Vitamin D mistake

The Institutes of Medicine, now the Academy of Medicine, made a major and inexplicable error in determining the recommended daily allowance for vitamin D. This error, documented in a 2014 paper, suggests that the recommended amount in the US is 15 times too low, and in the UK, it's 22 times too low. This mistake has not been corrected in over 11 years, leading to a state where people receive inadequate vitamin D.

The Institutes of Medicine calculated that 600 units of vitamin D daily would ensure 97.5% of the population achieved 63 nanomoles per liter. However, the correct calculation reveals that 600 units actually only achieve 26.8 nanomoles per liter, putting individuals in the deficient range. To actually reach the desired 63 nanomoles per liter for 97.5% of the population, a dose of 8,895 international units would be needed, not 600 or 400 as recommended by the US and UK authorities, respectively.

The root of the error lies in confusing averages of groups with averages of individuals. The Institutes of Medicine analyzed the average outcomes from different studies rather than the data of individual participants within those studies. This smoothed out the data, leading to the incorrect assumption that if the average of a study group was sufficient, then nearly everyone was covered. This is a fundamental statistical mistake, often referred to as the 'average versus individual' error, which has massive implications for public health.

The current, incorrect vitamin D recommendations have serious public health consequences. Adequate vitamin D levels are crucial for reducing prostate cancer mortality, preventing pre-diabetes, and protecting against colon cancer, heart disease, and various immune deficiencies. The current recommendations, designed primarily to prevent rickets and bone disease, are far too low to address these broader health benefits. The authors of the paper emphasize the urgency of reconsidering the RDA for vitamin D to support proper public health and clinical decision-making.

The Institutes of Medicine aimed to find a vitamin D dose that ensured 97.5% of individuals reached a healthy blood level of 50 nanomoles per liter. Their miscalculation was based on analyzing the average differences between studies instead of collecting individual participant data, effectively smoothing out individual variability. This led them to believe 600 IUs would cover 97.5% of the population, when in reality, it only ensured 97.5% of people reached a much lower, deficient blood level of 26.8 nanomoles per liter. The true amount needed for their original goal is 8,895 IUs.