Colleagues, the following is FYI and does not necessarily reflect my own
opinion. I have no further knowledge of the topic.
------------------------
JAMA. 2005 May 11;293(18):2257-64.
Fracture prevention with vitamin D supplementation: a meta-analysis
of randomized controlled trials.
Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich
T, Dawson-Hughes B.
Department of Nutrition, Harvard School of Public Health, Boston,
Mass 02115, USA. [log in to unmask]
CONTEXT: The role and dose of oral vitamin D supplementation in
nonvertebral fracture prevention have not been well established.
OBJECTIVE: To estimate the effectiveness of vitamin D supplementation in
preventing hip and nonvertebral fractures in older persons. DATA
SOURCES: A systematic review of English and non-English articles using
MEDLINE and the Cochrane Controlled Trials Register (1960-2005), and
EMBASE (1991-2005). Additional studies were identified by contacting
clinical experts and searching bibliographies and abstracts presented at
the American Society for Bone and Mineral Research (1995-2004). Search
terms included randomized controlled trial (RCT), controlled clinical
trial, random allocation, double-blind method, cholecalciferol,
ergocalciferol, 25-hydroxyvitamin D, fractures, humans, elderly, falls,
and bone density. STUDY SELECTION: Only double-blind RCTs of oral
vitamin D supplementation (cholecalciferol, ergocalciferol) with or
without calcium supplementation vs calcium supplementation or placebo in
older persons (> or =60 years) that examined hip or nonvertebral
fractures were included. DATA EXTRACTION: Independent extraction of
articles by 2 authors using predefined data fields, including study
quality indicators. DATA SYNTHESIS: All pooled analyses were based on
random-effects models. Five RCTs for hip fracture (n = 9294) and 7 RCTs
for nonvertebral fracture risk (n = 9820) met our inclusion criteria.
All trials used cholecalciferol. Heterogeneity among studies for both
hip and nonvertebral fracture prevention was observed, which disappeared
after pooling RCTs with low-dose (400 IU/d) and higher-dose vitamin D
(700-800 IU/d), separately. A vitamin D dose of 700 to 800 IU/d reduced
the relative risk (RR) of hip fracture by 26% (3 RCTs with 5572 persons;
pooled RR, 0.74; 95% confidence interval [CI], 0.61-0.88) and any
nonvertebral fracture by 23% (5 RCTs with 6098 persons; pooled RR, 0.77;
95% CI, 0.68-0.87) vs calcium or placebo. No significant benefit was
observed for RCTs with 400 IU/d vitamin D (2 RCTs with 3722 persons;
pooled RR for hip fracture, 1.15; 95% CI, 0.88-1.50; and pooled RR for
any nonvertebral fracture, 1.03; 95% CI, 0.86-1.24). CONCLUSIONS: Oral
vitamin D supplementation between 700 to 800 IU/d appears to reduce the
risk of hip and any nonvertebral fractures in ambulatory or
institutionalized elderly persons. An oral vitamin D dose of 400 IU/d is
not sufficient for fracture prevention.
Publication Types:
* Meta-Analysis
* Review
PMID: 15886381 [PubMed - indexed for MEDLINE]
--
Kathrynne Holden, MS, RD < [log in to unmask] >
"Ask the Parkinson Dietitian" http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
http://www.nutritionucanlivewith.com/
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