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Low vitamin D status, high bone turnover, and bone fractures in centenarians.
Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M, Franceschi C.
J Clin Endocrinol Metab. 2003 Nov;88(11):5109-15.
PMID: 14602735

We conclude that the extreme decades of life are characterized by a pathophysiological sequence of events linking vitamin D deficiency, low serum calcium, and secondary hyperparathyroidism with an increase in bone resorption and severe osteopenia. These data offer a rationale for the possible prevention of elevated bone turnover, bone loss, and consequently the reduction of osteoporotic fractures and fracture-induced disability in the oldest olds through the supplementation with calcium and vitamin D.

jcem.endojournals.org/...5109 - Preview

2003 November jcem study research epidemiological humans centenarians old older oldest vitamin_D deficiency prevalence 25ohd undetectable nutrition status osteopenia secondary_hyperparathyroidism PTH IL-6 medline bone fractures turnover resorption

[Vitamin K2]
Ishida Y.
Clin Calcium. 2008 Oct;18(10):1476-82. Review. Japanese.
PMID: 18830045

"Vitamin K2 has been approved for the treatment of osteoporosis in Japan since 1995. Vitamin K2 treatment in osteoporosis has been shown to inhibit the occurrence of new bone fractures and to maintain BMD. The uniqueness of the prevention of bone fractures by vitamin K2 is that there has been no direct evidence of the relationship between increase of BMD and a decrease in the occurrence of bone fractures. A recent systematic review of seven Japanese randomized controlled trials by Cockayne has also shown that supplementation with phytonadione (Vitamin K1) and menaquinone (Vitamin K2) , particularly menaquinone-4, is associated with increased BMD and reduced fracture incidence. To confirm these results, a larger well design RCT using fractures as the primary endpoint is clearly needed."

www.ncbi.nlm.nih.gov/...18830045 - Preview

2008 October study review humans Japanese vitamin_K vitamin_K2 nutrition osteoporosis bone BMD MK-4 menaquinone medline fractures fracture

Benefit-risk assessment of vitamin D supplementation.
Bischoff-Ferrari HA, Shao A, Dawson-Hughes B, Hathcock J, Giovannucci E, Willett WC.
Osteoporos Int. 2009 Dec 3. [Epub ahead of print]
PMID: 19957164

Conclusion Our analysis suggests that mean serum 25(OH)D levels of about 75 to 110 nmol/l provide optimal benefits for all investigated endpoints without increasing health risks. These levels can be best obtained with oral doses in the range of 1,800 to 4,000 IU vitamin D per day; further work is needed, including subject and environment factors, to better define the doses that will achieve optimal blood levels in the large majority of the population.

www.springerlink.com/...g18x734546417446 - Preview

2009 December study review meta-analysis humans rcts clinical_trials vitamin_D supplementation falls fractures hypercalcemia optimal dose optimal_dose nutrition Willett Giovannucci Bischoff-Ferrari recommendations Dawson-Hughes medline

"For more than 80 years, scientists have known that vitamin D is important for building bones. And for most of those 80 years, people thought this was the only thing it was good for. In the past decade, however, we've learned two important things about vitamin D: it appears to have many other important health effects, and many Americans don't get enough of it. In 2008, new research pointed to a vitamin D deficiency as a possible contributing factor in heart disease. And the suspected link between vitamin D deficiency and cancer grew even stronger. This surely will spur much new research in 2009.

Why is vitamin D deficiency so common? The vitamin is made in our skin when sunlight strikes it. Many Americans—especially those who live in the northern part of the country, are elderly or have dark skin—don't soak up enough sun. And the vitamin isn't found in many foods. The main sources are fatty fish (such as salmon, mackerel, herring and sardines) and milk, cereal and juices that have been fortified with it. Vitamin D deficiency often is unsuspected because it causes no direct symptoms; like high blood pressure, it does its damage silently."

www.newsweek.com/...print - Preview

2008 December newsweek news Stampfer vitamin_D bone fractures cancer depression autoimmune infectious diseases CVD CHD infections nutrition

African Americans, 25-hydroxyvitamin D, and osteoporosis: a paradox.
Aloia JF.
Am J Clin Nutr. 2008 Aug;88(2):545S-550S. Review.
PMID: 18689399

African Americans have lower serum 25-hydroxyvitamin D concentrations and a lower risk of fragility fractures than do other populations. I review the evidence on factors other than vitamin D that might explain this paradox and the calcium economy in different life stages.

www.ajcn.org/...545S - Preview

2008 August ajcn study review Aloia African Americans black humans 25ohd calcidiol vitamin_D status osteoporosis bone health paradox fractures nutrition fracture risk medline blacks African_Americans skin color

www.grassrootshealth.net/...ncidence_prev_chart_101608.pdf - Preview

2008 grassrootshealth Disease Incidence Prevention by Serum 25OHD Level vitamin_D cancer CVD CHD type_1 diabetes chart graph graphical presentation table falls fractures MS nutrition muliple sclerosis rickets

Serum 25-hydroxyvitamin D levels in vitamin D-insufficient hip fracture patients after supplementation with ergocalciferol and cholecalciferol.
Glendenning P, Chew GT, Seymour HM, Gillett MJ, Goldswain PR, Inderjeeth CA, Vasikaran SD, Taranto M, Musk AA, Fraser WD.
Bone. 2009 Nov;45(5):870-5. Epub 2009 Jul 23.
PMID: 19631774
doi:10.1016/j.bone.2009.07.015

Cholecalciferol supplementation resulted in a 31% greater increase in total HPLC-measured 25OHD (p=0.010) and 52% greater rise in RIA-measured 25OHD (p<0.001) than supplementation with an equivalent dose of ergocalciferol. Changes in iPTH and wPTH were not significantly different between calciferol treatments (p>0.05). In vitamin D-insufficient hip fracture patients, supplementation with cholecalciferol 1000 IU/day for three months was more effective in increasing serum 25OHD than an equivalent dose of ergocalciferol. However, the lack of difference in PTH lowering between calciferol treatments raises questions about the biological importance of this observation.

www.journals.elsevierhealth.com/...abstract - Preview

2009 November Bone study research clinical_trial rct humans patients hip fracture hip_fracture vitamin_D insufficiency deficiency vitamin_D2 vitamin_D3 supplementation 25ohd nutrition fractures PTH medline serum

Severe vitamin D deficiency in Swiss hip fracture patients.
Bischoff-Ferrari HA, Can U, Staehelin HB, Platz A, Henschkowski J, Michel BA, Dawson-Hughes B, Theiler R.
Bone. 2008 Mar;42(3):597-602. Epub 2007 Nov 28.
PMID: 18180211

BACKGROUND: Most clinical guidelines for the prevention of hip fractures recommend 800 IU vitamin D per day. This dose shifted serum 25-hydroxyvitamin D levels (25(OH)D) in previous studies to between 60 and 100 nmol/l. AIM: To measure 25(OH)D levels and prevalence of vitamin D supplementation in individuals age 65+ with acute hip fracture. METHODS: 222 consecutive hip fracture patients were investigated over a 12 month period. Mean age of patients was 86 years and 77% were women. RESULTS: Mean serum 25(OH)D levels were low among hip fracture patients admitted from home (34.6 nmol/l), from assisted living (27.7 nmol/l), and from nursing homes (24 nmol/l). Severe vitamin D deficiency below 30 nmol/l was present in 60%, 80% were below 50 nmol/l, and less than 4% reached desirable levels of at least 75 nmol/l. Consistently, only 10% of hip fracture patients had any vitamin D supplementation on admission to acute care with significantly higher 25(OH)D levels among individuals supplemented with 800-880 IU/day (63.5 nmol/l). Controlling for age and gender, vitamin D supplementation, type of dwelling, and season were independently and significantly associated with 25(OH)D levels. CONCLUSION: These data provide evidence that current guidelines for the prevention of hip fractures need further effort to be translated into clinical practice.

www.ncbi.nlm.nih.gov/...18180211 - Preview

2008 March study research epidemiological humans patients elderly old older acute hip fracture hip_fracture fractures vitamin_D deficiency 25ohd severe nutrition Bischoff-Ferrari medline Swiss Switzerland

Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial.
Trivedi DP, Doll R, Khaw KT.
BMJ. 2003 Mar 1;326(7387):469.
PMID: 12609940

Conclusion: Four monthly supplementation with 100 000 IU oral vitamin D may prevent fractures without adverse effects in men and women living in the general community.

www.bmj.com/...469 - Preview

2003 March BMJ study research clinical_trial rct elderly old older humans vitamin_D supplementation oral fractures fracture prevention mortality nutrition medline four monthly

Effectiveness and safety of vitamin D in relation to bone health.
Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D, Fang M, Yazdi F, Garritty C, Sampson M, Barrowman N, Tsertsvadze A, Mamaladze V.
Evid Rep Technol Assess (Full Rep). 2007 Aug;(158):1-235. Review.
PMID: 18088161

CONCLUSIONS: The results highlight the need for additional high quality studies in infants, children, premenopausal women, and diverse racial or ethnic groups. There was fair evidence from studies of an association between circulating 25(OH)D concentrations with some bone health outcomes (established rickets, PTH, falls, BMD). However, the evidence for an association was inconsistent for other outcomes (e.g., BMC in infants and fractures in adults). It was difficult to define specific thresholds of circulating 25(OH)D for optimal bone health due to the imprecision of different 25(OH)D assays. Standard reference preparations are needed so that serum 25(OH)D can be accurately and reliably measured, and validated. In most trials, the effects of vitamin D and calcium could not be separated. Vitamin D(3) (>700 IU/day) with calcium supplementation compared to placebo has a small beneficial effect on BMD, and reduces the risk of fractures and falls although benefit may be confined to specific subgroups. Vitamin D intake above current dietary reference intakes was not reported to be associated with an increased risk of adverse events. However, most trials of higher doses of vitamin D were not adequately designed to assess long-term harms.

www.ncbi.nlm.nih.gov/...bv.fcgi - Preview

2007 August study review humans vitamin_D 25ohd Effectiveness efficacy safety bone health bone_health nutrition fractures falls medline adverse effects full

Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health.
Cranney A, Weiler HA, O'Donnell S, Puil L.
Am J Clin Nutr. 2008 Aug;88(2):513S-519S. Review.
PMID: 18689393

We found inconsistent evidence of an association between serum 25-hydroxyvitamin D [25(OH)D] concentration and bone mineral content in infants and fair evidence of an association with bone mineral content or density in older children and older adults. The evidence of an association between serum 25(OH)D concentration and some clinical outcomes (fractures, performance measures) in postmenopausal women and older men was inconsistent, and the evidence of an association with falls was fair. We found good evidence of a positive effect of consuming vitamin D–fortified foods on 25(OH)D concentrations. The evidence for a benefit of vitamin D on falls and fractures varied. We found fair evidence that adults tolerated vitamin D at doses above current dietary reference intake levels, but we had no data on the association between long-term harms and higher doses of vitamin D.

www.ajcn.org/...513S - Preview

2008 August ajcn study review humans vitamin_D 25ohd Effectiveness efficacy safety bone health bone_health nutrition fractures falls medline adverse effects summary

Effectiveness and safety of vitamin D in relation to bone health.
Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D, Fang M, Yazdi F, Garritty C, Sampson M, Barrowman N, Tsertsvadze A, Mamaladze V.
Evid Rep Technol Assess (Full Rep). 2007 Aug;(158):1-235. Review.
PMID: 18088161

CONCLUSIONS: The results highlight the need for additional high quality studies in infants, children, premenopausal women, and diverse racial or ethnic groups. There was fair evidence from studies of an association between circulating 25(OH)D concentrations with some bone health outcomes (established rickets, PTH, falls, BMD). However, the evidence for an association was inconsistent for other outcomes (e.g., BMC in infants and fractures in adults). It was difficult to define specific thresholds of circulating 25(OH)D for optimal bone health due to the imprecision of different 25(OH)D assays. Standard reference preparations are needed so that serum 25(OH)D can be accurately and reliably measured, and validated. In most trials, the effects of vitamin D and calcium could not be separated. Vitamin D(3) (>700 IU/day) with calcium supplementation compared to placebo has a small beneficial effect on BMD, and reduces the risk of fractures and falls although benefit may be confined to specific subgroups. Vitamin D intake above current dietary reference intakes was not reported to be associated with an increased risk of adverse events. However, most trials of higher doses of vitamin D were not adequately designed to assess long-term harms.

www.ncbi.nlm.nih.gov/...18088161 - Preview

2007 August study review humans vitamin_D 25ohd Effectiveness efficacy safety bone health bone_health nutrition fractures falls medline adverse effects

Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis.
Avenell A, Gillespie WJ, Gillespie LD, O'Connell D.
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD000227. Review.
PMID: 19370554
DOI: 10.1002/14651858.CD000227.pub3

AUTHORS' CONCLUSIONS: Frail older people confined to institutions may sustain fewer hip fractures if given vitamin D with calcium. Vitamin D alone is unlikely to prevent fracture. Overall there is a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D or its analogues. Calcitriol is associated with an increased incidence of hypercalcaemia.

mrw.interscience.wiley.com/...frame.html - Preview

2009 April Cochrane Database study systematic review vitamin_D bone fracture fractures prevention involutional post-menopausal osteoporosis adverse effects nutrition medline

Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials.
Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ.
Arch Intern Med. 2006 Jun 26;166(12):1256-61. Review.
PMID: 16801507

Conclusions This systematic review suggests that supplementation with phytonadione and menaquinone-4 reduces bone loss. In the case of the latter, there is a strong effect on incident fractures among Japanese patients.

archinte.ama-assn.org/...1256 - Preview

2006 June archinte study review humans systematic meta-analysis clinical_trials rcts vitamin_K vitamin_K1 vitamin_K2 bone fractures fracture prevention supplementation nutrition MK-4 vitamin_K3 medline phytonadione menaquinone-4 osteoporosis

Lääkäri Juha-Petri Ruoholan väitöskirjan mukaan liian vähäinen D-vitamiinin saanti voi altistaa rasitusmurtumien syntymiselle urheilijoille. Tutkimuksen mukaan murtumapotilailla oli selkeästi normaalia alhaisemmat D-vitamiinitasot. On olemassa erityinen TRACP5b-entsyymi (tartrate-resistant acid phosphatase 5b), joka antaa aika selvän kuvan luun hajotuksen määrästä elimistössä. Tätä entsyymiä mitataan osteoporoosin (luukato) diagnostiikassa ja yllätyksettömästi sama entsyymi soveltui myös rasitusmurtumien osoittamiseen. Kohonnut seerumin TRACP5b-arvo nosti murtuman todennäköisyyden kahdeksankertaiseksi verrokkeihin nähden näissä Ruoholan tutkimuksissa. D-vitamiinia voi siis lämpimästi suositella urheilijoille varsinkin talvikuukausina, jolloin auringon kautta saatava D-vitamiinivaikutus on Suomessa lähes olematon.

sundqvist.blogspot.com/...amiini-ja-rasitusmurtumat.html - Preview

2007 maaliskuu March veteraaniurheilija christer sundqvist blogiartikkeli keskustelu D-vitamiini rasitusmurtumat terveys ravitsemus vitamin_D 25ohd bone fatigue stress fractures nutrition thesis dissertation Ruohola TRACP5b-entsyymi TRACP5b entsyymi

Kovaa harjoittelevat urheilijat! Lukekaa tämä teksti! Kova harjoittelu voi aiheuttaa rasitusmurtumia alaraajan luihin ja D-vitamiinia nauttimalla voidaan rasitusmurtumien synty ehkäistä.

Lääkäri Juha-Petri Ruoholan väitöskirjan mukaan liian vähäinen D-vitamiinin saanti voi altistaa rasitusmurtumien syntymiselle urheilijoille. Tutkimuksen mukaan murtumapotilailla oli selkeästi normaalia alhaisemmat D-vitamiinitasot.

manninen-nutraceuticals.blogspot.com/...-from-past-d-vitamiini-ja.html - Preview

2009 elokuu Manninen Nutraceuticals Anssi blogi_artikkeli ravitsemus terveys D-vitamiini rasitusmurtumat urheilu ehkäisy luunmurtumat murtumat luusto 2007 March Ruohola bone fatigue stress fractures vitamin_D 25ohd dissertation thesis

Fatigue fractures in military conscripts : A study on risk factors, diagnostics and long-term consequences
Ruohola, Juha-Petri
University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Orthopaedics and Traumatology, Helsinki University Central Hospital
Centre of Military Medicine, Helsinki
2007-03-09
Doctoral dissertation (article-based)

It seems likely that low vitamin D levels are related to fatigue fractures, and that an increasing trend exists between TRACP-5b bone resorption marker elevation and fatigue fracture incidence. Though seldom detected by plain radiography, fatigue fractures often underlie unclear lower leg stress-related pain occurring in the distal parts of the tibia. Femoral neck fatigue fractures, when displaced, lead to long-term morbidity in a high percentage of patients, whereas, when non-displaced, they do not predispose patients to subsequent adverse complications. Importantly, an educational intervention can diminish the incidence of fracture displacement by enhancing awareness and providing instructions for earlier diagnosis of fatigue fractures

oa.doria.fi/4050 - Preview

2007 March study research epidemiological humans Doctoral dissertation Helsinki university bone fatigue fractures stress vitamin_D 25ohd Ruohola military conscripts nutrition recruits thesis risk factors long-term consequences diagnostics

Stress fractures in the Israeli defense forces from 1995 to 1996.
Givon U, Friedman E, Reiner A, Vered I, Finestone A, Shemer J.
Clin Orthop Relat Res. 2000 Apr;(373):227-32.
PMID: 10810481

Serum levels of bone specific alkaline phosphatase and osteocalcin were elevated in patients with high grade stress fractures compared with control subjects with no symptoms: 37.6 versus 26.2 units/L, and 10.8 versus 8.8 ng/mL, respectively. Levels of 25-hydroxy vitamin D were lower in patients with high grade stress fractures (25.3 ng/mL) than in control subjects (29.8 ng/mL). This study revealed that several parameters can distinguish soldiers with high grade stress fractures, but their predictive value and precise pathogenetic role remain unclear.

www.ncbi.nlm.nih.gov/...10810481 - Preview

2000 April study research epidemiological humans soldiers army recruits Israel Israeli bone stress fractures vitamin_D 25ohd low_levels nutrition medline

Calcium and vitamin d supplementation decreases incidence of stress fractures in female navy recruits.
Lappe J, Cullen D, Haynatzki G, Recker R, Ahlf R, Thompson K.
J Bone Miner Res. 2008 May;23(5):741-9.
PMID: 18433305
doi: 10.1359/jbmr.080102

Conclusions: Generalizing the findings to the population of 14,416 women who entered basic training at the Great Lakes during the 24 mo of recruitment, calcium and vitamin D supplementation for the entire cohort would have prevented 187 persons from fracturing. Such a decrease in SFx would be associated with a significant decrease in morbidity and financial costs.

www.jbmronline.org/...jbmr.080102 - Preview

2008 May JBMR study research clinical_trial rct humans young women female navy recruits calcium vitamin_D supplementation bone stress fractures nutrition medline USA incidence risk Lappe prevention prevented

Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men.
Ruohola JP, Laaksi I, Ylikomi T, Haataja R, Mattila VM, Sahi T, Tuohimaa P, Pihlajamäki H.
J Bone Miner Res. 2006 Sep;21(9):1483-8.
doi: 10.1359/jbmr.060607

Conclusions: A lower level of serum 25(OH)D concentration may be a generally predisposing element for bone stress fractures. Considering the obvious need of additional vitamin D in prevention of stress fractures, the effects of vitamin D fortification of foods and supplementation will be subjects of interest for future research
PMID: 16939407

www.jbmronline.org/...jbmr.060607 - Preview

2006 September study research epidemiological humans Finnish young men Finland vitamin_D 25ohd bone stress fractures nutrition Ruohola Laaksi Tuohimaa medline status low_levels serum