|Dawson-Hughes, Bess -|
Submitted to: Calcified Tissue International
Publication Type: Book / Chapter
Publication Acceptance Date: May 1, 2012
Publication Date: January 29, 2013
Citation: Dawson-Hughes, B. 2013. What is the optimal dietary intake of vitamin D for bone health?. In: Ralston, S.H., Civitelli, R. editors. Calcified Tissue International. New York, NY: Springer Science & Business Media. p. 184-190. Technical Abstract: Vitamin D has long been known to be important for bone health, but there is currently no consensus on the amount of vitamin D needed or how it varies with age, race/ethnicity, body size, absorption efficiency, season and other factors. This review describes the effects of vitamin D on calcium absorption, parathyroid hormone (PTH) levels, and changes in bone mineral density briefly and focuses in more detail on the results and interpretation of double blind randomized controlled trials (RCTs) with fracture outcomes in older adults. Based on these trials, 400 IU per day, bringing 25-hydroxyvitamin D (25OHD) levels to 60 to 65 nmol/L, is not effective in lowering fracture risk in community dwelling elders or in elders with prior fractures. Several large trials indicate that doses in the range of 700 to 1000 IU per day can lower fracture risk by aproximately 20%. From these trials, it appears that a 25OHD level of 65 nmol/L is needed to reduce non-vertebral fracture risk and 75 nmol/L may be needed to lower hip fracture risk. Trials testing additional doses of vitamin D in different segments of the population are needed.