NOV 08, 2017 09:00 AM PST

Vitamin D as a Modifier of Genomic Function and Phenotypic expression During Pregnancy

C.E. CREDITS: P.A.C.E. CE | Florida CE
Speakers
  • Professor, Pediatrics, Biochemistry and Molecular Biology, Director of Pediatric Nutritional Sciences, Medical University of South Carolina
    Biography
      Bruce W. Hollis, Ph.D. received his B.Sc. and M.Sc. from the Ohio State University and subsequently his Ph.D. from the University of Guelph in 1979. Dr. Hollis then completed an Endocrine Fellowship at The Case Western Reserve University School of Medicine in 1982. Dr. Hollis was then Appointed Assistant Professor of Nutrition at Case Western and remained there until 1986 when he moved to The Medical University of South Carolina where to he is Professor of Pediatrics, Biochemistry and Molecular Biology. He is also Director of Pediatric Nutritional Sciences. Dr. Hollis has studied vitamin D metabolism and nutrition for the past 35 years and has been an NIH grant recipient for the past 30 years. His current work focuses on the vitamin D requirements during pregnancy and lactation. Dr. Hollis has in excess of 200 peer reviewed articles in this area of investigation.

    Abstract:

    Pregnancy represents a time of rapid bodily change, which include physical proportions, physiology and responsibility. Arguably, nothing during these times changes more than the requirement and metabolism of vitamin D, although from current Institute of Medicine (IOM) recommendations one would never surmise this fact.  Do the current recommendations for the requirements of vitamin D during these critical time periods reflect emerging data?  Sadly, no.  The minimal recommendations by the IOM and the zero recommendation by The World Health Organization (WHO), which was echoed by a recent Cochrane Review, stating that there are simply no requirement for vitamin D during pregnancy, are contrary to expanding published data (later reviewed in this chapter) that suggest otherwise. Why these recommendations continue to be made remains unclear, but clearly not recognizing a problem exists suggests that one does not need to address the “problem.”

    During these dramatic times of physiologic change, the roles of vitamin D in the pregnant versus, for example, the lactating woman are quite different.  In the pregnant women, we believe the primary role of vitamin D to be an immunomodulatory – rather than a calcium-regulating factor, although, it would also retain that function.  Further, vitamin D inadequacy in early life is clearly an instance of the “Barker Hypothesis”.  This theory states that certain adult-onset diseases might have their roots in nutritional insults sustained in the perinatal period (either in utero or in the early months of infancy or both).  Clearly, conditions associated with vitamin D deficiency such as asthma, multiple sclerosis and other neurological disorders would qualify.

    If one is reading this review to relive the past 50 years of vitamin D recommendations during pregnancy, we suggest you read other recent publications for history in this area.  However, if the reader is interested in gaining new insight into the vitamin D requirements and function during pregnancy supported by recent data, we suggest you read on. Also, with regard to randomized controlled trials (RCT’s) for vitamin D, they are largely doomed to fail.  The reasons for this are many and specific cases of this failure will be presented.
     


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