Vitamin D status and clinical implications in the adult population of Malaysia: a position paper by the Malaysian Vitamin D Special Interest Group

• Published in: Osteoporosis international 2023-11, Vol.34 (11), p.1837-1850
• Main Authors: Lee, Joon-Kiong, Chee, Winnie SS, Foo, Siew Hui, Lee, Verna KM, Sallehuddin, Hakimah, Khor, Hui-Min, Arasu, K., Mohamad, Masni, Ahmad, A.R., a/l Puvaneswaran, Sivaroshan, Koh, Kar-Chai, Hoo, Fan-Kee, Tan, Gie-Hooi, Mitchell, P.J.
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Adult; Diet; Dietary Supplements; Endocrinology; Food intake; Food, Fortified; Humans; Literature reviews; Malaysia - epidemiology; Medicine; Medicine & Public Health; Nutritional Status - physiology; Orthopedics; Position Paper; Rheumatology; Risk groups; Standardization; Sunlight; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D - therapeutic use; Vitamin D Deficiency - blood; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - prevention & control; Vitamin deficiency
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-023-06841-4

Purpose Vitamin D deficiency and insufficiency is common among populations globally, and in Asia and Malaysia. The purpose of this Position Paper is to propose recommendations for both clinicians and non-clinicians to promote vitamin D sufficiency in Malaysian adults. Formation of a national multisector, multidisciplinary alliance is also proposed to progress initiatives relating to safe sun exposure, adequate vitamin D intake through food fortification, and vitamin D supplementation for high-risk groups. Methods Literature reviews were undertaken to inform summaries of the following: vitamin D status globally and in Asian and Malaysian populations, vitamin D status among individuals with common medical conditions, and current recommendations to achieve vitamin D sufficiency through sun exposure, food intake and supplementation. Recommendations were based on the findings of the literature reviews, recent European guidance on vitamin D supplementation, the 2018 road map for action on vitamin D in low- and middle-income countries, and research recommendations proposed by the Malaysian Ministry of Health in 2017. Results Recommendations on assessment of vitamin D in the adult Malaysian population include using serum or plasma 25-hydroxyvitamin D concentration as a biomarker, widespread participation by Malaysian laboratories in the Vitamin D Standardization Program, adoption of the US Endocrine Society definitions of vitamin D deficiency and insufficiency, and development of a comprehensive nationwide vitamin D status study. Specific high-risk groups are identified for vitamin D assessment and recommendations relating to loading doses and ongoing management are also made. Conclusion This Position Paper provides individual clinicians and national stakeholder organisations with clear recommendations to achieve vitamin D sufficiency in the adult population of Malaysia.