Institute of Medicine Committee Uses AHRQ Evidence Reports to Review Dietary Reference Intakes for Vitamin D and Calcium

An expert committee convened by the Institute of Medicine used two AHRQ evidence reports as key resources to review data pertaining to calcium and vitamin D requirements.

The goal of the committee of 14 scientists was to identify nutrient reference values, known as dietary reference intakes, based on current scientific evidence about the roles of calcium and vitamin D in human health. AHRQ's reports, "Effectiveness and Safety of Vitamin D in Relation to Bone Health" and "Vitamin D and Calcium: A Systematic Review of Health Outcomes," issued in 2007 and 2009, respectively, were influential in this task.

Christine Taylor, PhD, Institute of Medicine Scholar and project lead, says, "The public health community, as well as the media, has been aware of a growing focus on the role of vitamin D in health and the suggestions of widespread deficiency. Beyond the well-established role in bone health, the discussions related to conditions such as cancer, heart disease, and immune function have been based largely on observational data."

While considerable data have been generated, they were of varying quality and relevance, and required in-depth review before the evidence could be considered as a whole. AHRQ's two evidence reports were highly relevant to this review and served as key foundations of the committee's analysis. The Institute of Medicine expert committee examined more than 1,000 publications relevant to the health outcomes associated with vitamin D and calcium.

Taylor adds, "While the outcomes from AHRQ were not intended to replace the scientific judgment that is inherent in formulating dietary reference values, the data and the clear presentations related to the data sets' strengths, weaknesses, and overall trends proved to be an invaluable framework for the process. Further, the AHRQ grading system was extrapolated by the committee for use with other reviews outside the AHRQ data sets."

The Institute of Medicine report "Dietary Reference Intakes: Calcium and Vitamin D" (available at http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx) was issued in November 2010. It explains the extensive review and justification for the conclusion that roles for vitamin D in health outcomes beyond bone health cannot be supported by the available literature. Based on these data, dietary recommendations and specification of optimal levels of serum vitamin D were provided. The report outlines the need for further research and for the continuation of systematic evidence-based reviews.