Public health impact and cost-effectiveness of dairy products supplemented with vitamin D in prevention of osteoporotic fractures

Ethgen, Olivier; Hiligsmann, Mickaël; Burlet, Nansa; Reginster, Jean‐Yves

doi:10.1186/s13690-015-0099-3

Cited by 27 publications

(31 citation statements)

References 55 publications

(77 reference statements)

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“…(<600 mg/d) (79) . These public health approaches need concerted consideration as the population ages and the proportion of high-risk older adults increases.…”

Section: Dairy Foods and Fracture Risk Reduction: Seeking The Elusivementioning

confidence: 99%

Dairy foods and bone health throughout the lifespan: a critical appraisal of the evidence

Iuliano

Hill

2019

Br J Nutr

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The consumption of high-Ca, high-protein dairy foods (i.e. milk, cheese, yogurt) is advocated for bone health across the lifespan to reduce the risk of low-trauma fractures. However, to date, the anti-fracture efficacy of dairy food consumption has not been demonstrated in randomised controlled trials but inferred from cross-sectional and prospective studies. The anti-fracture efficacy of dairy food consumption is plausible, but testing this requires a robust study design to ensure outcomes are suitably answering this important public health question. The evidence of skeletal benefits of dairy food consumption is equivocal, not because it may not be efficacious but because the study design and execution are often inadequate. The key issues are compliance with dietary intervention, dropouts, sample sizes and most importantly lack of deficiency before intervention. Without careful appraisal of the design and execution of available studies, precarious interpretations of outcomes may be made from these poorly designed or executed studies, without consideration of how study design may be improved. Dairy food interventions in children are further hampered by heterogeneity in growth: in particular sex and maturity-related differences in the magnitude, timing, location and surface-specific site of bone accrual. Outcomes of studies combining children of different sexes and maturity status may be masked or exaggerated by these differences in growth, so inaccurate conclusions are drawn from results. Until these critical issues in study design are considered in future dairy food interventions, the anti-fracture efficacy of dairy food consumption may remain unknown and continue to be based on conjecture.

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“…(<600 mg/d) (79) . These public health approaches need concerted consideration as the population ages and the proportion of high-risk older adults increases.…”

Section: Dairy Foods and Fracture Risk Reduction: Seeking The Elusivementioning

confidence: 99%

Dairy foods and bone health throughout the lifespan: a critical appraisal of the evidence

Iuliano

Hill

2019

Br J Nutr

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“…In chronic vitamin D-deficient states, individuals are susceptible to osteopenia, osteoporosis, and increased incidence of bone fractures [49,50]. Administration of vitamin D is recommended as a first-line strategy reducing the incidence of osteoporotic fractures [51]. Indeed, low 25(OH)D levels in women could be viewed as a general marker of impaired health as the Malmö study has documented correlating with increased overall mortality [52].…”

Section: Effects Of Vitamin D In Calcium Absorption and Bone Physiologymentioning

confidence: 99%

Vitamin D and Physical Activity

Koundourakis¹,

Margioris²

2017

A Critical Evaluation of Vitamin D - Basic Overview

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Vitamin D is synthesized in the skin following exposure to ultraviolet radiation, producing cholecalciferol, while only a small percentage of the circulating vitamin D is of exogenous origin deriving from food. Following two sequential hydroxylations, in the liver and in the kidneys, vitamin D is fully activated. Although its role in bone physiology and calcium homeostasis is well documented, there is emerging evidence that vitamin D exerts a plethora of additional effects on most tissues regulating the musculoskeletal, cardiovascular, and immune systems as well as energy homeostasis. Its deficiency/insufficiency poses a major public health problem observed in all age groups and regardless of latitude and insolation. In muscles, vitamin D deficiency is associated with a decline in neuromuscular function including muscular strength, walking speed, balance, jumping and sprinting performance, and aerobic capacity, although the evidence is still weak regarding its effects in the young and the athletes. Supplementation counteracts the negative effects of vitamin D deficiency on performance although in individuals with adequate levels of vitamin D, additional supplementation does not appear to enhance further physical capabilities. The aim of this chapter is to review our current understanding of diverse effects of vitamin D in physical performance in athletic and nonathletic populations.

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“…To date, relatively few studies have assessed the public health and economic impact of vitamin D-fortified dairy products given to the general elderly population [14–17]. These studies suggest the public health and economic value of fortified dairy products.…”

Section: Introductionmentioning

confidence: 99%

Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France

et al. 2016

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SummaryThe recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years.IntroductionThis study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years.MethodsWe estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015). A validated microsimulation model was used to simulate three age cohorts for both women and men (60–69, 70–79, and >80 years). The incremental cost per QALY gained of vitamin D-fortified dairy products compared to the absence of appropriate intake was estimated in different populations, assuming the cost of two dairy products per day in base case.ResultsThe total lifetime number of fractures decreased by 64,932 for the recommended intake of dairy products in the general population over 60 years, of which 46,472 and 18,460 occurred in women and men, respectively. In particular, 15,087 and 4413 hip fractures could be prevented in women and men. Vitamin D-fortified dairy products also resulted in 32,569 QALYs and 29,169 life years gained. The cost per QALY gained of appropriate dairy intake was estimated at €58,244 and fall below a threshold of €30,000 per QALY gained in women over 70 years and in men over 80 years.ConclusionVitamin D-fortified dairy products have the potential to substantially reduce the burden of osteoporotic fractures in France and seem an economically beneficial strategy, especially in the general population aged above 70 years.

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Public health impact and cost-effectiveness of dairy products supplemented with vitamin D in prevention of osteoporotic fractures

Cited by 27 publications

References 55 publications

Dairy foods and bone health throughout the lifespan: a critical appraisal of the evidence

Dairy foods and bone health throughout the lifespan: a critical appraisal of the evidence

Vitamin D and Physical Activity

Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France

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