Beyond PTH: assessing vitamin D status during early pregnancy.
Beyond PTH: assessing vitamin D status during early pregnancy.
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DOI：
10.1111/j.1365-2265.2011.04164.x
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发表时间：
2011-09
影响因子：
3.2
通讯作者：
Hollis BW
中科院分区：
文献类型：
--
作者：
Wagner CL;Hollis BW
新的医学研究所（IOM）建议维生素D摄入量分别为新生儿和哺乳期母亲10和10-15 μg/d（1），与以前的建议相比仅略有变化（2）。我们对婴儿的建议没有问题;但是，哺乳期妇女的建议是另一回事。我们的实验室已经在这一领域研究了三十多年，并且是第一个真正量化母乳中维生素D化合物的实验室（3）。令人惊讶的是，我们的大多数数据都被忽略了，而支持Blumberg，福布斯和Fraser在1963年提出的原始解释--或者更恰当地说，“估计”（4）。作为20世纪70年代人类营养学的研究生（BWH），我们实验室的高级研究员Hollis博士对人乳是人类新生儿“完美”食物的教导感到震惊，但有一个例外：维生素D含量不足，如果不提供外源性维生素D补充剂，哺乳期婴儿可能会患佝偻病。怎么会这样？在发现维生素D之前，这些婴儿做了什么？大自然是如何允许这种情况发生的？事实上，答案很简单：我们在医学上相信我们自己的教条，而不是真正遵循科学，因此我们试图“适应”我们的10 μg/d的建议，而不是应用生理学来发现真正的建议。
The new Institute of Medicine (IOM) recommendation for vitamin D intake is stated to be 10 and 10–15 μg/d for the newborn infant and lactating mother, respectively (1), and represents only a marginal change from its previous recommendations (2). We have no issue with respect to the infant recommendations; however, the lactating woman’s recommendation is another matter. Our lab has been investigating this area for more than three decades and was the first to actually quantify the vitamin D compounds in human milk (3). Surprisingly, most of our data have been ignored in favour of the original recommendation–or, more appropriately,‘the estimation’–by Blumberg, Forbes and Fraser in 1963 (4).As a graduate student in human nutrition in the 1970s (BWH), the senior investigator in our lab Dr Hollis was struck by the teaching that human milk was the ‘perfect’food for the human neonate with one exception: it was inadequate with respect to vitamin D content, and rickets could result in the nursing infant if not provided with exogenous vitamin D supplementation. How could this be? What did these infants do prior to the discovery of vitamin D and how could nature have allowed this to happen? Actually, the answer is quite simple: we in medicine believed our own dogma instead of actually following the science, and thus we tried to ‘fit’our 10 μg/d recommendation to the physiology instead of applying the physiology to discover the true recommendation.