Intensive Care and Vitamin D Status

Vitamin D has receptors in a vast majority of cells, and thus a normal vitamin D state is preferable to ensure an adequate function and appropriate response of the different receptors to a multitude of changes, namely, in critical illness. Vitamin D has many sources and exists in two different forms. Vitamin D state is divided into sufficient, insufficient, and deficient, and the variety in levels depends on plenty of factors, including the role of vitamin D-binding protein and possible influences from testing assays. Other possibilities that may take place in case of acute illness are also taken into consideration and discussed here. This chapter deals with the general aspects of vitamin D role in acute illness and how a replete state may affect the outcomes. The prevalence of vitamin D deficiency in critical illness and the frequency of testing and correction in case of deficiency are all considered here. ▶Chapter 67, “Specific Considerations Relevant to Critical Illness” by Dr. Amrein et al., discusses specific considerations of critical illness where vitamin D may have a role

Vitamin D2-Enriched Button Mushroom (Agaricus bisporus) Improves Memory in Both Wild Type and APPswe/PS1dE9 Transgenic Mice

Vitamin D deficiency is widespread, affecting over 30% of adult Australians, and increasing up to 80% for at-risk groups including the elderly (age>65). The role for Vitamin D in development of the central nervous system is supported by the association between Vitamin D deficiency and incidence of neurological and psychiatric disorders including Alzheimer’s disease (AD). A reported positive relationship between Vitamin D status and cognitive performance suggests that restoring Vitamin D status might provide a cognitive benefit to those with Vitamin D deficiency. Mushrooms are a rich source of ergosterol, which can be converted to Vitamin D(2) by treatment with UV light, presenting a new and convenient dietary source of Vitamin D(2). We hypothesised that Vitamin D(2)-enriched mushrooms (VDM) could prevent the cognitive and pathological abnormalities associated with dementia. Two month old wild type (B6C3) and AD transgenic (APP(Swe)/PS1dE9) mice were fed a diet either deficient in Vitamin D(2) or a diet which was supplemented with VDM, containing 1±0.2 µg/kg (∼54 IU/kg) vitamin D(2), for 7 months. Effects of the dietary intervention on memory were assessed pre- and post-feeding. Brain sections were evaluated for amyloid β (Aβ) plaque loads and inflammation biomarkers using immuno-histochemical methods. Plasma vitamin D metabolites, Aβ40, Aβ42, calcium, protein and cholesterol were measured using biochemical assays. Compared with mice on the control diet, VDM-fed wild type and AD transgenic mice displayed improved learning and memory, had significantly reduced amyloid plaque load and glial fibrillary acidic protein, and elevated interleukin-10 in the brain. The results suggest that VDM might provide a dietary source of Vitamin D(2) and other bioactives for preventing memory-impairment in dementia. This study supports the need for a randomised clinical trial to determine whether or not VDM consumption can benefit cognitive performance in the wider population