Vitamin D was recognized a century ago as the cure for rickets, a childhood disease that causes weak bones. Then, in the early 2000s, a pile of studies suggested that low vitamin D levels could be a factor in cancer, cardiovascular(心血管) disease, Parkinson's disease and so on. This simple vitamin seemed to be a cure for whatever troubled us. However, all these observational studies have a fundamental weakness: they can identify a co-occurrence between vitamin D and a disease, but they can't prove there is a cause-and-effect relation.
To look at whether taking vitamin D had curative effects, Manson and her team started the world's largest and most far-reaching randomized vitamin D trial. The study followed nearly 26,000 healthy adults, randomized to receive either 2,000 international units (IU) of vitamin D or a placebo(安慰剂), for an average of 5.3 years. The volunteers were almost evenly split between men and women, and 20 percent of the participants were black.
The results came as a shock. Not only did vitamin D not reduce rates of cancer or heart disease, but the trial also found that vitamin D did not prevent or improve cognitive function, or reduce the risk of bone fractures(骨折). The finding about fractures "was a real surprise to many people," Manson says.
In 2011, the Institute of Medicine established an expert committee to conduct a thorough analysis of all existing studies on vitamin D and health. The committee concluded that the bone-strengthening benefits of vitamin D remain steady when blood levels reach 12 to 16 nanograms per millililter. They also found that there were no benefits to having levels above 20ng/ml. According to measurements of vitamin D levels in the general U. S. population, most had levels of 20 ng/ml or more in 2011. Levels have actually risen since then, meaning that most people don't need to take extra vitamin D.
The ups and downs of vitamin D offer a lesson in humility. The relation between the vitamin and disease is far more complicated than it first seemed and a reminder that scientific understanding is always developing over time.