Meer over vitamine D

Afbeelding: Slim Aarons

Vitamine D

Good old vitamine D blijkt belangrijker te zijn dan we ooit voor mogelijk hielden. Het is eigenlijk geen vitamine maar een pre-hormoon. Je krijgt het binnen als vitamine uit zonneschijn, dierlijke voeding (eieren, vette vis, rood vlees en lever) of in een pilletje en je lichaam zet het om in het hormoon calcitriol dat vervolgens je hele lichaam doorreist en een scala aan functies uitvoert.

Vitamine D bouwt botten en spieren, werkt ontstekingsremmend, het helpt je om enzymen en eiwitten te maken die je beschermen tegen ziekten, remt het verouderingsproces en beïnvloedt de activiteit van meer dan 1000 genen – dat is ongeveer 5% van ál je genen. We kunnen het belang ervan dus niet genoeg benadrukken.

De meeste mensen hebben een tekort

Wereldwijd hebben veel mensen een tekort aan vitamine D. Vooral ouderen, zwangeren en mensen met een donker(der)e huidskleur komen vaak niet aan de ondergrens van een gezonde vitamine D-waarde in hun bloed. Maar in de praktijk blijkt dat mensen die geen vitamine D-supplementen gebruiken eigenlijk allemaal een tekort hebben. Veel binnenzitten, het gebruik van zonnebrand en in noordelijke contreien wonen – waar alleen in de zomer de zonnekracht sterk genoeg is om vitamine D aan te maken – werkt natuurlijk ook niet mee.

Te weinig vitamine D binnenkrijgen is niet gezond, maar een teveel ook niet: uit studies blijkt dat meer dan 250 mcg (dat is 10.000 iu) per dag kan zorgen voor toxische waarden.

Vitamine D: de science

Vandaar dat het zo belangrijk is niet lukraak te slikken maar minimaal eens per jaar je vitamine D te prikken. Er zijn algemene richtlijnen, maar die houden geen rekening met de variabele factoren die de aanmaak van voldoende vitamine D voor iedereen anders maken. 

Jouw persoonlijke vermogen om calcitriol – de voor je lichaam bruikbare vorm van vitamine D – aan te maken hangt namelijk af van onder meer:

 

  • Je leeftijd – een 70-jarige maakt nog maar 25% van de vitamine D aan als dezelfde persoon op 20-jarige leeftijd
  • Je vetpercentage – omdat vitamine D een vetoplosbare vitamine is hebben mensen met een hoger BMI en/of meer buikvet tot meer dan 50% meer vitamine D nodig dan mensen met een normaal vetpercentage
  • Je huidskleur –  een donkere huid is een handige evolutionaire aanpassing die werkt als een natuurlijke SPF, maar hindert ook de aanmaak van vitamine D uit zonneschijn, zeker als je niet op of rond de evenaar woont
  • Je genen – sommige mensen hebben genetisch meer vitamine D nodig om tot normale bloedwaarden te komen
  • Je woonplaats – ten noorden van Sicilië (de 37ste breedtegraad) is het buiten de zomermaanden vrijwel onmogelijk om genoeg vitamine D aan te maken via de huid

meten = weten

Het is dus heel belangrijk om minimaal eens per jaar en liefst twee keer per jaar je vitamine D-level in bloed te laten bepalen. Idealiter doe je dat in de lente – zodat je weet hoe je uit de winter gekomen bent – en in de herfst – zodat je weet hoeveel je bij moet slikken om weer gezond de winter door te komen.

Er is wetenschappelijk onderzocht wat de sweet spot is: de vitamine D-waarde die geassocieerd wordt met de laagste kans op sterfte aan alle oorzaken.

Die ideale bloedwaarde blijkt tussen de 100 en 150 nmol/l te liggen (in de VS gebruiken ze een andere meeteenheid waardoor ze het daar over 40-60 ng/ml hebben). Als je weet wat je vitamine D-waarde in bloed is, kunnen we precies voor je berekenen hoeveel je bij moet slikken op tot een optimale waarde te komen.

Meer lezen in onze Journal

Waarom je vitamine D-waarde zo persoonlijk is

Waarom je vitamine D-waarde zo persoonlijk is

Eén van de essentiële testen die we in alle pakketten gestopt hebben is de vitamine D-test. En dat is niet voor niets. Vitamine D speelt een immens belangrijke rol in je algehele gezondheid: een tekort wordt onder andere in verband gebracht met allergieën,...

De 3 basisvoorwaarden voor een goede hormoonbalans

De 3 basisvoorwaarden voor een goede hormoonbalans

In elke leeftijdsfase kunnen hormonen je voor flinke uitdagingen stellen. De lijst met kwalen waar je last van kunt hebben loopt uiteen van acné tot opvliegers, van menstruatiepijn tot schildklierproblemen en van PCOS tot ongewenste kinderloosheid. Veel vrouwen zoeken...

Door de Europese Unie toegestane gezondheidsclaims voor vitamine D:

  • is belangrijk voor de calcium- en fosforopname voor het behoud van sterke botten en een sterk gebit
  • goed voor de spieren
  • draagt bij aan het proces van celvernieuwing
  • ondersteunt de afweer van het lichaam
  • draagt bij aan een normale groei en ontwikkeling van de botten van kinderen
  • ondersteunt het immuunsysteem van kinderen

Wetenschappelijke studies met betrekking tot vitamine D:

Abboud, M., Rybchyn, M.S., Rizk, R., Fraser, D. R., & Mason, R. S. (2017). Sunlight exposure is just one of the factors which influence vitamin D status. // Photochemical & Photobiological Sciences
Al Mheid, I., Patel, R., Murrow, J., Morris, A., Rahman, A., Fike, L., Kavtaradze, N., Uphoff, I., Hooper, C., Tangpricha, V., Alexander, R. W., Brigham, K., & Quyyumi, A. A. (2011). Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. // Journal of the American College of Cardiology
Ananthakrishnan, A. N., Khalili, H., Higuchi, L. M., Bao, Y., Korzenik, J. R., Giovannucci, E. L., […] Chan, A.T. (2012). Higher Predicted Vitamin D Status Is Associated With Reduced Risk of Crohn’s Disease. // Gastroenterology
Anderson, J. L., May, H. T., Horne, B. D., Bair, T. L., Hall, N. L., Carlquist, J. F., Lappé, D. L., Muhlestein, J. B., & Intermountain Heart Collaborative (IHC) Study Group. (2010). Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. // The American Journal of Cardiology
Armas, L. A. G., Hollis, B. W., & Heaney, R. P. (2004). Vitamin D 2 Is Much Less Effective than Vitamin D 3 in Humans. // The Journal of Clinical Endocrinology & Metabolism
Arunabh, S., Pollack, S., Yeh, J., & Aloia, J. F. (2003). Body Fat Content and 25-Hydroxyvitamin D Levels in Healthy Women. // The Journal of Clinical Endocrinology & Metabolism
Balion, C., Griffith, L. E., Strifler, L., Henderson, M., Patterson, C., Heckman, G., … Raina, P. (2012). Vitamin D, cognition, and dementia: A systematic review and meta-analysis. // Neurology
Bettoun, D. J., Burris, T. P., Houck, K. A., Buck, D. W., Stayrook, K. R., Khalifa, B., … Nagpal, S. (2003). Retinoid X Receptor Is a Nonsilent Major Contributor to Vitamin D Receptor-Mediated Transcriptional Activation. // Molecular Endocrinology
Bikle, D. D. (2014). Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. // Chemistry & Biology
Bischoff-Ferrari, H., Borchers, M., Gudat, F., Dürmüller, U., Stähelin, H., & Dick, W. (2004). Vitamin D Receptor Expression in Human Muscle Tissue Decreases With Age. // Journal of Bone and Mineral Research
Bischoff-Ferrari, H. A., Giovannucci, E., Willett, W. C., Dietrich, T., & Dawson-Hughes, B. (2006). Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. // The American Journal of Clinical Nutrition
Bruce, D., Whitcomb, J. P., August, A., McDowell, M. A., & Cantorna, M. T. (2009). Elevated non- specific immunity and normal Listeria clearance in young and old vitamin D receptor knockout mice. // International Immunology
Cannell, J.J., Hollis, B.W. (2008). Use of vitamin D in clinical practice. Alternative Medicine Review
Cashman, K. D., Dowling, K. G., Škrabáková, Z., Gonzalez-Gross, M., Valtueña, J., De Henauw, S., Moreno, L., Damsgaard, C. T., Michaelsen, K. F., Mølgaard, C., Jorde, R., Grimnes, G., Moschonis, G., Mavrogianni, C., Manios, Y., Thamm, M., Mensink, G. B., Rabenberg, M., Busch, M. A., … Kiely, M. (2016). Vitamin D deficiency in Europe: Pandemic? // The American Journal of Clinical Nutrition
Chandra, P., Wolfenden, L. L., Ziegler, T. R., Tian, J., Luo, M., Stecenko, A. A., … Tangpricha, V. (2007). Treatment of vitamin D deficiency with UV light in patients with malabsorption syndromes: A case series. // Photodermatology, Photoimmunology & Photomedicine
Christensen, N., Søndergaard, J., Fisker, N., & Christesen, H. T. (2017). Infant Respiratory Tract Infections or Wheeze and Maternal Vitamin D in Pregnancy: A Systematic Review. // The Pediatric Infectious Disease Journal
Doorenbos, C. R. C., van den Born, J., Navis, G., & de Borst, M. H. (2009). Possible renoprotection by vitamin D in chronic renal disease: Beyond mineral metabolism. // Nature Reviews. Nephrology
Dawson-Hughes, B., Harris, S. S., Lichtenstein, A. H., Dolnikowski, G., Palermo, N. J., & Rasmussen, H. (2015). Dietary Fat Increases Vitamin D-3 Absorption. // Journal of the Academy of Nutrition and Dietetics
Engelsen, O. (2010). The Relationship between Ultraviolet Radiation Exposure and Vitamin D Status. // Nutrients
Eyles, D. W., Trzaskowski, M., Vinkhuyzen, A. A. E., Mattheisen, M., Meier, S., Gooch, H., Anggono, V., Cui, X., Tan, M. C., Burne, T. H. J., Jang, S. E., Kvaskoff, D., Hougaard, D. M., Nørgaard- Pedersen, B., Cohen, A., Agerbo, E., Pedersen, C. B., Børglum, A. D., Mors, O., … McGrath, J. J. (2018). The association between neonatal vitamin D status and risk of schizophrenia. // Scientific Reports
Farmacotherapeutisch kompas (z.d.) Colecalciferol.
Ford, J. A., MacLennan, G. S., Avenell, A., Bolland, M., Grey, A., Witham, M., & for the RECORD Trial Group. (2014). Cardiovascular disease and vitamin D supplementation: Trial analysis, systematic review, and meta-analysis. // The American Journal of Clinical Nutrition
Fluss, J., Kern, I., de Coulon, G., Gonzalez, E., & Chehade, H. (2014). Vitamin D deficiency: A forgotten treatable cause of motor delay and proximal myopathy. // Brain and Development
Fukumoto, S., Matsumoto, T., Tanaka, Y., Harada, S.-I., & Ogata, E. (1987). Renal Magnesium Wasting in a Patient with Short Bowel Syndrome with Magnesium Deficiency: Effect of 1 α – Hydroxyvitamin D 3 Treatment*. // The Journal of Clinical Endocrinology & Metabolism
Gallagher, J. C., Yalamanchili, V., & Smith, L. M. (2013). The effect of vitamin D supplementation on serum 25OHD in thin and obese women. // Journal of Steroid Biochemistry and Molecular Biology
Ganji, V., Tangpricha, V., & Zhang, X. (2020). Serum Vitamin D Concentration ≥75 nmol/L Is Related to Decreased Cardiometabolic and Inflammatory Biomarkers, Metabolic Syndrome, and Diabetes; and Increased Cardiorespiratory Fitness in US Adults. // Nutrients
Gao, Q., Kou, T., Zhuang, B., Ren, Y., Dong, X., & Wang, Q. (2018). The Association between Vitamin D Deficiency and Sleep Disorders: A Systematic Review and Meta-Analysis. // Nutrients
Gezondheidsraad (2012). Evaluatie van de voedingsnormen voor vitamine D.
Gezondheidsraad (2018). Kernadvies Voedingsnormen voor vitamines en mineralen voor volwassenen.
Goldacre, M., Hall, N., & Yeates, D. G. R. (2014). Hospitalisation for children with rickets in England: A historical perspective. // The Lancet
Grant, W. B., Lahore, H., McDonnell, S. L., Baggerly, C. A., French, C. B., Aliano, J. L., & Bhattoa, H. P. (2020). Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID- 19 Infections and Deaths. // Nutrients
Gröber, U., Spitz, J., Reichrath, J., Kisters, K., Holick, M.F. (2013). Vitamin D: Update 2013: From rickets prophylaxis to general preventive healthcare. // Dermatoendocrinology
Groves, N. J., McGrath, J. J., & Burne, T. H. J. (2014). Vitamin D as a neurosteroid affecting the developing and adult brain. // Annual Review of Nutrition
Guo, C., Sinnott, B., Niu, B., Lowry, M. B., Fantacone, M. L., & Gombart, A. F. (2014). Synergistic induction of human cathelicidin antimicrobial peptide gene expression by vitamin D and stilbenoids. // Molecular Nutrition & Food Research
Hardwick, L. L., Jones, M. R., Brautbar, N., & Lee, D. B. N. (1991). Magnesium Absorption: Mechanisms and the Influence of Vitamin D, Calcium and Phosphate. // The Journal of Nutrition
He, C.-S., Fraser, W. D., Tang, J., Brown, K., Renwick, S., Rudland-Thomas, J., Teah, J., Tanqueray, E., & Gleeson, M. (2016). The effect of 14 weeks of vitamin D3 supplementation on antimicrobial peptides and proteins in athletes. // Journal of Sports Sciences
Heaney, R. P. (2005). The Vitamin D requirement in health and disease. // The Journal of Steroid Biochemistry and Molecular Biology
Herr, C., Greulich, T., Koczulla, R. A., Meyer, S., Zakharkina, T., Branscheidt, M., … Bals, R. (2011). The role of vitamin D in pulmonary disease: COPD, asthma, infection, and cancer. // Respiratory Research
Holick, M. F. (2002). Sunlight and vitamin D: Both good for cardiovascular health. // Journal of General Internal Medicine
Holick, M. F. (2003). Vitamin D: A millenium perspective: Vitamin D. // Journal of Cellular Biochemistry
Holick, M. F. (2004). Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. // American Journal of Clinical Nutrition
Holick, M. F. (2006). High Prevalence of Vitamin D Inadequacy and Implications for Health. // Mayo Clinic Proceedings
Holick, M.F. (2007). Vitamin D deficiency. // New England Journal of Medicine
Houghton, L. A., & Vieth, R. (2006). The case against ergocalciferol (vitamin D2) as a vitamin supplement. // American Journal of Clinical Nutrition
Hujoel, P. P. (2013). Vitamin D and dental caries in controlled clinical trials: Systematic review and meta-analysis. // Nutrition Reviews
Hyppönen, E., Läärä, E., Reunanen, A., Järvelin, M.-R., & Virtanen, S. M. (2001). Intake of vitamin D and risk of type 1 diabetes: A birth-cohort study. // The Lancet
Institute of Medicine (1997). Dietary Reference Intakes for Ca, P, Mg, Vit D and F. National Academy Press: Washington D.C.
Iqbal, S. F., & Freishtat, R. J. (2011). Mechanism of action of vitamin D in the asthmatic lung. // Journal of Investigative Medicine: The Official Publication of the American Federation for Clinical Research
Janssen, H. C., Samson, M. M., & Verhaar, H. J. (2002). Vitamin D deficiency, muscle function, and falls in elderly people. // The American Journal of Clinical Nutrition
Jones, G. (2008). Pharmacokinetics of vitamin D toxicity. // The American Journal of Clinical Nutrition
Jørgensen, S. P., Agnholt, J., Glerup, H., Lyhne, S., Villadsen, G. E., Hvas, C. L., Bartels, L. E., Kelsen, J., Christensen, L. A., & Dahlerup, J. F. (2010). Clinical trial: Vitamin D3 treatment in Crohn’s disease – a randomized double-blind placebo-controlled study. // Alimentary Pharmacology & Therapeutics
Khan, A., Dawoud, H., & Malinski, T. (2018). Nanomedical studies of the restoration of nitric oxide/peroxynitrite balance in dysfunctional endothelium by 1,25-dihydroxy vitamin D3— Clinical implications for cardiovascular diseases. // International Journal of Nanomedicine
Kim, G., & Bae, J.-H. (2016). Vitamin D and atopic dermatitis: A systematic review and meta-analysis. // Nutrition
Knekt, P., Kilkkinen, A., Rissanen, H., Marniemi, J., Sääksjärvi, K., & Heliövaara, M. (2010). Serum Vitamin D and the Risk of Parkinson Disease. // Archives of Neurology
Kotsi, E., Perrea, D.N. (2018). Vitamin D levels in children and adolescents with attention-deficit hyperactivity disorder (ADHD): a meta-analysis. // Attention Deficit and Hyperactivity Disorders
Koutkia, P., Chen, T. C., & Holick, M. F. (2001). Vitamin D intoxication associated with an over-the- counter supplement. // New England Journal of Medicine
Kunutsor, S. K., Burgess, S., Munroe, P. B., & Khan, H. (2014). Vitamin D and high blood pressure: Causal association or epiphenomenon? // European Journal of Epidemiology
Krall, E. A., Wehler, C., Garcia, R. I., Harris, S. S., & Dawson-Hughes, B. (2001). Calcium and vitamin D supplements reduce tooth loss in the elderly. // American Journal of Medicine
Levis, S., Gomez, A., Jimenez, C., Veras, L., Ma, F., Lai, S., Hollis, B., & Roos, B. A. (2005). Vitamin D Deficiency and Seasonal Variation in an Adult South Florida Population. // Journal of Clinical Endocrinology & Metabolism
Li, Y. C., Kong, J., Wei, M., Chen, Z.-F., Liu, S. Q., & Cao, L.-P. (2002). 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. // Journal of Clinical Investigation
Linus Pauling Institute, Micronutrient Information Center, Oregon State University (2018)
Lin, L., Zhang, L., Li, C., Gai, Z., & Li, Y. (2019). Vitamin D and Vitamin D Receptor: New Insights in the Treatment of Hypertension. // Current Protein & Peptide Science
Locantore, P., Del Gatto, V., Gelli, S., Paragliola, R. M., & Pontecorvi, A. (2020). The Interplay between Immune System and Microbiota in Osteoporosis. // Mediators of Inflammation
Luxwolda, M. F., Kuipers, R. S., Kema, I. P., van der Veer, E., Dijck-Brouwer, D. A. J., & Muskiet, F. A. J. (2013). Vitamin D status indicators in indigenous populations in East Africa. // European Journal of Nutrition
Malluche, H. H., Monier-Faugere, M.-C., & Koszewski, N. J. (2002). Use and indication of vitamin D and vitamin D analogues in patients with renal bone disease. Nephrology, Dialysis, Transplantation. // Official Publication of the European Dialysis and Transplant Association – European Renal Association
Malihi Z, Lawes CMM, Wu Z, Huang Y, Waayer D, Toop L, Khaw K, Camargo CA, Scragg R, (2018). Monthly high-dose vitamin D3 supplementation and self-reported adverse events in a 4-year randomized controlled trial. // Clinical Nutrition
Martineau, A. R., Jolliffe, D. A., Hooper, R. L., Greenberg, L., Aloia, J. F., Bergman, P., … Camargo, C. A. (2017). Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. // BMJ
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Maurya, V. K., & Aggarwal, M. (2017). Factors influencing the absorption of vitamin D in GIT: An overview. // Journal of Food Science and Technology
Mazahery, H., Conlon, C. A., Beck, K. L., Mugridge, O., Kruger, M. C., Stonehouse, W., … von Hurst, P. R. (2019). A randomised controlled trial of vitamin D and omega-3 long chain polyunsaturated fatty acids in the treatment of irritability and hyperactivity among children with autism spectrum disorder. // The Journal of Steroid Biochemistry and Molecular Biology
Munger, K. L., Zhang, S. M., O’Reilly, E., Hernán, M. A., Olek, M. J., Willett, W. C., & Ascherio, A. (2004). Vitamin D intake and incidence of multiple sclerosis. // Neurology
Muris, A.H., Smolders, J., Rolf, L., Thewissen, M., Hupperts, R., Damoiseaux, J. (2016). Immune regulatory effects of high dose vitamin D3 supplementation in a randomized controlled trial in relapsing remitting multiple sclerosis patients receiving IFNβ; the SOLARIUM study. // Journal of Neuroimmunology
Muskiet, F. A. J., & van der Veer, E. (2007). Vitamine D: Waar liggen de grenzen van deficiëntie, adequate status en toxiciteit? // Nederlands Tijdschrift voor Klinisch Chemische Labgeneeskunde
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Spedding, S. (2014). Vitamin D and Depression: A Systematic Review and Meta-Analysis Comparing Studies with and without Biological Flaws. // Nutrients
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Wortsman, J., Matsuoka, L. Y., Chen, T. C., Lu, Z., & Holick, M. F. (2000). Decreased bioavailability of vitamin D in obesity. // American Journal of Clinical Nutrition
Xue, L.-N., Xu, K.-Q., Zhang, W., Wang, Q., Wu, J., & Wang, X.-Y. (2013). Associations Between Vitamin D Receptor Polymorphisms and Susceptibility to Ulcerative Colitis and Crohnʼs Disease: A Meta-analysis. // Inflammatory Bowel Diseases
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Ketha H., Thacher T.D., Oberhelman S.S., Fischer P.R., Singh R.J., Kumar R. (2018). Comparison of the effect of daily versus bolus dose maternal vitamin D3 supplementation on the 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 ratio // Bone 
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Martineau A.R., MacLaughlin B.D., Hooper R.L., Barnes N.C., Jolliffe D.A., Greiller C.L., Kilpin K., McLaughlin D., Fletcher G., Mein C.A., Hoti M., Walton R., Grigg J., Timms P.M., Rajakulasingam R.K., Bhowmik A., Rowe M., Venton T.R., Choudhury A.B., Simcock D.E., Sadique Z., Monteiro W.R., Corrigan C.J., Hawrylowicz C.M., Griffiths C.J. (2015). Double- blind randomised placebo-controlled trial of bolus-dose vitamin D3 supplementation in adults with asthma (ViDiAs) // Thorax 
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