Author
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Dawson-Hughes, Bess |
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Submitted to: Endocrine Society Meeting
Publication Type: Abstract Only Publication Acceptance Date: 1/30/2008 Publication Date: 6/15/2008 Citation: Dawson-Hughes, B. 2008. Vitamin D and Calcium for Fracture Prevention. Endocrine Society Meeting. Paper No. S50-3. Interpretive Summary: Technical Abstract: Inadequate intakes of vitamin D and calcium lead to reduced calcium absorption, higher bone-remodeling rates and increased bone loss. Vitamin D has also been linked to muscle function and risk of falling. In older men and women, higher 25-hydroxyvitamin D [25(OH)D] levels are associated with better muscle performance. Recent controlled vitamin D intervention studies reveal that supplementation with vitamin D significantly lowers risk of falling in the elderly. Falls and fractures lead to loss of independence, nursing home admissions, and increased mortality. A low 25(OH)D level has also been identified as an independent risk factor for mortality. There have been many recent randomized, controlled trials to determine the impact of vitamin D (with and without calcium) on risk of hip and all non-vertebral fractures in older adults. While the results are mixed, in aggregate, these data suggest that 25(OH)D levels at or above 75 nmol/L are associated with greater suppression of serum PTH and often with fracture risk reduction in elderly subjects. The 25(OH)D threshold for fall risk reduction appears to be similar. In 1997, the National Academy of Sciences recommended 400 IU/d of vitamin D for men and women age 51-70 yrs and 600 IU/d for those over age 70, together with 1,200 mg/d of calcium. There is increasing recognition that 400 to 600 IU/d of vitamin D3 will not raise mean 25(OH)D levels to 75 nmol/L and that intakes of 800 to 1000 IU/d or more are needed by the average older man and woman to accomplish this. Over half of older adults worldwide consume far less than these amounts, have 25(OH)D levels below 75 nmol/L, and therefore stand to benefit from additional vitamin D. |
