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Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al., editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011.

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Dietary Reference Intakes for Calcium and Vitamin D.

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FEvidence Maps

As part of the committee's approach to the evaluation of data, evidence maps were developed to assist the committee in organizing its review of the available evidence for each indicator of interest. No effort was made to “fine tune” these maps, but rather they were an initial tool used by the committee to quickly summarize the nature of the available data. The evidence maps below show the evidence from mechanistic and animal data, observational studies, and randomized controlled trials (RCTs). In its evaluation of RCT evidence, the committee considered the study design and whether an indicator was pre-specified as a primary or secondary outcome. Overall, the committee evaluated individual studies and when needed, took methodological differences into account when categorizing a study for inclusion in the evidence maps. However the committee acknowledges the variability in the quality of studies within and across categories, and relied on its expert judgment and a detailed evaluation of each study when drawing conclusions about the relevance and application of an indicator to further consideration in the DRI process. Chapter 4 provides detailed text on each of the key studies that were considered by the committee for the selection of an indicator.

TABLE F-1Evidence Map for Cancer/Neoplasms

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
Calcium
 All cancersbb
 Breast cancer
 Colorectal cancerbb
 Colorectal adenoma
 Prostate cancer
Vitamin D
 All cancersb
 Breast cancerb
 Colorectal cancerb
 Colorectal adenomab
 Prostate cancer

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

b

Limited data.

TABLE F-2Evidence Map for Cardiovascular Diseases (CVD)/ Hypertension

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomea
Calciumb
Vitamin Db

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

b

Limited data.

TABLE F-3Evidence Map for Diabetes (Type 2) and Metabolic Syndrome

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre–specified Outcomesa
Vitamin D

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

TABLE F-4Evidence Map for Falls and Physical Performance

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
Calcium
Vitamin D

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

TABLE F-5Evidence Map for Immune Function

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
Vitamin D
Asthma
 Diabetes (Type 1)
 Irritable bowel and crohn's disease
Multiple sclerosis
Rheumatoid arthritis
Systemic lupus erythematosus
Tuberculosis
Influenza/Upper respiratory infections

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

TABLE F-6Evidence Map for Neuropsychological Functioning

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
Vitamin D
Autism
 Cognitive
 Function
Depression

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not prespecified by the investigators.

TABLE F-7Evidence Map for Preeclampsia of Pregnancy

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
Calcium
Vitamin D

NOTE: ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

TABLE F-8Evidence Map for Bone Health

Randomized Trials
IndicatorMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
Calcium absorption
Calcium balance
BMD/BMC
Fracture risk
Osteomalacia/ rickets
Randomized Trials
IntermediateMechanistic DataAnimal DataObservational StudiesPrimary OutcomeSecondary or Non–Pre-specified Outcomesa
25OHD
PTH

NOTE: Data may reflect studies designed to study combined calcium and vitamin D administration, calcium alone, or vitamin D alone. ✓ = evidence is published; — = no available evidence.

a

Secondary outcomes often were not pre-specified by the investigators.

Copyright © 2011, National Academy of Sciences.
Bookshelf ID: NBK56052

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