasha, P. J. Ngu et al., “Circulating vitamin D levels are associated with the presence and severity of coronary artery disease but not peripheral arterial disease in patients undergoing coronary angiography,” Nutrition, Metabolism and Cardiovascular Diseases, vol. 25, no. 3, pp. 274–279, 2015. View at Publisher · View at Google Scholar · View at Scopus
  54. J. A. Ford, G. S. MacLennan, A. Avenell et al., “Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis,” The American Journal of Clinical Nutrition, vol. 100, no. 3, pp. 746–755, 2014. View at Publisher · View at Google Scholar · View at Scopus
  55. M. B. Elamin, N. O. Abu Elnour, K. B. Elamin et al., “Vitamin D and cardiovascular outcomes: a systematic review and meta-analysis,” The Journal of Clinical Endocrinology & Metabolism, vol. 96, no. 7, pp. 1931–1942, 2011. View at Publisher · View at Google Scholar · View at Scopus
  56. S. E. Makariou, P. Michel, M. S. Tzoufi, A. Challa, and H. J. Milionis, “Vitamin D and stroke: promise for prevention and better outcome,” Current Vascular Pharmacology, vol. 12, no. 1, pp. 117–124, 2014. View at Publisher · View at Google Scholar · View at Scopus
  57. S. Pilz, A. Tomaschitz, C. Drechsler, A. Zittermann, J. M. Dekker, and W. März, “Vitamin d supplementation: a promising approach for the prevention and treatment of strokes,” Current Drug Targets, vol. 12, no. 1, pp. 88–96, 2011. View at Publisher · View at Google Scholar · View at Scopus
  58. P. Brøndum-Jacobsen, B. G. Nordestgaard, P. Schnohr, and M. Benn, “25-Hydroxyvitamin D and symptomatic ischemic stroke: an original study and meta-analysis,” Annals of Neurology, vol. 73, no. 1, pp. 38–47, 2013. View at Publisher · View at Google Scholar · View at Scopus
  59. M. D. Witham, F. J. Dove, J. A. Sugden, A. S. Doney, and A. D. Struthers, “The effect of vitamin D replacement on markers of vascular health in stroke patients—a randomised controlled trial,” Nutrition, Metabolism and Cardiovascular Diseases, vol. 22, no. 10, pp. 864–870, 2012. View at Publisher · View at Google Scholar · View at Scopus
  60. J. Hsia, G. Heiss, H. Ren et al., “Calcium/vitamin D supplementation and cardiovascular events,” Circulation, vol. 115, no. 7, pp. 846–854, 2007. View at Publisher · View at Google Scholar · View at Scopus
  61. A. Avenell, G. S. MacLennan, D. J. Jenkinson et al., “Long-term follow-up for mortality and cancer in a randomized placebo-controlled trial of vitamin D3 and/or calcium (RECORD Trial),” Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 2, pp. 614–622, 2012. View at Publisher · View at Google Scholar · View at Scopus
  62. D. P. Trivedi, R. Doll, and K. T. Khaw, “Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial,” British Medical Journal, vol. 326, article 469, 2003. View at Publisher · View at Google Scholar · View at Scopus
  63. J. L. Anderson, H. T. May, B. D. Horne et al., “Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population,” American Journal of Cardiology, vol. 106, no. 7, pp. 963–968, 2010. View at Publisher · View at Google Scholar · View at Scopus
  64. M. L. Melamed, P. Muntner, E. D. Michos et al., “Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease results from NHANES 2001 to 2004,” Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 28, no. 6, pp. 1179–1185, 2008. View at Publisher · View at Google Scholar · View at Scopus
  65. A. Fahrleitner, H. Dobnig, A. Obernosterer et al., “Vitamin D deficiency and secondary hyperparathyroidism are common complications in patients with peripheral arterial disease,” Journal of General Internal Medicine, vol. 17, no. 9, pp. 663–669, 2002. View at Publisher · View at Google Scholar · View at Scopus
  66. E. Gouveri, N. Papanas, A. I. Hatzitolios, and E. Maltezos, “Hypovitaminosis D and peripheral arterial disease: emerging link beyond cardiovascular risk factors,” European Journal of Internal Medicine, vol. 23, no. 8, pp. 674–681, 2012. View at Publisher · View at Google Scholar · View at Scopus
  67. M. M. McDermott, K. Liu, L. Ferrucci et al., “Vitamin D status, functional decline, and mortality in peripheral artery disease,” Vascular Medicine, vol. 19, no. 1, pp. 18–26, 2014. View at Publisher · View at Google Scholar · View at Scopus
  68. A. Zittermann, S. Iodice, S. Pilz, W. B. Grant, V. Bagnardi, and S. Gandini, “Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies,” American Journal of Clinical Nutrition, vol. 95, no. 1, pp. 91–100, 2012. View at Publisher · View at Google Scholar · View at Scopus
  69. H. Johansson, A. Odén, J. Kanis et al., “Low serum vitamin D is associated with increased mortality in elderly men: MrOS Sweden,” Osteoporosis International, vol. 23, no. 3, pp. 991–999, 2012. View at Publisher · View at Google Scholar · View at Scopus
  70. M. B. Elamin, N. O. Abu Elnour, K. B. Elamin et al., “Vitamin D and cardiovascular outcomes: a systematic review and meta-analysis,” Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 7, pp. 1931–1942, 2011. View at Publisher · View at Google Scholar · View at Scopus
  71. L. Rejnmark, A. Avenell, T. Masud et al., “Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials,” Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 8, pp. 2670–2681, 2012. View at Publisher · View at Google Scholar · View at Scopus
  72. G. Bjelakovic, L. L. Gluud, D. Nikolova et al., “Vitamin D supplementation for prevention of mortality in adults,” The Cochrane Database of Systematic Reviews, vol. 10, no. 1, Article ID CD007470, 2014. View at Google Scholar · View at Scopus
  73. M. F. Holick, R. M. Biancuzzo, T. C. Chen et al., “Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D,” The Journal of Clinical Endocrinology & Metabolism, vol. 93, no. 3, pp. 677–681, 2008. View at Publisher · View at Google Scholar · View at Scopus
  74. A. C. Ross, J. E. Manson, S. A. Abrams et al., “The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know,” Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 1, pp. 53–58, 2011. View at Publisher · View at Google Scholar · View at Scopus
  75. P. Pramyothin and M. F. Holick, “Vitamin D supplementation: guidelines and evidence for subclinical deficiency,” Current Opinion in Gastroenterology, vol. 28, no. 2, pp. 139–150, 2012. View at Publisher · View at Google Scholar · View at Scopus
  76. Publich Health England, Vitamin D; Information for Healthcare Professionals, Publich Health England, London, UK, 2014.
  77. European Food Safety Authority, Tolerable Upper Intake Levels for Vitamins and Minerals, EFSA, 2006.
  78. R. Vieth, “Vitamin D toxicity, policy, and science,” Journal of Bone and Mineral Research, vol. 22, supplement 2, pp. V64–V68, 2007. View at Publisher · View at Google Scholar · View at Scopus
  79. M. L. Melamed, E. D. Michos, W. Post, and B. Astor, “25-hydroxyvitamin D levels and the risk of mortality in the general population,” Archives of Internal Medicine, vol. 168, no. 15, pp. 1629–1637, 2008. View at Publisher · View at Google Scholar · View at Scopus
  80. National Institute for Health and Care Excellence, “Vitamin D: increasing supplement use among at-risk groups,” NICE Public Health Guidance 56, NICE, London, UK, 2014. View at Google Scholar