In Reply We agree with Dr Plotnikoff that people need sufficient vitamin D to prevent osteoporotic fracture, but we disagree with his call for routine population-wide screening of vitamin D blood levels and with the implication that investigators conducting clinical trials of vitamin D intentionally undertreat participants to maintain low blood levels in the placebo group. With respect to vitamin D testing, no major US medical organization, including the IOM1 and the US Preventive Services Task Force (USPSTF),2 endorses routine, universal screening. Regarding clinical trials, those in progress allow background intake up to the recommended dietary allowance (RDA) of vitamin D to ensure that bone health is not sacrificed among those assigned to the placebo group.3
Manson JE, Bassuk SS. Determining the Value of Vitamin D Supplementation—Reply. JAMA. 2015;314(6):627–628. doi:10.1001/jama.2015.7558
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