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Calcium and vitamin D supply in Polish population – facts and myths
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Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Medical Univerity of Lodz, Poland
Ann Agric Environ Med. 2014;21(3):455-456
ABSTRACT
Traditionally, calcium and vitamin D are treated as partners
crucial for bone health. In the human body calcium is
located mostly in the skeleton, only 1–2% is present in
body fluids and this part is metabolically active. Serum
calcium concentration is closely regulated within a narrow
physiological range [1]. However, calcium is responsible not
only for bone mineralization but also for muscular and
neural conductivity and blood coagulation [1]. Vitamin D
is necessary for calcium absorption, through amplification
of calbindin synthesis, it is also involved in the regulation of
parathyroid hormone synthesis [1, 2]. Recently, the pleiotropic
effects of vitamin D have become the subject of interest [1, 2];
potential extraskeletal benefits of vitamin D intake include
lower cardiovascular morbidity and mortality, reduced risk of
diabetes mellitus, breast and colon cancer, multiple sclerosis,
allergy, asthma and cognitive illness [1, 2, 3].
Calcium and vitamin D deficiency may lead to secondary
hyperparathyroidism which results in the development of
rickets and low peak bone mass in children and processes
of osteomalacia and osteoporosis in adults [2]. Low vitamin
D status in women is associated with impaired fertility
[4], adverse pregnancy outcomes, such as miscarriage,
preeclampsia and preterm birth, development of gestational
diabetes and bacterial vaginosis [4, 5]. Vitamin D deficiency
in pregnant women may affect their offspring, because there
is a strong correlation between maternal and cord blood
25(OH)D and newborns have inadequate vitamin D storage
to draw on in early life [6]. Vitamin D affects more than 3,000
genes, many of which have a role to play in foetal development
[7], supporting hypothesis on the role of vitamin D in foetal
programming, influencing the genomic programming of
foetal and neonatal development, and subsequent disease
risk of respiratory infections and asthma, type-1 diabetes and
schizophrenia in both childhood and adult life [8, 9]. Rickets,
low bone mineral density and reduced postnatal linear
growth and weight gain may also occur, particularly if the
postnatal supplementation of vitamin D is not sufficient [9].
Diet is the main source of calcium for humans and dairy
products are the richest in calcium. On the contrary, a diet
that includes fatty fish, beef liver and egg yolk provides only
about 10% of vitamin D demand. Most vitamin D comes
from skin synthesis.
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