Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials

Abstract

ABSTRACT

Oral supplementation with 25(OH)D3 versus vitamin D3: Effects on 25(OH)D levels, lower extremity function, blood pressure, and markers of innate immunity

“…(43) Third, vitamin D supplementation increased muscle strength and balance, (24,44) and reduced the risk of falling in communitydwelling participants of double-blind randomized-controlled trials that gave 700 to 1000 IU vitamin D per day as summarized in a 2009 meta-analysis. (45) Notably, a threshold of 25(OH)D that may confer a maximum benefit on lower extremity function suggested to be at least 24 ng/mL and best 30 to 40 ng/mL based on the large National Health and Nutrition Examination Survey (NHANES) III study, (46) and the same thresholds were suggested for fall prevention based on the 2009 meta-analysis of doubleblind randomized controlled trials (RCTs). (45) Consistent with the concept of optimal 25(OH)D threshold accomplishment, participants in the HyD group compared to the vitamin D 3 group improved in all of four lower extremity tests at 4-month follow-up, although statistical significance was only achieved for knee extensor strength with a 17% improvement.…”

“…(45) Notably, a threshold of 25(OH)D that may confer a maximum benefit on lower extremity function suggested to be at least 24 ng/mL and best 30 to 40 ng/mL based on the large National Health and Nutrition Examination Survey (NHANES) III study, (46) and the same thresholds were suggested for fall prevention based on the 2009 meta-analysis of doubleblind randomized controlled trials (RCTs). (45) Consistent with the concept of optimal 25(OH)D threshold accomplishment, participants in the HyD group compared to the vitamin D 3 group improved in all of four lower extremity tests at 4-month follow-up, although statistical significance was only achieved for knee extensor strength with a 17% improvement. Improvements did not reach statistical significance for knee flexor strength (4%), for functional mobility (timed up-and-go test; 8%) and for reaction time (repeated sit-to-stand test; 12%), which may have been due to the small sample size.…”

“…Although the 2010 Institute of Medicine (IOM) recommendations support a 25(OH)D threshold of 20 ng/mL for bone health, (1) the International Osteoporosis Foundation, in their 2010 position paper on vitamin D, recommends a threshold of 30 ng/mL for optimal fall and fracture reduction, (2) consistent with the most recent recommendations by the U.S. Endocrine Society published in June 2011. (3) The recommendations by the International Osteoporosis Foundation (IOF) and the Endocrine Society are based on two meta-analyses of double-blind randomized controlled trials that suggested fall reduction required a threshold of at least 24 ng/mL (4) and fracture reduction a threshold of at least 30 ng/mL. (5) Regarding general health endpoints, the Endocrine Society states that while evidence from randomized controlled trials is lacking, numerous epidemiological studies have suggested that a 25(OH)D blood level of 30 ng/mL and above may have additional health benefits in reducing the risk of common cancers, autoimmune diseases, type 2 diabetes, cardiovascular disease, and infectious diseases.…”

How pleiotropic genetics of the musculoskeletal system can inform genomics and phenomics of aging

“…Bischoff et al (Bischoff et al 2001;Bischoff-Ferrari et al 2004) pointed out that the expression of the VDR in human skeletal muscle tissue decreases with age, and several studies have demonstrated that serum 25(OH) Vit D is related to physical performance (including walking test, chair stand and tandem stand; Wicherts et al 2007) and its rate of decline, body sway, and lower body strength (Pfeifer et al 2000). In a recent meta-analysis, Vit D status was significantly associated with falls (Bischoff-Ferrari et al 2009). Notably, 25-OH Vit D is heritable (h 2 =53%; Livshits et al 2003;Wang et al 2010).…”

Ten ways to improve the care of elderly patients in the hospital

“…27 Meta-analyses have demonstrated that vitamin D supplementation of 700-1,000 IU daily may reduce the risk of falls in the elderly by about 20%, that the effect is achieved in the short term (on the order of 2-5 months), and that the benefit persists for up to 36 months. 28,29 …”