Vitamin D and adult bone health in Australia and New Zealand: a position statement

Diamond, Terrence; Eisman, John A.; Mason, Rebecca; Nowson, Caryl; Pasco, Julie A.; Sambrook, Philip N.; Wark, John D.

doi:10.5694/j.1326-5377.2005.tb06701.x

Cited by 204 publications

(63 citation statements)

References 31 publications

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“…These structural modifications mean that the molecule no longer conforms within the plasma membrane and is ejected into the extra-cellular space and drawn into the capillary beds where it is bound by the vitamin D binding protein [DBP] and transported to the liver [1]. Maximal production of vitamin D is reached after 10-15 minutes of sun exposure in summer [2] depending on skin pigmentation [3] and during this period one erythaema dose is achieved which is the equivalent to an intake of over 500µg of vitamin D3 [4]. Further UVB exposure results in the formation of in-active photoproducts such as tachysterol and lumisterol that have negligible effects on calcium metabolism [4] and prevent vitamin D toxicity from sun exposure.…”

Section: Vitamin D Synthesismentioning

confidence: 99%

Vitamin D and Bone Health; Potential Mechanisms

Laird

Ward²,

McSorley³

et al. 2010

Nutrients

219

148

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Osteoporosis is associated with increased morbidity, mortality and significant economic and health costs. Vitamin D is a secosteriod hormone essential for calcium absorption and bone mineralization which is positively associated with bone mineral density [BMD]. It is well-established that prolonged and severe vitamin D deficiency leads to rickets in children and osteomalacia in adults. Sub-optimal vitamin D status has been reported in many populations but it is a particular concern in older people; thus there is clearly a need for effective strategies to optimise bone health. A number of recent studies have suggested that the role of vitamin D in preventing fractures may be via its mediating effects on muscle function (a defect in muscle function is one of the classical signs of rickets) and inflammation. Studies have demonstrated that vitamin D supplementation can improve muscle strength which in turn contributes to a decrease in incidence of falls, one of the largest contributors to fracture incidence. Osteoporosis is often considered to be an inflammatory condition and pro-inflammatory cytokines have been associated with increased bone metabolism. The immunoregulatory mechanisms of vitamin D may thus modulate the effect of these cytokines on bone health and subsequent fracture risk. Vitamin D, therefore, may influence fracture risk via a number of different mechanisms.

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Section: Vitamin D Synthesismentioning

confidence: 99%

Vitamin D and Bone Health; Potential Mechanisms

Laird

Ward²,

McSorley³

et al. 2010

Nutrients

219

148

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“…Vitamin D repletion in individuals presenting with vitamin D deficiency has been shown to have a positive effect on bone biology, resulting in mineralization of osteoid, increases in bone mineral density measurements and reduced fracture rates (Diamond et al 2005). In a landmark trial in elderly institutionalized women, 800 IU of oral vitamin D3 with calcium supplements resulted in significant reduction in both nonvertebral (3.8%) and hip (2%) fractures, and a significant improvement in femoral neck bone density after 36 months of therapy (Chapuy et al 1992).…”

Section: Discussionmentioning

confidence: 99%

“…There is a resurgence of vitamin D deficiency in the developed world, even in “sunny” Australia (Diamond et al 2005). The clinical spectrum ranges from mild to severe deficiency, with serum 25-hydroxyvitamin D (25OHD) levels less than 25 nmol/L.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of vitamin D deficiency among elderly people living in residential homes has been estimated to be at least 50% (Flicker et al 2003). Other high risk groups include ethnic populations from the Horn of Africa, India, and Pakistan, and patients with gastrointestinal malabsorption syndromes (Skull et al 2003; Diamond et al 2005). Vitamin D deficiency is frequently seen in women treated for osteoporosis (MORE study) (Ettinger et al 1999).…”

Section: Introductionmentioning

confidence: 99%

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The effect of a combined oral calcium and vitamin D supplement for treating mild to moderate vitamin D deficiency in postmenopausal women

Golombick

Diamond²

2008

CIA

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Objective: To evaluate the effi cacy of a combined calcium and vitamin D (Ca-D3) supplement for vitamin D defi ciency in a small group of postmenopausal women. Methods:A prospective open label 3 month-study. Participants: 23 postmenopausal women (mean age 61.2 yrs) with vitamin D defi ciency were given a combined oral Ca-D3 supplement called "Osteoblast". The supplement comprises 500 mg elemental calcium and 500 IU of cholecalciferol. The dosing regimen comprised a loading dose of 1000 IU of cholecalciferol per day for one month (two tablets) and thereafter a maintenance dose of 500 IU of cholecalciferol per day for 2 months (one tablet). Outcome measure: Serum was collected for calcium, 25 hydroxyvitamin D3 (25OHD3), and PTH measurements, as well as early morning 2-hour urine calcium/creatinine excretion index (Uca/creat). Specimens were collected at baseline and after 3 months of therapy. Data are reported as mean ± 1 standard error and 95% confi dence intervals.Results: Data was available for the 21 subjects who completed the study. Two subjects (9%) withdrew because of gastrointestinal intolerance. There were 3 subjects with moderate (12.5-24 nmol/L) and 18 with mild (25-49 nmol/L) vitamin D defi ciency. Ten subjects (48%) had secondary hyperparathyroidism. Following the oral Ca-D3 combination, serum 25OHD3 levels normalised in all subjects with 18 (86%) subjects achieving values of greater than 70 nmol/L. Serum 25OHD3 levels increased from 36 (31-41) to 91 (79-102) nmol/L (p = 0.0001), increasing by an average of 152% over the 3-month period. There was a corresponding 38% decrease in serum PTH concentrations at 3 months (5.1 + 0.6 pmol/L), compared with baseline (8.0 + 1 pmol/L) (p = 0.001). No subject developed hypercalcemia, but an elevated Uca/creat excretion index occurred in one subjects. Conclusions: A combined oral Ca-D3 product (Osteoblast) is effective for treating vitamin D defi ciency and is adequately tolerated.

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“…An adequate intake of calcium and vitamin D is essential to maintain skeletal integrity throughout life (Follin and Hansen 2003; Diamond et al 2005). Vitamin D is formed from 7-dehydrocholesterol in the skin during exposure to sunlight and subsequent hydroxylation in the liver to form 25-hydroxyvitamin D, which has a half-life of about 2 months (Eastell and Lambert 2002; Holick 2004).…”

Section: Prevention Of Osteoporosismentioning

confidence: 99%

Dietary approaches that delay age-related diseases

Everitt¹,

Hilmer²,

Brand-Miller³

et al. 2006

Clinical Interventions in Aging

Self Cite

142

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Reducing food intake in lower animals such as the rat decreases body weight, retards many aging processes, delays the onset of most diseases of old age, and prolongs life. A number of clinical trials of food restriction in healthy adult human subjects running over 2–15 years show significant reductions in body weight, blood cholesterol, blood glucose, and blood pressure, which are risk factors for the development of cardiovascular disease and diabetes. Lifestyle interventions that lower energy balance by reducing body weight such as physical exercise can also delay the development of diabetes and cardiovascular disease. In general, clinical trials are suggesting that diets high in calories or fat along with overweight are associated with increased risk for cardiovascular disease, type 2 diabetes, some cancers, and dementia. There is a growing literature indicating that specific dietary constituents are able to influence the development of age-related diseases, including certain fats (trans fatty acids, saturated, and polyunsaturated fats) and cholesterol for cardiovascular disease, glycemic index and fiber for diabetes, fruits and vegetables for cardiovascular disease, and calcium and vitamin D for osteoporosis and bone fracture. In addition, there are dietary compounds from different functional foods, herbs, and neutraceuticals such as ginseng, nuts, grains, and polyphenols that may affect the development of age-related diseases. Long-term prospective clinical trials will be needed to confirm these diet—disease relationships. On the basis of current research, the best diet to delay age-related disease onset is one low in calories and saturated fat and high in wholegrain cereals, legumes, fruits and vegetables, and which maintains a lean body weight. Such a diet should become a key component of healthy aging, delaying age-related diseases and perhaps intervening in the aging process itself. Furthermore, there are studies suggesting that nutrition in childhood and even in the fetus may influence the later development of aging diseases and lifespan.

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Vitamin D and adult bone health in Australia and New Zealand: a position statement

Cited by 204 publications

References 31 publications

Vitamin D and Bone Health; Potential Mechanisms

Vitamin D and Bone Health; Potential Mechanisms

The effect of a combined oral calcium and vitamin D supplement for treating mild to moderate vitamin D deficiency in postmenopausal women

Dietary approaches that delay age-related diseases

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