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Title: The effect of vitamin D supplementation on lower-extremity power and function in older adults: a randomized controlled trial

Author
item SHEA, KYLA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/24/2018
Publication Date: 2/1/2019
Citation: Shea, K., Fielding, R.A., Dawson-Hughes, B. 2019. The effect of vitamin D supplementation on lower-extremity power and function in older adults: a randomized controlled trial. American Journal of Clinical Nutrition. 109(2):369-379. https://doi.org/10.1093/ajcn/nqy290.
DOI: https://doi.org/10.1093/ajcn/nqy290

Interpretive Summary: It is important to identify strategies to help maintain muscle function in older adults because loss of muscle function can lead to disability. One possible strategy is vitamin D supplementation. The Institute of Medicine recommends 800 IU/day of vitamin D for older men and women and maintaining a serum 25-hydroxyvitamin D (25(OH)D, a measure of vitamin D status) of at least 20 ng/ml for bone health. However, some have proposed that higher vitamin D intakes and blood concentrations are needed to meet all the body's vitamin D needs. We tested the effect of vitamin D supplementation on muscle function by randomizing 100 men and women age 60 years and older who were screened for low vitamin D status to receive 800 IU/day vitamin D or placebo for one year. Leg power, strength, and function were measured every other month. Serum 25(OH)D concentrations were measured repeatedly as well. Those in the vitamin D group whose serum 25(OH)D was less than 28 ng/ml after 4 months were given an additional 800 IU vitamin D, while all other participants received placebo as an additional pill. After one year, the average 25(OH)D in the vitamin D group was greater than 32 ng/ml and in the placebo group it was 20 ng/ml. However, the leg power, strength and function did not differ between the two groups over one year. These findings suggest increasing serum 25(OH)D to >32 ng/ml (on average) with vitamin D supplementation does not improve lower-extremity power, strength, or function in older community-dwelling adults. Our study's participants were generally healthy, so it is possible vitamin D could improve muscle function in people who are less healthy or more frail.

Technical Abstract: Background: The effect of vitamin D supplementation on muscle function in older adults has been tested in randomized trials with mixed results, which may be due to differences in the study participant characteristics, including baseline vitamin D status. The results of two meta-analyses of randomized trials function suggested a beneficial effect of vitamin D supplementation on muscle function in older adults with low baseline serum 25(OH)D. Objective: To test the effect of 12-months of vitamin D supplementation on lower-extremity power and function in older community-dwelling adults with low serum 25(OH)D. Design: Single center, double-blind, randomized, placebo-controlled trial. Participants: 100 community-dwelling men and women >/= 60 years who had serum 25(OH)D /=0.60), nor did the change in lean mass (treatment*time p>/=0.89). Conclusion: Increasing serum 25(OH)D to >32 ng/ml (on average) over 12 months did not affect lower-extremity power, strength, or lean mass in older community-dwelling adults.