IOM vitamin D guidelines deemed a failure by some doctors

IOM vitamin D guidelines deemed a failure by some doctors

Numerous doctors and other healthcare practitioners disagree with the IOM’s new vitamin D guidelines and say the report won't affect what they recommend to patients.

The Institute of Medicine (IOM) ruffled some health practitioner feathers and likely caused consumer confusion with the new vitamin D and calcium recommendations its Food and Nutrition Board (FNB) released to the American public on Nov. 29. The new guidelines triggered a landslide of mainstream press coverage, some of it questioning the need for and even safety of vitamin D supplementation.

In its recommendations, the IOM’s FNB advocated a doubling of vitamin D intake for infants (to 400 IU), a tripling of vitamin D intake for those between ages 1 and 50 (to 600 IU), a 50 percent hike in those ages 51 to 70 (to 600 IU), and a 33 percent increase for those older than 71 years old (to 800 IU). On calcium, the report said post-menopausal women should be cautious about calcium intake over concerns about kidney stones, though they advocated adolescent girls are most in need and should increase their calcium intake to 1,300 mg/day.

The IOM also said that most people receive the recommended total intake of vitamin D from food and that the number of people in the United States and Canada who are vitamin D deficient may have been overestimated because of inconsistent testing methods.

These points were reiterated during a Nov. 30 IOM briefing about the recommendations. When asked whether The New York Times’ headline, “Extra Vitamin D and Calcium Are Not Needed, Report Says,” accurately conveyed the message from the IOM report, FNB Committee Chair Catharine A. Ross said: That’s not quite the message that we would hope for in the headline. … These are recommendations for intake from all sources of diet and supplement. We are saying that for a goodly portion of the population, it is possible to obtain the calcium and vitamin D at these recommended levels from diet.”

Added FNB Committee Member Steven Clinton: “The New York Timesarticle as a whole is very well written and is a reasonable message for the readers. The headline is just a little bit too strong for what the report really is saying. But I think it will hopefully stimulate some folks to read the article, where the information, I think, is a little more balanced.”

IOM report does not reflect views of some practitioners

Numerous doctors and other healthcare practitioners disagree with the IOM’s recommendations, including Robert Rountree, MD, a medical author and practicing physician in Boulder, Colorado.

“This report does not represent the views of researchers who are true experts in the field,” Rountree told “For reasons that I don't understand, the panel members deliberately chose to ignore a large body of published information regarding the effects of vitamin D in cancer, cardiometabolic disease, obesity, autoimmune disease and mood regulation and instead focused almost exclusively on studies related to bone health. They also failed to make the case that vitamin D supplements are toxic in the dose ranges currently being recommended (2000 IU to 10,000 IU daily).”

As a practicing clinician, Rountree said he is “much more interested” in of vitamin D status on the overall health of my patients than I am in its singular effects on bone density and fracture risk.  “There is nothing in the IOM report,” Rountree added, “that makes me want to change my current recommendation to aggressively monitor vitamin D levels with frequent blood testing in my patients and to supplement as necessary to maintain adequate levels.”

A failure for pregnant women and their unborn babies

John Jacob Cannell, MD, executive director of the Vitamin D Council, is another medical professional who takes issue with the new vitamin D guidelines. The Vitamin D Council’s stated mission is to educate the public and healthcare professionals about vitamin D deficiency and its associated diseases.

“After 13 years of silence, the quasi governmental agency, [the IOM’s FNB] recommended that a three-pound premature infant take virtually the same amount of vitamin D as a 300 pound pregnant woman,” Cannell writes in a statement on the Vitamin D Council website. “While that 400 IU/day dose is close to adequate for infants, 600 IU/day in pregnant women will do nothing to help the three childhood epidemics most closely associated with gestational and early childhood vitamin D deficiencies: asthma, auto-immune disorders, and, as recently reported in the largest pediatric journal in the world, autism.”

Gregory Plotnikoff, MD, of Allina's Penny George Institute for Health and Healing in Minneapolis, accused the IOM’s report of being “too easily misinterpreted” in an interview with the Minnesota NBC affiliate Kare 11 news. He said that offering the same vitamin D recommendations for all of the U.S. population—regardless of where people live or their skin tone or body size—is nonsensical from a scientific standpoint. As a result, Plotnikoff said he will continue to recommend that his patients have their vitamin D levels checked.

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