Association Between Vitamin <scp>D<sub>3</sub></scp> Supplementation and Serum 25‐ Hydroxyvitamin <scp>D</scp> Levels in Older Individuals Residing in Long‐Term Care in Ontario, Canada

Ioannidis, George; Kennedy, Courtney; Dykeman, Joanne; Dudziak, Sandra; Παπαϊωάννου, Αλεξάνδρα

doi:10.1111/j.1532-5415.2012.03914.x

Cited by 8 publications

(18 citation statements)

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“…We also compared our findings with those of three Canadian studies that surveyed older adults, the Canadian Health Measures Survey (CHMS) [22,24], the Canadian Community Health Survey (CCHS) [25], and a recent report focusing on 25(OH)D levels in older individuals residing in long term care in the same geographic area where our study was conducted, Mississauga, Ontario [26]. …”

Section: Discussionmentioning

confidence: 99%

“…The aim of this study was to explore the wintertime vitamin D status of an understudied segment of the Canadian population: older adults of diverse ancestry. Secondly, we wanted to contrast our findings with previous studies of 25(OH)D levels in older adults [22,24-26], and a previous study of young adults of diverse ancestry living in the Greater Toronto Area (GTA) [23]. …”

Section: Introductionmentioning

confidence: 97%

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Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

et al. 2013

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BackgroundPhysiological and lifestyle factors put older adults at an increased risk of vitamin D insufficiency and resulting negative health outcomes. Here we explore the vitamin D status in a sample of community dwelling older adults of diverse ancestry living in the Greater Toronto area (GTA).MethodsTwo hundred and twenty-four (224) adults over 60 years of age were recruited from the Square One Older Adult Centre, in Mississauga, Ontario. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations were measured from dried blood spot cards. Dietary and supplemental intakes of vitamin D were assessed via questionnaires. Skin pigmentation was assessed quantitatively by measuring melanin levels using a reflectometer.ResultsThe mean 25(OH)D concentration in the total sample was 82.4 nmol/L. There were no statistically significant differences in serum 25(OH)D concentrations, supplemental or dietary vitamin D intakes between the three major ancestral groups (East Asians, Europeans and South Asians). Females had significantly higher 25(OH)D concentrations than males (84.5 nmol/L vs. 72.2 nmol/L, p = 0.012). The proportion of participants with 25(OH)D concentrations below 50 nmol/L and 75 nmol/L were 12.1%, and 38.8%, respectively. The mean daily supplemental intake of vitamin D was 917 IU/day. Vitamin D intake from supplements was the major factor determining 25(OH)D concentrations (p < 0.001).ConclusionsMean concentration of 25(OH)D in a sample of older adults of diverse ancestry living in the GTA exceeded 80 nmol/L, and there were no significant differences in 25(OH)D levels between ancestral groups. These results sharply contrast with our recent study focused on young adults of diverse ancestry living in the same geographic area, in which we found substantially lower 25(OH)D concentrations (mean 39.5 nmol/L), low supplemental vitamin D intake (114 IU/day), and significant differences in 25(OH)D levels between ancestral groups. High daily intake of supplemental vitamin D in this sample of older adults likely accounts for such disparate findings with respect to the young adult sample.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

et al. 2013

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“…Given the challenge of attaining the dietary reference intake for calcium and vitamin D from diet alone in the Canadian elderly [32,33,34,35,36] and public health messages encouraging use of vitamin D supplements, it was not surprising that calcium and vitamin D supplement use increased in the post-50 age categories. As part of the Canada’s Food Guide, Health Canada advises that all Canadians 50 years or older consume a vitamin D supplement containing 400 IU per day [37].…”

Section: Discussionmentioning

confidence: 99%

“…This is supported by a survey of Canadian community-living older adults in which calcium, vitamin C and D were frequently used micronutrients and overall multivitamin use was high (43.5%) [35]. In a study of Ontario seniors living in long term care facilities, supplementation with the recommended vitamin D dose (>400 IU/day) was effective in ensuring that >90% of the seniors achieved optimum serum 25(OH)D levels (>75 nmol/L) [36]. …”

Section: Discussionmentioning

confidence: 99%

Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

2013

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Dietary supplement use may modify the risk of periodontal disease but effects on wound healing after periodontal procedures are less clear. This study characterized dietary supplement use by male and female patients (n = 376) attending a periodontal clinic—information that is essential for evidence-based intervention studies that may improve patient outcomes after periodontal procedures. Calcium, vitamin D, multivitamin and vitamin C were most commonly used. A greater (p ≤ 0.05) number of males took no supplements compared to females, and more (p ≤ 0.05) females than males took ≥ four supplements. Females took more (p ≤ 0.05) calcium, vitamin D, fish oil, green tea, magnesium, omega 3,6,9 and B vitamin complex. Younger patients (31–50 years) had the highest (p ≤ 0.05) frequency of no supplement use compared to older age groups. Patients over age 50 had a higher (p ≤ 0.05) frequency of using ≥ four supplements including calcium and vitamin D. Supplement use was lower (p ≤ 0.05) in smokers, particularly for calcium, fish oil, green tea and vitamin D. In conclusion, females, older individuals and non-smokers have higher supplement use. Future dietary intervention studies can focus on supplements with known biological activities—anti-inflammatory, antioxidant or osteogenic activity—that may enhance wound healing after reconstructive periodontal procedures.

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“…Pharmacologic therapy is indicated for patients at (1) high absolute fracture risk (> 20% probability over 10 years) based on risk tools Leslie et al, 2011a) and (2) individuals over age 50 with a hip or vertebral fracture or more than one fragility fracture (Papaioannou et al, 2010b). Several studies in Ontario (Giangregorio et al, 2009;Ioannidis et al, 2012a) and other regions (Colon-Emeric et al, 2007b;Jachna, Shireman, Whittle, Ellerbeck, & Rigler, 2005;Kamel, 2007;Parikh, Avorn, & Solomon, 2009;Parikh, Mogun, Avorn, & Solomon, 2008;Wright, 2007) have demonstrated that the management of osteoporosis and fractures is sub-optimal in LTC residents.In 2007, at the outset of the Ontario Osteoporosis Strategy for LTC, we conducted an environmental scan to examine the prescribing of vitamin D, calcium, and osteoporosis medications in a convenience sample of 10 Ontario LTC homes. In 2012, we had access to prescribing records and facility characteristics for a large, unselected cohort of Ontario LTC homes (n = 166).…”

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Osteoporosis Prescribing in Long-Term Care: Impact of a Provincial Knowledge Translation Strategy

et al. 2015

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This study described prescribing trends before and after implementing a provincial strategy aimed at improving osteoporosis and fracture prevention in Ontario long-term care (LTC) homes. Data were obtained from a pharmacy provider for 10 LTC homes in 2007 and 166 homes in 2012. We used weighted, multiple linear regression analyses to examine facility-level changes in vitamin D, calcium, and osteoporosis medication prescribing rates between 2007 and 2012. After five years, the estimated increase in vitamin D, calcium, and osteoporosis medication prescribing rates, respectively, was 38.2 per cent (95% confidence interval [CI]: 29.0, 47.3; p < .001), 4.0 per cent (95% CI: −3.9, 12.0; p = .318), and 0.2 per cent (95% CI: −3.3, 3.7; p = .91). Although the study could not assess causality, findings suggest that wide-scale knowledge translation activities successfully improved vitamin D prescribing rates, although ongoing efforts are needed to target homes with low uptake. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptAn estimated 60 to 80 per cent of long-term care (LTC) residents have osteoporosis (Gloth & Simonson, 2008;Zimmerman et al., 1999) and in Canada, it is estimated that the fracture rate for LTC residents is approximately two to four times that of similarly aged communitydwelling residents (Crilly, Tanner, Kloseck, & Chesworth, 2010). Combined with agerelated losses in bone quantity and quality (Chen, Zhou, Fujita, Onozuka, & Kubo, 2013), the high prevalence of sarcopenia (Landi et al., 2012), frailty (Kanwar et al., 2013) and falls (Norris, Walton, Patterson, Feightner, & the Canadian Task Force on Preventive Health Care, 2003) in LTC residents may synergistically increase susceptibility for fractures (Ensrud et al., 2007;Ensrud et al., 2009;Gielen et al., 2012;Frisoli, Chaves, Ingham, & Fried, 2011). Furthermore, many LTC residents have sub-optimal vitamin D levels (Flicker et al., 2003;Ioannidis, Kennedy, Dykeman, Dudziak, & Papaioannou, 2012a), which is associated with lower bone mineral density (Bischoff-Ferrari, Dietrich, Orav, & Dawson-Hughes, 2004a;Bischoff-Ferrari et al., 2009;Hanley, Cranney, Jones, Whiting, & Leslie, 2010), decreased lower extremity function (Bischoff-Ferrari et al., 2004b;Dawson-Hughes, 2008), falls (Dawson-Hughes, 2008;Flicker et al., 2003), and fractures (Bischoff-Ferrari, Giovannucci, Willett, Dietrich, & Dawson-Hughes, 2006;Cauley et al., 2011;Holvik et al., 2013;Looker & Mussolino, 2008). In a Canadian LTC study , 54 per cent of all residents and 69 per cent of residents taking ≤ 400 IU/day had sub-optimal levels [25-hydroxyvitamin D (25(OH)D) < 75 nmol/L] for bone health (Hanley et al., 2010).In 2005, the Ontario Ministry of Health and LTC launched the Ontario Osteoporosis Strategy (Jaglal et al., 2010; Osteoporosis Action Plan Committee, 2003). This ongoing, population-based, strategic action plan is targeted at improving osteoporosis prevention and care across all residents in Ontario, with the overall goal of reducing morbidity, mortalit...

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Association Between Vitamin D₃ Supplementation and Serum 25‐ Hydroxyvitamin D Levels in Older Individuals Residing in Long‐Term Care in Ontario, Canada

Cited by 8 publications

References 9 publications

Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

Osteoporosis Prescribing in Long-Term Care: Impact of a Provincial Knowledge Translation Strategy

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Association Between Vitamin D3 Supplementation and Serum 25‐ Hydroxyvitamin D Levels in Older Individuals Residing in Long‐Term Care in Ontario, Canada

Cited by 8 publications

References 9 publications

Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

Osteoporosis Prescribing in Long-Term Care: Impact of a Provincial Knowledge Translation Strategy

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Product

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Association Between Vitamin D₃ Supplementation and Serum 25‐ Hydroxyvitamin D Levels in Older Individuals Residing in Long‐Term Care in Ontario, Canada